Hansell P S, Hughes C B, Caliandro G, Russo P, Budin W C, Hartman B, Hernandez O C
Graduate Nursing Department, Seton Hall University, South Orange, NJ, USA.
Nurs Res. 1998 Mar-Apr;47(2):79-86. doi: 10.1097/00006199-199803000-00006.
Caring for the human immunodeficiency virus (HIV)-infected child is challenging and affects the entire family system. Studies have shown that social support can mitigate caregiver stress and enhance coping; however, social support may not always result in a positive outcome for the recipient.
To measure caregiver stress, coping, and social support, and to test the effect of a social support boosting intervention on levels of stress, coping, and social support among caregivers of children with HIV/acquired immune deficiency syndrome (AIDS).
An experimental design was used with monthly social support boosting interventions implemented. The stratified randomized sample included 70 primary caregivers of children with HIV/AIDS. The sample strata were seropositive caregivers (biological parents) and seronegative caregivers (foster parents and extended family members). Study measures included the Derogatis Stress Profile, Family Crisis Oriented Personal Evaluation Scale, and the Tilden Interpersonal Relationship Inventory. Data were analyzed using descriptive statistics and repeated measure MANOVA.
Statistically significant differences between the experimental and control groups were found on changes in the dependent variables over time when caregiver strata were included as a factor in the analysis; no statistically significant results were found when caregiver strata were combined. Univariate Ftests indicated that the level of social support for caregivers who were seronegative in the experimental group was significantly different from seronegative caregivers in the control group and seropositive caregivers in both groups. No significant treatment group differences were found for seropositive caregivers.
Seronegative caregivers derived substantial benefit from the social support boosting intervention. Seronegative caregivers who acquire a child with HIV/AIDS are confronted with a complex stressful situation; the critical need to enhance their social support is achievable through the intervention tested in this study.
照顾感染人类免疫缺陷病毒（HIV）的儿童具有挑战性，且会影响整个家庭系统。研究表明，社会支持可以减轻照顾者的压力并增强应对能力；然而，社会支持对接受者并不总是产生积极的结果。
测量照顾者的压力、应对能力和社会支持，并测试增强社会支持的干预措施对HIV/获得性免疫缺陷综合征（AIDS）患儿照顾者的压力水平、应对能力和社会支持的影响。
采用实验设计，每月实施增强社会支持的干预措施。分层随机样本包括70名HIV/AIDS患儿的主要照顾者。样本分层为血清反应阳性照顾者（亲生父母）和血清反应阴性照顾者（养父母和大家庭成员）。研究测量工具包括德罗加蒂斯压力概况量表、家庭危机导向个人评估量表和蒂尔登人际关系量表。使用描述性统计和重复测量多变量方差分析对数据进行分析。
当将照顾者分层作为分析因素时，发现实验组和对照组在随时间变化的因变量上存在统计学显著差异；当将照顾者分层合并时未发现统计学显著结果。单因素F检验表明，实验组中血清反应阴性的照顾者的社会支持水平与对照组中血清反应阴性的照顾者以及两组中血清反应阳性的照顾者有显著差异。血清反应阳性的照顾者在治疗组之间未发现显著差异。
血清反应阴性的照顾者从增强社会支持的干预措施中获得了实质性益处。收养HIV/AIDS患儿的血清反应阴性的照顾者面临着复杂的压力情况；通过本研究测试的干预措施来增强他们的社会支持这一迫切需求是可以实现的。
