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<p>Older people living with HIV/AIDS (PLWHA) (aged ≥ 50 years) face multiple unique challenges. Psychosocial assessment can help identify patients at risk of impaired health-related quality of life (HRQoL). Guiding by the revised model of response shift, this study sought to explore the role of psychosocial variables and response shift in adjustment to compromised HRQoL following HIV/AIDS diagnosis.&#xa0;This study adopted purposive sampling to recruit older PLWHA. Semi-structured interviews were conducted with 32 older PLWHA (60.6 ± 8.4 years old). The time since HIV/AIDS diagnosis ranged from 5 days to 19 years. The design of interview outlines was based on the revised model of response shift as a thematic framework. Verbatim transcripts were analyzed using thematic analysis, and the deductive approach was used to finalize the main findings.&#xa0;The qualitative analysis concluded four themes (<i>significant health events or life experiences; personal and environmental-related stable characteristics; coping and future; response shift and appraisal processes</i>) and eighteen sub-themes. Experiencing catalyst events like HIV/AIDS diagnosis and treatment, psychological mechanisms (e.g., medical coping modes, social comparison) were triggered to accommodate the heath change. The mechanisms an individual adopted were dependent on the personal characteristics (e.g., optimistic and determined personality), and environmental characteristics (e.g., social stigmatization, social support). Older PLWHA also provided narrative examples of how response shift occurs, such as changes in their conceptualization, internal standards, values of HRQoL, and appraisals.&#xa0;Despite the adverse effects of HIV/AIDS, psychosocial variables and response shift could help patients cope positively and facilitate their HRQoL adjustment. Understanding the adjustment processes will have implications for the theory development of response shift, and for older PLWHA’s clinical care and psychosocial assessments focusing on these variables.</p>

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Health-related quality of life among older people living with HIV/AIDS: a qualitative study applied response shift revised model

  • 期刊论文

  • 发表日期：

    2025年1月28日

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  • Renjun Gu,
  • Jing Hu,
  • Lifang Shao,
  • Xiaorong Peng,
  • Huayu Li,
  • Hongmei Wang

摘要

Older people living with HIV/AIDS (PLWHA) (aged ≥ 50 years) face multiple unique challenges. Psychosocial assessment can help identify patients at risk of impaired health-related quality of life (HRQoL). Guiding by the revised model of response shift, this study sought to explore the role of psychosocial variables and response shift in adjustment to compromised HRQoL following HIV/AIDS diagnosis. This study adopted purposive sampling to recruit older PLWHA. Semi-structured interviews were conducted with 32 older PLWHA (60.6 ± 8.4 years old). The time since HIV/AIDS diagnosis ranged from 5 days to 19 years. The design of interview outlines was based on the revised model of response shift as a thematic framework. Verbatim transcripts were analyzed using thematic analysis, and the deductive approach was used to finalize the main findings. The qualitative analysis concluded four themes (significant health events or life experiences; personal and environmental-related stable characteristics; coping and future; response shift and appraisal processes) and eighteen sub-themes. Experiencing catalyst events like HIV/AIDS diagnosis and treatment, psychological mechanisms (e.g., medical coping modes, social comparison) were triggered to accommodate the heath change. The mechanisms an individual adopted were dependent on the personal characteristics (e.g., optimistic and determined personality), and environmental characteristics (e.g., social stigmatization, social support). Older PLWHA also provided narrative examples of how response shift occurs, such as changes in their conceptualization, internal standards, values of HRQoL, and appraisals. Despite the adverse effects of HIV/AIDS, psychosocial variables and response shift could help patients cope positively and facilitate their HRQoL adjustment. Understanding the adjustment processes will have implications for the theory development of response shift, and for older PLWHA’s clinical care and psychosocial assessments focusing on these variables.