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Self-Management Model fails to Predict Quality of Life for People Living with Dual Diagnosis of HIV and Diabetes.

ABSTRACT: The objective of this study was to test a self-management model for self-management in people living with HIV and type 2 diabetes (PLWH + T2DM). We conducted a predictive, longitudinal study of data from a national research cohort of PLWH using lag analysis to test short- and long-term health outcomes for PLWH + T2DM. We used a dataset from the Center for AIDS Research (CFAR) Network of Integrated Clinic Systems (CNICS), a nation-wide research network of 8 clinics that serves PLWH. Patient-reported outcomes, collected at clinic visit, included depression, adherence, CD4 cell count, and health-related quality of life (HRQoL). We computed summary statistics to describe the sample. Using lag analysis, we then modeled the three variables of adherence, CD4 count, and HRQoL as a function of their predecessors in our conceptual model. In the final model, an increase of in medication adherence corresponded to a small increase in HRQoL. An increase in CD4 count corresponded to a small increase in HRQoL. An increase in lagged depression was associated with a small decrease in HRQoL. The model was not sufficient to predict short- or long-term outcomes in PLWH + T2DM. Although depression had a moderate impact, the final model was not clinically significant. For people with a dual diagnosis of HIV and T2DM, variables other than those traditionally addressed in self-management interventions may be more important.

SUBMITTER: Zuniga JA

PROVIDER: S-EPMC8816808 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

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Self-Management Model fails to Predict Quality of Life for People Living with Dual Diagnosis of HIV and Diabetes.

Zuñiga Julie Ann JA Sales Adam A Jang Dong Eun DE West Ohueri Chelsi C Burkholder Greer G Moore Richard R Davy-Méndez Thibaut T Christopoulos Katerina K García Alexandra A AA

AIDS and behavior 20210805 2

The objective of this study was to test a self-management model for self-management in people living with HIV and type 2 diabetes (PLWH + T2DM). We conducted a predictive, longitudinal study of data from a national research cohort of PLWH using lag analysis to test short- and long-term health outcomes for PLWH + T2DM. We used a dataset from the Center for AIDS Research (CFAR) Network of Integrated Clinic Systems (CNICS), a nation-wide research network of 8 clinics that serves PLWH. Patient-repor ...[more]

PMID: 34351517

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Project description:BackgroundUnderstanding the psychosocial factors influencing self-management behaviors among people living with HIV/AIDS (PLWHA) is crucial for effective medical interventions and improving their quality of life. However, few studies have explored the psychosocial mechanisms influencing self-management behaviors among PLWHA in China. This study, conducted in accordance with STROBE guidelines, uses SEM to explore the roles of social support, self-efficacy, and self-esteem in predicting self-management behaviors among Chinese PLWHA.MethodsFrom March 2023 to July 2023, a convenience sample of 282 PLWHA, recruited from one designated AIDS hospital and one Centers for Disease Control and Prevention in Sichuan Province, China, was surveyed. Data were collected via four validated self-report scales (the Social Support Rating Scale, the General Self-Efficacy Scale, the Self-Esteem Scale, and the HIV/AIDS Patient Self-Management Scale). Structural equation modeling was used to assess the relationships among social support, self-efficacy, self-esteem, and self-management behaviors.ResultsThe new model demonstrated acceptable fit parameters (χ2/df = 2.15, GFI = 0.96, AGFI = 0.93, CFI = 0.93, IFI = 0.94, RMSEA = 0.05). The direct effect of social support on self-management behaviors was significant (β = 0.117, P < 0.05). In addition, self-efficacy and self-esteem played significant mediating roles in the influence of social support on self-management behaviors, accounting for 38.73% and 22.79% of the total effect, respectively. Moreover, they served as chain mediators, contributing 9.80% to the total effect.ConclusionsThese findings contribute to our understanding of the psychosocial dynamics influencing self-management behavior in Chinese PLWHA and have broader implications for populations in other countries. Targeted interventions that enhance social support, self-efficacy, and self-esteem could be applied in various cultural contexts to improve self-management practices among PLWHA globally.

Project description:BackgroundeHealth has enormous potential to support the self-management of depressive symptoms in people living with HIV. However, a lack of personalization is an important barrier to user engagement with eHealth. According to goal-directed design, personalized eHealth requires the identification of user personas before concrete design to understand the goals and needs of different users.ObjectiveThis study aimed to identify user personas for eHealth regarding the self-management of depressive symptoms in people living with HIV and explore the goals and needs of different user personas for future eHealth.MethodsWe used an explanatory sequential mixed methods design at the First Hospital of Changsha City, Hunan Province, China, from April to October 2022. In the quantitative phase, 572 people living with HIV completed validated questionnaires with questions related to demographics, self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. Latent profile analysis was performed to identify different user personas. In the qualitative phase, 43 one-to-one semistructured interviews across different user personas were conducted, transcribed verbatim, and analyzed using conventional content analysis. The findings from both phases were integrated during the interpretation phase.ResultsThree types of user personas could be identified, including "high-level self-managers" (254/572, 44.4%), "medium-level self-managers" (283/572, 49.5%), and "low-level self-managers" (35/572, 6.1%). High-level self-managers had relatively high levels of self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. High-level self-managers had a positive attitude toward using eHealth for the self-management of depressive symptoms and desired access to self-management support for depressive symptoms from eHealth with high usability. Medium-level self-managers had relatively medium levels of self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. Medium-level self-managers felt burdened by using eHealth for the self-management of depressive symptoms and preferred to access self-management support for HIV from eHealth with privacy. Low-level self-managers had relatively low levels of self-efficacy, self-management abilities of depressive symptoms, and eHealth literacy. Low-level self-managers had an acceptable attitude toward using eHealth for the self-management of depressive symptoms and desired access to professional guidance from eHealth with privacy and no cost ("free of charge").ConclusionsThe 3 user personas shed light on the possibility of personalized eHealth to support the self-management of depressive symptoms in different people living with HIV. Further research is needed to examine the generalizability of the user personas across study sites.

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Self-Management Model fails to Predict Quality of Life for People Living with Dual Diagnosis of HIV and Diabetes.

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Self-Management Model fails to Predict Quality of Life for People Living with Dual Diagnosis of HIV and Diabetes.

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