مجله علوم روانشناختی (Sep 2021)
Structural equation modeling of community-based approach and positive prevention approach with mediating coping strategies to evaluate adherence to treatment in people with HIV
Abstract
Background: Numerous models have been developed for the prevention of AIDS in people with HIV. However, the present study sought to intervente structural relationships between a community-based adaptation model and adherence therapy mediated by coping strategies in HIV-positive people supported by positive clubs of the Welfare Organization of Iran. Aims: The aim of this study was to determine the causal relationship between community-based coping methods for positive prevention based on adherence therapy mediated by coping strategies in HIV patients. Method: The present study was descriptive and of correlation and structural equations. The statistical population of this study included all patients with AIDS in Tehran in 1398, of which 250 people were selected as the sample by purposive sampling of the available type from patients referring to positive clubs under the supervision of the Welfare Organization. In order to collect data, the Coping Styles Questionnaire (Lazarus and Folkman, 1984), the Psychosocial Adjustment Questionnaire (Drogtis and Drogtis, 1990) and the Adherence Therapy Questionnaire (Seyed Fatemi, Rafiei, Hajizadeh and Madanloo, 2018) were used. The Conceptual Model was evaluated by the structural equation modeling method and indirect relationships were tested using the bootstrap method (using AMOS-21 software). Results: The corrected proposed model had an acceptable fit with the data and all direct and indirect (the relationship between adaptation methods for positive prevention and adherence therapy through coping strategies) paths were statistically significant (P< 0.05). The bootstrap estimation method confirmed the indirect path of adherence therapy on psychosocial adjustment mediated by coping strategies in people with HIV. In addition, therapeutic adherence (P< 0.001) and coping strategies (P < 0.002) had a direct effect on psychosocial adjustment of people with HIV. Adherence to treatment also causes psychosocial adjustment and, consequently, the use of appropriate and active coping strategies with stress and facilitates problem-oriented coping behavior. Conclusions: Based on the results of the study, adherence therapy and coping strategies training can be used to increase the level of psychosocial adjustment in HIV-positive people. Therefore, it is suggested that psychological counseling be provided for patients in addition to medical measures to strengthen adaptation to the disease.
