The proposed study uses personal narrative data in a new approach to the study of how primary caregivers of persons with AIDS adapt to continually worsening conditions. This approach focuses on how the individual appraises stressful events, the goals the individual formulates in the context of the events, and the individual's strategies for dealing with goal success or goal failure. Approximately 3,000 narratives generated by 86 HIV+ and 167 HIV- primary caregivers of men with AIDS will be analyzed to identify specific coping mechanisms that help them sustain emotional well-being while providing care to their partners and immediately following their partner's death, and to determine the extent to which these mechanisms predict emotional well-being and physical health up to 3 years following the death of the caregiver's partner. The narrative approach employed is based on Stein and Trabasso's theory of narrative analysis, integrated with Lazarus and Folkman's theory of coping and adaptation. The analyses will be evaluated in tandem with self reports from the Ways of Coping scale, a widely used standardized measure of coping. The proposed study will use data form a two-phase ongoing prospective study of caregiving partners of men with AIDS. The ongoing study is focused exclusively on quantitative data gathered primarily from paper and pencil measures and clinical assessments. The proposed study will analyze and quantify rich narrative data about stressful events that occur during caregiving and bereavement. The primary aims of the study are to: 1) describe the thematic content of stressful events experienced by HIV+ and HIV- gay men during caregiving and bereavement; 2) evaluate cross-sectional relationships between goal processes and the Ways of Coping scale, and contemporaneous positive and negative mood during caregiving and following the death of the partner; 3) describe prospective relationships between goal processes and the ways of coping during caregiving, prior to the death of the caregiver's partner, and measures of positive and negative mood, diagnosed syndromal depression, and physical health (physical symptoms of HIV disease and CD4 cell levels) 6, 12, 24, and 36 months following the death of the caregiver's partner; and, 4) describe how the coherence of individuals' understanding of the causes and consequences of their stressful events is related to success and failure in achieving their goals in those events, contemporaneous positive and negative mood, and positive and negative mood and physical health 6, 12, 24, and 36 months following the death of the caregiver's partner.
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