HIV Illness Representation as a Predictor of Self-care Management and Health Outcomes: A Multi-site, Cross-cultural Study

Abstract

Research has shown that the perceptions that form the cognitive representation of an illness (illness representation) are fundamental to how persons cope with illness. This study examined the relationship of illness representation of HIV with self-care behavior and health outcomes. Data were collected at 16 sites in the United States, Taiwan, Norway, Puerto Rico and Colombia via survey. HIV seropositive participants (n = 1,217, 31% female, 38% African-American/Black, 10% Asian/Pacific Islander and 26% White/Anglo) completed measures of illness representation based on the commonly accepted five-component structure: identity, time-line, consequences, cause, and cure/controllability (Weinman et al. 1996, Psychology and Health, 11, 431-445). Linear regression analyses were conducted to investigate relationships among illness representation, selfcare behaviors and quality-of-life outcomes. Components of illness representation were associated with self-care and health outcomes, indicating that the cognitive representation of HIV has consequences for effective illness management. For example, perception that there is little that can be done to control HIV was significantly associated with fewer and less effective self-care activities (F = 12.86, P < .001) and poorer health function in the domain of quality-of-life (F = 13.89, P < .001). The concept of illness representation provides a useful framework for understanding HIV symptom management and may be useful in directing development of effective patient-centered interventions.

Associação entre percepção de doença e ansiedade, depressão e autoeficácia em pessoas com HIV/Aids

“…Observa-se que a população soropositiva para o HIV apresenta frequentemente crenças disfuncionais sobre a enfermidade. Tais interpretações distorcidas − como considerar que a aids é sinônimo de morte, que não pode ser tratada e controlada − levam ao sofrimento e a estratégias desadaptativas, que podem infl uenciar comportamentos de autogerenciamento da doença, entre eles a adesão ao tratamento (Reynolds et al, 2009;Seidl & Faustino, 2014).…”

“…No presente estudo esta variável correlacionou-se com percepção de doença, especialmente com percepção de controle pessoal (crença do indivíduo na capacidade de controlar a doença) e controle do tratamento (crença na efi cácia do tratamento), associação também descrita em um estudo multicêntrico. Nessa investigação, realizada em Taiwan, Noruega, Porto Rico, Colômbia e Estados Unidos, a percepção de que pouco poderia ser feito para controlar a doença esteve associado com menos ações de autocuidado efetivas (Reynolds et al, 2009). Associação entre autoefi cácia e percepção de controle da doença também foi identifi cada em outras enfermidades, como doença cardíaca (Lau-Walker, 2006;Paryad, Hosseinzade, Kazemnejad, & Asiri, 2013) e diabetes em adolescentes (Griva, Myers, & Newman, 2000).…”

Prevalence, correlates, and self-management of HIV-related depressive symptoms

“…Illness representation of PLHAs in Colombia, Norway, Puerto Rico, Taiwan, and the US showed that the control, timeline, and consequences dimensions of illness representation were significantly associated with frequency and effectiveness of self-care symptom management (Reynolds et al, 2009).…”

Investigating the factor structure of the Illness Perception Questionnaire-Revised for substance dependence among injecting drug users in China

“…The importance of illness representations can be seen by their associations with health outcomes such as medication adherence Ross et al, 2004;Chen et al, 2011), self-care activities (Reynolds et al, 2009), psychological distress and depression (Broadbent et al, 2011;Scollan-Koliopoulos et al, 2011;Dempster et al, 2012;Paddison et al, 2010;Paschalides et al, 2004;Knibb and Horton, 2008) across conditions such as hypertension (Chen et al, 2011;Ross et al, 2004), cancer (Dempster et al, 2012), allergy (Knibb and Horton, 2008), diabetes (Mc Sharry et al, 2011;Paddison et al, 2010), and HIV (Reynolds et al, 2009). Such associations have also been investigated among healthy individuals (Mo and Lau, 2014;Figueiras and Alves, 2007).…”