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ABSTRACT: Research has revealed differences on scales measuring HIV knowledge between individuals from various ethnic backgrounds and cultures. Few studies have examined this knowledge with immigrant populations and persons living with HIV. This study examined HIV knowledge among persons living with HIV who were either born in Canada or in sub-Saharan Africa and, for comparison, in a sample of college students. All participants were residing in Canada. Participants completed questionnaires measuring demographic variables, sexual health behaviour, and HIV status, treatment, and knowledge. Canadian-born patients living with HIV were more likely to be older and male than the other groups. On average, patients living with HIV were diagnosed 6.4 years ago, and 80% reported having current or previous experience taking HIV medications. After adjusting for age and gender, significant differences were found between the groups on the Brief HIV Knowledge Questionnaire. Canadian-born persons living with HIV (n = 110) scored higher than sub-Saharan African-born patients (n = 23) and college students (n = 81); mean percentage correct was 86, 70, and 62%, respectively (P < .01). These results suggested that ongoing HIV education is needed for all groups, and that additional tailored and targeted educational interventions are needed to address important gaps in knowledge among persons living with HIV patients originating from Africa and among college students.
Journal of Immigrant and Minority Health 06/2011; 14(1):132-9. · 1.16 Impact Factor
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ABSTRACT: There is a paucity of service research on the effectiveness of short-term mental health clinics.
To outline the development of the Urgent Consultation Clinic (UCC), an inter-professional, short-term, mental health program in a general hospital, and to evaluate the effectiveness of the UCC from a quality improvement perspective.
Participants (n = 143) completed a battery of validated measures assessing psychological and physical symptoms, quality of life, life satisfaction, and satisfaction with services at three time-points. Inter-professional team members rated participants' overall functioning and severity of mental health problems at intake and termination.
The median time from referral to initial UCC visit was 12 days. A significant decline in the severity of mental health symptoms was observed, with 87% of participants reporting clinically elevated symptoms at intake compared to 71% at termination. Significant improvements were observed in life satisfaction, overall functioning, and mental quality of life. Sixty-nine percent of participants rated the quality of services as good or excellent.
The UCC model of care contributed to improved access to psychiatric evaluation and short-term treatment. This inter-professional model could be applied to other health care settings to meet the needs of patients requiring acute psychiatric services.
Journal of Mental Health 02/2011; 20(1):5-14. · 1.01 Impact Factor
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ABSTRACT: Hepatitis C virus (HCV) is silently becoming a major public health problem. Currently, no validated HCV knowledge measures exist. This study aimed to develop and validate a brief measure to assess general knowledge about HCV risk factors, modes of transmissions, and treatment options. A total of 406 individuals participated in this cross-sectional study. All participants completed the proposed 19-item Brief HCV Knowledge Scale. Participants were: HCV mono-infected patients (n = 83), HCV-human immunodeficiency virus (HIV) co-infected patients (n = 24), HIV mono-infected patients (n = 128) community healthcare workers (n = 89), and college students (n = 82). Two-week test-retest data were collected for the college student sample. Psychometric evaluation of the proposed scale demonstrated high levels of validity (content and construct validity) and reliability (internal consistency and retest stability). Factor analysis indicated a one-factor solution, which accounted for 49% of the variance. HCV knowledge was positively correlated with length of time since HCV diagnosis (r = 0.29, p < 0.05). HCV treatment-experienced patients obtained significantly higher HCV knowledge scores (82% correct) than HCV treatment-naïve patients (72% correct) (p < 0.05). HCV knowledge in College students (43% correct) and HIV patients (54% correct) was significantly lower than in HCV patients (77% correct) and community healthcare workers (80% correct) (p < 0.001). Community workers' HCV knowledge was positively correlated with years of HCV work experience (r = 0.30, p < 0.01). This self-administered Brief HCV Knowledge scale has high levels of validity and reliability across patient, healthcare provider and college student populations. It has valuable applications as a clinical teaching tool with patients and healthcare providers and could be used as an outcome indicator in novel HCV educational intervention studies.
Scandinavian Journal of Caring Sciences 06/2009; 23(4):801-8. · 0.89 Impact Factor
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ABSTRACT: With increased life expectancy of individuals living with HIV, quality of life (QOL) has become a focus of treatment. More research is needed to address pain-related QOL and modifiable variables, such as health behaviors, depressive symptoms, and coping styles, which could be included in treatment protocols to improve QOL among individuals with HIV. Objectives of this study were to (1) examine relationships among health behaviors, psychological variables, and QOL, particularly pain-specific QOL, (2) examine the relationships among coping, depressive symptoms, and QOL, and (3) compare QOL scores of individuals with HIV and population-based normative data. HIV positive men and women not currently on highly active antiretroviral therapy were recruited during regular visits to an HIV outpatient clinic. They completed the Medical Outcome Study Health Survey SF-36 scale, which includes a physical components scale, a mental components scale, and a bodily pain subscale. They also completed questionnaires assessing health behaviors, depressive symptoms, and coping styles. Participants (n=97) scored significantly lower on most aspects of QOL than age-matched Canadian and U.S. norms. Hierarchical multiple regressions revealed that physical activity and CD4 cell count were independently related to lower physical components scale scores; smoking and depressive symptoms were independently associated with lower mental components scale scores; and education, physical activity, and depressive symptoms were independently associated with lower pain-related QOL. Depressive symptoms mediated the relationship between coping styles and the mental components scale and pain-related QOL. Results suggest that targeting depressive symptoms, physical activity, and coping strategies as part of comprehensive treatment protocols could help improve pain-specific QOL and overall QOL among individuals with HIV.
Journal of pain and symptom management 05/2008; 36(3):247-58. · 2.42 Impact Factor
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ABSTRACT: Excellent medication adherence (>95%) is required for optimal HIV treatment success. This study aimed to develop and validate a brief scale to assess psychological readiness for successfully starting and adhering to HIV medications. HIV-positive men and women (N = 142) from an HIV outpatient clinic completed the proposed HIV Medication Readiness Scale (HMRS) prior to starting HIV medications. The 10-item HMRS demonstrated high internal consistency (alpha = .90), test-retest reliability (r = .83), and sensitivity to change following a standardized 4-session psychoeducational intervention designed to increase readiness for successful adherence. Predictive validity was supported by higher readiness scores on the day starting HIV medications, predicting higher treatment adherence at 1-month follow-up. The HMRS is a brief, easy-to-use, clinically relevant tool that can assist in identifying people living with HIV at high risk of nonadherence, who might benefit from tailored readiness counseling prior to initiating HIV medications.
Assessment 12/2007; 14(4):408-16. · 2.01 Impact Factor
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ABSTRACT: The majority of North American women are insufficiently active. Using an ecological approach to examine physical activity behavior in a sample of middle-aged and older women, this study aimed to (1) describe barriers to physical activity behavior change as well as environmental characteristics present in their neighborhoods, (2) examine relationships between barriers and physical activity behavior change, and (3) investigate environmental characteristics that may contribute to physical activity behavior change. Participants were 149 women ranging in age between 39 and 68. At Time 1, self-reported physical activity was assessed. Six months later (Time 2), barriers and environmental characteristics were measured, and physical activity was re-assessed. The most prevalent barriers were daily activities and fatigue. Over time, inactive women reported higher levels of barriers (e.g. fatigue, lack of interest in physical activity) than women who remained active or increased their physical activity level. Certain environmental characteristics (e.g. enjoyable scenery, seeing others exercising in their neighborhood) are suggested as potential contributors to physical activity behavior change.
Journal of Behavioral Medicine 07/2007; 30(3):233-42. · 3.10 Impact Factor
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ABSTRACT: The purpose of this study was to propose and test a model of attachment insecurity in a clinical sample of 268 eating disordered women. Structural relationships among attachment insecurity, BMI, perceived pressure to diet, body dissatisfaction, restrained eating, and negative affect were assessed. A heterogeneous sample of treatment seeking women with a diagnosed eating disorder completed psychometric tests prior to receiving treatment. The data were analysed using structural equation modeling. Fit indices indicated that the hypothesized model fit adequately to the data. Although cross-sectional in nature, the data suggested that attachment insecurity may lead to negative affect. As well, attachment insecurity may lead to body dissatisfaction, which in turn may lead to restrained eating among women with eating disorders. Attachment insecurity could be a possible vulnerability factor for the development of eating disorder symptoms among women.
Eating Behaviors 09/2006; 7(3):252-7. · 1.58 Impact Factor
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ABSTRACT: Many people living with chronic viral hepatitis C (HCV) report reduced health-related quality of life. The relative contribution of behavioural, psychosocial and HCV disease factors to reduction in HCV health-related quality of life is not well understood. The objectives of the present study were to compare standardized health-related quality of life scores between Canadian HCV patients and age-matched Canadian and American norms, and to examine the relative contribution of biopsychosocial variables (ie, cigarette smoking, alcohol intake and depression) to health-related quality of life scores among Canadian HCV patients.
HCV RNA-positive patients were recruited during their first visit to the Ottawa Hospital Viral Hepatitis Clinic (Ottawa, Ontario). A questionnaire assessing health behaviours, health-related quality of life and depressed mood was completed. Data on liver studies, liver biopsy findings and HIV serostatus were also collected.
A total of 123 participants (71% men) ranging from 20 to 67 years of age were evaluated. All had compensated liver function. Patients reported significantly lower health-related quality of life compared with age-matched Canadian and American normative samples. In a series of hierarchical multiple regression models, depression and smoking were independently related to compromised health-related quality of life scores, even after controlling for sociodemographic variables and health behaviours.
These results highlight the value of adopting a biopsychosocial model of HCV care. Depressed mood and smoking behaviour should be evaluated in HCV patients. Empirically validated psychological and pharmacological treatments for depression and smoking cessation may improve health-related quality of life in HCV infected patients.
Canadian journal of gastroenterology = Journal canadien de gastroenterologie 03/2006; 20(2):81-6. · 1.21 Impact Factor
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ABSTRACT: The onset of chronic illness is one of the most pervasive health problems facing North Americans today. Only recently have researchers and clinicians seriously examined chronic physical conditions in the context of close relationships. This article briefly reviews the literature on chronic illness in adult couples. Initially, the focus is on the reciprocal link between close relationships and chronic physical conditions. A number of clinical approaches for working with chronic illness in couples are outlined, a particular case is made for the utility of emotionally focused therapy, and a case study is presented.
Journal of Marital and Family Therapy 08/2003; 29(3):299-310. · 1.01 Impact Factor
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ABSTRACT: To define self-reported hepatitis C knowledge, health care needs, and patient satisfaction in a representative cohort of hepatitis C virus (HCV)-infected adults treated at a university hospital-based viral hepatitis clinic in Canada.
A questionnaire package evaluating HCV knowledge, health care needs, and patient satisfaction was administered to 111 consecutive consenting HCV patients during their first and 10-month follow-up HCV clinic visits.
At their first HCV clinic visit, 52% of patients rated their current HCV knowledge as "fair" or "poor". Patients identified HCV education, quality medical care, medication coverage, and psychological counselling as important HCV health care needs. Health care satisfaction outcome data at 10-month follow-up indicated that patients felt significantly better informed, more satisfied, and more actively involved in their HCV health care.
A bio-psychosocial framework in which medical, psychological, educational, and social issues are addressed is desirable for optimal HCV health care.
Canadian journal of public health. Revue canadienne de santé publique 95(4):272-7. · 1.02 Impact Factor
