Gladys Eugenia Canaval

Symptom management and self-care for peripheral neuropathy in HIV/AIDS.

Abstract Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of peripheral neuropathy in HIV disease, sociodemographic and disease-related correlates and self-care strategies. A convenience sample of 1,217 respondents was recruited from data collection sites in several US cities, Puerto Rico, Colombia and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified 20 self-care behaviors including complementary therapies, use of medications, exercise and rest and/or elevation of extremities. Ratings of frequency and effectiveness were also included. An activities checklist summarized into five categories of self-care behaviors including activities/thoughts, exercise, medications, complementary therapies and substance was used to determine self-care behaviors. Taking a hot bath was the most frequent strategy used by those with peripheral neuropathy (n=292) and received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.1 (scale 1–10). Other self-care strategies to manage this symptom included: staying off the feet (n=258), rubbing the feet with cream (n=177), elevating the feet (n=236), walking (n=262), prescribed anti-epileptic agent (n=80), prescribed analgesics (n=84), over-the-counter medications (n=123), vitamin B (n=122), calcium supplements (n=72), magnesium (n=48), massage (n=156), acupuncture (n=43), reflexology (n=23) and meditation (n=80). Several behaviors that are often deemed unhealthy were included among the strategies reported to alleviate peripheral neuropathy including use of marijuana (n=67), cigarette smoking (n=139), drinking alcohol (n=81) and street drugs (n=30).

Does "Asymptomatic" Mean Without Symptoms for Those Living with HIV Infection?

Abstract Throughout the history of the HIV epidemic, HIV-positive patients with relatively high CD4 counts and no clinical features of opportunistic infections have been classified as “asymptomatic” by definition and treatment guidelines. This classification, however, does not take into consideration the array of symptoms that an HIV-positive person can experience long before progressing to AIDS. This short report describes two international multi-site studies conducted in 2003–2005 and 2005–2007. The results from the studies show that HIV-positive people may experience symptoms throughout the trajectory of their disease, regardless of CD4 count or classification. Providers should discuss symptoms and symptom management with their clients at all stages of the disease.

Marijuana Effectiveness as an HIV Self-Care Strategy

Persons living with HIV/AIDS use self-care for symptom management. This study assesses the use of marijuana as a symptom management approach for six common symptoms for persons living with HIV/AIDS--anxiety, depression, fatigue, diarrhea, nausea, and peripheral neuropathy. This sub-analysis of the efficacy of a symptom management manual encompasses the experiences of participants from sites in the U.S., Africa, and Puerto Rico. Baseline data are analyzed to examine differences in the use and efficacy of marijuana as compared with prescribed and over-the-counter medications as well as the impact on adherence and quality of life.

Unhealthy behaviours for self-management of HIV-related peripheral neuropathy

Abstract The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with antiretroviral therapy. Unhealthy behaviours, particularly substance-use behaviours, are utilized by many HIV-positive individuals to manage neuropathic symptoms. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of unhealthy behaviours to self-manage peripheral neuropathy in HIV disease. Sociodemographic and disease-related correlates and unhealthy behaviours were examined in a convenience sample of 1,217 respondents who were recruited from data collection sites in several US cities, Puerto Rico, Colombia, and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified a variety of unhealthy self-care behaviours including injection drug use, oral drug use, smoking cigarettes and alcohol ingestion. Specific unhealthy behaviours that participants reported to alleviate peripheral neuropathy included use of marijuana (n=67), smoking cigarettes (n=139), drinking alcohol (n=81) and street drugs (n=30). A subset of those individuals (n=160), who identified high levels of neuropathy (greater than five on a scale of 1–10), indicated significantly higher use of amphetamines and injection drug use in addition to alcohol use and cigarette smoking. For participants from Norway, substance use (using alcohol: 56%) was one of the most frequent self-management strategies. Implications for clinical practice include assessment and education of persons with HIV for self-care management of the complex symptom of peripheral neuropathy.

Age-related effects on symptom status and health-related quality of life in persons with HIV/AIDS

Health-related quality of life (HRQOL) is linked to symptom status and may be related to age in HIV-positive persons. Data were collected in a multisite HIV-positive sample (N = 1,217) using an HIV-specific HRQOL and three symptom status instruments according to the Wilson and Cleary HRQOL model. Multiple stepwise linear regression analysis found that younger age predicted higher sexual function (ΔR(2) = .12, p < .01) and older age predicted greater provider trust (ΔR(2) = .04, p < .01). No significant differences were found in symptom status or the other seven HRQOL dimensions. Although older HIV-positive persons reported more comorbidities, they did not report more symptoms.

Espiritualidad y resiliencia en mujeres maltratadas que denuncian su situación de violencia de pareja

Introducción: Entender qué tan resilientes y espirituales son las mujeres maltratadas y la relación entre las dos variables ayuda a ampliar la comprensión que se tiene de la respuesta humana a situaciones de violencia de pareja. El modelo de manejo de síntomas guió la investigación. Pregunta de investigación: ¿Cuál es el grado de espiritualidad y resiliencia que muestran las mujeres maltratadas y cómo se relacionan estas variables? Objetivos: Generales. Examinar la relación entre espiritualidad y resiliencia en mujeres maltratadas que denuncian su situación en Comisarías de Familia de la ciudad de Cali, Colombia. Específicos: 1. Identificar el grado de espiritualidad y de resiliencia que poseen las mujeres maltratadas. 2. Establecer si existe o no relación entre la espiritualidad y la resiliencia en mujeres maltratadas. Materiales y métodos: Diseño correlacional con una muestra a propósito de 100 mujeres, que denuncian situaciones de violencia de pareja ante las Comisarías de Familia de Cali, Colombia. Se aplicó la escala de perspectiva espiritual y la de resiliencia. Resultados: La edad de las mujeres osciló entre 18 y 65 años, promedio igual a 36.5+10.4. El promedio de la escala de espiritualidad fue 4.8+0.48. La escala de resiliencia obtuvo un promedio de la suma total de 143.3+19.07. La correlación de Pearson entre espiritualidad y resiliencia fue de r=0.301 p=0.004. Discusión: Los resultados son consistentes con los informes de la literatura en este campo. La correlación entre espiritualidad y resiliencia señala una relación positiva y significativa e indica que resiliencia y espiritualidad son fenómenos diferentes pero relacionados. Se propone que enfermería juegue un papel preponderante en alentar a las mujeres a expresar sus creencias y practicas espirituales. Conclusión: La espiritualidad y la resiliencia de las mujeres del estudio son altas. Estos hallazgos indican la necesidad de valorar la espiritualidad y la resiliencia e identificar los recursos de apoyo que las mujeres poseen. Se recomienda realizar intervenciones que aumenten las fortalezas de las mujeres maltratadas.

Translation and Adaptation of the Life Stressor Checklist-Revised With Colombian Women

We undertook the translation and adaptation of an instrument developed to measure womens lifetime trauma exposure, the Life Stressor Checklist-Revised (LSC-R), in order to determine its utility and cultural appropriateness with Colombian Spanish-speaking women. The LSC-R was forward and backward translated and administered to a sample (N = 217) of community-based women volunteers in Medellín, Colombia. Open-ended questions were included to assess the construct validity and cultural appropriateness of the LSC-R. The LSC-R was found to be valid and easily understood. Trauma exposure was common, but its assessment was not overly distressing to Colombian women.

FACTORES PROTECTORES Y DE RIESGO PARA VIH/SIDA EN MUJERES DE CALI, COLOMBIA

The purpose of this study was to contribute with the health promotion of women from Cali city, in addition to sensitize to participants women about HIV/AIDS and others ITS’ problem. The goals were 1. To explore risks factors for HIV/AIDS and protective factors in women participants of this study 2. To determine the vulnerability and perception of risk for HIV/STI of women. IT was used a transversal design with survey. The total sample was 312 women from 21 Comunas of Cali, age range between 12 and 76 years. Of those 61% were sexually active; 84% reported heterosexual encounters, 11% of women had sex with more than one person in the previous 12 months: 45% perceived sexual partner’s infidelity, 51% of women from the sample felt comfortable talking with their sexual partner about their sexual life, these percentage decreased to 40% when they talked about their needs in the relationship and declined to 29% when they talked about another sexual partner. Vulnerability to

The Relationship of Two Types of Trauma Exposure to Current Physical and Psychological Symptom Distress in a Community Sample of Colombian Women: Why Interpersonal Violence Deserves More Attention

Our purpose in this study was to examine the relationship between interpersonal violence and background traumas and symptom distress in a community sample of Colombian women (N = 217). We utilized the Life Stressor Checklist-Revised (LSC-R) to measure lifetime interpersonal violence (IPV) and background trauma exposure and the Brief Symptom Inventory (BSI) to measure current symptom distress. Although both exposures were common in this sample, IPV was strongly correlated with current symptom distress; background traumas made no unique contribution to the variance in current symptom distress. Based on our findings, it is suggested that interpersonal events may be particularly distressing.

Trauma Exposure Among Women in the Pacific Rim

PURPOSE Healthcare professionals who provide services in the immediate or long-term aftermath of traumatic events need to understand the nature and frequency of traumatic events in the lives of women. However, research on trauma exposure in women has only recently begun to assess events other than intimate partner and sexual violence and has not supported direct statistical comparison of cross-national and cross-cultural data. The purpose of this descriptive, correlational study was to describe and compare trauma exposure prevalence and type in community-based samples of women in the United States, Colombia, and Hong Kong. DESIGN Women were recruited through posted notices at community health sites, snowball sampling, and online advertisements (N = 576). The Life Stressor Checklist-Revised (total score range 0 to 30) was used to determine the type and prevalence of trauma exposure. Data were collected by native language members of the research team. METHODS Descriptive statistics were used to summarize demographic characteristics and trauma exposure for the total sample and each community-based sample (location). Between-location differences were tested using Fishers exact tests for categorical measures and general linear models with pairwise a posteriori least squares t-test for continuous measures. Responses to open-ended questions were translated and categorized. FINDINGS Over 99% of women in the total sample reported at least one traumatic life event. The mean number of traumatic life events per participant was 7, ranging from 0 to 24. Although there was consistency in the most commonly reported trauma exposures across locations, the rates of specific events often differed. CONCLUSIONS Historical, political, geographic, and cultural factors may explain differences in trauma exposure among women in the four locations studied. CLINICAL RELEVANCE This study offers relevant knowledge for providers in diverse locations who provide services to women who have experienced traumatic events and provides evidence for the need for future research to further enhance knowledge of trauma exposure among women, and on the effects of trauma in womens lives.