What is the Relathionship Between Hope And Medication Adherence in HIV Patents?

Running Head : Hope and Medication Adherence in HIV Patients

Is There A Relationship Between Hope and HIV Medication Adherence in HIV Patients

Linda L . Sulton

Case Western Reserve University

NURS 520

Dr Donna Dowling

Dr Barbara Morrison

Date Submitted

June 23 , 2008

Abstract

The use of highly active anti-retroviral therapy (HAART ) medications has shown

significant benefits to longevity for in-treatment HIV /AIDS individuals (Mocroft

Lundgren , 2004 . Non-adherence to these medications , however , has numerous factors

which are not easily tracked or ascertained , and studies generally

br involve several methods

of data gathering . What remains consistent throughout many studies is that less than 95

medication adherence is considered as adherence failure which , in turn leads to further

illness and morbidity among this population . Does hope play a part in medication adherence among HIV patients is the focus of this review and study

Table of Contents

Page

Abstract . 2

Table of Contents .3

CHAPTER 1 INTRODUCTION . 4

Background of the Study . 4

Statement of the Problem . 7

Purpose of the Study . 8

Research Questions . 8

Hypothesis .8

Research Objectives .9

Definition of Terms . 9

Assumptions . 10

CHAPTER 2 : LITERATURE REVIEW . 12

Introduction . 12

Determinants of Adherence to HAART Model .15

Behaviors and Adherence . 16

Research related to high adherence .19

The Role of Hope in Adherence .21

Framework of the Study .22

Significance of the Study .22

CHAPTER 3 METHODOLOGY . 24

Research Design 24

Sample .24

Procedures . 24

Focused Group Methodology .26

Focused Group Discussion .28

Background Information Form .28

Data Analysis . 28

REFERENCES . 30

CHAPTER 1 . INTRODUCTION

Background of the Study

Adherence to human immunodeficiency virus (HIV ) medications is a critical factor for the successful treatment of this chronic illness . An adherence rate of less than 95 can impair these medications effectiveness in constraining the replication of the virus as well as impeding

the ability of the human immunodeficiency virus to diversify and create strains that are resistant to immune suppression thereby increasing the probability of secondary illness and progression to AIDS . Becoming immune to antiretroviral medications due to virus mutation carries the possibility for resistance to all medications within that drug category (e .g . protease inhibitors . Termed cross-resistance , this can endanger further utilization of not just one , but a whole category of medications for treatment (Ickovics Meade , 2002 Richter , Michaels , Carlson Coates , 1998 Stone , Jordon , Tolson , Miller Pilon , 2004 Tennenberg 1999 Young , 2007

active ART , or HAART , was then introduced

The introduction of these medications led to improved treatment of HIV infections in the United States , dramatic reductions in death rates and significant improvements in clinical outcomes (Johnson et al , 2003 Karon , Fleming , Steketee DeCook , 2001 Lewis Abell , 2002 Murphy et al , 2001 Poppa et al , 2004 Thorner Rosenberg , 2003 Reynolds 2004 Vittinghoff et al , 1999 Zorilla et al , 2003 . Prior to the advent of HAART , median survival after infection with HIV ranged from 8 to 12 years (CASCADE , 2003 Palella et al , 1998 . A conceptual shift from the view of HIV infection as an acute and terminal illness to one more...