No abstract

This study describes the symptom experience of 743 men and women living with HIV/AIDS in Botswana, Lesotho, South Africa, and Swaziland. Data were obtained in 2002 by using a cross-sectional design. A survey of participants included 17 sociodemographic items and the 64-item Revised Sign and Symptom Checklist for Persons with HIV Disease. Results indicate a strong correlation between the frequency of reported symptoms and their intensity (r = .84, p < .00). Participants who reported having enough money for daily expenses also reported significantly fewer symptoms. There were no significant differences in symptom frequency between men and women or by location of residence. The study showed a complex picture of HIV-related symptoms in all four countries. Because of the high levels of symptoms reported, the results imply an urgent need for effective home- and community-based symptom management in countries where antiretroviral therapy is unavailable to help patients and their families manage and control AIDS symptoms and improve quality of life.

Several dimensions of the Wilson and Cleary model of quality of life were significantly related to life satisfaction for people living with HIV/AIDS in sub-Saharan Africa. Quality of life for this sample was primarily defined as overall functional ability and control over symptom intensity. These findings are similar to studies in developed countries that have shown the significant relationships among functional abilities, symptom control, and perceived quality of life. As antiretroviral medications become more available in these areas, community members and care providers can help clients realize the possibility of living well with HIV/AIDS, and can work with clients to improve functional ability and control symptom intensity to make living well a reality.

The purpose of this study was to understand the phenomenon of hand holding as a coping strategy used by adolescents to deal with treatment-related pain. The convenience sample consisted of 20 adolescents whose ages were 11 to 19 years: 10 had cancer and 10 had renal disease (this served as the comparison group). Using a descriptive design, a semistructured interview was conducted with each adolescent. To supplement and support interview data, structured observations were conducted as adolescents underwent painful treatments (eg, blood draws, shunt placement, peripheral chemotherapy, lumbar punctures, and bone marrow aspirations). Data were analyzed using descriptive statistics and qualitative analytic techniques similar to those delineated by Strauss and Corbin. The results of this study indicated that subjects in both the cancer and the renal disease group perceived hand holding to be a very effective coping strategy in ameliorating treatment-related pain. Overwhelmingly the patients preferred to hold their mother's hand. When the mother was unavailable, they preferred to hold a specific nurse's hand. Hand holding functioned to reduce tension associated with impending treatments, as a source of distraction, and as a source of security. Accordingly, adolescents' subjective experience of treatment-related pain was reduced when they felt more secure, less tense, and were distracted.