Spirituality and Quality of Life in HIV-Positive Persons
Grimsley, Linda Pennington, Journal of Cultural Diversity
Abstract: With the amount of turmoil in the world today and often in our personal lives as well, spirituality has become a major focus for many people. Because of the demonstrated importance of spiritual well-being in coping with a chronic illness, the author researches the effects of spirituality and quality of life on the lives of HIV-positive persons.
Key words: Spirituality, HIV, Quality of Life, QOL
With the amount of turmoil in the world and often in our personal lives as well, spiritual ity has become a major focus for many. Because of the demonstrated importance of spiritual well-being in coping with a chronic illness, the author researches the effects of spirituality and quality of life (QOL) on the lives of HIV-positive persons. The question posed in this study was: "Does spirituality influence the QOL of a person who has a terminal illness or infection, such as HIV?"
REVIEW OF THE LITERATURE
Numerous articles have been published on spirituality and on QOL among HIV-positive persons. A review of the literature regarding both spirituality and QOL revealed three studies that investigated both subjects among HIV-positive persons (Mellors, Riley, & Erlen, 1997; So well, Moneyham, Hennessey, Guillory, Demi, & Seals, 2000; and Tsevat, Sherman, McElwee, Mandell, Simbartl, Sonnenberg, & Fowler, 1999). The three studies are discussed below before detailing the current study.
Although it is intuitive to believe that spirituality and QOL are linked, there has been very little researchon the relationship between the two concepts. Mellors and others (1997) examined self-transcendence (an awareness of something greater than self) and QOL in 46 HIV-positive subjects (Reed, 1987). Using a spirituality scale, a QOL scale, and a demographic questionnaire, Mellors and others divided study participants into three categories: Category A was asymptomatic HIV patients with a CD4 count above 200; Category B was symptomatic HIV patients with a CD4 count above 200, and Category C was patients with an AIDSdefining condition and/or a CD4 count below 200.
Mellors and others (1997) found evidence to support Reed's theory of self-transcendence, that as persons become increasingly aware of their personal mortality, self-transcendence increases. For example, subjects in Category B had the highest transcendence scores, therefore the authors postulated that the initial symptomology of HIV infection might trigger selftranscendence (Mellors et al., 1997). Mellors and others observed that as self-transcendence increased, as seen in Category B, QOL increased. They found that as persons were faced with their own mortality, their spirituality increased, and as self-transcendence increased, QOL increased.
Tsevat and others (1999) examined the will to live in 51 HIV-positive persons using an investigator-developed instrument to conduct structured and indepth cognitive interviews. Interview questions included one spirituality question, one religiosity question, and four questions about life-satisfaction. Responses to the spirituality question suggested that over half of the patients were at peace with God and the universe.
One question about life satisfaction asked patients to compare life before and after the HIV diagnosis. Twenty-nine percent responded that life was currently worse, 18% reported life was about the same, and 4% did not know. More women (73%) than men (39%) reported life was better. After the diagnosis, non-White patients and non-married patients stated that life had gotten better, but not at a statistically significant level. Those stating life was better reported greater peace with God. According to Tsevat and others (1999), half of their participants indicated that life was better after an HIV diagnosis than before, and that they would prefer to live longer even if their health was worse.
Sowell and others (2000), in a longitudinal study, examined spiritual activities as a resource for 184 HIVpositive women in eight rural and urban areas in the state of Georgia. …