Rodkjaer L, Chesney M A, Lomborg K, Ostergaard L, Laursen T, Sodemann M
Department of Infectious Diseases, Aarhus University Hospital, Skejby, 8200 Aarhus N., Denmark.
University of California, San Francisco, California, USA.
Int J Infect Dis. 2014 May;22:67-72. doi: 10.1016/j.ijid.2013.12.008. Epub 2014 Mar 18.
Having effective ways to cope helps HIV-infected individuals maintain good psychological and physical well-being. This study investigated the relationship between coping self-efficacy levels, as determined by the Coping Self-Efficacy Scale (CSE), HIV status disclosure, and depression in a Danish cohort.
In 2008, the CSE was administered to 304 HIV-infected individuals to measure their confidence in their ability to cope with HIV infection. HIV status disclosure was assessed on a three-point scale: living openly with the disease, partly openly, or secretly. The Beck Depression Inventory (BDI) was used to assess depression prevalence and severity.
The CSE score was significantly related to depression (Spearman's rho = -0.71; the test of H0: BDI and coping, probability >t=0.0001). There was a significant relationship between higher CSE scores and living openly with HIV. The risk of depression was four times higher in HIV-infected individuals who did not disclose their HIV status (i.e. who lived 'secretly'; odds ratio = 4.1) than in individuals who lived openly.
Those with low CSE scores were more likely to report living secretly with HIV and to be depressed. Disclosing HIV may constitute a social stressor, and a lack of coping self-efficacy may increase the likelihood of non-disclosure and depression. Interventions that enhance self-efficacy may help in managing the demands of daily life with HIV, increase disclosure, and reduce depression.
拥有有效的应对方式有助于感染艾滋病毒的个体保持良好的心理和身体健康。本研究调查了丹麦一个队列中,由应对自我效能量表(CSE)所测定的应对自我效能水平、艾滋病毒感染状况披露与抑郁之间的关系。
2008年,对304名感染艾滋病毒的个体进行了CSE测试,以衡量他们应对艾滋病毒感染的能力信心。艾滋病毒感染状况披露通过一个三点量表进行评估:公开感染状况生活、部分公开或隐瞒。使用贝克抑郁量表(BDI)评估抑郁患病率和严重程度。
CSE得分与抑郁显著相关(斯皮尔曼等级相关系数rho = -0.71;原假设检验:BDI与应对,概率>t = 0.0001)。CSE得分越高与公开感染艾滋病毒生活之间存在显著关系。未披露艾滋病毒感染状况的感染艾滋病毒个体(即“隐瞒”生活的个体;优势比 = 4.1)患抑郁症的风险是公开感染者的四倍。
CSE得分低的个体更有可能报告隐瞒感染艾滋病毒的情况并出现抑郁。披露艾滋病毒感染状况可能构成一种社会压力源,而缺乏应对自我效能可能会增加隐瞒感染状况和抑郁的可能性。增强自我效能的干预措施可能有助于应对感染艾滋病毒后的日常生活需求,增加感染状况的披露,并减少抑郁。