Hopefulness Fosters Affective and Cognitive Constructs for Actions to Cope and Enhance Quality of Life among People Living with HIV in Dar Es Salaam, Tanzania

Siril, Hellen; Fawzi, Mary C. Smith; Todd, Jim; Wyatt, Monique A.; Kilewo, Japheth; Ware, Norma C.; Kaaya, Sylvia

doi:10.1177/2325957414539195

Cited by 15 publications

(21 citation statements)

References 29 publications

(33 reference statements)

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“…Eighteen studies (20.7%) used focus group discussions (FDGs) [19,23–25,28,50,53,61,68,73,74,76,77,82,94,98,167,169], 16 used both IDIs and FDGs (18.4%) [18,30,31,38,44,52,64,72,75,79,83,86,92,93,99,170], one used free attitude interviews (FAIs) and FGDs (1.1%) [80], one used group sessions without more detail [168], one used IDIs and life history and illness narratives [48] and one used digital stories [91]. …”

Section: Resultsmentioning

confidence: 99%

Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa

Croome

Ahluwalia²,

Hughes³

et al. 2017

Aids

136

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Objective:The aim of this study was to identify the range and frequency of patient-reported barriers and facilitators to antiretroviral treatment (ART) adherence in sub-Saharan Africa (SSA).Design:Studies from 2005 to 2016 were identified by searching 10 electronic databases and through additional hand and web-searching.Methods:Inclusion criteria were HIV-positive adults taking ART based in any SSA country, qualitative study or quantitative survey and included at least one patient-reported barrier or facilitator to ART adherence. Exclusion criteria were only including data from treatment-naive patients initiating ART, only single-dose treatment, participants residing outside of SSA and reviews.Results:After screening 11 283 records, 154 studies (161 papers) were included in this review. Forty-three barriers and 30 facilitators were reported across 24 SSA countries. The most frequently identified barriers across studies were forgetting (n = 76), lack of access to adequate food (n = 72), stigma and discrimination (n = 68), side effects (n = 67) and being outside the house or travelling (n = 60). The most frequently identified facilitators across studies were social support (n = 60), reminders (n = 55), feeling better or healthier after taking ART (n = 35), disclosing their HIV status (n = 26) and having a good relationship with a health provider (n = 22).Conclusion:This review addresses the gap in knowledge by collating all the patient-reported barriers and facilitators to ART adherence in SSA. Current barriers measures need to be adapted or new tools developed to include the wide variety of factors identified. The factors that have the greatest impact need to be isolated so interventions are developed that reduce the barriers and enhance the facilitators.

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Section: Resultsmentioning

confidence: 99%

Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa

Croome

Ahluwalia²,

Hughes³

et al. 2017

Aids

136

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“…The aim of this study was to develop and validate a local measure for hope among PLH in a high HIV prevalence and low-income setting that will reflect understandings of hope among PLH and consider the relevant terms used to express hope in this socio-cultural context [49]. This was an adjunct study done to complement the main larger NAMWEZA study.…”

Section: Study Objectivementioning

confidence: 99%

“…The data for the FGDs and IDIs was collected from February to June 2012. More details are available in our previously published study [49]. The data for phase I pilot survey were collected from June 2012 to early August 2012.…”

Section: Identification Of Potential Questions and Domains Of The Locmentioning

confidence: 99%

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The value of hope: development and validation of a contextual measure of hope among people living with HIV in urban Tanzania a mixed methods exploratory sequential study

et al. 2020

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Background: Hope or hopefulness enhances coping and improves quality of life in persons with chronic or incurable illnesses. Lack of hope is associated with depression and anxiety, which impact negatively on quality of life. In Tanzania, where HIV prevalence is high, the rates of depression and anxiety are over four times higher among people living with HIV (PLH) compared to persons not infected and contribute annual mortality among PLH. Tanzania has a shortage of human resources for mental health, limiting access to mental health care. Evidence-based psychosocial interventions can complement existing services and improve access to quality mental health services in the midst of human resource shortages. Facilitating hope can be a critical element of nonpharmacological interventions which are underutilized, partly due to limited awareness and lack of hope measures, adapted to accommodate cultural context and perspectives of PLH. To address this gap, we developed and validated a local hope measure among PLH in Tanzania. Methods: Two-phased mixed methods exploratory sequential study among PLH. Phase I was Hope-related items identification using deductive, inductive approaches and piloting. Phase II was an evaluation of psychometric properties at baseline and 24 months. Classical test theory, exploratory, confirmatory factor analysis (CFA) were used. Results: Among 722 PLH, 59% were women, mean age was 39.3 years, and majority had primary school level of education. A total of 40 hope items were reduced to 10 in a three-factor solution, explaining 69% of variance at baseline, and 93% at follow-up. Internal consistency Cronbach's alpha was 0.869 at baseline and 0.958 at follow-up. The three-factor solution depicted: positive affect; cognition of effectiveness of HIV care; and goals/plans/ future optimism. Test-retest reliability was good (r = 0.797) and a number of indices were positive for CFA model fit, including Comparative Fit Index of 0.984. Conclusion: The developed local hope scale had good internal reliability, validity, and its dimensionality was confirmed against expectations. The fewer items for hope assessment argue well for its use in busy clinical settings to improve HIV care in Tanzania. Hope in this setting could be more than cognitive goal thinking, pathway and motivation warranting more research. Trial registration: The intervention was registered in USA ClinicalTrials.gov on September 26, 2012, Registration number: NCT01693458.

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“…This scale has demonstrated good internal consistency (Cronbach's alpha ranging from 0.81 to 0.91) and construct validity has been shown through positive correlations with optimism and negative correlations with depression and anxiety [43]. Hope is assessed through a scale developed locally by Siril et al [44] with individuals living with HIV in Tanzania. For HIV-related stigma, the HIV Stigma Scale developed by Berger et al [45] is used.…”

Section: Methodsmentioning

confidence: 99%

Healthy Options: study protocol and baseline characteristics for a cluster randomized controlled trial of group psychotherapy for perinatal women living with HIV and depression in Tanzania

et al. 2020

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Background: Perinatal women accessing prevention of mother-to-child transmission of HIV (PMTCT) services are at an increased risk of depression; however, in Tanzania there is limited access to services provided by mental health professionals. This paper presents a protocol and baseline characteristics for a study evaluating a psychosocial support group intervention facilitated by lay community-based health workers (CBHWs) for perinatal women living with HIV and depression in Dar es Salaam.Methods: A cluster randomized controlled trial (RCT) is conducted comparing: 1) a psychosocial support group intervention; and 2) improved standard of mental health care. The study is implemented in reproductive and child health (RCH) centers providing PMTCT services. Baseline characteristics are presented by comparing sociodemographic characteristics and primary as well as secondary outcomes for the trial for intervention and control groups. The trial is registered under clinicaltrials.gov (NCT02039973).Results: Among 742 women enrolled, baseline characteristics were comparable for intervention and control groups, although more women in the control group had completed secondary school (25.2% versus 18.2%). Overall, findings suggest that the population is highly vulnerable with over 45% demonstrating food insecurity and 17% reporting intimate partner violence in the past 6 months. Conclusions: Baseline characteristics for the cluster RCT were comparable for intervention and control groups. The trial will examine the effectiveness of a psychosocial support group intervention for the treatment of depression among women living with HIV accessing PMTCT services. A reduction in the burden of depression in this vulnerable population has implications in the short-term for improved HIV-related outcomes and for potential long-term effects on child growth and development.Trial registration: The trial is registered under clinicaltrials.gov (NCT02039973).

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Hopefulness Fosters Affective and Cognitive Constructs for Actions to Cope and Enhance Quality of Life among People Living with HIV in Dar Es Salaam, Tanzania

Cited by 15 publications

References 29 publications

Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa

Patient-reported barriers and facilitators to antiretroviral adherence in sub-Saharan Africa

The value of hope: development and validation of a contextual measure of hope among people living with HIV in urban Tanzania a mixed methods exploratory sequential study

Healthy Options: study protocol and baseline characteristics for a cluster randomized controlled trial of group psychotherapy for perinatal women living with HIV and depression in Tanzania

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