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Aim: The purpose of this study was to examine the relationship between self‐efficacy for managing HIV and acceptance of illness and to identify the potential mediation effect of active coping and passive coping on this relationship. Design: The study used a cross‐sectional survey. Methods: A sample of 555 people living with HIV were recruited from September–December 2018 in the HIV clinic of a tertiary general hospital in Changsha, China. Survey data were collected through face‐to‐face interviews that included measures of sociodemographic and HIV‐related clinical characteristics, Acceptance of Illness Scale, the Simplified Coping Style Questionnaire and the Self‐efficacy for Managing Chronic Disease Scale. Step‐by‐step linear regression models combined with bootstrap testing were used to test the relationships when controlling for gender and HIV diagnosis duration. Results: Self‐efficacy was positively related to acceptance of illness and this relationship was partially mediated by both active coping and passive coping. Acceptance of illness increased by 0.175 for every point increase in self‐efficacy indirectly through active coping, while acceptance of illness decreased by 0.034 for every point increase in self‐efficacy via passive coping. Conclusion: The findings highlighted the importance of self‐efficacy for managing HIV and ways of coping, especially active coping, for illness acceptance. Impact: The findings suggested that interventions that improve confidence in managing HIV and active coping may enhance the illness acceptance of people living with HIV. [ABSTRACT FROM AUTHOR]

The article offers information on shifting paradigms to build resilience among patients and families experiencing multiple chronic conditions. Topics include examines that developing feasible, effective and scalable interventions to reduce risk among people with multiple chronic conditions is increasingly urgent as the population ages; and reports that science of multiple chronic conditions is hampered by care, lack of family inclusion, inadequate attention to the social determinants of health.

Background: Disclosing HIV status to HIV-positive children is a major challenge facing families and health care providers. Despite recommendations for disclosure, rates remain low. We tested whether a pediatric HIV disclosure intervention delivered as an integral component of routine HIV health care in Ghana would improve disclosure to children. Methods: Dyads of HIV-infected children aged 7-18 years and their caregivers were enrolled from 2 HIV clinics in Accra and Kumasi, Ghana. The sites were randomly assigned to one of the 2 intervention arms to avoid treatment contamination between intervention and control participants. Trained interventionist used theoryguided therapeutic communication and personalized interaction to promote disclosure. Disclosure outcomes were measured at 12-week intervals. All analyses were completed using a modified intention-totreat approach. Results: We enrolled 446 child-caregiver dyads (N = 240 intervention group; N = 206 control group); 52% of the children were boys, mean age 9.78 (±2.27) years. For disclosure at 1 year, a better overall treatment effect was observed (P < 0.001). Children in the treatment group had greater disclosure at each time point (P < 0.001) and a higher proportion of them had been disclosed to by 1 year (51.4% vs. 16.2%; P < 0.001; un-adjusted hazard ratio = 3.98: 95% confidence interval: 2.63 to 6.03) and 3 years (71.3% vs. 34.0%; unadjusted hazard ratio = 4.21: 95% confidence interval: 3.09 to 5.72). In the multivariate Cox model, factors associated with disclosure were treatment group (P < 0.001), children <11 years of age (P < 0.001), HIV-infected caregivers (P = 0.015), and caregiver's with greater education (P = 0.022). Conclusions: This practical clinic-based disclosure intervention shows excellent promise as a means of improving HIV pediatric disclosure outcomes. [ABSTRACT FROM AUTHOR]

To assess the prevalence and correlates of perinatal depression, 200 HIV-positive pregnant/post-partum women receiving antiretroviral therapy (ART) were interviewed at eight government ART centers in four states across India. 52.5% (105) participants had depressive symptomology (Edinburgh Postnatal Depression Scale score > 13) while 23% of the participants reported thoughts of self-harm; there was no difference between pregnant and postpartum participants. Poor illness perception was associated with depression (AOR, 1.09; 95%CI, 1.05, 1.14); there was no association between adherence and depression in this population. [ABSTRACT FROM AUTHOR]

China is experiencing a rapid increase in the number of HIV-infected women. In this study, we describe the development and preliminary evaluation of an intervention tailored for Chinese HIV-infected women and caregivers to improve their self- and family management, with goals of enhancing their physical quality of life (QOL) and decreasing their depressive symptomatology. Forty-one HIV-infected women and their caregivers were recruited from two premier Chinese hospitals from July 2014 through March 2016. Participants were randomized to either the control or intervention arm for the Self- and Family Management Intervention (SAFMI). Each study dyad in the intervention arm received three counseling sessions with a nurse interventionist. At baseline, immediate post-intervention (month 1) and follow-up (month 3), the participants were assessed by a self-reported survey. Generalized Hierarchical Linear Modeling was used to evaluate the efficacy of the intervention. Chinese HIV-infected women in the intervention arm had significantly higher probability of higher physical QOL at month 1 and lower probability of clinically meaningful depressive symptomatology at month 3 compared with women in the control arm. In contrast, the effects of the intervention were less salient for caregivers. This study represents one of the first in China to include family caregivers in HIV management. Feasibility and acceptability were high, in that family members were willing to join the study, learn about HIV, and practice new skills to support the HIV-infected women in their lives. A larger trial is needed to fully evaluate this intervention which shows promising preliminary effects in promoting physical QOL and decreasing depressive symptomatology among Chinese HIV-infected women. [ABSTRACT FROM AUTHOR]

The article offers information on the growth and impact of advanced nursing practice (NPs) continues throughout the world in the U.S. and China. It mentions that there are over 4.1 million Registered Nurses in China providing healthcare services to 1.4 billion people; and also mentions that NPs are increasingly regarded in both countries as the solution to bridge the healthcare gap.

This qualitative study assessed psychosocial concerns that rural women with HIV who had multiple psychosocial vulnerabilities were able to express and communicate during a mobile phone intervention delivered by nurses. The study is part of a pilot randomised controlled trial of an mHealth self-care intervention by nurses for women living with HIV in rural India. For the trial, 60 women were randomised to receive the mHealth intervention. All calls were recorded and call logs were maintained. Call logs of 59 women based on 1186 calls were scanned for psychosocial themes. Audio recordings of 400 calls rich in content were then transcribed and translated for analysis. Themes and subthemes were identified by two independent raters. Majority of the women had low literacy and more than half were widowed. Clinical depression was found in 18.6%. Of the 1186 call logs analysed, 932 calls had a record of at least one psychosocial concern and 493 calls recorded two psychosocial concerns. Some of the major themes that women discussed with nurses included worries about their own and their children’s future; loneliness; stigma; inadvertent disclosure; death and dying; abandonment by partner; financial difficulties; body image; poor social support; emotions such as sadness, guilt, and anger; and need for social services. Almost all expressed appreciation for the intervention. Findings indicate the usefulness of mHealth-based self-care interventions delivered by nurses in hard to reach women in low- and middle-income countries, especially those with multiple psychosocial vulnerabilities. [ABSTRACT FROM AUTHOR]