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Symptom Status, Medication Adherence, and Quality of Life in HIV Disease

Corless, Inge B. PhD, RN, FAAN; Nicholas, Patrice K. DNSc, MPH, RN, ANP; Davis, Sheila M. MSN, RN, ANP; Dolan, Sara A. MSN, RN, ANP; McGibbon, Chris A. PhD

Journal of Hospice & Palliative Nursing: May-June 2005 - Volume 7 - Issue 3 - p 129–138
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People living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) experience numerous symptoms due to the disease, side effects of medications, and comorbidities. It is not clear whether the perceived intensity of symptoms or their bothersomeness is more significant. In this pilot study, we decided to explore further the relationship between these two aspects of a symptom's severity along with the question of the relationship between symptom status, quality of life, and medication adherence. The Symptom Management Model developed by the University of California San Francisco School of Nursing Symptom Management Faculty Group serves as the framework for this study. The purpose of this pilot study was to examine the individual's perception of the intensity and bothersomeness of symptoms, antiretroviral medication adherence, and quality of life. In addition, sociodemographic variables and their relationship to symptom intensity, bothersomeness, and quality of life were also examined. A self-report questionnaire was employed to assess intensity and bothersomeness of symptoms, quality of life, and adherence. Data were collected in a convenience sample (N = 50) of HIV-positive persons in a community-based agency in a major metropolitan area in the northeastern United States. The results of this exploratory, descriptive, cross-sectional study indicated that certain sociodemographic and symptom-related variables were associated with adherence. Gender was significantly associated with the degree to which one would be bothered by symptoms (bothersomeness) (r = −0.30, P = .05), where women were more bothered by symptoms than men. “Bothered by symptoms” was significantly associated with forgetting to take medications (r = −0.45, P = .003), difficulty taking medications (r = −0.32, P = .04), and discontinuing medications when feeling better (r = −0.41, P = .007). Intensity of symptoms was also associated with discontinuing taking medications when feeling better (r = −0.31, P = .047). Despite the chronic nature of HIV disease in the United States, the symptom management and end-of-life care issues are germane in this population as with all chronic diseases. Understanding such relationships is key to their management and essential for effective palliative care.

Inge B. Corless, PhD, RN, FAAN, is Professor at MGH Institute of Health Professions, Boston, MA.

Patrice K. Nicholas, DNSc, MPH, RN, ANP, is Professor at MGH Institute of Health Professions, Boston, MA.

Sheila M. Davis, MSN, RN, ANP, is Adult Nurse Practitioner at Massachusetts General Hospital, Boston, MA.

Sara A. Dolan, MSN, RN, ANP, is Adult Nurse Practitioner at Massachusetts General Hospital, Boston, MA.

Chris A. McGibbon, PhD, is Professor at University of New Brunswick, Fredericton, New Brunswick, Canada.

Address correspondence to Inge B. Corless, PhD, RN, FAAN, MGH Institute of Health Professions, Boston, MA (e-mail: icorless@MGH/HP.edu).

© 2005 The Hospice and Palliative Nurses Association