A comparative analysis of perceived stigma among HIV-positive Ghanaian and African American males

The purpose of this paper was to address two questions: (i) Do Ghanaian and African American males with HIV/AIDS experience different types and degrees of stigma? and (ii) Is the impact of stigma associated with HIV/AIDS on the self different for Ghanaian and African American males? A quantitative method was used, and the four dimensions of stigma (social rejection, financial insecurity, internalised shame, and social interaction) were identified and measured using combination Likert-type questionnaires. Data regarding positive feelings of selfworth and self-deprecation, stress related to body image, and personal control were also collected in Ghana and the southeastern USA.The sample consisted of 55 men from Ghana and 55 men from the southeastern USA. Results indicate that values for the scales measuring stigma and self-perception were significantly higher for the Ghanaian sample than for the African American sample.Thus we conclude that the Ghanaian sample living with HIV/AIDS experienced a greater amount of negative self-perception and stigma-related strife than the African American sample.Keywords: stigma, HIV/AIDS, social rejection, financial insecurity, internalised shame, cultureRésuméLe but de cette communication est d'aborder deux questions, à savoir: (i) Est-ce que les hommes Ghanéens et Afro-Américains vivant avec le VIH/SIDA éprouvent de types et de degrés différents de stigmatisation? et (ii) Estce que l'impact de stigmatisation liée au VIH/SIDA sur le moi est différent chez les Ghanéens en comparaison aux Afro-Américains? Une méthode quantitative a été employée et les quatre dimensions de stigmatisation (le rejet social, l'insécurité financière, la honte intériorisée et l'interaction sociale) ont été identifiés et mesurés grâce à une combinaison des questionnaires Likert-type. Des données concernant des sentiments positifs de la valeur personnelle et d'auto-dénigrement, le stresse lié à l'image corporel et le contrôle de soi-même ont été recueilles au Ghana et au sud-est des États Unis. L'échantillon consistait de 55 hommes du Ghana et 55 hommes du sud-est des États Unis. Les chiffres des barèmes utilisées pour mesurer la stigmatisation et la perception de soi-même étaient sensiblement élevés pour l'échantillon ghanéen par rapport à l'échantillon afro-américain. L'échantillon ghanéen vivant avec le VIH/SIDA a davantage de perception négative de soi-même ainsi que la lutte liée à la stigmatisation par rapport à l'échantillon afro-américain.Mots clés: stigmatisation,VIH, SIDA, rejet social, insécurité financière, honte intériorisée, culture SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 344-35

Preliminary efficacy of a brief family intervention to prevent declining quality of life secondary to parental bone marrow transplantation

The primary purpose of this research was to develop and evaluate the efficacy and feasibility of a brief, cost-effective family-focused intervention to promote adaptive coping and quality of life throughout a parent's bone marrow transplantation (BMT). Targeted outcomes were cohesion, decreased use of avoidance coping, open communication and effective management of emotional distress. Participants included an intervention group of 31 families and 29 families in a control group who received usual care. Each family included the BMT recipient, a partner/caregiver and children 10-18 years old. The intervention included two dyadic sessions for the BMT recipient and the partner/caregiver, one individual session for the caregiver and two digital video discs (DVDs) for children. Statistical analyses indicated that the intervention had a positive impact on at least one aspect of the adaptation of each family member. Caregivers reported the most distress but benefitted least from the intervention, whereas recipients and children reported improvement in distress. Ratings of satisfaction/acceptability were high, with 97% responding that they would recommend the intervention to others. Plans for future research include increased intervention intensity for the caregiver, a larger more diverse sample and implementation over an extended period post BMT

The Relationship Between Depressive Symptoms and Social Cognitive Processing in Partners of Long-Term Breast Cancer Survivors

Purpose/Objectives: To determine 1) if depressive symptoms in partners of long-term breast cancer survivors (BCS) could be predicted by social cognitive processing theory, and 2) if partners of younger and older breast cancer survivors were differentially affected by the cancer experience. Design: A cross-sectional, descriptive study utilizing self-report questionnaires. Setting: Indiana University and 97 ECOG-ACRIN sites. Sample: Partners of breast cancer survivors (n=508) diagnosed 3-8 years prior. Methods: Secondary data mediation analyses were conducted to determine if cognitive processing mediated the relationship between social constraints and depressive symptoms. Age-related differences on all scales were tested. Main Research Variables: Depressive symptoms; secondary variables included social constraints, cognitive processing (avoidance and intrusive thoughts), and potentially confounding variables. Findings: Cognitive processing mediated the relationship between social constraints and depressive symptoms for partners (F(5,498)= 19.911, R2=.167, p<.001). Partners of young BCS reported worse outcomes on all measures than partners of older breast cancer survivors Conclusions: As predicted by the social cognitive processing theory, cognitive processing mediated the relationship between social constraints and depressive symptoms. Furthermore, partners of younger BCS fared worse on social constraints, intrusive thoughts and depressive symptoms than partners of older BCS. Implications for Nursing: Results provide support for using the social cognitive processing theory in intervention design with partners of long-term BCS to decrease depressive symptoms. Knowledge Translation: • Partners of long-term BCS report clinically significant depression. • Partners of younger BCS report higher levels of depressive symptoms than the national average and than partners of older survivors. • Addressing social constraints within the dyad may improve depressive symptoms.This study was coordinated by the ECOG-ACRIN Cancer Research Group (Robert L. Comis, MD and Mitchell D. Schnall, MD, PhD, Group Co-Chairs) and supported in part by Public Health Service Grants CA189828, CA180795, CA37403, CA35199, CA17145 and CA49883, and from the National Cancer Institute, National Institutes of Health and the Department of Health and Human Services. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number F31NR013822, and by the National Cancer Institute of the National Institutes of Health under Award Numbers K05CA175048 and R25CA117865. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, including the National Cancer Institute or the National Institute of Nursing Research

Long-Term Fear of Recurrence in Young Breast Cancer Survivors and Partners

Background Fear of a breast cancer recurrence is the most prevalent and disruptive source of distress for long-term survivors and their partners. However, few studies have focused on predictors of fear of recurrence. The aim of this study is to test the efficacy of the Social Cognitive Processing Theory (SCPT) in predicting fear of recurrence in long-term breast cancer survivors diagnosed at age 45 years or younger and their partners. Methods In a large cross-sectional study, breast cancer survivors (n = 222) 3–8 years from diagnosis and their partners completed a survey assessing demographic characteristics, fear of recurrence, social constraints, and cognitive processing (intrusive thoughts and cognitive avoidance). Mediation analyses were conducted for survivors and partners separately to determine if cognitive processing would mediate the relationship between social constraints and fear of recurrence. Results Cognitive processing mediated the relationship between social constraints and fear of recurrence both for survivors [F(3,213) = 47.541, R2 = 0.401, p < 0.001] and partners [F(3,215) = 27.917, R2 = 0.280, p < 0.001). Demographic variables were not significant predictors of fear of recurrence. Conclusions As predicted, cognitive processing mediated the relationship between social constraints and fear of recurrence. Results expand the utility of the SCPT in long-term survivors and their partners by supporting its use in intervention design.Acknowledgement: This research was supported by an American Cancer Society grant: RSGPB-04-089-01-PBP. This study was coordinated by the ECOG-ACRIN Cancer Research Group (Robert L. Comis, MD and Mitchell D. Schnall, MD, PhD, Group Co-Chairs) and supported in part by Public Health Service Grants CA189828, CA180795 and from the National Cancer Institute, National Institutes of Health and the Department of Health and Human Services. Its content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute. Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number F31NR013822. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health under Award Number K05CA175048. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health

Factors associated with depressive symptoms in young long-term breast cancer survivors

Purpose Long-term breast cancer survivors frequently report distress (i.e., depressive symptoms) that impacts their quality of life. Previous studies have found that negative social interactions (“social constraints”) from partners contribute to long-term, unresolved cycling of intrusive thoughts and cognitive avoidance, resulting in psychological distress. However, these relationships have not been tested in long-term breast cancer survivors. Furthermore, the effect of partners’ depressive symptoms on the survivors’ depressive symptoms has not been tested within the context of these relationships. Therefore, the purpose of this study was to test relationships between breast cancer survivors’ depressive symptoms and (1) social constraints, cognitive avoidance, and intrusive thoughts, and (2) partners’ depressive symptoms. Methods Data were from a cross-sectional descriptive study of breast cancer survivors (N = 222) 3–8 years post-diagnosis and their partners, who completed surveys assessing demographic characteristics, social constraints, intrusive thoughts, cognitive avoidance, and depressive symptoms. Structural equation modeling confirmatory path analyses were conducted to determine significant relationships between survivors’ depressive symptoms and all other variables. Results Our model fits the data well. Breast cancer survivors’ depressive symptoms were predicted by social constraints and intrusive thoughts. The relationship between survivors’ depressive symptoms and partners’ depressive symptoms was close but not significant. Conclusions As hypothesized, depressive symptoms were predicted by social constraints and intrusive thoughts. Further research is needed to understand the possible relationship between survivors’ long-term depressive symptoms and cognitive avoidance and partners’ depressive symptoms. Our findings highlight the negative impact of social constraints from partners on psychological outcomes in long-term breast cancer survivors

The role of constructed meaning in adaptation to the onset of life-threatening illness

Do the meanings inherent within a traumatic life event increase our understanding of differential mental health outcomes? In light of this question two central issues are addressed in this article: (1) what variables influence the meaning that is constructed in response to a crisis, and (2) how does this meaning affect the self and ultimately the adaptation/mental health outcome as indicated by the level of emotional distress? A theoretical model is evaluated via a comparative analysis that incorporates the data of 76 persons with cancer and 130 persons with HIV/AIDS. Three primary findings support this model and the significance of the role of meaning in response to a crisis: (1) the meaning constructed in response to a crisis can be operationalized and its role evaluated as a dimension of the adaptation process, (2) evidence indicates constructed meaning affects self-perception, which subsequently affects adaptation, and (3) the pattern of effects does not differ by illness type since analyses indicate meaning is central to individuals' responses regardless of differences in characteristics of the event.Mental health Stress Coping Meaning HIV/AIDS Cancer USA

The conceptualization of meaning in illness

The focus of this paper is the development of a conceptualization of meaning within the context of serious illness. It is based on a symbolic interactionist perspective, with the significance of the concept of meaning for the process of adaptation being a primary point of discussion. Meaning, as it is defined here, refers to the perceived nature of the relationship between the individual and his/her world that is developed within the context of specific events. It is comprised of two inextricably linked dimensions: meaning that pertains to one's identity and how that is affected by the event of the illness, and meaning which pertains to perceived characteristics of the event and to the social circumstances that surround it. Interviews with 38 persons living with the stress of cancer provide qualitative data that illustrate the concept as it is set forth in this paper. Four specific domains relevant to symbolic interactionism were explored in these interviews: (1) the individual's response to the illness; (2) changes that occurred relative to identify as a consequence of the illness; (3) the impact of cancer on the individual's relationship to the social world; (4) anticipated effects of the illness on the individual's future. Clinical implications of specific aspects of meaning are discussed.meaning stress cancer coping adaptation

A comparative analysis of perceived stigma among HIV-positive Ghanaian and African American males

The purpose of this paper was to address two questions: (i) Do Ghanaian and African American males with HIV/AIDS experience different types and degrees of stigma? and (ii) Is the impact of stigma associated with HIV/AIDS on the self different for Ghanaian and African American males? A quantitative method was used, and the four dimensions of stigma (social rejection, financial insecurity, internalised shame, and social interaction) were identified and measured using combination Likert-type questionnaires. Data regarding positive feelings of selfworth and self-deprecation, stress related to body image, and personal control were also collected in Ghana and the southeastern USA.The sample consisted of 55 men from Ghana and 55 men from the southeastern USA. Results indicate that values for the scales measuring stigma and self-perception were significantly higher for the Ghanaian sample than for the African American sample.Thus we conclude that the Ghanaian sample living with HIV/AIDS experienced a greater amount of negative self-perception and stigma-related strife than the African American sample.Keywords: stigma, HIV/AIDS, social rejection, financial insecurity, internalised shame, cultureRésuméLe but de cette communication est d'aborder deux questions, à savoir: (i) Est-ce que les hommes Ghanéens et Afro-Américains vivant avec le VIH/SIDA éprouvent de types et de degrés différents de stigmatisation? et (ii) Estce que l'impact de stigmatisation liée au VIH/SIDA sur le moi est différent chez les Ghanéens en comparaison aux Afro-Américains? Une méthode quantitative a été employée et les quatre dimensions de stigmatisation (le rejet social, l'insécurité financière, la honte intériorisée et l'interaction sociale) ont été identifiés et mesurés grâce à une combinaison des questionnaires Likert-type. Des données concernant des sentiments positifs de la valeur personnelle et d'auto-dénigrement, le stresse lié à l'image corporel et le contrôle de soi-même ont été recueilles au Ghana et au sud-est des États Unis. L'échantillon consistait de 55 hommes du Ghana et 55 hommes du sud-est des États Unis. Les chiffres des barèmes utilisées pour mesurer la stigmatisation et la perception de soi-même étaient sensiblement élevés pour l'échantillon ghanéen par rapport à l'échantillon afro-américain. L'échantillon ghanéen vivant avec le VIH/SIDA a davantage de perception négative de soi-même ainsi que la lutte liée à la stigmatisation par rapport à l'échantillon afro-américain.Mots clés: stigmatisation,VIH, SIDA, rejet social, insécurité financière, honte intériorisée, culture SAHARA J (Journal of Social Aspects of HIV/AIDS Research Alliance) Vol. 2(3) 2005: 344-35

Evaluation of the psychometrics of the Social Impact Scale: A measure of stigmatization

As stigmatization has a large impact on patients, therapists need a measure of this impact to provide patients with adequate services. This study, therefore, examined the reliability and validity of the Social Impact Scale (SIS) when applied to three groups of individuals diagnosed with major depression, schizophrenia, or HIV/AIDS. The study sample (N=580 ) included 237 patients with depressive disorder, 119 with schizophrenia, and 224 with HIV/AIDS. Of these, 56% were men, 45.5% had an elementary school education or less, 48% were employed, and 56% were single. The Rasch measurement model, an item-response theory, was used to analyze the SIS structure and quality. The Rasch model solves several statistical problems of traditional measurement theory, such as misuse of ordinal data as interval data and sample dependence. Rasch analysis indicated that the 24 items of the SIS fit the measurement model. The match between item difficulties and person abilities was adequate. All items showed acceptable rating scale structure. The separation reliability of the scale reached 0.99. The SIS had acceptable psychometric qualities in terms of internal consistency, item validity, person validity, sensitivity, and concurrent validity when applied to patients with depression, schizophrenia, and HIV/AIDS in Taiwan