The three aims of this study are: l) to describe significant environmental and physiological correlates of disturbed sleep for 105 ethnically diverse women who are HIV seropositive; 2) to describe and contrast strategies these women use to manage their daily activities within the context of their complex environment; and 3) to develop and pilot test an educational intervention to enhance sleep efficiency and daily activities. In this study, a woman's complex environment includes components in her socio- cultural, home, and physiological life. Symptom experience includes her distress related to a variety of somatic symptoms, her level of depression, and her level of fatigue. Symptom response includes amount of consolidated sleep, level of daytime activity, and strategies used by these women to manage their daily lives within the context of their environment and symptom experience. Data will include demographics to obtain environment variables, the Brief Symptom Checklist to assess distress, the Center for Epidemiologic Studies Depression Scale, an Inventory of Functional Status to estimate daytime activities, and the Visual Analog Scale for Fatigue to assess morning and evening fatigue. A motion sensor (wrist actigraph) will be worn to monitor sleep efficiency and level of activity continuously for 48 hours and a 2-day diary will be used to obtain subjective indicators of sleep and wake times, meal and exercise times, and distressful symptom experiences. Environmental factors and symptom experiences that significantly predict sleep efficiency will be determined from a multiple regression analysis. An intervention will be developed from the management strategies described by the women, in conjunction with principles of sleep hygiene. The intervention will be pilot tested with the final 25 women in the sample using a paired t-test to compare pre- and post-intervention sleep efficiency scores, and the efficacy of the intervention will be assessed. The findings from this study will provide data on the multi-faceted environmental context and symptom experiences for women with HIV. Data from this study will also provide a gender specific and culturally relevant nursing intervention based on empirical data that can be further tested in other samples of women with chronic illness.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
1R01NR003969-01
Application #
2258007
Study Section
Special Emphasis Panel (SRC)
Project Start
1994-09-30
Project End
1997-07-31
Budget Start
1994-09-30
Budget End
1995-07-31
Support Year
1
Fiscal Year
1994
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
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Hudson, Angela L; Portillo, Carmen J; Lee, Kathryn A (2008) Sleep disturbances in women with HIV or AIDS: efficacy of a tailored sleep promotion intervention. Nurs Res 57:360-6
Portillo, Carmen J; Tom, Lili; Lee, Kathryn A et al. (2003) Physical and mental fullness as descriptors that influence sleep in women with HIV. Holist Nurs Pract 17:91-8
Hudson, A L; Lee, K A; Portillo, C J (2003) Symptom experience and functional status among HIV-infected women. AIDS Care 15:483-92
Hudson, A L; Lee, K A; Miramontes, H et al. (2001) Social interactions, perceived support, and level of distress in HIV-positive women. J Assoc Nurses AIDS Care 12:68-76
Lee, K A; Portillo, C J; Miramontes, H (2001) The influence of sleep and activity patterns on fatigue in women with HIV/AIDS. J Assoc Nurses AIDS Care 12 Suppl:19-27
Lee, K A; Portillo, C J; Miramontes, H (1999) The fatigue experience for women with human immunodeficiency virus. J Obstet Gynecol Neonatal Nurs 28:193-200