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Abstract@#In recent years, the incidence of mental disorders among children and adolescents has been increasing worldwide. To decrease the incidence of mental health problems, many relevant policies and regulations have been successively issued and mental health services have been implemented in China. The article focused on the development and progression of mental health problems during the transition from childhood to adolescence, emphasized possible determinants on the association between physical and mental health, and presented causality in psychiatry and related models. Especially, the article highlighted some viewpoints from the clinical perspective and put forward relevant considerations and suggestions.
ABSTRACT
ABSTRACT OBJECTIVE The objective of this study has been to test the ability of variables of a psychological model to predict antiretroviral therapy medication adherence behavior. METHODS We have conducted a cross-sectional study among 172 persons living with HIV/AIDS (PLWHA), who completed four self-administered assessments: 1) the Psychological Variables and Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess the variable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional Social Support Questionnaire. Structural equation modeling was used to construct a model to predict medication adherence behaviors. RESULTS Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. CONCLUSIONS The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.
Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , CD4 Lymphocyte Count/statistics & numerical data , Anti-HIV Agents/therapeutic use , Medication Adherence/psychology , Social Support , Surveys and QuestionnairesABSTRACT
OBJETIVO: Explorar la adecuación de modelo de la teoría del comportamiento planificado (TCP) para el análisis de la conducta sexual de riesgo en el colectivo "hombres que tienen sexo con hombres" (HSH) con el objetivo de proponer un modelo alternativo que mejore su comprensión. MÉTODOS: Análisis cualitativo de entrevistas semiestructuradas individuales y de grupos nominales realizadas con 45 HSH que durante los últimos 12 meses mantuvieron relaciones sexuales de riesgo (penetración anal insertiva o receptiva sin utilizar preservativo). Para el manejo de los datos se realizó un análisis del discurso mediante el "método comparativo constante" realizado en dos fases: a) identificación de variables de la TCP y de inadecuaciones entre esta teoría y las declaraciones de los informadores, y b) propuesta de un modelo psicosocial alternativo coherente con los resultados. RESULTADOS: Se confirmó una adecuación general de la TCP, su modificación en aspectos puntuales y la incorporación de nuevas variables que, en posteriores investigaciones, podrían ser incluidas para verificar cuantitativamente su potencial incremento de la capacidad predictiva y/o explicativa del modelo para la conducta sexual de riesgo en HSH. CONCLUSIONES: Los resultados obtenidos parecen indicar la importancia de poner a prueba los postulados matemáticos del modelo TCP. Se estableció un equilibrio estable entre la validación de la TCP, sugiriéndose posibles modificaciones en aspectos puntuales que, en posteriores investigaciones, podrían ser incluidas para verificar su potencial incremento de la capacidad explicativa del modelo para la conducta sexual de riesgo en HSH.
OBJECTIVE: Explore the appropriateness of the theory of planned behavior (TPB) model for analyzing risky sexual behavior in men who have sex with other men (MSM), with the object of proposing an alternative model that improves understanding. METHODS: Qualitative analysis of semi-structured individual and nominal group interviews conducted with 45 MSM who engaged in risky sexual behavior (insertive or receptive anal penetration without use of a condom) during the past 12 months. In order to manage the data, a discourse analysis using the constant comparative method was performed in two phases: a) identification of TPB variables and incongruities between this theory and the statements made by the informants, and b) proposal of an alternative psychosocial model that is consistent with the results. RESULTS: The overall appropriateness of the TPB was confirmed, with changes in specific aspects and the introduction of new variables that could be included in subsequent research in order to quantitatively verify the potential increase in the predictive and/or explanatory capacity of the model for risky sexual behavior in MSM. CONCLUSIONS: The results obtained appear to indicate the importance of testing the mathematical assumptions of the TPB model. A stable balance was established between validation of the TPB and suggesting possible changes in specific aspects that could be included in subsequent research to confirm the potential increase in the explanatory capacity of the model for risky sexual behavior in MSM.