SpringerLink
Log in

Development of a New Instrument for the Assessment of Psychological Predictors of Well-being and Quality of Life in People with HIV or AIDS

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

This study aims to develop an instrument for the assessment of psychological predictors of well-being and quality of life (QoL) in people living with HIV. A four-step procedure was followed to achieve this objective. A literature review, focus group in different regions of Spain and content analysis generated a preliminary pool of 96 items. Interjudgement ratings over the items and a cognitive debriefing interview were performed to delete or review items (one omitted and 15 reviewed). The psychometric properties of the instrument were assessed in a sample of 84 HIV+. Pilot testing allowed a new wave of depuration process by empirical criteria (30 items omitted). A final pool of 63 items covering 23 facets (α from 0.53 to 0.95) of psychological predictors remained. Exploratory factorial analysis (GLS) assessing the underlying structure of the questionnaire showed a six-factor model explaining 56.5 of variance. Empirical exploratory structure revealed evidence of goodness of fit (χ2 = 113.110, gl = 130, p > 0.05; RMSEA = 0.017; RMSEA IC90 % 0.000–0.057). This study presents the first instrument able to screen key psychological variables expected to be related to adjustment, well-being and QoL in people with HIV.

Resumen

Este estudio tuvo como objetivo desarrollar un instrumento para la evaluación de los predictores psicológicos del bienestar y la calidad de vida de las personas que viven con el VIH. Cuatro pasos se siguieron para lograr este objetivo. Revisión de la literatura, grupos de discusión en diferentes regiones de España y análisis cualitativo de contenido del material transcrito de los grupos, permitieron generar un conjunto preliminar de 96 ítems. Los ítems fueron sometidos a una valoración interjueces y, posteriormente, a la valoración de personas con VIH, para revisar o eliminar aquellos ítems menos relevantes o que no se entendían bien (uno eliminado y 15 revisados). Las propiedades psicométricas del instrumento fueron entonces valoradas en una muestra de 84 VIH+. El estudio piloto permitió una nueva oleada de depuración de ítems utilizando criterios empíricos (30 ítems fueron eliminados). Un grupo final de 63 ítems distribuidos en 23 facetas (α 0.53 a 0.95) de predictores psicológicos se mantuvieron. El análisis factorial exploratorio identificó la estructura subyacente del cuestionario con un modelo de seis factores que explican 56.5 de la varianza. La estructura exploratoria empírica mostró evidencias de bondad del ajuste (χ2 = 113.110, gl = 130, p > 0.05; RMSEA = 0,017; RMSEA IC90 % 0,000–0,057). Este estudio presenta el primer instrumento capaz de valorar variables psicológicas clave en la predicción de la adaptación, bienestar y la calidad de vida en personas con VIH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. UNAIDS. Getting to zero: 2011–2015 strategy, Joint United Nations Programme on HIV/AIDS (UNAIDS). Geneva: UNAIDS; 2010 (UNAIDS/10.12E/JC2034E).

  2. Chida Y, Vedhara K. Adverse psychosocial factors predict poorer prognosis in HIV disease: a meta-analytic review of prospective investigations. Brain Behav Immun. 2009;23(4):434–45.

    Article  PubMed  Google Scholar 

  3. Leserman J, Petitto JM, Gu H, et al. Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors. Psychol Med. 2002;32(6):1059–73.

    Article  PubMed  CAS  Google Scholar 

  4. Moskowitz JT, Hult JR, Bussolari C, Acree M. What works in co** with HIV? A meta-analysis with implications for co** with serious illness. Psychol Bull. 2009;135(1):121–41.

    Article  PubMed  Google Scholar 

  5. Remor E, Penedo FJ, Shen BJ, Schneiderman N. Perceived stress is associated with CD4+ cell decline in men and women living with HIV/AIDS in Spain. AIDS Care. 2007;19(2):215–9.

    Article  PubMed  CAS  Google Scholar 

  6. Penedo FJ, González JS, Dahn JR, et al. Personality, quality of life and HAART adherence among men and women living with HIV/AIDS. J Psychosom Res. 2003;54(3):271–8.

    Article  PubMed  Google Scholar 

  7. O’Brien KK, Bayoumi AM, Strike C, Young NL, King K, Davis AM. How do existing HIV-specific instruments measure up? Evaluating the ability of instruments to describe disability experienced by adults living with HIV. Health Qual Life Outcomes. 2010;8:88.

    Article  PubMed  Google Scholar 

  8. Clayson DJ, Wild DJ, Quarterman P, Duprat-Lomon I, Kubin M, Coons SJ. A comparative review of health-related quality of life measures for use in HIV/AIDS clinical trials. Pharmacoeconomics. 2006;24(8):751–65.

    Article  PubMed  Google Scholar 

  9. Eignor DR. Standards for the development and use of tests: the standards for educational and psychological testing. Eur J Psychol Assess. 2001;17(3):157–63.

    Article  Google Scholar 

  10. Revicki D, Gnanasakthy A, Weinfurt K. Documenting the rationale and psychometric characteristics of patient-reported outcomes for labeling and promotional claims: the PRO Evidence Dossier. Qual Life Res. 2007;16(4):717–23.

    Article  PubMed  Google Scholar 

  11. Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for develo** grounded theory. 3rd ed. London: Sage; 2008.

    Google Scholar 

  12. Wowers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13(4):227–36.

    Article  Google Scholar 

  13. Arranz P, Remor E, Quintana M, et al. Development of a new disease-specific quality of life questionnaire to adults living with haemophilia. Haemophilia. 2004;10(4):376–82.

    Article  PubMed  CAS  Google Scholar 

  14. Swindells S, Mohr J, Justis JC, et al. Quality of life in patients with human immunodeficiency virus infection: impact of social support, co** style and hopelessness. Int J STD AIDS. 1999;1999(10):383–91.

    Article  Google Scholar 

  15. Bastardo YM, Kimberlin CL. Relationship between quality of life, social support and disease related factors in HIV-infected persons in Venezuela. AIDS Care. 2000;12:673–84.

    Article  PubMed  CAS  Google Scholar 

  16. Remor E. Apoyo social y calidad de vida en la infección por VIH. Aten Primaria. 2002;30(3):143–8.

    PubMed  CAS  Google Scholar 

  17. Cowdery JE, Pesa JA. Assessing quality of life in women living with HIV infection. AIDS Care. 2002;14(2):235–45.

    Article  PubMed  CAS  Google Scholar 

  18. Onwumere J, Holttum S, Hirst F. Determinants of quality of life in black African women with HIV living in London. Psychol Health Med. 2002;7(1):61–74.

    Article  Google Scholar 

  19. Jia H, Uphold CR, Wu S, Chen GJ, Duncan PW. Predictors of changes in health-related quality of life among men with HIV infection in the HAART era. AIDS Patient Care STDS. 2005;19(6):395–405.

    Article  PubMed  Google Scholar 

  20. Jia H, Uphold C, Zheng Y, et al. A further investigation of health related quality of life over time among men with HIV infection in the HAART era. Qual Life Res. 2007;2007(16):961–8.

    Article  Google Scholar 

  21. Uphold CR, Holmes W, Reid K, Findley K, Parada JP. Healthy lifestyles and health-related quality of life among men living with HIV infection. J Assoc Nurses AIDS Care. 2007;18(6):54–66.

    Article  PubMed  Google Scholar 

  22. Te Vaarwerk MJE, Gaal EA. Psychological distress and quality of life in drug-using and non-drug-using HIV-infected women. Eur J Public Health. 2001;11(1):109–15.

    Article  Google Scholar 

  23. Mrus JM, Leonard AC, Yi MS, et al. Health-related quality of life in Veterans and Nonveterans with HIV/AIDS. J Gen Intern Med. 2006; 21(S5):S39–S47.

    Google Scholar 

  24. Mutimura E, Stewart A, Crowther NJ, Yarasheski KE, Cade WT. The effects of exercise training on quality of life in HAART-treated HIV-positive Rwandan subjects with body fat redistribution. Qual Life Res. 2008;17(3):377–85.

    Article  PubMed  Google Scholar 

  25. Worthington C, Krentz HB. Socio-economic factors and health-related quality of life in adults living with HIV. Int J STD AIDS. 2005;16(9):608–14.

    Article  PubMed  CAS  Google Scholar 

  26. Stangl AL, Wamai N, Mermin J, Awor AC, Bunnell RE. Trends and predictors of quality of life among HIV-infected adults taking highly active antiretroviral therapy in rural Uganda. AIDS Care. 2007;19(5):626–36.

    Article  PubMed  CAS  Google Scholar 

  27. Liu C, Johnson L, Ostrow D, Silvestre A, Visscher B, Jacobson LP. Predictors for lower quality of life in the HAART era among HIV-infected men. J Acquir Immune Defic Syndrom. 2006;2006(42):470–7.

    Article  Google Scholar 

  28. Schroecksnadel K, Sarcletti M, Winkler C, Mumelter B, Weiss G, Fuchs D, Kemmler G, Zangerle R. Quality of life and immune activation in patients with HIV-infection. Brain Behav Immun. 2008;22(6):881–9.

    Article  PubMed  CAS  Google Scholar 

  29. Préau M, Protopopescu C, Spire B, et al. Health related quality of life among both current and former injection drug users who are HIV-infected. Drug Alcohol Depend. 2007;86(2–3):175–82.

    Article  PubMed  Google Scholar 

  30. Berger BE, Ferrans CE, Lashley FR. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale. Res Nurs Health. 2001;24(6):518–29.

    Article  PubMed  CAS  Google Scholar 

  31. Holzemer WL, Human S, Arudo J, et al. Exploring HIV stigma and quality of life for persons living with HIV infection. J Assoc Nurses AIDS Care. 2009;20(3):161–8.

    Article  PubMed  Google Scholar 

  32. Mak WW, Cheung RY, Law RW, Woo J, Li PC, Chung RW. Examining attribution model of self-stigma on social support and psychological well-being among people with HIV+/AIDS. Soc Sci Med. 2007;64(8):1549–59.

    Article  PubMed  Google Scholar 

  33. Wright K, Naar-King S, Lam P, Templin T, Frey M. Stigma scale revised: reliability and validity of a brief measure of stigma for HIV+ youth. J Adolesc Health. 2007;40(1):96–8.

    Article  PubMed  Google Scholar 

  34. Atkinson JS, Schönnesson LN, Williams ML, Timpson SC. Associations among correlates of schedule adherence to antiretroviral therapy (ART): a path analysis of a sample of crack cocaine using sexually active African-Americans with HIV infection. AIDS Care. 2008;20(2):253–62.

    Article  PubMed  CAS  Google Scholar 

  35. Ironson G, Hayward H. Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosom Med. 2008;70(5):546–54.

    Article  PubMed  Google Scholar 

  36. Taylor SE, Kemeny ME, Reed GM, Bower JE, Gruenewald TL. Psychological resources, positive illusions, and health. Am Psychol. 2000;55(1):99–109.

    Article  PubMed  CAS  Google Scholar 

  37. Vance DE. Self-rated emotional health in HIV-positive and HIV-negative adults. Psychol Rep. 2006;98(1):106–8.

    Article  PubMed  Google Scholar 

  38. Nunnally JC, Bernstein IJ. Teoría psicométrica. Madrid: McGraw-Hill; 1995.

    Google Scholar 

  39. Lord FM, Novick MR. Statistical theories of mental tests scores. Massachusetts: Addison-Wesley; 1968.

    Google Scholar 

  40. Anastasi A, Urbina S. Psychological testing. Englewood Cliffs: Prentice Hall; 1997.

    Google Scholar 

  41. Spaan M. Test and item specifications development. Lang Assess Q. 2006;3(1):71–9.

    Article  Google Scholar 

  42. Holt JK. Item parceling in structural equation models for optimum solutions. In: Annual meeting of the Mid-Westerns Educational Research Association. Columbus, OH, October 13–16, 2004.

  43. Kishton JM, Widaman KF. Unidimensional versus domain representative parceling of questionnaire items: an empirical example. Educ Psychol Meas. 1994;54(3):757–65.

    Article  Google Scholar 

Download references

Acknowledgments

This work has been supported by a grant from FIPSE Spain (Fundación para la Investigacion y Prevención del Sida en España, Grant 36-0743/09). This paper was prepared by the authors on behalf of the Spanish Group for the Quality of Life Improvement in HIV or AIDS. The members of the Spanish Group for the Quality of Life Improvement in HIV or AIDS are: López-Zúñiga, A.M., Santos-Miguel, I. (Asociación T-4); Albiol-Soto, M. (CESIDA); Ferrer-Lasala, M.J., Fumaz, C. R., González-García, M., Tuldrà-Niño, A. (Fundació Lluita contra la Sida. Hospital Germans Trias i Pujol); Santamaria-Jauregui, J.M. (Hospital de Basurto); Ferrando-Vilalta, R. (Hospital Clínico de Valencia); Iribarren-Loyarte, J.A. (Hospital de Donostia); Tornero-Esteban, C. (Hospital Fco Borja de Gandía); Roca, B. (Hospital General de Castellón, Universitat Jaume I de Castelló); Cánoves-Martínez, L. (Hospital General de Valencia); Lorenzo-González, J.F. (Hospital General Yagüe de Burgos); Fuster-Ruiz de Apodaca, R., Pasquau-Liaño, F. (Hospital de la Marina Baixa de Villajoyosa); Remor, E. (Universidad Autónoma de Madrid); Ubillos-Landa, S. (Universidad de Burgos); Ruzafa-Martínez, M. (Universidad de Murcia); Fuster-Ruiz de Apodaca, M.J., Molero, F., Nouvilas-Pallejà, E., Pérez-Garín, D., Sanjuan-Suárez, P. (Universidad Nacional de Educación a Distancia); Aguirrezabal-Prado, A., Arnoso-Martínez, A., Larrañaga-Eguilegor, M., Mayordomo-López, S. (Universidad del País Vasco); Ballester-Arnal, R., Gil-Juliá, B., Giménez-García, C., Gómez-Martínez, S., Ruiz-Palomino, E. (Universitat Jaume I de Castelló); Gil-Llario, M.D., Madrigal-Vilchez, A. (Universitat de València-Estudi General).

Author information

Authors and Affiliations

  1. Departamento de Psicología Biológica y de la Salud, Facultad de Psicología, Universidad Autónoma de Madrid, Ciudad, C/Ivan Pavlov, 6, Universitaria de Cantoblanco, 28049, Madrid, Spain

    Eduardo Remor

  2. Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain

    Maria José Fuster & Fernando Molero

  3. Facultad de Ciencias de la Salud, Universitat Jaume I de Castelló, Castelló, Castelló de la Plana, Spain

    Rafael Ballester-Arnal & Sandra Gómez-Martínez

  4. Fundació Lluita Contra la Sida, Hospital Germans Trias i Pujol, Barcelona, Spain

    Carmina R. Fumaz & Marian González-Garcia

  5. Facultad de Humanidades y Educación, Universidad de Burgos, Burgos, Spain

    Silvia Ubillos-Landa

  6. Facultad de Psicología, Universidad del País Vasco, Gipuzkoa, San Sebastián, Spain

    Arrate Aguirrezabal-Prado

Authors
  1. Eduardo Remor
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria José Fuster
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rafael Ballester-Arnal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sandra Gómez-Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Carmina R. Fumaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marian González-Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Silvia Ubillos-Landa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Arrate Aguirrezabal-Prado
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Fernando Molero
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eduardo Remor.

Additional information

The study was conducted on behalf of the Spanish Group for the Quality of Life Improvement in HIV or AIDS.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Remor, E., Fuster, M.J., Ballester-Arnal, R. et al. Development of a New Instrument for the Assessment of Psychological Predictors of Well-being and Quality of Life in People with HIV or AIDS. AIDS Behav 16, 2414–2423 (2012). https://doi.org/10.1007/s10461-012-0230-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-012-0230-1

Keywords

Palabras-Clave

Search

Navigation