Effects of Spirituality on Health-Related Quality of Life in Men with HIV/AIDS: Implications for Counseling
Frame, Marsha Wiggins, Uphold, Constance R., Shehan, Constance L., Reid, Kimberly J., Counseling and Values
This study examined the association of spirituality and health-related quality of life among 226 HIV-positive men. Two measures of spirituality were used: the Spiritual Growth subscale from the Health-Promoting Lifestyle Profile II (S. N. Walker, K. R. Sechrist, & N. J. Pender, 1987) and the Spirituality subscale of the HIV Coping Instrument (L. Moneyham, A. Demi, Y. Mizuno, R. Sowell, & J. Guillory, 1998). Health related quality of life was measured with the HIV Cost and Services Utilization Study (R. D. Hays et al., 1998). Spiritual coping (i.e., relying on religion-based coping techniques) was not associated with health-related quality of life at baseline or 12-month follow-up. Spiritual growth (i.e., existential feelings of connection with a force greater than oneself) improved some aspects of mental and emotional well-being but did not affect physical functioning or pain management.
Learning that one has contracted HIV/AIDS often results in a crisis that precipitates emotional distress and existential anxiety. However, beginning in 1996, researchers began discovering declines in deaths among persons with AIDS. Indeed, survival time after an AIDS diagnosis improved significantly from 1984 to 1997 (Lee, Karon, Selik, Neal, & Fleming, 2001). The effectiveness of highly active antiretroviral therapy (HAART) seems to account for some of the improved survival rates (Gerard et al., 2002; Tam et al., 2002). In spite of the likelihood of living with HIV/AIDS for a median of 9 years (Morgan et al., 2002) because of new drug therapies such as HAART, persons with HIV/AIDS diagnoses must still marshal all of the coping mechanisms available to deal with the stressors associated with managing the disease. These demands include compliance with pharmacological regimens and lifestyle adjustments (Tuck, McCain, & Elswick, 2001). In addition, persons with HIV/ AIDS must face the psychosocial stressors associated with such a diagnosis and must confront the probability of a life cut short by a terminal illness. Although sometimes overlooked by the helping community, spiritual beliefs and practices are important vehicles for coping with the reality of a chronic illness (Somlai et al., 1996).
Attending to the needs of the whole person is an important dimension in assisting persons living with HIV/AIDS to manage the effects of the disease (Dossey & Dossey, 1998). The HIV infection significantly affects clients' overall quality of life. Thus, the physical, psychological, interpersonal and spiritual aspects of individuals' lives are critical domains for counselors to consider. Indeed, considerable writing and research over the past 2 decades have supported the notion of counselors addressing clients' spiritual concerns (Bergin, 1988; Constantine, Lewis, Conner, & Sanchez, 2000; Curtis & Davis, 1999; Frame & Williams, 1996; Fukuyama & Sevig, 1997; Hoge, 1996; Koch, 1998; Mack, 1994; Powers, 2005). The purpose of this research was to examine the relationship between two baseline spirituality indicators and health-related quality of life variables at baseline and at a 12-month follow-up in a sample (N = 226) of HIV-infected men.
Review of Literature
Before examining literature related to spirituality and its relationship to the quality of life of persons with HIV/AIDS, it is important to offer some rudimentary definitions of the terms. Religion refers to a set of beliefs and practices of an organized religious institution (Shafranske & Maloney, 1990). It tends to be expressed in ways that are "denominational, external, cognitive, behavioral, ritualistic, and public" (Richards & Bergin, 1997, p. 13). Spirituality is concerned with persons' search for meaning, purpose, and value in life. It may or may not include a Supreme Being or a Higher Power (Frame, 2003). Cervantes and Ramirez (1992) spoke of spirituality as including the search for harmony and wholeness in the universe. …