Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-23T22:24:52.568Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental health status of clients from three HIV/AIDS palliative care projects

Published online by Cambridge University Press:  04 April 2005

DANIEL KARUS ,
VICTORIA H. RAVEIS ,
KATHERINE MARCONI ,
PETER SELWYN ,
CARLA ALEXANDER ,
BARBARA HANNA  and
IRENE J. HIGGINSON
DANIEL KARUS
Affiliation:
Mailman School of Public Health, Columbia University, New York, New York, USA
VICTORIA H. RAVEIS
Affiliation:
Mailman School of Public Health, Columbia University, New York, New York, USA
KATHERINE MARCONI
Affiliation:
Office of Science & Epidemiology, HIV/AIDS Bureau, Health Resources & Services Administration, Health and Human Services, Rockville, Maryland
PETER SELWYN
Affiliation:
Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
CARLA ALEXANDER
Affiliation:
University of Maryland Medical Center, Institute of Human Virology, Baltimore, Maryland
BARBARA HANNA
Affiliation:
Health Services Center, Inc., Hobson City, Alabama
IRENE J. HIGGINSON
Affiliation:
Department of Palliative Care and Policy, King's College London, UK
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective: To describe mental health status and its correlates among clients of three palliative care programs targeting underserved populations.

Methods: Mental Health Inventory (MHI-5) scores of clients from programs in Alabama (n = 39), Baltimore (n = 57), and New York City (n = 84) were compared.

Results: Mean MHI-5 scores did not differ among sites and were indicative of poor mental health. Significant differences were noted among sites with regard to client sociodemographics, physical functioning, and perceptions of interpersonal relations. Results of multivariate regression models estimated for each site suggest variation in the relative importance of potential predictors among sites. Whereas poorer mental health was primarily associated with history of drug dependence at Baltimore and more physical symptomatology at New York, better mental health was most strongly correlated with more positive perceptions of interpersonal relationships at Baltimore and increasing age and more positive perceptions of meaning and purpose in life at New York.

Significance of results: The data presented suggest the importance of assessing clients' history of and current need for mental health services. Evidence of a relationship between positive perceptions of meaning and purpose and better psychological function underscores the importance of existential issues for the overall well-being of those who are seriously ill.

Keywords

HIVMental healthPalliative careSupportive care
Type
Research Article
Information
Palliative & Supportive Care , Volume 2 , Issue 2 , June 2004 , pp. 125 - 138
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Anderson, J.P., Kaplan, R.M., Coons, S.J., et al. (1998). Comparison of the quality of well-being scale and the SG-36 results among two samples of ill adults: AIDS and other illnesses. Journal of Clinical Epidemiology, 51, 755–762.Google Scholar
Berwick, D.M., Murphy, J.M, Goldman, P.A., et al. (1991). Performance of a Five-Item Mental Health Screening Test. Medical Care, 29, 169–176.Google Scholar
Bing, E.G., Burnam, M.A., Longshore, D., et al. (2001). Psychiatric disorders and drug use among human immunodeficiency virus-infected adults in the United States. Archives of General Psychiatry, 58, 721–728.Google Scholar
Buchanan, R.J., Wang, S., & Huang, C. (2002). Analyses of nursing home residents with Human Immunodeficiency Virus and depression using the minimum data set. AIDS Patient Care & STDs, 16, 441–455.Google Scholar
Burgoyne, R.W. & Saunders, D.S. (2001). Quality of life among urban Canadian HIV/AIDS clinic outpatients. International Journal of STD & AIDS, 12, 505–512.Google Scholar
Byock, I.R. & Merriman, M.P. (1998). Measuring quality of life for patients with terminal illness: The Missoula-Vitas Quality of Life Index (MVQOLI). Palliative Medicine, 12, 231–244.Google Scholar
Cascade Collaboration (2003). Determinants of survival following HIV-1 seroconversion after the introduction of HAART. Lancet, 362, 1267–1274.Google Scholar
Conviser, R. & Pounds, M.B. (2002). Background for the studies on ancillary services and primary care use. AIDS Care, 14(Suppl. 1), S7–S14.Google Scholar
Culhane, D.P., Gollub, E., Kuhn, R., et al. (2001). The co-occurrence of AIDS and homelessness: Results from the integration of administrative databases for AIDS surveillance and public shelter utilization in Philadelphia. Journal of Epidemiology & Community Health, 55, 515–520.Google Scholar
DesJarlais, D.C., Perlis, T., Friedman, S.R., et al. (2000). Behavioral risk reduction in a declining HIV epidemic: Injection drug users in New York City, 1990–1997. American Journal of Public Health, 90, 1112–1116.Google Scholar
Detels, R., Munoz, A., McFarlane, G., et al. (1999). Effectiveness of potent antiretroviral therapy on time to AIDS and death in men with known HIV infection duration. Journal of the American Medical Association, 280, 1497–1503.Google Scholar
Fleishman, J.A. & Fogel, B. (1994). Coping and depressive symptoms among people with AIDS. Health Psychology, 13, 156–169.Google Scholar
Gomez-Batiste, X., Fontanals, D., Roca, J., et al. (1996). Catalonia WHO demonstration project on palliative care implementation 1990–1995: Results in 1995. Journal of Pain and Symptom Management, 12, 73–78.Google Scholar
Hays, R.D., Cunningham, W.E., Sherbourne, C.D., et al. (2000). Health-related quality of life in patients with human immunodeficiency virus infection in the United States: Results from the HIV cost and services utilization study. American Journal of Medicine, 108, 714–722.Google Scholar
Herek, G.M., Capitanio, J.P., & Widaman, K.F. (2002). HIV-related stigma and knowledge in the United States: Prevalence and trends, 1991–1999. American Journal of Public Health, 92, 371–377.Google Scholar
Holmes, W.C. (1998). A short, psychiatric, case-finding measure for HIV seropositive outpatients: Performance characteristics of the 5-item Mental Health Subscale of the SG-20 in a male, seropositive sample. Medical Care, 36, 237–243.Google Scholar
Holtgrave, D.R., Pinkerton, S.D., Jones, T.S., et al. (1998). Cost and cost effectiveness of increasing access to sterile syringes and needles as an HIV prevention intervention in the United States. Journal of Acquired Immune Deficiency Syndromes, 18(Suppl. 1), S133–138.Google Scholar
Hwang, S.W., O'Connell, J.J., Lebow, J.M., et al. (2001). Health care utilization among homeless adults prior to death. Journal of Health Care for the Poor & Underserved, 12, 50–58.Google Scholar
Ickovics, J.R., Hamburger, M.E., Vlahov, D., et al. (2001). Mortality, CD4 cell count decline, and depressive symptoms among HIV-seropositive women: Longitudinal analysis from the HIV Epidemiology Research Study. Journal of the American Medical Association, 285, 1466–1474.Google Scholar
Karus, D., Raveis, V.H., Marconi, K., et al. (2004). Service needs of patients with advanced HIV disease: A comparison of client and staff reports at three palliative care projects. AIDS Patient Care & STD's, 18, 145–158.Google Scholar
Karus, D., Siegel, K., & Raveis, V.H. (1999). Psychosocial adjustment of women to living with HIV/AIDS. AIDS Behavior, 3, 277–287.Google Scholar
Lesserman, J., Jackson, E.D., Petitto, J.M., et al. (1999). Progression to AIDS: The effects of stress, depressive symptoms, and social support. Psychosomatic Medicine, 61, 397–406.Google Scholar
Linn, M.W. & Linn, B.S. (1982). The Rapid Disability Rating Scale-2. Journal of the American Geriatric Society, 30, 378–382.Google Scholar
Martens, W.H. (2001). A review of physical and mental health in homeless persons. Public Health Reviews, 29, 13–33.Google Scholar
McFarland, W., Chan, S., Ling, H., et al. (2003). Low socioeconomic status is associated with a higher rate of death in the era of Highly Active Antiretroviral Therapy, San Francisco. Journal of Acquired Immune Deficiency Syndromes, 33, 96–103.Google Scholar
McHorney, C.A. & Ware, J.E. (1995). Construction and validation of an alternate form General Mental Health scale for the Medical Outcomes Study Short-Form 36-item Health Survey. Medical Care, 33, 15–28.Google Scholar
National Center for HIV, STD and TB Prevention. (2001). HIV/AIDS Surveillance Report. Vol. 13(2). Centers for Disease Control & Prevention. Available at: http://www.cdc.gov/hiv/stats/hasr1302.htm.
National Center for HIV, STD and TB Prevention. (2002a). Drug-associated HIV transmission continues in the United States. Centers for Disease Control & Prevention. Available at: http://www.cdc.gov/hiv/pubs/facts/idu.htm.
National Center for HIV, STD and TB Prevention. (2002b). HIV/AIDS among African Americans. Centers for Disease Control & Prevention. Available at: http://www.cdc.gov/hiv/pubs/facts/afam.htm.
National Center for HIV, STD and TB Prevention. (2002c). Young people at risk: HIV/AIDS among America's youth. Centers for Disease Control & Prevention. Available at: http://www.cdc.gov/hiv/pubs/facts/youth.htm.
Nott, K.H., Vedhara, K., & Power, M.J. (1995). The role of social support in HIV infection. Psychological Medicine, 25, 971–983.Google Scholar
O'Neill, J.F. & Barini-Garcia, M. (2003). HIV and palliative care. In A Clinical Guide to Supportive and Palliative Care for HIV/AIDS, O'Neill, J.F., Selwyn, P.A. & Schietinger, H., (eds.). Available at: http://hab.hrsa.gov/tools/palliative/.
Palella, F.J., Delaney, K.M., Moorman, A.C., et al. (1998). Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. New England Journal of Medicine, 338, 853–860.Google Scholar
Penzak, S.R., Reddy, S., & Grimsley, S.R. (2000). Depression in patients with HIV infection. American Journal of Health System Pharmacy, 57, 376–389.Google Scholar
Perkins, D.O., Leserman, J., Stern, R.A., et al. (1995). Somatic symptoms of HIV infection: Relationship to depressive symptoms and indicators of HIV disease. American Journal of Psychiatry, 152, 1776–1781.Google Scholar
Portenoy, R.K., Thaler, H.T., Kornblith, A.B., et al. (1994). The Memorial Symptom Assessment Scale: An instrument for the evaluation of symptom prevalence, characteristics and distress. European Journal of Cancer, 30A, 1226–1236.Google Scholar
Rodgers, A.Y. (1995). The relationship between changes in social support and adjustment to AIDS in gay males. Social Work in Health Care, 20, 37–49.Google Scholar
Sambamoorthi, U., Walkup, J., Olfson, M., et al. (2000). Antidepressant treatment and health services utilization among HIV-infected Medicaid patients diagnosed with depression. Journal of General Internal Medicine, 15, 311–320.Google Scholar
Schlenk, E.A., Erlen, J.A., Dunbar-Jacob, J., et al. (1998). Health-related quality of life in chronic disorders: A comparison across studies using the MOS SF-36. Quality of Life Research, 7, 57–65.Google Scholar
Sears, C., Guydish, J.R., Weltzien, E.K., et al. (2001). Investigation of a secondary syringe exchange program for homeless young adult injection drug users in San Francisco, California, USA. Journal of Acquired Immune Deficiency Syndromes, 27, 193–201.Google Scholar
Siegel, K., Karus, D., & Dean, L. (2004). Psychosocial characteristics of New York City HIV-infected women in two time periods. American Journal of Public Health, 94, 1127–1132.Google Scholar
Siegel, K., Karus, D., Epstein, J., et al. (1996). Psychological and psychosocial adjustment of HIV-infected gay/bisexual men: Disease stage comparisons. Journal of Community Psychology, 24, 229–243.Google Scholar
Siegel, K., Karus, D., & Raveis, V.H. (1997a). Correlates of change in depressive symptomatology among gay men with AIDS. Health Psychology, 16, 230–238.Google Scholar
Siegel, K., Karus, D., Raveis, V.H., et al. (1998a). Psychological adjustment of women with HIV/AIDS: Racial and ethnic comparisons. Journal of Community Psychology, 26, 439–455.Google Scholar
Siegel, K., Raveis, V.H., & Karus, D. (1997b). Illness-related support and negative network interactions: Effects on HIV-infected men's depressive symptomatology. American Journal of Community Psychology, 25, 395–420.Google Scholar
Siegel, K., Raveis, V.H., & Karus, D. (1998b). Perceived advantages and disadvantages of age among older HIV-infected adults. Research on Aging, 20, 686–711.Google Scholar
Somlai, A.M., Kelly, J.A., Wagstaff, D.A., et al. (1998). Patterns, predictors, and situational contexts of HIV risk behaviors among homeless men and women. Social Work, 43, 7–20.Google Scholar
Starace, F., Ammassari, A., Trotta, M.P., et al. (2002). Depression is a risk factor for suboptimal adherence to Highly Active Antiretroviral Therapy. Journal of Acquired Immune Deficiency Syndromes, 31, S136–S139.Google Scholar
Thompson, S.C., Manni, C., & Levine, A. (1996). The stressors and stress of being HIV-positive. AIDS Care, 8, 5–14.Google Scholar
Wachtel, T., Piette, J., Mor, V., et al. (1992). Quality of life in persons with Human Immunodeficiency Infection: Measurement by the medical outcomes study instrument. Annals of Internal Medicine, 116, 129–137.Google Scholar
Ware, J.E. (1993). SF-36 Health Survey: Manual & Interpretation Guide. Boston: New England Medical Center.
Weinreb, L., Goldberg, R., & Perloff, J. (1998). Health characteristics and medical service use patterns of sheltered homeless and low-income housed mothers. Journal of General Internal Medicine, 13, 389–397.Google Scholar
World Health Organization. (1990). Cancer Pain Relief and Palliative Care: Report of a WHO Expert Committee (Technological Report Series 804). Geneva: World Health Organization.
Wu, A.W., Revicki, D.A., Jacobson, D., et al. (1997). Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Quality of Life Research, 6, 481–493.Google Scholar