Quality of life in patients with human immunodeficiency virus infection: impact of social support, coping style and hopelessness

Abstract

We aimed to determine whether the quality of life (QOL) in the patients infected with human immunodeficiency virus (HIV) infection was influenced by satisfaction with social support, coping style and hopelessness. One hundred and thirty-eight HIV-infected patients were prospectively studied in this multicentre, longitudinal study. The QOL was assessed by Medical Outcome Study Health Survey SF-36, social support by Sarason Social Support Questionnaire, hopelessness by Beck Hopelessness Scale, and coping by Billing and Moos Inventory of coping with illness. The QOL did not correlate with age, sex, race, HIV risk factor, education or marital status. Employment (P = 0.0001), higher income (P = 0.03), satisfaction with social support (P = 0.04), regardless of the source of that support, and problem-focused coping (P = 0.03) were associated with a significantly better QOL, while, emotion-focused coping (r = -0.19, P = 0.04), avoidant coping (r = 0.40, P = 0.0001), hopelessness (r = -0.64, P = 0.0001) and AIDS (P = 0.09) were predictors of poorer QOL. Physical functioning correlated positively with employment (P = 0.0001), and inversely with AIDS (P = 0.0002), hopelessness (P = 0.03), avoidant coping (P = 0.03), and age (P = 0.10). At 6 months follow up, QOL score had changed in 20% of the patients; older age (P = 0.01), and lesser satisfaction with social support (P = 0.15) were associated with a decline in QOL, while adherence with antiretroviral therapy (P = 0.006) was associated with an increase in QOL score. Seven of 138 patients died during follow up; these patients had significantly lower QOL at baseline than all other patients (P = 0.003). Interventions to alleviate hopelessness, maladaptive coping, and enhancement of satisfaction with social support may improve overall QOL in HIV-infected patients. Older patients with HIV were less satisfied with their social support, were more likely to utilize unhealthy coping styles, and experienced a greater decline in QOL over time.

Assessment of factors associated with the quality of life of patients living with HIV/HCV co-infection

“…Our findings are in line with these associations, which have been previously recognised (e.g., da Silva et al, 2013;Degroote et al, 2013;Hays et al, 2000;Liu et al, 2006;Rueda et al, 2011). Because higher education and employment have been considered a proxy of a higher socioeconomic status in general, these findings are comprehensible and support the notion that socioeconomic circumstances are an important part of one's life and QoL and may provide more than simple financial benefits for PLWHA (Swindells et al, 1999). It is also likely that higher education may denote an improved ability to comprehend the treatment recommendations and, accordingly, to a better engagement in medical care, which therefore may reflect better QoL.…”

Gender and Age Differences in Quality of Life and the Impact of Psychopathological Symptoms Among HIV-Infected Patients

“…Interestingly, and yet not surprising, being unemployed (or not currently working) was associated with poorer QoL in all domains, with the exception of Spirituality. This finding is consistent with Swindells and colleagues' study [32] that suggests that employment may provide more than just financial benefits for PLWHA. Also consistent with prior work [7-9, 18, 26, 35], clinical variables (CD4?…”

“…Comparisons between educational groups showed that those with less education reported significantly poorer QoL than those with higher education [8,13,15,16,26]. Previous research that has incorporated employment status as a variable of interest verified that employed individuals generally reported enhanced QoL [26,27,31,32].…”

Emotional Stress, Psychosocial Variables and Coping Associated with Hepatitis C Virus and Human Immunodeficiency Virus Infections in Intravenous Drug Users

“…It should be noted that a significant coping strategy, that is, avoidance, has not been studied here for methodological reasons. With respect to this issue, avoidance has been associated with a higher risk of depression [44], greater risk-taking behavior [45], lower adherence to antiretroviral therapy [46], poorer quality of life [47]and a slower decline in CD4 count [48]among HIV-infected patients. This area deserves further attention, both among HIV-infected as well as HCV-positive subjects.…”