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Improvements in health-related quality of life following a group intervention for coping with AIDS-bereavement among HIV-infected men and women

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Abstract

Background: AIDS-related bereavement is a severe life stressor that may be particularly distressing to persons themselves infected with HIV. Increasing evidence suggests that psychological health is associated with disease progression, HIV-related symptoms, and mortality. Purpose: This study assessed change in health-related quality of life among HIV+ persons following a group intervention for coping with AIDS-related loss. Methods: The sample included 235 HIV+ men and women of diverse ethnicities and sexual orientations who had experienced an AIDS-related loss within the previous 2 years. Participants were randomly assigned to a 12-week cognitive-behavioral bereavement coping group intervention or offered individual psychotherapy upon request. Quality of life was assessed at baseline and 2 weeks after the intervention. Results: Participants in the group intervention demonstrated improvements in general health-related and HIV-specific quality of life, while those in the comparison remained the same or deteriorated. Effect sizes indicated that the majority of change occurred in women. Conclusion: This bereavement group aimed at improving coping with grief also had a positive impact on health-related quality of life among HIV+ men and women, and suggests that cognitive-behavioral interventions may have a broad impact on both emotional and physical health.

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References

  1. UNAIDS. Report on the Global HIV/AIDS Epidemic. Geneva: World Health Organization, 2003

  2. Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/hiv/stats.htm; March, 2004

  3. S Gupta RM Anderson RM. May (1989) ArticleTitleNetworks of sexual contacts: Implications for the pattern of spread of HIV AIDS 3 807–817 Occurrence Handle1:STN:280:By%2BB3M7mslI%3D Occurrence Handle2517202

    CAS  PubMed  Google Scholar 

  4. JL. Martin (1988) ArticleTitlePsychological consequences of AIDS-related bereavement among gay men J Consult Clin Psychol 56 856–862 Occurrence Handle1:STN:280:BiaD2sbpsV0%3D Occurrence Handle3204195

    CAS  PubMed  Google Scholar 

  5. R Neugebauer JG Rabkin JB Williams et al. (1992) ArticleTitleBereavement reactions among homosexual men experiencing multiple losses in the AIDS epidemic Am J Psychiatry. 149 1374–1379 Occurrence Handle1:STN:280:By2H3M7jsVU%3D Occurrence Handle1530075

    CAS  PubMed  Google Scholar 

  6. SW Perry B Fishman L Jacobsberg et al. (1992) ArticleTitleRelationships over 1 year between lymphocyte subsets and psychosocial variables among adults with infection by human immunodeficiency virus Arch Gen Psychiatry. 49 396–401 Occurrence Handle1:STN:280:By2B28vosl0%3D Occurrence Handle1586275

    CAS  PubMed  Google Scholar 

  7. KJ Sikkema SC Kalichman R Hoffmann et al. (2000) ArticleTitleCoping strategies and emotional wellbeing among HIV-infected men and women experiencing AIDS-related bereavement AIDS Care. 12 613–624 Occurrence Handle1:STN:280:DC%2BD3M7jsFKrtw%3D%3D Occurrence Handle11218547

    CAS  PubMed  Google Scholar 

  8. JL Martin L. Dean (1993) ArticleTitleEffects of AIDS-related bereavement and HIV-related illness on psychological distress among gay men: A 7-year longitudinal study, 1985–1991 J Consult Clin Psychol. 61 94–103 Occurrence Handle1:STN:280:ByyC1MrhtlY%3D Occurrence Handle8450113

    CAS  PubMed  Google Scholar 

  9. K Goodkin NT Blaney RS Tuttle et al. (1996) ArticleTitleBereavement and HIV infection Int Rev Psychiatr. 8 201–216

    Google Scholar 

  10. JE Bower ME Kemeny SE Taylor et al. (1998) ArticleTitleCognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men J Consult Clin Psychol. 66 979–986 Occurrence Handle1:STN:280:DyaK1M%2Fpt1Sksg%3D%3D Occurrence Handle9874911

    CAS  PubMed  Google Scholar 

  11. GM Reed ME Kemeny SE Taylor et al. (1999) ArticleTitleNegative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men Health Psychol. 18 354–363 Occurrence Handle1:STN:280:DyaK1MzlvVyrsQ%3D%3D Occurrence Handle10431936

    CAS  PubMed  Google Scholar 

  12. H Schut MS Stroebe J Bout Particlevan den et al. (2001) The efficacy of bereavement interventions: Determining who benefits MS Stroebe RO Hansson W Stroebe H. Schut (Eds) Handbook of Bereavement Research: Consequences, Coping, and Care American Psychological Association Washington, DC 705–737

    Google Scholar 

  13. PM Kato T. Mann (1999) ArticleTitleA synthesis of psychological interventions for the bereaved Clin Psychol Rev. 19 275–296 Occurrence Handle1:STN:280:DyaK1M7psl2ntw%3D%3D Occurrence Handle10097872

    CAS  PubMed  Google Scholar 

  14. H Chochinov JC Holland (1989) Bereavement: A special issue in oncology JC Holland JH Rowland (Eds) Handbook of Psychooncology: Psychological Care of the Patient with Cancer Oxford University Press New York 583–627

    Google Scholar 

  15. K Goodkin NT Blaney DJ Feaster et al. (1999) ArticleTitleA randomized controlled clinical trial of a bereavement support group intervention in human immunodeficiency virus type 1-seropositive and -seronegative homosexual men Arch Gen Psychiatry. 56 52–59 Occurrence Handle1:STN:280:DyaK1M7gslaktg%3D%3D Occurrence Handle9892256

    CAS  PubMed  Google Scholar 

  16. K Goodkin DJ Feaster D Asthana et al. (1998) ArticleTitleA bereavement support group intervention is longitudinally associated with salutary effects on the CD4 cell count and number of physician visits Clin Diagn Lab Immunol. 5 382–391 Occurrence Handle1:STN:280:DyaK1c3mslSgsA%3D%3D Occurrence Handle9605995

    CAS  PubMed  Google Scholar 

  17. KJ Sikkema NB Hansen A Kochman et al. (2004) ArticleTitleOutcomes from a randomized controlled trial of a group intervention for HIV positive men and women coping with AIDS-related loss and bereavement Death Stud. 28 187–209 Occurrence Handle15053030

    PubMed  Google Scholar 

  18. DM Fernandez MA Gomez M Velazquez et al. (1997) ArticleTitlePsychological and behavioral issues of a cohort of Puerto Rican HIV/AIDS patients Cell Mol Biol. 43 1115–1122 Occurrence Handle1:CAS:528:DyaK2sXnvFGmtbk%3D Occurrence Handle9449545

    CAS  PubMed  Google Scholar 

  19. JR Ickovics ME Hamburger D Vlahov et al. (2001) ArticleTitleMortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: Longitudinal analysis from the HIV epidemiology research study J Amer Med Assoc. 285 1466–1474 Occurrence Handle1:STN:280:DC%2BD3M7osFCmtA%3D%3D

    CAS  Google Scholar 

  20. TJ Mayne E Vittinghoff MA Chesney et al. (1996) ArticleTitleDepressive affect and survival among gay and bisexual men infected with HIV Arch Intern Med. 156 2233–2238 Occurrence Handle1:STN:280:ByiD2c%2FltFQ%3D Occurrence Handle8885823

    CAS  PubMed  Google Scholar 

  21. J Leserman ED Jackson JM Petitto et al. (1999) ArticleTitleProgression to AIDS: The effects of stress, depressive symptoms, and social support Psychosom Med. 61 397–406 Occurrence Handle1:STN:280:DyaK1M3psVSnsA%3D%3D Occurrence Handle10367622

    CAS  PubMed  Google Scholar 

  22. K Page-Shafer GN Delorenze WA Satariano et al. (1996) ArticleTitleComorbidity and survival in HIV-infected men in the San Francisco Men’s Health Survey Ann Epidemiol. 6 420–430 Occurrence Handle1:STN:280:ByiD2s3ntVw%3D Occurrence Handle8915473

    CAS  PubMed  Google Scholar 

  23. EP Zorrilla JR McKay L Luborsky et al. (1996) ArticleTitleRelation of stressors and depressive symptoms to clinical progression of viral illness Am J Psychiatry. 153 626–635 Occurrence Handle1:STN:280:BymB3crislU%3D Occurrence Handle8615407

    CAS  PubMed  Google Scholar 

  24. AJ Elliott J Russo PP. Roy-Byrne (2002) ArticleTitleThe effect of changes in depression on health related quality of life (HRQoL) in HIV infection Gen Hosp Psychiatry. 24 43–47 Occurrence Handle11814533

    PubMed  Google Scholar 

  25. JK. Kemppainen (2001) ArticleTitlePredictors of quality of life in AIDS patients J Assoc Nurses AIDS Care. 12 61–70 Occurrence Handle1:STN:280:DC%2BD3M3ht1Cqug%3D%3D Occurrence Handle11211673

    CAS  PubMed  Google Scholar 

  26. CD Sherbourne RD Hays JA Fleishman et al. (2000) ArticleTitleImpact of psychiatric conditions on health-related quality of life in persons with HIV infection Am J Psychiatry. 157 248–254 Occurrence Handle1:STN:280:DC%2BD3c7jslKqug%3D%3D Occurrence Handle10671395

    CAS  PubMed  Google Scholar 

  27. K Walker A McGown M Jantos et al. (1997) ArticleTitleFatigue, depression, and quality of life in HIV-positive men J Psychosoc Nurs Ment Health Serv. 35 32–40 Occurrence Handle1:STN:280:ByiH2czmslU%3D

    CAS  Google Scholar 

  28. MH Antoni L Baggett G Ironson et al. (1991) ArticleTitleCognitive-behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity J Consult Clin Psychol. 59 906–915 Occurrence Handle1:STN:280:By2C38bnt1Y%3D Occurrence Handle1774375

    CAS  PubMed  Google Scholar 

  29. MH Antoni DG Cruess S Cruess et al. (2000) ArticleTitleCognitive-behavioral stress management intervention effects on anxiety, 24-hr urinary norepinephrine output, and T-cytotoxic/suppressor cells over time among symptomatic HIV-infected gay men J Consult Clin Psychol. 68 31–45 Occurrence Handle1:STN:280:DC%2BD3c7ns1WksQ%3D%3D Occurrence Handle10710838

    CAS  PubMed  Google Scholar 

  30. M Chesney S Folkman D. Chambers (1996) ArticleTitleCoping effectiveness training for men living with HIV: Preliminary findings Int J STD AIDS. 7 75–82 Occurrence Handle8799801

    PubMed  Google Scholar 

  31. DG Cruess MH Antoni N Schneiderman et al. (2000) ArticleTitleCognitive-behavioral stress management increases free testosterone and decreases psychological distress in HIV-seropositive men Health Psychol. 19 12–20 Occurrence Handle1:STN:280:DC%2BD3c7nsVOhtw%3D%3D Occurrence Handle10711583

    CAS  PubMed  Google Scholar 

  32. J Kelly D Murphy G Bahr et al. (1993) ArticleTitleOutcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons Am J Psychiatry. 150 1679–1686 Occurrence Handle1:STN:280:ByuD38jks1M%3D Occurrence Handle8214177

    CAS  PubMed  Google Scholar 

  33. SK Lutgendorf MH Antoni G Ironson et al. (1997) ArticleTitleCognitive-behavioral stress management decreases dysphoric mood and herpes simplex virus-Type 2 antibody titers in symptomatic HIV-seropositive gay men J Consult Clin Psychol. 65 31–43 Occurrence Handle1:STN:280:ByiB2Mjgs1Y%3D Occurrence Handle9103732

    CAS  PubMed  Google Scholar 

  34. A Molassiotis P Callaghan SF Twinn et al. (2002) ArticleTitleA pilot study of the effects of cognitive–behavioral group therapy and peer support/counseling in decreasing psychologic distress and improving quality of life in Chinese patients with symptomatic HIV disease AIDS Patient Care STDS. 16 83–96 Occurrence Handle1:STN:280:DC%2BD387jvVKrtQ%3D%3D Occurrence Handle11874640

    CAS  PubMed  Google Scholar 

  35. SC Lechner MH Antoni D Lydston et al. (2003) ArticleTitleCognitive-behavioral interventions improve quality of life in women with AIDS J Psychosom Res. 54 253–261 Occurrence Handle12614835

    PubMed  Google Scholar 

  36. RS Lazarus S. Folkman (1984) Stress, Appraisal, and Coping Springer New York

    Google Scholar 

  37. S Folkman M Chesney L McKusick et al. (1991) Translating coping theory into an intervention J Eckenrode (Eds) The Social Context of Coping Plenum New York 239–260

    Google Scholar 

  38. TA Rando (1984) Grief, Dying, and Death: Clinical Interventions for Caregivers Research Press Company Champaign, Illinois

    Google Scholar 

  39. JW. Worden (1991) Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner Springer New York

    Google Scholar 

  40. Cella DF. Manual: Functional Assessment of Cancer Therapy (FACT) Scales and the Functional Assessment of HIV Infection (FAHI) Scale (Version 3). Chicago, IL: Rush-Presbyterian-St. Luke’s Medical Center, 1994

  41. DF Cella NL McCain AH Peterman et al. (1996) ArticleTitleDevelopment and validation of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument Qual Life Res. 5 450–463 Occurrence Handle1:STN:280:BymH3sfktVI%3D Occurrence Handle8840825

    CAS  PubMed  Google Scholar 

  42. S Folkman M Chesney L Collette et al. (1996) ArticleTitlePostbereavement depressive mood and its prebereavement predictors in HIV+ and HIV- gay men J Pers Soc Psychol. 70 336–348 Occurrence Handle1:STN:280:BymC1MzktVc%3D Occurrence Handle8636886

    CAS  PubMed  Google Scholar 

  43. MB First M Gibbon JB Williams et al. (1996) SCID Screen Patient Questionnaire Computer Program Multi-Health Systems and American Psychiatric Press Toronto

    Google Scholar 

  44. MB First M Gibbon RL Spitzer et al. (1997) CAS II: Computer-Assisted SCID II (for Personality Disorders Multi-Health Systems and American Psychiatric Press Toronto

    Google Scholar 

  45. SA Murphy C Johnson KC Cain et al. (1998) ArticleTitleBroad-spectrum group treatment for parents bereaved by the violent deaths of their 12- to 28-year-old children: A randomized controlled trial Death Stud 22 209–235 Occurrence Handle1:STN:280:DyaK1cnhvVCltA%3D%3D Occurrence Handle10182433

    CAS  PubMed  Google Scholar 

  46. K Goodkin TT Baldewicz D Asthana et al. (2001) ArticleTitleA bereavement support group intervention affects plasma burden of human immunodeficiency virus type 1 Report of a randomized controlled trial. J Hum Virol. 4 44–54 Occurrence Handle1:STN:280:DC%2BD3M3ksVWjuw%3D%3D

    CAS  Google Scholar 

  47. KJ Sikkema A Kochman W DiFranceisco et al. (2003) ArticleTitleAIDS-related grief and coping with loss among HIV-positive men and women J Behav Med. 26 165–181 Occurrence Handle12776385

    PubMed  Google Scholar 

  48. NB Hansen MJ Lambert EM. Forman (2002) ArticleTitleThe psychotherapy dose-response effect and its implications for treatment delivery services Clin Psychol-Sci Pr. 9 329–343

    Google Scholar 

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Sikkema, K.J., Hansen, N.B., Meade, C.S. et al. Improvements in health-related quality of life following a group intervention for coping with AIDS-bereavement among HIV-infected men and women. Qual Life Res 14, 991–1005 (2005). https://doi.org/10.1007/s11136-004-2959-0

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