Leiberich P, Engeter M, Olbrich E, Rubbert A, Schumacher K, Brieger M, Kalden J R, Joraschky P
Department of Psychosomatics and Psychotherapy, University of Erlangen-Nürnberg, Germany.
Psychother Psychosom. 1997;66(5):237-47. doi: 10.1159/000289141.
Longitudinal study on burdens, quality of life and coping strategies of HIV-positive persons to identify patterns of successful adaptation to the demands of the infection.
In a semiprospective multimodal approach, 61 HIV-positive persons in all stages of the infection attending an HIV ambulatorium were assessed by inventories (3 times) and by a half-standardized interview (baseline T1 focussing on first reactions after diagnosis, follow-up T3 1.5 years later). Subjects had a mean age of 35.3 years and 69% were male. Forty-four percent were infected via homosexual intercourse, 46% via intravenous needle sharing and 10% via heterosexual intercourse or an unknown source.
Global, psychic and familial distress decreased significantly from the first period after the diagnosis of HIV to the third time of measurement, while somatic complaints increased. Most test persons were able to deal effectively with the demands of the infection and showed a great degree of flexibility in their use of cognitive-actional and emotional-palliative strategies; they achieved a high quality of life. In contrast, highly distressed individuals, mainly drug users, tended to cope in an evasive-regressive way and reported a low quality of life. Correlations between ineffective coping strategies and low quality of life were found to be significant.
After an initial phase of sorrow and lack of orientation regarding their future life, most HIV-positive persons deal effectively with the demands of the HIV infection and report a good quality of life. In contrast, HIV-positive persons with a high degree of distress and an evasive-regressive coping pattern need professional support, such as psychotherapy.
对艾滋病毒呈阳性者的负担、生活质量和应对策略进行纵向研究，以确定成功适应感染需求的模式。
采用半前瞻性多模式方法，通过量表（3次）和半标准化访谈（基线T1聚焦于诊断后的首次反应，1.5年后的随访T3）对61名处于感染各阶段、在艾滋病毒门诊就诊的艾滋病毒呈阳性者进行评估。受试者的平均年龄为35.3岁，69%为男性。44%通过同性性行为感染，46%通过共用静脉注射针头感染，10%通过异性性行为或不明来源感染。
从艾滋病毒诊断后的第一阶段到第三次测量时，总体、心理和家庭困扰显著减少，而躯体不适增加。大多数受测者能够有效应对感染带来的需求，并在使用认知行动和情感缓解策略方面表现出很大的灵活性；他们实现了较高的生活质量。相比之下，高度困扰的个体，主要是吸毒者，倾向于以回避 - 退行的方式应对，并报告生活质量较低。发现无效应对策略与低生活质量之间存在显著相关性。
在经历了对未来生活悲伤和迷茫的初始阶段后，大多数艾滋病毒呈阳性者能够有效应对艾滋病毒感染带来的需求，并报告良好的生活质量。相比之下，高度困扰且采用回避 - 退行应对模式的艾滋病毒呈阳性者需要专业支持，如心理治疗。
