Department of Family Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Aging Ment Health. 2023 May;27(5):948-956. doi: 10.1080/13607863.2022.2068126. Epub 2022 Apr 29.
Quality of life (QoL) is an important consideration for people living with HIV (PWH). We investigated the relationship between stress, psychological resources, and proactive behaviors, on QoL (conceptualized as life satisfaction, successful aging, and depressive symptoms) by testing the hypotheses: (1) greater life stress (stress and functional impairment) is associated with poorer QoL; (2) resources (mastery, resilience, and social support) are associated with better QoL, beyond the influence of stress; and (3) proactive behaviors (medication management and leisure activities) mediate the relationship between resources and QoL.
Secondary analyses were performed ( = 128 PWH). Participants' mean age was 52.3, 83.6% were male, and 53.9 identified as white. Multivariate regressions were performed within the context of path analyses.
In series 1, greater stress was associated with poorer life satisfaction ( < 0.001), lower self-rated successful aging ( < 0.001), and greater depression ( < 0.001). Functional impairment was associated with lower successful aging ( = 0.017) and greater depression ( = 0.001). In series 2, which accounted for mastery, resilience, social support, as well as demographic covariates, mastery was associated with greater life satisfaction ( = 0.038). In series 3, stress, functional impairment, leisure activities, and ART management were added to the model and social support was associated with engagement in leisure activities ( < 0.001), which was associated with better successful aging ( = 0.006). Fit indices suggested adequate relative fit. In bootstrapped analyses of indirect effects, social support was indirectly associated with successful aging through leisure activities ( = 0.020).
QoL, as captured by self-rated successful aging, is threatened by stress but positively influenced by social support and engaging in leisure activities. Findings support a model of proactive successful aging for PWH.
生活质量（QoL）是感染 HIV 的人（PWH）的重要考虑因素。我们通过测试以下假设来研究压力、心理资源和积极行为与 QoL（生活满意度、成功老龄化和抑郁症状）之间的关系：（1）更大的生活压力（压力和功能障碍）与较差的 QoL 相关；（2）资源（掌控力、韧性和社会支持）与更好的 QoL 相关，超出压力的影响；（3）积极行为（药物管理和休闲活动）在资源和 QoL 之间起中介作用。
进行了二次分析（ = 128 名 PWH）。参与者的平均年龄为 52.3 岁，83.6%为男性，53.9%为白人。在路径分析的背景下进行了多元回归分析。
在系列 1 中，更大的压力与较低的生活满意度相关（ < 0.001）、较低的自我评估成功老龄化相关（ < 0.001）和更高的抑郁相关（ < 0.001）。功能障碍与较低的成功老龄化相关（ = 0.017）和更高的抑郁相关（ = 0.001）。在系列 2 中，考虑到掌控力、韧性、社会支持以及人口统计学协变量，掌控力与更高的生活满意度相关（ = 0.038）。在系列 3 中，将压力、功能障碍、休闲活动和 ART 管理添加到模型中，社会支持与参与休闲活动相关（ < 0.001），这与更好的成功老龄化相关（ = 0.006）。拟合指数表明适当的相对拟合度。在间接效应的bootstrap 分析中，社会支持通过休闲活动与成功老龄化呈间接相关（ = 0.020）。
QoL 作为自我评估成功老龄化的指标，受到压力的威胁，但受到社会支持和参与休闲活动的积极影响。研究结果支持了 PWH 积极主动的成功老龄化模型。
