Quality of Life Research

, Volume 14, Issue 4, pp 923–933 | Cite as

Assessing a conceptual framework of health-related quality of life in a HIV/AIDS population

  • Damon J. Vidrine
  • Benjamin C. AmickIII
  • Ellen R. Gritz
  • Roberto C. Arduino
Article

Abstract

With the recognition of health-related quality of life (HRQOL) as an important outcome in the course of HIV-disease, it is important to gain a better understanding of the complex relationships among the various factors that influence it. This study assesses a conceptual framework of HRQOL, consisting of disease status, socio-economic status (SES), behavioral variables, symptom status, role-specific functional status and HRQOL, among a multiethnic, economically disadvantaged population of individuals living with HIV/AIDS. Self-report data were collected from 348 patients receiving care at a large HIV/AIDS care center, serving residents of a large metropolitan area. The relationships between the study variables were examined using structural equation modeling. Results indicated that the hypothesized framework provided a well-fitted solution to the data, χ2(44df)=57.62], p = 0.08 and root mean square error of approximation=0.03, 90% confidence interval 0.01; 0.05. This framework suggests that health-related variables fall along a continuum, beginning with disease status and ending in generic HRQOL. In addition, the framework suggests that behavioral factors (i.e., smoking status, alcohol consumption, and illicit drug use) and SES exert significant effects along this continuum and should be carefully considered when analyzing and interpreting HRQOL data.

Keywords

Functional status HIV/AIDS Quality of life Socioeconomic status 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Palella, FJ,Jr., Delaney, KM, Moorman, AC,  et al. 1998Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV outpatient study investigatorsN Engl J Med338853860CrossRefPubMedGoogle Scholar
  2. 2.
    Wilson, IB, Cleary, PD. 1995Linking clinical variables with health-related quality of lifeA conceptual model of patient outcomes. JAMA2735965Google Scholar
  3. 3.
    Wilson, IB, Cleary, PD. 1996Clinical predictors of functioning in persons with acquired immunodeficiency syndromeMed Care34610623PubMedGoogle Scholar
  4. 4.
    Brenner, MH, Curbow, B, Legro, MW. 1995The proximal-distal continuum of multiple health outcome measures: The case of cataract surgeryMed Care33AS236244PubMedGoogle Scholar
  5. 5.
    Call, SA, Klapow, JC, Stewart, KE,  et al. 2000Health-related quality of life and virologic outcomes in an HIV clinicQual Life Res9977985PubMedGoogle Scholar
  6. 6.
    Bing, EG, Hays, RD, Jacobson, LP,  et al. 2000Health-related quality of life among people with HIV disease: results from the Multicenter AIDS Cohort StudyQual Life Res95563PubMedGoogle Scholar
  7. 7.
    Hays, RD, Cunningham, WE, Sherbourne, CD,  et al. 2000Health-related quality of life in patients with human immunodeficiency virus infection in the United States: results from the HIV cost and services utilization studyAm J Med108714722PubMedGoogle Scholar
  8. 8.
    Swindells, S, Mohr, J, Justis, JC,  et al. 1999Quality of life in patients with human immunodeficiency virus infection: Impact of social support, coping style and hopelessnessInt J STD AIDS10383391PubMedGoogle Scholar
  9. 9.
    Turner, J, Page-Shafer, K, Chin, DP,  et al. 2001Adverse impact of cigarette smoking on dimensions of health-related quality of life in persons with HIV infectionAIDS Patient Care STDS15615624PubMedGoogle Scholar
  10. 10.
    Low-Beer, S, Chan, K, Wood, E,  et al. 2000Health related quality of life among persons with HIV after the use of protease inhibitorsQual Life Res9941949PubMedGoogle Scholar
  11. 11.
    Sherbourne, CD, Hays, RD, Fleishman, JA,  et al. 2000Impact of psychiatric conditions on health-related quality of life in persons with HIV infectionAm J Psychiatry157248254PubMedGoogle Scholar
  12. 12.
    Brechtl, JR, Breitbart, W, Galietta, M, Krivo, S, Rosenfeld, B. 2001The use of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection: Impact on medical, palliative care, and quality of life outcomesJ Pain Symptom Manage214151PubMedGoogle Scholar
  13. 13.
    Carr, A. 2000HIV protease inhibitor-related lipodystrophy syndromeClin Infect Dis30S135142PubMedGoogle Scholar
  14. 14.
    Max, B, Sherer, R. 2000Management of the adverse effects of antiretroviral therapy and medication adherenceClin Infect Dis30S96116PubMedGoogle Scholar
  15. 15.
    Niaura, R, Shadel, WG, Morrow, K, Tashima, K, Flanigan, T, Abrams, DB. 2000Human immunodeficiency virus infection, AIDS, and smoking cessation: The time is nowClin Infect Dis31808812PubMedGoogle Scholar
  16. 16.
    Harris County Hospital District – Thomas Street Clinic. In: Harris County Hospital District, 2001Google Scholar
  17. 17.
    Lorenz, KA, Shapiro, MF, Asch, SM, Bozzette, SA, Hays, RD. 2001Associations of symptoms and health-related quality of life: Findings from a national study of persons with HIV infectionAnn Intern Med.134854860PubMedGoogle Scholar
  18. 18.
    Rogers WH, Wittink H, Wagner A, Cynn D, Carr DB. Assessing individual outcomes during outpatient multidisciplinary chronic pain treatment by means of an augmented SF-36. Pain Medicine 2000; 1(1)Google Scholar
  19. 19.
    Vidrine, DJ, Amick, BC, Gritz, ER,III, Arduino, RC. 2004Validity of the household and leisure time activities questionnaire (HLTA) in a multiethnic HIV-positive populationAIDS Care16187197PubMedGoogle Scholar
  20. 20.
    Ware, J,Jr., Kosinski, M, Keller, SD. 1996A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validityMed Care34220233PubMedGoogle Scholar
  21. 21.
    Delate, T, Coons, SJ. 2000The discriminative ability of the 12-item short form health survey (SF-12) in a sample of persons infected with HIVClin Ther2211121120PubMedGoogle Scholar
  22. 22.
    U.S. Bureau of the Census. 1970 Census of Population, Alphabetical Index of Industries and Occupations. Washington, D.C.: U.S. Government Printing Office, (1971)Google Scholar
  23. 23.
    Kline, RB. 1998Principles and Practice of Structural Equation ModelingThe Guilford PressNew YorkGoogle Scholar
  24. 24.
    Hu, LH, Bentler, PM. 1999Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternativesStructural Equation Modeling.6155Google Scholar
  25. 25.
    Enders, CK, Bandalos, DL. 2001The relative performance of full information maximum likelihood estimation for missing data in structural equation modelsStructural Equation Modeling8430457MathSciNetGoogle Scholar
  26. 26.
    Enders, CK. 2001The impact of nonnormality on full information maximum-likelihood estimation for structural equation models with missing dataPsychol Methods6352370PubMedGoogle Scholar
  27. 27.
    Joreskog K, Sorbom D. LISREL 8: User’s Reference Guide. Chicago: Scientific Software International, 1996.Google Scholar
  28. 28.
    Sousa, KH, Holzemer, WL, Henry, SB, Slaughter, R. 1999Dimensions of health-related quality of life in persons living with HIV diseaseJ Adv Nurs29178187PubMedGoogle Scholar
  29. 29.
    Heckman, TG. 2003The chronic illness quality of life (CIQOL) model: explaining life satisfaction in people living with HIV diseaseHealth Psychol22140147PubMedGoogle Scholar
  30. 30.
    Schmitz, MF, Crystal, S. 2000Social relations, coping, and psychological distress among persons with HIV/AIDSJournal of Applied Social Psychology30665683Google Scholar
  31. 31.
    Eriksson, LE, Nordstrom, G, Berglund, T, Sandstrom, E. 2000The health-related quality of life in a Swedish sample of HIV-infected personsJ Adv Nurs3212131223PubMedGoogle Scholar
  32. 32.
    Vidrine, DJ, Amick, BC,III, Gritz, ER, Arduino, RC. 2003Functional status and overall quality of life in a multiethnic HIV-positive populationAIDS Patient Care STDS17187197PubMedGoogle Scholar
  33. 33.
    Collins, RL, Kanouse, DE, Gifford, AL,  et al. 2001Changes in health-promoting behavior following diagnosis with HIV: prevalence and correlates in a national probability sampleHealth Psychol20351360PubMedGoogle Scholar
  34. 34.
    Mamary, EM, Bahrs, D, Martinez, S. 2002Cigarette smoking and the desire to quit among individuals living with HIVAIDS Patient Care STDS163942PubMedGoogle Scholar
  35. 35.
    Gritz, ER, Vidrine, DJ, Lazev, AB, Amick, BC,III, Arduino, RC. 2004Smoking behavior in a low-income multiethnic HIV/AIDS populationNicotine Tob Res67177PubMedGoogle Scholar
  36. 36.
    Lenderking, WR, Testa, MA, Katzenstein, D, Hammer, S. 1997Measuring quality of life in early HIV disease: the modular approachQual Life Res6515530PubMedGoogle Scholar
  37. 37.
    Cunningham, WE, Rana, HM, Shapiro, MF, Hays, RD. 1997Reliability and validity of self-report CD4 counts-in persons hospitalized with HIV diseaseJ Clin Epidemiol50829835PubMedGoogle Scholar
  38. 38.
    Hessol, NA, Schwarcz, S, Ameli, N, Oliver, G, Greenblatt, RM. 2001Accuracy of self-reports of acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related conditions in womenAm J Epidemiol15311281133PubMedGoogle Scholar
  39. 39.
    MacArthur RD, Perez G, Walmsley S, Baxter J, Neaton J, Wentworth D. CD4+ cell count is a better predictor of disease progression than HIV RNA level in persons with advanced HIV infection on highly active antiretroviral therapy CPCRA. In: 8th annual Conference on Retroviruses and Opportunistic Infections (CROI), 2001 Frebruary 4–8, Chicago, (2001)Google Scholar
  40. 40.
    Cunningham, WE, Shapiro, MF, Hays, RD,  et al. 1998Constitutional symptoms and health-related quality of life in patients with symptomatic HIV diseaseAm J Med104129136PubMedGoogle Scholar
  41. 41.
    O’Neill, WM, Sherrard, JS. 1993Pain in human immunodeficiency virus disease: A reviewPain54314PubMedGoogle Scholar
  42. 42.
    IOM.,  2001Committee on HIV Prevention Strategies in the United StatesNo Time to Lose: Getting More from HIV Prevention. National Academy PressWashington D.C.Google Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Damon J. Vidrine
    • 1
    • 4
  • Benjamin C. AmickIII
    • 2
  • Ellen R. Gritz
    • 1
  • Roberto C. Arduino
    • 3
  1. 1.The University of Texas M.D.Anderson Cancer CenterUSA
  2. 2.The University of Texas Health Science Center at Houston School of Public Health and The Texas Program on Society and HealthRice UniversityUSA
  3. 3.The University of Texas Health Science Center at Houston Medical SchoolUSA
  4. 4.Department of Behavioral ScienceUT M.D. Anderson Cancer CenterHoustonUSA

Personalised recommendations