EFFECTS OF NURSE-DELIVERED COGNITIVE BEHAVIOUR (CBT) ON ADHERENCE AND DEPRESSIVE SYMPTOMS IN PEOPLE LIVING WITH HIV IN SOUTH KOREA
For conducting nurse-delivered CBT-AD, a clinical psychologist developed manuals, and educated and supervised a nurse. PLHIV with depressive symptoms or adherence <90% were enrolled, and CBT-AD was conducted once weekly for 12 sessions. PLHIV were assessed with an adherence in the last 30-days by visual analogue scale (ranges from 0-100%), Beck depression inventory for depressive symptoms (ranges from 0-63, higher score means more depressed), PozQoL for quality of life (ranges from 13-65, higher score means higher quality of life), and Berger’s 40-item stigma scale for stigma (ranges from 40-160, the higher the score, the worse the stigma) at baseline, and after the 6th and 12th sessions. In addition, acceptability and feasibility were evaluated by PLHIV and providers through surveys.
Five study participants completed 12 sessions of CBT-AD. Two of them had <90% adherence before CBT-AD, but nearly 100% adherence after CBT-AD. Regarding depression, all study participants showed improved depressive symptoms after CBT-AD. In addition, all study participants were also found to have improved their quality of life. As for stigma, although there was some variability among study participants, overall stigma of participants showed improving trends. In a survey regarding acceptability, all study participants received great help from CBT-AD and expressed their desire to continue.
Our findings suggest that a nurse-delivered CBT-AD was effective and acceptable for improving depressive symptoms, quality of life, stigma and ART adherence of PLHIV. The implementation of this nurse-delivered intervention should be applied more widely in clinical practice to understand its value.
Key study materials
In collaboration with La Trobe University in Melbourne, Australia, and other partners, we continue to support the development, evaluation and dissemination of a short, validated HIV specific quality of life measure (PozQoL) to help researchers, clinical practitioners and program evaluators to assess the needs of PLHIV