STRESS, COGNITIVE APPRAISAL, COPING, AND ADAPTATIONAL OUTCOMES AMONG ASYMPTOMATIC PERSONS WITH HUMAN IMMUNODEFICIENCY VIRUS INFECTION (IMMUNE DEFICIENCY).
Contributors: University of Rochester.
Published: 1992
Number of pages: 189
Subjects: Health Sciences, Nursing.; Psychology, Social.
Description: The general purpose of the study was to investigate the relationship among factors that influenced adaptational outcomes. The specific purpose was to explicate Lazarus and Folkman's theory of Stress, Appraisal, and Coping among persons with asymptomatic Human Immunodeficiency Virus (HIV) disease.

A convenience sample of 77 men and 50 women were obtained from University of Rochester AIDS clinic and a private clinic in the Rochester area. Mean age of subjects was 32.9 (SD = 7.95) years. Measures of socioeconomic status, self-esteem, optimism, and HIV threat appraisal were obtained. Functional outcome was conceptualized as disruption in activities of daily living and measured with Sickness Impact Profile. Emotional outcomes were mood disturbance (Profile of Moods State) and well-being (Satisfaction with Life and Purpose in Life Test).

Hierarchical regression analyses revealed that cognitive appraisal mediates between optimism and mood disturbance in the total sample and between self-esteem and mood disturbance in women. Appraisal did not mediate between personality variables and disruption in daily activities or a sense of well-being. Self-esteem predicted functional and emotional outcomes for men, but only predicted purpose in life and satisfaction with life for women. Socioeconomic status moderated self-esteem in predicting disruption in daily activities and purpose in life. Theoretical explanations of these findings were advanced.

Persons with high self-esteem and high optimism were more likely to consider threat associated with HIV disease as less stressful. In addition, persons with high self-esteem and high optimism who perceived HIV as a minor threat were more likely to perceive a higher purpose in life.

Correlational analyses indicated that time from diagnosis, participation in AIDS Clinical Group Trial studies, and CD4 levels were not related to adaptational outcomes.

Nursing interventions designed to help persons with asymptomatic HIV disease cope with their health problem should consider reduction in threat appraisal as one means to alleviate mood disturbance. Given the differences identified between men and women, it may be salient to consider different interventions for men and for women. Future research needs to identify mediating factors influencing activities of daily living, satisfaction with life and purpose in life.
Notes: Source: Dissertation Abstracts International, Volume: 54-06, Section: B, page: 2990.

Thesis (PH.D.)--THE UNIVERSITY OF ROCHESTER, 1992.

School code: 0188.