Perceived social support, symptoms of common mental disorders and adherence levels of patients receiving antiretroviral treatment

Nel, Adriaan (2011-12)

Thesis (MA)--University of Stellenbosch, 2011.

Thesis

ENGLISH ABSTRACT: Optimal adherence to antiretroviral medication is essential for effective treatment of the human immunodeficiency virus (HIV), and ensuring high levels of adherence has proven to be a major challenge in the fight against HIV. As funding for antiretroviral treatment (ART) programs is limited, ensuring optimal adherence is critical, not only to decrease patient mortality and improve quality of life, but also to make these ART programs financially sustainable. In recent years a small but growing body of literature on the associations between social support, common mental disorders and adherence to ART has emerged. This thesis builds on the burgeoning body of studies by seeking to test the associations between level of perceived social support, symptoms of common mental disorders, and adherence to ART among a South African sample of ART users. The study investigated a convenience sample of 101 patients living with HIV, and receiving ART from a state funded HIV clinic in the Overberg region of the Western Cape, South Africa. A cross-sectional survey design was used to gather self-report data on the level of perceived social support, severity of symptoms of common mental disorders, and adherence to ART. Bivariate correlations demonstrated significant negative associations between perceived social support and severity of symptoms of common mental disorders, specifically symptoms of depression, anxiety and posttraumatic stress disorder (PTSD). Biserial correlations and logistic regression analysis indicated an inverse relationship between severity of symptoms of depression and self-reported ART adherence. However, when symptoms of anxiety and PTSD were included as predictors, the association between symptoms of depression and self-reported ART adherence was no longer significant. Furthermore, no significant relationships were found between self-reported ART adherence and symptoms of anxiety and PTSD. Follow-up research is recommended to gain a better understanding of these relationships. A longitudinal experimental research design is recommended to determine the direction of causality with regard to the association between symptoms of depression and adherence to ART.

AFRIKAANSE OPSOMMING: Optimale nakoming van antiretrovirale medikasie is noodsaaklik vir effektiewe behandeling van die menslike immuniteitsgebreks virus (MIV), en een van die groot uitdagings in die stryd teen MIV is om hoë vlakke van nakoming te verseker. Aangesien die beskikbare fondse vir antiretrovirale behandeling (ARB) beperk is, is dit van kritiese belang om optimale nakoming te verseker, nie net om sterftes te verminder en lewenskwaliteit te verbeter nie, maar ook om ARB programme finansieël volhoubaar te maak. In die afgelope jare, het daar 'n klein maar groeiende liggaam van literatuur oor die assosiasies tussen sosiale ondersteuning, algemene geestesversteurings, en nakoming van ARB na vore gekom. Hierdie proefskrif bou voort op die groeiende liggaam van studies deur om die verhoudings tussen waargenome sosiale ondersteuning, simptome van algemene geestesversteurings, en nakoming van ARB onder 'n Suid-Afrikaanse steekproef van ARB gebruikers te toets. Die studie het ondersoek gedoen op 'n gerieflikheidsteekproef van 101 pasiënte wat MIV positief is, en ARB ontvang by 'n staats befondse MIV-kliniek in die Overberg-streek van die Wes-Kaap, Suid-Afrika. 'n Deursnee-opname ontwerp is gebruik om self-verslag data te kry oor die vlak van waargenome sosiale ondersteuning, simptome van algemene geestesversteurings, en nakoming van ARB. Tweeveranderlike korrelasies het gedui op 'n beduidende negatiewe verhouding tussen waargenome sosiale ondersteuning and simptome van algemene geestesversteurings, spesifiek simptome van depressie, angs en post-traumatiese stresversteuring (PTSS). Biseriale korrelasies and logistieke regressie-analise het 'n beduidende inverse verhouding tussen simptome van depressie and self-gerapporteerde ARB nakoming getoon. Die verhouding tussen simptome van depressie and self-gerapporteerde ARB nakoming was egter nie meer beduidend na die symptome van angs en PTSS as voorspellers ingesluit was nie. Verder was daar geen beduidende verhoudings gevind tussen self-gerapporteerde ARB nakoming en simptome van angs en PTSS nie. Verdere navorsing word aanbeveel om 'n beter begrip van hierdie verhoudings te verkry. 'n Longitudinale eksperimentele ontwerp word aanbeveel om vas te stel wat die rigting van oorsaaklikheid is ten opsigte van die verhouding tussen simptome van depressie en nakoming van ARB.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/17915
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