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中国艾滋病毒血清学不一致夫妻的伴侣身份与幸福感:在耻辱风险下的复原力

Couple identity and well-being in Chinese HIV serodiscordant couples: resilience under the risk of stigma.

作者信息

Huang Jiasheng, Zhang Jianxin, Yu Nancy Xiaonan

机构信息

a Department of Social and Behavioural Sciences , City University of Hong Kong , Hong Kong , People's Republic of China.

b Institute of Psychology, Chinese Academy of Sciences , Beijing , People's Republic of China.

出版信息

AIDS Care. 2018 Aug;30(sup5):S58-S66. doi: 10.1080/09540121.2018.1510105. Epub 2019 Jan 11.

Abstract

Resilience literature has suggested the context-specific nature of resilience while such framework has yet to be expanded to health psychology research among HIV serodiscordant couples. Conceptualizing a couple affected by chronic diseases using a "we-ness" framework rather than two separate individuals is important for stress coping of the couple. Considering this social-cognitive context of couple coping would be helpful to facilitate resilience of both the patient and the spouse. It is not clear whether couple identity serves as a protective factor for HIV serodiscordant couples and whether stigma, a prevalent contextual risk in this population, will alter the strength of such a protective effect on well-being. This longitudinal study examined the protective effect of couple identity in predicting the psychological and physical well-being of HIV discordant couples and the moderating role of stigma in such associations. A total of 160 Chinese HIV serodiscordant couples completed the baseline survey and follow-up one year later. Results showed that couple identity predicted fewer depressive symptoms at both the within- and between-couple level and better self-rated physical health at the between-couple level one year later. These protective effects were diminished when HIV stigma was high. This study highlights the importance of examining resources with consideration of contextual factors. It also calls for the sensitivity of stigma in developing a couple-based intervention for HIV serodiscordant couples.

摘要

复原力相关文献表明了复原力具有情境特定性,然而这样的框架尚未扩展到对HIV血清学不一致伴侣的健康心理学研究中。使用“我们感”框架而非将夫妻视为两个独立个体来概念化受慢性病影响的夫妻,对于夫妻应对压力而言至关重要。考虑到夫妻应对的这种社会认知情境将有助于促进患者及其配偶的复原力。目前尚不清楚夫妻身份是否对HIV血清学不一致夫妻起到保护作用,以及耻辱感(该人群中普遍存在的情境性风险)是否会改变这种对幸福感的保护作用的强度。这项纵向研究考察了夫妻身份在预测HIV血清学不一致夫妻的心理和身体健康方面的保护作用,以及耻辱感在这些关联中的调节作用。共有160对中国HIV血清学不一致夫妻完成了基线调查,并在一年后进行了随访。结果显示,夫妻身份在个体内和夫妻间层面均能预测一年后较少的抑郁症状,在夫妻间层面能预测更好的自评身体健康状况。当HIV耻辱感较高时,这些保护作用会减弱。本研究强调了在考虑情境因素的情况下考察资源的重要性。它还呼吁在为HIV血清学不一致夫妻制定基于夫妻的干预措施时要考虑到耻辱感的敏感性。

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