A randomized trial of a cognitive coping intervention for acutely ill HIV-positive men

People who are HIV-positive now live longer when they have contracted AIDS, and nursing interventions can help improve their quality of life.

To test the effects of an intervention based on developing cognitive coping skills as compared to one focused on facilitating the expression of emotions. Both interventions were intended to help regulate emotional response to an exacerbation of HIV-related symptoms.

In a randomized, controlled trial, 90 hospitalized HIV-positive men were randomly assigned to one of three groups: cognitive, expression, or control. The intervention was administered on three consecutive days in 20-30 minute sessions. Preintervention and postintervention data were gathered on mood, distress, and anxiety.

Both interventions produced a beneficial effect on negative affect (cognitive group p =.002, expression group p =.011), and immediately following the first daily session (p =.001). No change in positive affect was produced by either intervention. Paired t tests indicated a decrease in distress (p =.039), specifically, of intrusive ideation (p =.03), for the cognitive group, which also experienced a decrease in anxiety from immediately before to immediately after each session. Conversely, the expression group experienced an increase in anxiety (p =.018).

The cognitive coping skills nursing intervention was effective in helping to regulate HIV-positive persons' emotional responses to advanced disease. This nursing intervention is feasible for use by skilled practitioners providing daily care.