Chronic Pain, Functional Status, and Life Satisfaction Are Associated With Patients Living With HIV Discussing Advance Care Planning With Their Family or Friends

Abstract

Context. In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV from a universally fatal disease to a serious chronic illness, warranting discussions between patients and their loved ones about advance care planning (ACP). Evidence is needed on factors associated with patients' likelihood to discuss ACP with loved ones. Objectives. To further characterize factors associated with successful ACP in PLWHAs with their loved ones, we examined associations between patients having ACP discussions with the need for assistance with personal care, chronic pain, life satisfaction, prior family disagreements over health care decisions, sex, age, and interference in daily routines due to memory problems. Methods. Data were from the Affirm Care study (N ¼ 370), which examined social and environmental factors associated with health outcomes among PLWHAs and their informal caregivers. Results. Slightly more than half of respondents discussed ACP with loved ones (57%). In adjusted analysis, higher levels of chronic pain (odds ratio [OR] ¼ 2.09, P ¼ 0.045), needing assistance with personal care (OR ¼ 1.63, P ¼ 0.023), greater life satisfaction (OR ¼ 1.02, P ¼ 0.002), prior family arguments over health care decisions (OR ¼ 2.80, P < 0.001), and female sex (OR ¼ 2.22, P ¼ 0.001) were associated with higher odds of discussing ACP with loved ones, whereas age, drug use, education level, depression, and memory problems were nonsignificant. Conclusion. These results suggest that interventions to increase ACP among PLWHAs and their loved ones should target males. The findings also suggest PLWHAs with chronic pain, the need for assistance with personal care, and those with a history of prior family arguments over health care decisions may be primed for ACP.

Racial and Ethnic Differences in Informal and Formal Advance Care Planning Among U.S. Older Adults

“…We separately controlled for a history of any cancer (excluding skin cancer) because individuals with a cancer diagnosis are more likely to complete an advance directive than those without (Park et al, 2015). Finally, we controlled for difficulties with Activities of Daily Living (e.g., bathing or dressing; range 0–5) or Instrumental Activities of Daily Living (e.g., handling money or taking medication; range 0–5) because individuals with poorer functional status have previously been more likely to complete ACP (Hansen et al, 2019; Kim et al, 2021).…”

‘The Woman Gives’: Exploring gender and relationship factors in HIV advance care planning among African American caregivers

“…Research suggests that ACP rates may be low in the US partly due to healthcare advancements, which have reduced mortality rates from chronic life‐limiting illnesses such as HIV (Hansen et al, 2019). However, African Americans have benefitted less from ACP awareness efforts, much like they have benefitted less from HIV care advancements than other racial groups, even when controlling for factors such as socioeconomic status and/or interest in ACP (Maragh‐Bass et al, 2017; Mitchell, Hansen, et al, 2018; Mitchell, Isenberg, et al, 2018).…”

Bel Ağrısının Bireylerde Yaşam Doyumu ve Yüz Yüze İletişim Düzeylerine Etkisinin Değerlendirilmesi

“…Bu kavram özellikle günümüzde modern toplumlarda sıkça vurgulanmaya başlanmıştır 15 . Tıp literatürü incelendiğinde yaşam doyumu kavramının sıklıkla hipertansiyon 16 , diyabet 17 , kalp sağlığı 18 ve cinsel yolla bulaşan hastalıklar 19 özelinde araştırıldığı dikkat çekmektedir. Toplumun yaklaşık %85'inin yakındığı ve kişilerin hayata bakış açılarında değişiklik meydana getirebilecek bel ağrısının, hastaların yaşam doyumunu da düşürebileceği tarafımızca öne sürülmektedir.…”