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A Randomized Trial of a Cognitive Coping Intervention for Acutely Ill HIV-Positive Men

Côté, José K.; Pepler, Carolyn


Background People who are HIV-positive now live longer when they have contracted AIDS, and nursing interventions can help improve their quality of life.

Objectives To test the effects of an intervention based on developing cognitive coping skills as compared to one focused on facilitating the expression of emotions. Both interventions were intended to help regulate emotional response to an exacerbation of HIV-related symptoms.

Method In a randomized, controlled trial, 90 hospitalized HIV-positive men were randomly assigned to one of three groups: cognitive, expression, or control. The intervention was administered on three consecutive days in 20–30 minute sessions. Preintervention and postintervention data were gathered on mood, distress, and anxiety.

Results Both interventions produced a beneficial effect on negative affect (cognitive group p = .002, expression group p = .011), and immediately following the first daily session (p = .001). No change in positive affect was produced by either intervention. Paired t tests indicated a decrease in distress (p = .039), specifically, of intrusive ideation (p = .03), for the cognitive group, which also experienced a decrease in anxiety from immediately before to immediately after each session. Conversely, the expression group experienced an increase in anxiety (p = .018).

Discussion The cognitive coping skills nursing intervention was effective in helping to regulate HIV-positive persons’ emotional responses to advanced disease. This nursing intervention is feasible for use by skilled practitioners providing daily care.

José K Côté, N, PhD, is Assistant Professor, Faculty of Nursing, Université de Montréal, Canada.

Carolyn Pepler, N, PhD, is Associate Professor, School of Nursing, McGill University, Montreal, Canada.

Accepted for publication November 13, 2001.

The study was supported by the Fonds de la Recherche en Santé du Québec (FRSQ), the Ordre des Infirmières et Infirmiers du Québec (OIIQ), and the Canadian Nurses Foundation (CNF).

Corresponding author: José K Côté, N, PhD, Université de Montréal, C.P.6128, succursale Centre-ville, Montréal (Québec), H3C 3J7 (e-mail:

© 2002 Lippincott Williams & Wilkins, Inc.