Jane M Simoni1, Joyce P Yang, Cheng-Shi Shiu, Wei-Ti Chen, Wadiya Udell, Meijuan Bao, Lin Zhang, Hongzhou Lu. 1. aDepartment of Psychology bSchool of Social Work, University of Washington, Seattle, Washington cSchool of Nursing, Yale University, Orange, Connecticut dSchool of Interdisciplinary Arts and Sciences, University of Washington Bothell, Bothell, Washington, USA eShanghai Public Health Clinical Center, Fudan University, Shanghai, P.R. China.
Abstract
OBJECTIVE: The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. DESIGN: This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. SETTING: The study occurred at an outpatient HIV primary care centre in Shanghai, China. PARTICIPANTS: Participants were 20 HIV-positive outpatients with at least one child (13-25 years old) who was unaware of the parent's HIV diagnosis. INTERVENTION: The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. MAIN OUTCOME MEASURE(S): Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy, and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. RESULTS: In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a 'large' effect size. CONCLUSION: Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy.
RCT Entities:
OBJECTIVE: The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children. DESIGN: This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms. SETTING: The study occurred at an outpatient HIV primary care centre in Shanghai, China. PARTICIPANTS: Participants were 20 HIV-positive outpatients with at least one child (13-25 years old) who was unaware of the parent's HIV diagnosis. INTERVENTION: The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays. MAIN OUTCOME MEASURE(S): Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy, and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV. RESULTS: In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a 'large' effect size. CONCLUSION: Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy.
Authors: Tianyi Xie; Joyce P Yang; Jane M Simoni; Cheng-Shi Shiu; Wei-Ti Chen; Hongxin Zhao; Hongzhou Lu Journal: J Clin Psychol Med Settings Date: 2017-12
Authors: Lin Zhang; Wei-Ti Chen; Joyce P Yang; Jane M Simoni; Chengshi Shiu; Meijuan Bao; Jing Zhang; Meiyan Sun; Yang Qiu; Hongzhou Lu Journal: J Assoc Nurses AIDS Care Date: 2016-09-22 Impact factor: 1.354