ABSTRACT
OBJECTIVES: The objective of this study was to identify and describe ways that a spiritually based intervention of silently repeating a mantram-sacred word or phrase-was used as a coping strategy for managing human immunodeficiency virus (HIV) disease. DESIGN: The design was a qualitative research method, the critical incident technique. SETTINGS/LOCATION: The study was conducted at an academically affiliated Veterans Affairs Hospital in southern California. SUBJECTS: The subjects were outpatient adults living with HIV (n=32) who were receiving care through HIV clinics, community agencies, and HIV providers. INTERVENTIONS: Subjects who participated in the intervention arm of a randomized controlled trial that tested the efficacy of a 5-weekly group mantram intervention were interviewed 2 months postintervention. Follow-up telephone interviews were specifically aimed at identifying instances of mantram use, and also participant perceptions of intervention usefulness or nonusefulness. OUTCOME MEASURES: The outcome measures comprised categorization and comparison of the types and frequency of incidents reported, describing ways that the intervention was "helpful" or "not helpful" in managing stressors of HIV disease. RESULTS: Participants reported a total of 185 incidents. Analysis and classification of the incidents resulted in eight mutually exclusive categories, including Increasing calm and/or peace, Mastering the technique, Changing my viewpoint, Increasing personal awareness, Adjusting behaviors, Managing physical symptoms, Increasing spirituality, and Enhancing relationships. CONCLUSIONS: This study shows support for the benefits of the mantram intervention for adults with HIV. Additionally, the spiritually based mantram repetition intervention was found to be more helpful in providing a convenient, portable tool for managing a wide range of situations related to living with HIV disease.
Subject(s)
HIV Infections/psychology , Mind-Body Therapies , Quality of Life , Stress, Psychological , Adult , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
We examined the efficacy of a psycho-spiritual intervention of mantram repetition--a word or phrase with spiritual associations repeated silently throughout the day--on psychological distress (intrusive thoughts, stress, anxiety, anger, depression), quality of life enjoyment and satisfaction, and existential spiritual well-being in HIV-infected adults. Using a 2-group by 4-time repeated measures design, 93 participants were randomly assigned to mantram (n = 46) or attention control group (n = 47). Over time, the mantram group improved significantly more than the control group in reducing trait-anger and increasing spiritual faith and spiritual connectedness. Actual mantram practice measured by wrist counters was inversely associated with non-HIV related intrusive thoughts and positively associated with quality of life, total existential spiritual well-being, meaning/peace, and spiritual faith. Intent-to-treat findings suggest that a mantram group intervention and actual mantram practice each make unique contributions for managing psychological distress and enhancing existential spiritual well-being in adults living with HIV/AIDS.
Subject(s)
HIV Infections/psychology , Meditation , Religion and Psychology , Spirituality , Adaptation, Psychological , Adult , Anger , Antiretroviral Therapy, Highly Active/psychology , CD4 Lymphocyte Count , Depression/psychology , Female , Follow-Up Studies , HIV Infections/therapy , HIV-1/genetics , Humans , Male , Middle Aged , Outcome Assessment, Health Care , Practice, Psychological , RNA, Viral/genetics , Stress, Psychological/complications , Viral LoadABSTRACT
There has been a lack of research regarding nonpharmacologic interventions in heart failure. The objective was to determine the effect of behavioral management on health related quality of life (HRQL) in patients with heart failure. Participants (N = 116) were randomly assigned to one of two groups: usual care for heart failure (n = 58) and the 15-week behavioral management program (n = 58). Outcomes included exercise performance (6-min walk), physical and mental functioning (SF-36), general health perceptions (SF-36), and disease specific HRQL (Minnesota Living with Heart Failure Questionnaire-MLHF). Outcomes were assessed at baseline, 4, 10 and 16 months. Participants were mostly male (95%) and Caucasian (75%), with a mean age of 67 years (S.D. = 10). Intervention patients showed significantly improved self-reported disease specific HRQL (MLHF physical dimension scores) over time compared to control patients. There were no group differences in exercise performance, physical functioning, mental functioning or general health perceptions.
