Advertisement

AIDS and Behavior

, Volume 13, Issue 2, pp 258–267 | Cite as

HIV Illness Representation as a Predictor of Self-care Management and Health Outcomes: A Multi-site, Cross-cultural Study

  • N. R. Reynolds
  • L. Sanzero Eller
  • P. K. Nicholas
  • I. B. Corless
  • K. Kirksey
  • M. J. Hamilton
  • J. K. Kemppainen
  • E. Bunch
  • P. Dole
  • D. Wantland
  • E. Sefcik
  • K. M. Nokes
  • C. L. Coleman
  • M. Rivero
  • G. E. Canaval
  • Y. F. Tsai
  • W. L. Holzemer
Original Paper

Abstract

Research has shown that the perceptions that form the cognitive representation of an illness (illness representation) are fundamental to how persons cope with illness. This study examined the relationship of illness representation of HIV with self-care behavior and health outcomes. Data were collected at 16 sites in the United States, Taiwan, Norway, Puerto Rico and Colombia via survey. HIV seropositive participants (n = 1,217, 31% female, 38% African-American/Black, 10% Asian/Pacific Islander and 26% White/Anglo) completed measures of illness representation based on the commonly accepted five-component structure: identity, time-line, consequences, cause, and cure/controllability (Weinman et al. 1996, Psychology and Health, 11, 431–445). Linear regression analyses were conducted to investigate relationships among illness representation, self-care behaviors and quality-of-life outcomes. Components of illness representation were associated with self-care and health outcomes, indicating that the cognitive representation of HIV has consequences for effective illness management. For example, perception that there is little that can be done to control HIV was significantly associated with fewer and less effective self-care activities (F = 12.86, P < .001) and poorer health function in the domain of quality-of-life (F = 13.89, P < .001). The concept of illness representation provides a useful framework for understanding HIV symptom management and may be useful in directing development of effective patient-centered interventions.

Keywords

HIV Illness representation Self-care Self-management Beliefs Chronic illness 

Notes

Acknowledgments

Support: U.S. NIH, NIAID, AIDS Clinical Trials Group (U01AI68636), The Ohio State University (U01AI069474), NIH, NINR (R01 NR05108) nrr. We wish to thank the study volunteers for their contribution to this project and Christopher Holloman, PhD, Director Statistical Consulting Service, The Ohio State University, for his consultation.

References

  1. Alonzo, A. A., & Reynolds, N. R. (1998). The structure of emotions during acute myocardial infarction: A model of coping. Social Science & Medicine, 46, 1099–1110.CrossRefGoogle Scholar
  2. Cameron, L. D., & Leventhal, H. (2003). The self-regulation of health and illness behaviour. New York: Routledge.Google Scholar
  3. Chou, F. Y., Holzemer, W. L., Portillo, C. J., & Slaughter, R. (2004). Self-care strategies and sources of information for HIV/AIDS symptom management. Nursing Research, 53, 332–339.PubMedCrossRefGoogle Scholar
  4. Clark, N. M., Gong, M., & Kaciroti, N. (2001). A model of self-regulation for control of chronic disease. Health Education and Behavior, 28(6), 769–782.PubMedCrossRefGoogle Scholar
  5. Cleary, P. D., Fowler, F. J. Jr., Weissman, J., Massagli, M. P., Wilson, I., Seage, G. R. 3rd, Gatsonis, C., & Epstein, A. (1993). Health-related quality of life in persons with acquired immune deficiency syndrome. Medical Care, 31, 569–580.PubMedCrossRefGoogle Scholar
  6. Corless, I. B., Bunch, E. H., Kemppainen, J. K., Holzemer, W. L., Nokes, K. M., Eller, L. S., Portillo, C. J., Butensky, E., Nicholas, P. K., Bain, C. A., Davis, S., Kirksey, K. M., & Chou, F. Y. (2002). Self-care for fatigue in patients with HIV. Oncology Nursing Forum, 29, E60–E69.PubMedCrossRefGoogle Scholar
  7. Holmes, W. C., & Shea, J. A. (1998). A new HIV/AIDS-targeted quality of life (HAT-QoL) instrument: Development, reliability, and validity. Medical Care, 36, 138–154.PubMedCrossRefGoogle Scholar
  8. Holmes, W. C., & Shea, J. A. (1999). Two approaches to measuring quality of life in the HIV/AIDS population: HAT-QoL and MOS-HIV. Quality of Life Research, 8(6), 515–527.PubMedCrossRefGoogle Scholar
  9. Holzemer, W. L. (2002). HIV and AIDS: The symptom experience. What cell counts and viral loads won’t tell you. American Journal of Nursing, 102, 48–52.PubMedGoogle Scholar
  10. Holzemer, W. L., Hudson, A., Kirksey, K. M., Hamilton, M. J., & Bakken, S. (2001). The revised sign and symptom check-list for HIV (SSC-HIVrev). Journal of the Association of Nurses in AIDS Care, 12, 60–70.PubMedCrossRefGoogle Scholar
  11. Kemppainen, J. K., Holzemer, W. L., Nokes, K., Eller, L. S., Corless, I. B., Bunch, E. H., Kirksey, K. M., Goodroad, B. K., Portillo, C. J., & Chou, F. Y. (2003). Self-care management of anxiety and fear in HIV disease. Journal of the Association of Nurses in AIDS Care, 14, 21–29.PubMedCrossRefGoogle Scholar
  12. Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick Miller, L., & Robitaille, C. (1997). Illness representations: Theoretical Foundations. In K. J. Petrie & J. A. Weinman (Eds.), Perceptions of health and illness: Current research and applications. Singapore: Harwood Academic Publishers.Google Scholar
  13. Leventhal, H. L., Nerenz, D. R., & Steele, D. J. (1984). Illness representations and coping with health threats. In A. Baum, S. E. Taylor, & J. E. Singer (Eds.), Handbook of psychology and health. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
  14. Nicholas, P. K., Kemppainen, J. K., Holzemer, W. L., Nokes, K. M., Eller, L. S., Corless, I. B., Bunch, E. H., Bain, C. A., Kirksey, K. M., Davis, S. M., & Goodroad, B. K. (2002). Self-care management for neuropathy in HIV disease. AIDS Care, 14, 763–771.PubMedCrossRefGoogle Scholar
  15. Petrie, K. J., & Weinman, J. (1997). Perceptions of health and illness: Current research and applications. Amsterdam: Harwood Academic Publishers.Google Scholar
  16. Reynolds, N., & Alonzo A. A. (2000). Self-regulation theory: Review and analysis. In V. Rice (Ed.), Handbook of stress, coping and health. Thousand Oaks: Sage.Google Scholar
  17. Reynolds, N. R. (2003). The problem of antiretroviral adherence: A self-regulatory model for intervention. AIDS Care, 15, 117–124.PubMedCrossRefGoogle Scholar
  18. Strauss, A. (1990). A trajectory model for reorganizing the health care system, perspectives in nursing 1989–1991. New York: National League for Nursing.Google Scholar
  19. Strauss, A. L., Corbin, J., Fagerhaugh, S., Glaser, B. G., Maines, D., Suczek, B., & Wiener, C.L. (1984). Chronic illness and the quality of life (2 ed.). St. Louis: Mosby.Google Scholar
  20. Tsai, Y. F., Hsiung, P. C., & Holzemer, W. L. (2003). Validation of a Chinese version of the sign and symptom checklist for persons with HIV diseases. Journal of Pain and Symptom Management, 25, 363–368.PubMedCrossRefGoogle Scholar
  21. Weinman, J., Petrie, K. J., Moss-Morris, R., & Horne. R. (1996). The Illness Perception Questionnaire: A new method for assessing the cognitive representation of illness. Psychology and Health, 11, 431–445.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • N. R. Reynolds
    • 1
  • L. Sanzero Eller
    • 2
  • P. K. Nicholas
    • 3
  • I. B. Corless
    • 4
  • K. Kirksey
    • 5
  • M. J. Hamilton
    • 6
  • J. K. Kemppainen
    • 7
  • E. Bunch
    • 8
  • P. Dole
    • 9
  • D. Wantland
    • 10
  • E. Sefcik
    • 6
  • K. M. Nokes
    • 11
  • C. L. Coleman
    • 12
  • M. Rivero
    • 13
  • G. E. Canaval
    • 14
  • Y. F. Tsai
    • 15
  • W. L. Holzemer
    • 10
  1. 1.The Ohio State UniversityColumbusUSA
  2. 2.Rutgers UniversityNewarkUSA
  3. 3.Brigham and Women’s Hospital and MGH Institute of Health ProfessionsBostonUSA
  4. 4.MGH Institute of Health ProfessionsBostonUSA
  5. 5.University of TexasHoustonUSA
  6. 6.Texas A&M UniversityCorpus ChristiUSA
  7. 7.University of North Carolina at WilmingtonWilmingtonUSA
  8. 8.University of OsloOsloNorway
  9. 9.Village Diagnostic & Treatment CenterNew YorkUSA
  10. 10.University of California, San Francisco School of NursingSan FranciscoUSA
  11. 11.Hunter College, CUNYNew YorkUSA
  12. 12.University of PennsylvaniaPhiladelphiaUSA
  13. 13.University of Puerto RicoSan JuanUSA
  14. 14.Universidad del ValleCaliColombia
  15. 15.Chang Gung UniversityTao-YuanTaiwan

Personalised recommendations