Self-Reported Adherence to Antiretroviral Treatment and Degree of Sense of Coherence in a Group of HIV-Infected Patients

Abstract

The goal of this study was to explore the relation between self-reported adherence to antiretroviral treatment and degree of sense of coherence in a group of human immunodeficiency virus (HIV)-infected patients. Ninety-nine patients from an outpatient clinic, all undergoing antiretroviral therapy, participated. Questionnaires were answered twice at a 12-month interval. The 29-item Sense of Coherence (SOC) Scale was used for measuring the ability to cope with stressful life situations. Medication adherence was assessed with self-reported measurements. Clinical characteristics and background variables were collected from the medical records. Results from variables measured with the 12-month interval show a significant concordance with disease stage (p < or = 0.0001), and in HIV-RNA copies per milliliter (p < or = 0.0001) and an increase in CD4 cell count/mm3 (p = < 0.0001). Univariate analysis showed significant differences between nonadherent patients (n = 19) and adherent patients (n = 80) at the last measurement (i.e., the nonadherent group had lower CD4 cell count/mm3 [p = 0.004], higher HIV-1 RNA levels [p 50.029], and lower SOC [p = 0.04] than the adherent group). Finally, multiple regression analyses showed that at measurement 2 the SOC predicted nonadherence, the lower SOC the more missed doses (p < or = 0.01). Because SOC seems to play an important role in this group of patients managing their disease, a caring patient-provider relationship should be developed to minimize nonadherent behaviour. For this reason SOC scale might be of great clinical value to identify patients needing the most support for successful treatment.

Becoming Adherent: Experiences of Persons Living With HIV/AIDS

“…Negative influences on adherence have been described as depression (Sledjeski, Douglas, Delahanty, & Bogarty, 2005); perceived stress (Bottonari, Roberts, Ciesla, & Hewitt, 2005); residential patterns (Wagner, 2002); stigma (Siegel, Schrimshaw, & Ravies, 2000); addictions (Jimenez, Johnson, Hershow, & Wiebel, 1996); believing the drugs were ineffective (Murphy, Johnston Roberts, Hoffman, Molina, & Lu, 2003); denial of HIV status, side effects and symptoms (Balestra et al, 1996;Wagner, 2002); and increased alcohol intake and employment (Chesney & Ickovics, 1997;Murphy et al, 2003). Positive influences on adherence were the primary care provider's belief that the treatment was effective (Schrimshaw, Siegel, & Lekas, 2005;Seals, Hennessey, & Sowell, 1996), quality of the patient-provider relationship (van Servellan & Lombardi, 2005), the patient's view of life (Cederfjall, Languis-Eklof, Lidman, & Wredling, 2002), self-efficacy to adhere (Simoni, Frick, & Huang, 2006), and support from family and friends (Murphy et al, 2003;Simoni et al, 2006;van Servellan & Lombardi, 2005). The research clearly establishes that medication adherence is difficult.…”

The Application of Salutogenesis in Hospitals

“…Langius, Bjorvell, and Lind (1994) identify the SOC as related to the functioning and rehabilitation after oral and pharyngeal cancer, Kenne, Browall, and Gaston-Johansson (2013) note relations between the SOC and coping in women with breast cancer, and Stromsvik et al (2007) use the SOC theory to discuss their findings on the living experiences of Swedish men with multiple endocrine neoplasia. Cederfjall, Langius-Eklof, Lidman, and Wredling (2002) detect relations between low SOC scores and nonadherence in HIV patients. Warwick, Gallagher, Chenoweth, and Stein-Parbury (2010) conclude that a better understanding of the SOC may be helpful to support symptom monitoring and self-care in patients suffering from chronic obstructive pulmonary disease.…”

“…Richardson et al (2001) conclude that SOC measurements may help to individualize care for diabetes patients, Kenne et al (2013) come to similar conclusions for supporting women with breast cancer. Cederfjall et al (2002) suggest the development of a caring patient-provider relationship for HIV patients with low SOC scores.…”

The Application of Salutogenesis to Health Development in Youth with Chronic Conditions

“…Although some of the studies carried out with adult patients did not confirm the hypothesis that sense of coherence is related to higher adherence rates or self-management issues (Corless et al, 2006;Kamwendo, Hansson, & Hjerpe, 1998), a significant relationship between the sense of coherence and adherence was evidenced in the field of HIV, where less adherent patients were found to score lower on the sense of coherence (Cederfjall, Langius-Eklof, Lidman, & Wredling, 2002). Conversely, a significant relationship between good adherence and higher scores of sense of coherence was found in relation to hypertension (Nabi et al, 2008), as well as type 1 and type 2 diabetes (Cohen & Kanter, 2004).…”