Background: People living with HIV (PLWH) today have to deal with a chronic condition that requires efficient self-management due to increased longevity. Self-management interventions have been shown to improve physical and psychological symptoms as well as clinical results in chronic diseases. However, few studies have investigated the effect of self-management on quality of life (QOL) among PLWH in Indonesia.
Objective: To examine the effect of a self-management program on QOL among PLWH in Indonesia.
Methods: This was a quasi-experimental study with a comparison group in a general hospital in Jakarta, Indonesia. Of the 114 recruited PLWH, 57 were assigned to the intervention group and 57 to the comparison group. The self-management group attended a four-week program workshop. The intervention consisted of five sessions: need assessment and goal setting, maintaining a healthy lifestyle, educational participation to increase communication and self-esteem, and evaluation. The comparison group received standard educational material throughout the leaflet regarding HIV prevention. The post-test assessment was conducted immediately after intervention (T1) and two months (T2) after the intervention in both groups. QOL was measured using the World Health Organization Quality of Life (WHOQOL)-HIV brief Bahasa version. The estimations were obtained using fixed-effect regressions. The differences between T0, T1, and T2 for the intervention and comparison groups were evaluated and compared using the DI Differences method (DID).
Results: The self-management program improved outcomes relative to the comparison group at T1: 1) overall QOL score increased 8.7% (95% CI 0.021–0.149), 2) physical domain saw a modest increased 8.8% (95% CI 0.017–0.125), 3) psychological domain increased 23.5 % (95% CI 0.085–0.689), and 4) environmental domain showed a modest increase of 18.7% (95% CI 0.053–0.371). At T2, the total QOL score and the physical, psychological, and environmental dimensions were significantly improved compared to the comparison group.
Conclusion: The self-management program appears to improve the QOL of the life of PLWH. Nurses are advised to provide PLWH with self-management training. Future research on self-management intervention would need to be refined further to ensure that each community achieves consistent intervention outcomes.
Copyright (c) 2021 Achmad Fauzi, Nofa Anggraini, Novy Fatkhurohman
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Article MetricsAbstract views: 484 | PDF views: 325
Areri, H. A., Marshall, A., & Harvey, G. (2020). Interventions to improve self-management of adults living with HIV on antiretroviral therapy: A systematic review. PloS One, 15(5), e0232709. https://doi.org/10.1371/journal.pone.0232709
Bravo, P., Edwards, A., Rollnick, S., & Elwyn, G. (2010). Tough decisions faced by people living with HIV: A literature review of psychosocial problems. Aids Review, 12(2), 76-88.
Cooper, V., Clatworthy, J., Harding, R., & Whetham, J. (2017). Measuring quality of life among people living with HIV: A systematic review of reviews. Health and Quality of Life Outcomes, 15(1), 1-20. https://doi.org/10.1186/s12955-017-0778-6
Cutrono, S. E., Lewis, J. E., Perry, A., Signorile, J., Tiozzo, E., & Jacobs, K. A. (2016). The effect of a community-based exercise program on inflammation, metabolic risk, and fitness levels among persons living with HIV/AIDS. AIDS and Behavior, 20(5), 1123-1131. https://doi.org/10.1007/s10461-015-1245-1
ElZarrad, M. K., Eckstein, E. T., & Glasgow, R. E. (2013). Applying chronic illness care, implementation science, and self-management support to HIV. American Journal of Preventive Medicine, 44(1), S99-S107. https://doi.org/10.1016/j.amepre.2012.09.046
Engelhard, E. A. N., Smit, C., Van Dijk, P. R., Kuijper, T. M., Wermeling, P. R., Weel, A. E., . . . Nieuwkerk, P. T. (2018). Health-related quality of life of people with HIV: An assessment of patient related factors and comparison with other chronic diseases. Aids, 32(1), 103-112. https://doi.org/10.1097/QAD.0000000000001672
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G* Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149-1160. https://doi.org/10.3758/BRM.41.4.1149
Franek, J. (2013). Self-management support interventions for persons with chronic disease: An evidence-based analysis. Ontario Health Technology Assessment Series, 13(9), 1.
Ghiasvand, H., Higgs, P., Noroozi, M., Ghaedamini Harouni, G., Hemmat, M., Ahounbar, E., . . . Armoon, B. (2020). Social and demographical determinants of quality of life in people who live with HIV/AIDS infection: Evidence from a meta-analysis. Biodemography and Social Biology, 65(1), 57-72. https://doi.org/10.1080/19485565.2019.1587287
Handayani, S., Ratnasari, N. Y., Husna, P. H., & Susanto, T. (2019). Quality of life people living with HIV/AIDS and its characteristic from a VCT centre in Indonesia. Ethiopian Journal of Health Sciences, 29(6), 759–766. https://doi.org/10.4314/ejhs.v29i6.13
Iribarren, S., Siegel, K., Hirshfield, S., Olender, S., Voss, J., Krongold, J., . . . Schnall, R. (2018). Self-management strategies for coping with adverse symptoms in persons living with HIV with HIV associated non-AIDS conditions. AIDS and Behavior, 22(1), 297-307. https://doi.org/10.1007/s10461-017-1786-6
Jaggers, J. R., Snead, J. M., Lobelo, F., Hand, G. A., Dudgeon, W. D., Prasad, V. K., . . . Blair, S. N. (2016). Results of a nine month home-based physical activity intervention for people living with HIV. International Journal of Clinical Trials, 3(3), 106-119. http://dx.doi.org/10.18203/2349-3259.ijct20162793
Khumsaen, N., & Stephenson, R. (2019). Feasibility and acceptability of an HIV/AIDS self-management education program for HIV-positive men who have sex with men in Thailand. AIDS Education and Prevention, 31(6), 553-566. https://doi.org/10.1521/aeap.2019.31.6.553
Lindayani, L., Chen, Y.-C., Wang, J.-D., & Ko, N.-Y. (2018a). Complex problems, care demands, and quality of life among people living with HIV in the antiretroviral era in Indonesia. Journal of the Association of Nurses in AIDS Care, 29(2), 300-309. https://doi.org/10.1016/j.jana.2017.10.002
Lindayani, L., Darmawati, I., Purnama, H., & Permana, B. (2020). Integrating comprehensive geriatric assessment into HIV care systems in Indonesia: A synthesis of recent evidence. Creative Nursing, 26(1), 9-16. https://doi.org/10.1891/1078-4518.104.22.168
Lindayani, L., Ibrahim, K., Wang, J.-D., & Ko, N.-Y. (2018b). Independent and synergistic effects of self-and public stigmas on quality of life of HIV-infected persons. AIDS Care, 30(6), 706-713. https://doi.org/10.1080/09540121.2017.1396282
Mahathir, M., Wiarsih, W., & Permatasari, H. (2021). “Accessibility”: A new narrative of healthcare services for people living with HIV in the capital city of Indonesia. Belitung Nursing Journal, 7(3), 227-234. https://doi.org/10.33546/bnj.1409
Millard, T., Agius, P. A., McDonald, K., Slavin, S., Girdler, S., & Elliott, J. H. (2016). The positive outlook study: A randomised controlled trial evaluating online self-management for HIV positive gay men. AIDS and Behavior, 20(9), 1907-1918. https://doi.org/10.1007/s10461-016-1301-5
Ministry of Health of Indonesia. (2020). Infodatin HIV AIDS. Retrieved from https://pusdatin.kemkes.go.id/article/view/20111200002/infodatin-hiv.html
Nakagawa, F., Lodwick, R. K., Smith, C. J., Smith, R., Cambiano, V., Lundgren, J. D., . . . Phillips, A. N. (2012). Projected life expectancy of people with HIV according to timing of diagnosis. Aids, 26(3), 335-343. https://doi.org/10.1097/QAD.0b013e32834dcec9
Nkhoma, K., Norton, C., Sabin, C., Winston, A., Merlin, J., & Harding, R. (2018). Self-management interventions for pain and physical symptoms among people living with HIV: A systematic review of the evidence. JAIDS Journal of Acquired Immune Deficiency Syndromes, 79(2), 206-225. https://doi.org/10.1097/QAI.0000000000001785
Nolte, S., Elsworth, G. R., Sinclair, A. J., & Osborne, R. H. (2007). The extent and breadth of benefits from participating in chronic disease self-management courses: A national patient-reported outcomes survey. Patient Education and Counseling, 65(3), 351-360. https://doi.org/10.1016/j.pec.2006.08.016
Nolte, S., & Osborne, R. H. (2013). A systematic review of outcomes of chronic disease self-management interventions. Quality of Life Research, 22(7), 1805-1816. https://doi.org/10.1007/s11136-012-0302-8
OBrien, N., Chi, Y. L., & Krause, K. R. (2021). Measuring health outcomes in HIV: Time to bring in the patient experience. Annals of Global Health, 87(1), 2. https://dx.doi.org/10.5334%2Faogh.2958
Portilla-Tamarit, J., Reus, S., Portilla, I., Ruiz-de-Apodaca, M. J. F., & Portilla, J. (2021). Impact of advanced HIV disease on quality of life and mortality in the era of combined antiretroviral treatment. Journal of Clinical Medicine, 10(4), 716. https://doi.org/10.3390/jcm10040716
Richard, A. A., & Shea, K. (2011). Delineation of self‐care and associated concepts. Journal of Nursing Scholarship, 43(3), 255-264. https://doi.org/10.1111/j.1547-5069.2011.01404.x
Richardson, J., Loyola-Sanchez, A., Sinclair, S., Harris, J., Letts, L., MacIntyre, N. J., . . . McBay, C. (2014). Self-management interventions for chronic disease: A systematic scoping review. Clinical Rehabilitation, 28(11), 1067-1077. https://doi.org/10.1177%2F0269215514532478
Schulman Green, D., Jaser, S. S., Park, C., & Whittemore, R. (2016). A metasynthesis of factors affecting self‐management of chronic illness. Journal of Advanced Nursing, 72(7), 1469-1489. https://doi.org/10.1111/jan.12902
Skinner, D., Crowley, T., Van der Merwe, A., & Kidd, M. (2020). Adolescent human immunodeficiency virus self-management: Associations with treatment adherence, viral suppression, sexual risk behaviours and health-related quality of life. Southern African Journal of HIV Medicine, 21(1), 1-11. https://doi.org/10.4102/sajhivmed.v21i1.1054
Webel, A. R., Moore, S. M., Longenecker, C. T., Currie, J., Davey, C. H., Perazzo, J., . . . Josephson, R. A. (2018). A randomized controlled trial of the SystemCHANGE intervention on behaviors related to cardiovascular risk in HIV+ adults. Journal of Acquired Immune Deficiency Syndromes, 78(1), 23-33. https://dx.doi.org/10.1097%2FQAI.0000000000001635
Zhang, P., Gao, J., Wang, Y., Sun, Q., & Sun, X. (2019). Effect of chronic disease self‐management program on the quality of life of HIV‐infected men who have sex with men: An empirical study in Shanghai, China. The International Journal of Health Planning and Management, 34(3), 1055-1064. https://doi.org/10.1002/hpm.2874