This project is a 3-year plan to study nurse-led patient education for people with symptomatic HIV infections. A randomized controlled trial will be conducted to compare a support group, the Social Contact Program (SCP) to the Positive Self-Management Program (PSMP), a program based on self-efficacy theory developed to help patients improve their symptom status by becoming active participants in their disease management. HIV infection is a chronic, progressively disabling condition which has devastating physical, psychological, and social consequences, many of which are meditated by chronic symptomatology, which is nearly universal in advanced disease. Recent significant advances in the medical management of HIV disease are converting it to a chronic condition. In other chronic conditions, educational initiatives have been tested aimed at promoting self-management improve symptoms, adherence to medical regimens, and health status. There is a need for a broad, multidisciplinary approach to similarly help HIV/AIDS patients participate actively in managing their own health. The investigators' hypothesize that the PSMP will, as suggested by their pilot study, improve symptom status by improving skills for symptom self-management and increasing patients' perceived self-efficacy for and confidence in their ability to manage the symptoms, disabilities, and challenges created by HIV disease. The PSMP educational intervention, which has already been designed and piloted, has the following features: 1) small groups of 10-15 HIV patients meet for 7 weekly sessions; 2) each group is led by one trained nurse or nursing student and one peer leader for the San Diego community; 3) techniques are taught to manage the symptoms and problems most common in HIV disease, including when to seek care from a provider; 4) the group sessions are designed to maximize enhancement of self-efficacy; 5) sessions are highly interactive, and include modeling of skills, practice, corrective feedback, and teaching of information; 6) training and session curricula follow material in a published manual on the program; and 7) the program is designed to be highly portable to a wide variety of community settings if it is successful.
|Gifford, Allen L; Groessl, Erik J (2002) Chronic disease self-management and adherence to HIV medications. J Acquir Immune Defic Syndr 31 Suppl 3:S163-6|
|Bormann, J; Shively, M; Smith, T L et al. (2001) Measurement of fatigue in HIV-positive adults: reliability and validity of the Global Fatigue Index. J Assoc Nurses AIDS Care 12:75-83|
|Gifford, A L; Bormann, J E; Shively, M J et al. (2000) Predictors of self-reported adherence and plasma HIV concentrations in patients on multidrug antiretroviral regimens. J Acquir Immune Defic Syndr 23:386-95|