Psychological Flexibility, Catastrophising, and Their Associations with Health-Related Quality of Life and Clinical Management Outcomes in Patients with HIV: An Analysis from a Nigerian Tertiary Hospital
Le résumé fourni par la source
Background: The psychological responses of individuals living with HIV are critical determinants of disease management. Objectives: This study investigated the associations of psychological flexibility and catastrophising with health-related quality of life (HRQoL) and clinical management outcomes among Nigerian patients with HIV. Methods: A cross-sectional study of 500 adult patients attending the HIV clinic at Ahmadu Bello University Teaching Hospital, Zaria, was conducted. Participants completed validated measures: the Acceptance and Action Questionnaire-II (AAQ-II) for psychological flexibility, the Pain Catastrophising Scale (PCS) adapted for HIV, and the WHOQOL-HIV BREF for HRQoL. Clinical outcomes (viral load, CD4 count, adherence via self-report) were extracted from records. Analyses included Pearson’s correlations, multiple linear regressions, and multivariate analysis of covariance (MANCOVA). Results: The mean age was 42.3±9.1 years, with 345 (69.0%) females. Psychological flexibility showed a significant positive correlation with overall HRQoL (r=0.52, p<0.001) and was associated with optimal treatment adherence (OR=2.45, 95% CI: 1.72-3.49) and undetectable viral load (OR=1.89, 95% CI: 1.31-2.72). Catastrophising correlated negatively with HRQoL (r=-0.48, p<0.001) and was associated with sub-optimal adherence (OR=0.42, 95% CI: 0.29-0.61) and detectable viral load (OR=0.53, 95% CI: 0.37-0.76). Conclusion: Psychological flexibility is associated with superior HRQoL and clinical management outcomes, whereas catastrophising is linked to poorer outcomes. Integrating interventions that enhance psychological flexibility and reduce catastrophising into standard HIV care in Nigeria is recommended.
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