Finding meaning in life while living with HIV: validation of a novel HIV meaningfulness scale among HIV-infected participants living in Tennessee.

BACKGROUND: People living with HIV who maintain a positive outlook on their future may manage stress better than those who do not, leading to improved coping behaviors and better health outcomes. METHODS: While studying 125 HIV+ adults participating in two clinical trials of expressive writing we assessed their HIV-specific meaningfulness of life with a short, unidimensional scale (the HIVMS). RESULTS: The HIVMS had a strong Cronbach's alpha (0.80) and acceptable test-retest reliability (0.70). HIVMS scores were strongly correlated with measures of perceived control, optimism, and psychological well-being. Participants with lower HIVMS scores had higher probability of non-adherence to antiretroviral medication, suggesting a decreased ability to manage their illness successfully. Neither the control nor expressive writing intervention groups showed increased HIVMS scores. CONCLUSIONS: Future research is necessary to determine the effect of HIV meaning on long-term health outcomes and to develop interventions that can significantly improve a person's perception of their meaning in life.

The Perceived Medical Condition Self-Management Scale applied to persons with HIV/AIDS.

The Perceived Medical Condition Self-Management Scale (PMCSMS), a generic instrument developed to assess self-management self-efficacy in specific medical conditions, was tailored for use with HIV+ individuals and administered to 125 HIV+ adults, predominantly men. Cronbach's alpha was 0.78, indicating internal consistency reliability. Correlations between the Perceived HIV Self-Management Scale (PHIVSMS) and other validated psychometric instruments measuring generalized self efficacy, dispositional optimism, depressive symptoms, positive and negative affect and HIV quality of life demonstrate the validity of using this scale with an HIV population. The PMCSMS has broad utility as a generic template that can easily be adapted to different medical conditions.

Cognitive adaptability as a moderator of expressive writing effects in an HIV sample.

This study explored the effects of expressive writing on positive and negative outcomes related to perceived psychosocial and health status among persons with HIV. This was the first study to examine the moderating effects of cognitive adaptability--consisting of dispositional optimism coupled with perceived competence--on outcomes of expressive writing. Thirty-seven participants wrote about either traumatic experiences or trivial topics in four 20-min sessions. Dependent measures obtained at baseline were repeated 1 month later. Although no main effects for group were found, baseline levels of cognitive adaptability were differentially associated with changes in a positive outcomes index, and a pain and physical functioning index in those assigned to the two groups. No moderating effects of cognitive adaptability were found for changes in a negative outcomes index. Findings underscore the importance of identification of moderating variables in understanding the impact of expressive writing interventions among individuals with HIV or other conditions.