Catania J A, Turner H A, Choi K H, Coates T J
Department of Medicine, University of California, San Francisco 94105.
AIDS. 1992 Sep;6(9):999-1005.
OBJECTIVE, DESIGN AND PARTICIPANTS: We examined sources of help-seeking related to worries or concerns about death and dying and the effects of social support on death anxiety in a longitudinal sample of gay men (n = 52).
Friends and primary sexual partners were the most frequent sources sought in dealing with death concerns for all groups of respondents (HIV-negative, HIV-positive asymptomatic, and HIV-positive symptomatic). Men experiencing HIV symptoms were more likely than HIV-negative and asymptomatic men to use formal sources of support (medical, psychological). Although HIV-positive symptomatic men did not differ from HIV-negative men in terms of help-seeking from family sources, they were significantly more likely to seek the help of family members than HIV-positive asymptomatic men. All three HIV groups showed significantly different mean levels of death anxiety, with HIV-negative men reporting the lowest level and HIV-positive symptomatic men the highest. Among HIV-negative men, only mental health sources of support (psychologists and clergy) were significantly related to death anxiety, measured 1 year later (beta = -0.35). These sources of support were also associated with death anxiety among HIV-positive asymptomatic men, but in the opposite direction (beta = 0.26). Contrary to expectations, men experiencing HIV symptoms benefited most from family support (beta = -0.31), although peer (beta = -0.19) and medical (beta = -0.28) support sources were also prominent.
Thus, while earlier research found peers to be the most common and effective source of support among gay men, this study suggests that obtaining support from family may become particularly important as one approaches death. The effectiveness of social support in reducing death anxiety appears to vary over the course of the disease from asymptomatic to symptomatic. HIV-symptomatic men obtain support from a wide range of helpers, including medical and peer supports and family.
目的、设计与参与者：我们在一个由男同性恋者组成的纵向样本（n = 52）中，研究了与对死亡和临终的担忧相关的求助来源，以及社会支持对死亡焦虑的影响。
对于所有受访者群体（HIV阴性、HIV阳性无症状和HIV阳性有症状），朋友和主要性伴侣是处理死亡担忧时最常寻求帮助的来源。与HIV阴性和无症状男性相比，有HIV症状的男性更有可能使用正式的支持来源（医疗、心理）。尽管HIV阳性有症状男性在向家庭寻求帮助方面与HIV阴性男性没有差异，但他们比HIV阳性无症状男性更有可能寻求家庭成员的帮助。所有三个HIV组的死亡焦虑平均水平存在显著差异，HIV阴性男性报告的水平最低，HIV阳性有症状男性最高。在HIV阴性男性中，只有心理健康支持来源（心理学家和神职人员）与1年后测量的死亡焦虑显著相关（β = -0.35）。这些支持来源也与HIV阳性无症状男性的死亡焦虑相关，但方向相反（β = 0.26）。与预期相反，有HIV症状的男性从家庭支持中受益最大（β = -0.31），尽管同伴（β = -0.19）和医疗（β = -0.28）支持来源也很突出。
因此，虽然早期研究发现同伴是男同性恋者中最常见和有效的支持来源，但本研究表明，随着接近死亡，从家庭获得支持可能变得尤为重要。社会支持在减轻死亡焦虑方面的有效性似乎在疾病从无症状到有症状的过程中有所不同。有HIV症状的男性从广泛的帮助者那里获得支持，包括医疗、同伴支持和家庭。
