title: A randomized controlled trial of an HIV/AIDS Symptom Management Manual for depressive symptoms.
abstract: Abstract Depressive symptoms are highly prevalent, underdiagnosed, and undertreated in people living with HIV/AIDS (PLWH), and are associated with poorer health outcomes. This randomized controlled trial examined the effects of the HIV/AIDS Symptom Management Manual self-care symptom management strategies compared with a nutrition manual on depressive symptoms in an international sample of PLWH. The sample consisted of a sub-group (N=222) of participants in a larger study symptom management study who reported depressive symptoms. Depressive symptoms of the intervention (n=124) and control (n=98) groups were compared over three months: baseline, one-month, and two-months. Use and effectiveness of specific strategies were examined. Depressive symptom frequency at baseline varied significantly by country (χ (2) 12.9; p=0.04). Within the intervention group there were significant differences across time in depressive symptom frequency [F(2, 207) = 3.27, p=0.05], intensity [F(2, 91) = 4.6, p=0.01], and impact [F(2, 252) = 2.92, p= 0.05), and these were significantly lower at one month but not at two months, suggesting that self-care strategies are effective in reducing depressive symptoms, however effects may be short term. Most used and most effective self-care strategies were distraction techniques and prayer. This study suggests that people living with HIV can be taught and will employ self-care strategies for management of depressive symptoms and that these strategies are effective in reducing these symptoms. Self-care strategies are noninvasive, have no side-effects, and can be readily taught as an adjunct to other forms of treatment. Studies are needed to identify the most effective self-care strategies and quantify optimum dose and frequency of use as a basis for evidence-based practice.
authors.affiliation: College of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, USA. eller@rutgers.edu
authors.forename: Lucille S
authors.initials: LS
authors.lastname: Eller
authors.forename: Kenn M
authors.initials: KM
authors.lastname: Kirksey
authors.forename: Patrice K
authors.initials: PK
authors.lastname: Nicholas
authors.forename: Inge B
authors.initials: IB
authors.lastname: Corless
authors.forename: William L
authors.initials: WL
authors.lastname: Holzemer
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Wantland
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Willard
authors.forename: Linda
authors.initials: L
authors.lastname: Robinson
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Hamilton
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Sefcik
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Moezzi
authors.forename: Marta Rivero
authors.initials: MR
authors.lastname: Mendez
authors.forename: Maria
authors.initials: M
authors.lastname: Rosa
authors.forename: Sarie
authors.initials: S
authors.lastname: Human
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D055317:Evidence-Based Practice; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D008370:Manuals as Topic; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D011788:Quality of Life; D018570:Risk Assessment; D012648:Self Care; D013019:South Africa / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D000928:Antidepressive Agents