title: Self-care strategies for depressive symptoms in people with HIV disease.
abstract: OBJECTIVE
  This paper reports a study with people living with HIV to examine the experience of depressive symptoms, self-care symptom management strategies, symptom outcomes in response to those strategies, and sources from which the strategies were learned.
  
  
  BACKGROUND
  Depressive symptoms are common, under-diagnosed and under-treated in people living with HIV. These symptoms have been associated with lower medication adherence, risky behaviours and poorer health outcomes.
  
  
  METHODS
  The study was based on the model of symptom management developed by the University of California San Francisco School of Nursing Symptom Management Faculty. Thirty-four HIV+ men and women from a larger study of symptom self-care strategies (n = 422) reported experiencing depressive symptoms. Data were collected from this subset on the Web, by mail and in-person using the critical incident technique.
  
  
  RESULTS
  Depressive symptoms were described using 80 words and phrases clustered into eight categories: futility, sadness, loneliness/isolation, fatigue, fear/worry, lack of motivation, suicidal thoughts and other. A total of 111 self-care strategies were coded into six categories: practising complementary/alternative therapies, talking to others, using distraction techniques, using antidepressants, engaging in physical activity, and using denial/avoidant coping. Sources of information for strategies used were trial and error (31%), healthcare providers (28%), family and friends (20%), classes/reading (8%), clergy (8%), support groups (4%) and other (3%). Overall, 92% of the self-care strategies used were reported as helpful, 4% were sometimes helpful and 4% were not helpful.
  
  
  CONCLUSIONS
  People living with HIV use numerous effective self-care strategies to manage depressive symptoms. Further study is needed to validate the use of these strategies across populations, to standardize dose, duration and frequency, and to measure their effectiveness.
authors.affiliation: Rutgers, The State University of New Jersey College of Nursing, New Jersey 07102, USA. eller@nightingale.rutgers.edu
authors.forename: Lucille Sanzero
authors.initials: LS
authors.lastname: Eller
authors.forename: Inge
authors.initials: I
authors.lastname: Corless
authors.forename: Eli Haugen
authors.initials: EH
authors.lastname: Bunch
authors.forename: Jeanne
authors.initials: J
authors.lastname: Kemppainen
authors.forename: William
authors.initials: W
authors.lastname: Holzemer
authors.forename: Kathleen
authors.initials: K
authors.lastname: Nokes
authors.forename: Carmen
authors.initials: C
authors.lastname: Portillo
authors.forename: Patrice
authors.initials: P
authors.lastname: Nicholas
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003142:Communication; D000529:Complementary Therapies / Q000379:methods; D003863:Depression / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D015444:Exercise; D005260:Female; D015658:HIV Infections / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D012648:Self Care / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents