A Randomized Controlled Trial Testing the Efficacy of an HIV/AIDS Symptom Management Manual

Abstract

This study investigates whether using an HIV/AIDS symptom management manual with self-care strategies for 21 common symptoms, compared to a basic nutrition manual, had an effect on reducing symptom frequency and intensity. A 775-person, repeated measures, randomized controlled trial was conducted over three months in 12 sites from the United States, Puerto Rico, and Africa to assess the relationship between symptom intensity with predictors for differences in initial symptom status and change over time. A mixed model growth analysis showed a significantly greater decline in symptom frequency and intensity for the group using the symptom management manual (intervention) compared to those using the nutrition manual (control) (t=2.36, P=0.018). The models identified three significant predictors for increased initial symptom intensities and in intensity change over time: (1) protease inhibitor-based therapy (increased mean intensity by 28%); (2) having comorbid illness (nearly twice the mean intensity); and (3) being Hispanic receiving care in the United States (increased the mean intensity by 2.5 times). In addition, the symptom manual showed a significantly higher helpfulness rating and was used more often compared to the nutrition manual. The reduction in symptom intensity scores provides evidence of the need for palliation of symptoms in individuals with HIV/AIDS, as well as symptoms and treatment side effects associated with other illnesses. The information from this study may help health care providers become more aware of self-management strategies that are useful to persons with HIV/AIDS and help them to assist patients in making informed choices.

Exploring the Contribution of General Self-Efficacy to the Use of Self-Care Symptom Management Strategies by People Living with HIV Infection

“…[10][11][12] These strategies subsequently were organized into a self-care symptom management manual and compared with a manual containing information on nutrition based on the World Health Organization HIV/AIDS Nutrition Guide. 13 Although the self-care symptom management manual was found to have a higher helpfulness rating than the nutrition manual, there is a paucity of information regarding whether attributes of the individual affect self-care symptom management, including whether ARV adherence and the relationship with the HCP differs for those with higher general self-efficacy.…”

Self-Care Behaviors and Activities for Managing HIV-Related Anxiety

“…The RCT was designed to compare the efficacy of an HIV symptommanagement manual with that of a basic nutrition manual, over 3 months in 14 sites in the United States, Puerto Rico, and Africa (Wantland et al, 2008). The symptom-management manual contained self-care strategies for commonly occurring symptoms, and its content was validated by HIV expert clinicians and corroborated by scientific evidence on 21 commonly occurring HIV symptoms.…”

“…As HIV increases in areas of the world where self-care is the primary approach to managing HIV, additional research will be needed to address the effectiveness of cross-cultural differences in strategies for selfmanaging HIV-related anxiety. Key words: AIDS, anxiety, HIV, self-care, self-management, symptom management Advances in the treatment of HIV infection have dramatically transformed the course of HIV disease from an acute illness into a more manageable chronic condition (Wantland et al, 2008). Even with recent treatment advances, persons living with HIV (PLWH) often struggle as they attempt to manage the unique physical and psychological challenges that accompany living with this chronic illness.…”

Efectividad de un manual de autocuidado para el manejo de síntomas en personas colombianas que viven con VIH

“…Wantland et al (18) en un estudio con 885 personas de Estados Unidos, Puerto Rico y África encontraron una disminución significativa en la frecuencia y en la intensidad de los síntomas en los pacientes que utilizaron el "manual de autocuidado para el manejo de síntomas" comparado con quienes utilizaron el de nutrición. En el presente estudio no se pudo evidenciar que el manual de síntomas mejora la frecuencia o la intensidad de los síntomas, probablemente porque se requiere mayor número de personas en la muestra para evidenciar un cambio en estos.…”