Literature Review on HIV infected Victims

Added on - 30 Sep 2019

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Critique of Literature1.0 Literature reviewThe HIV infected victims fail to resist towards the attack of pathogenic and non-pathogenicdiseases. The complications of the patient are going to be increased. Therefore the life span isgoing to be reduced significantly if untreated. In view of the patient condition, by looking toother patients, most HIV infected patients develop a kind of psychological distress. Mostresearchers contributed for the identification of possible factors and their control towardsmanagement of disease. However, there exist certain gaps in the literature. The gaps havebeen identified and depicted in below sections. The review of literature made utilizing diversesources as depicted in preceding chapter. The outcome of the literature along with positiveand negative aspects is shown in this chapter. The critique would help in developing theobjectives and planning the research further.2.0. Effect of AIDS on Psychological disorders2.1. Effect of HIV mediated anxiety on medication/therapyThe methods employed by Blank et al (2011) are based onrandomized clinical trial innumerous AIDS patients with mental illnesses. The intervention comprises for the assessmentof mental status and AIDS for a period of 12 months. Despite of positive influence, it appearsthat there exist certain limitations in the study. No details are captured on the type of mentalillness in detail. An emphasis towards focus for the assessment of AIDS induced mentalillness should have been covered. No additional efforts put for the identification of mentalillness in the patients with AIDS. The investigation performed byVitiello et al., (2003)focused mainly on the effectiveness of psychotropic medication on recovery of AIDS. Thereasons why the psychotic symptoms are developed in those individuals is not addressed.Theoutcome of the study reported by Kuo et al., (2014) have covered a broad range of victims with anxiety as one of theeffect in AIDS patients from South African context. The report gave an insight of how the caregivers are influencingpsychologically. However, the researchers are not addressed the impact of AIDS on patient’s perspective. Similar toother reports, the investigators are not covered the factors contributing for anxiety and other psychological disorders.The focus of other reports (Mohanan & Kamath, 2009) is based on recommendations but not on the mechanisminvolved for the psychological distress in AIDS patients.1
2.2. Effect of HIV mediated depression on medication/therapyAntidepressant efficacy in HIV care have been evaluated by Pence et al., (2015), did not bring a significantimprovement in HIV outcome despite of following adequate assessment and statistics. The investigators evaluatedthe adherence of antiretroviral therapy and depression morbidity. Except depression, no other psychological diseasesbeen covered in the investigation. The study was also pseudo cluster randomization, a design most suits for insmaller number of study participants (Melis et al., 2011). The sample size included is reasonably goodhowever, the investigators employed pseudo cluster randomization.Mitzel et al., (2015) tested the role of depressive symptoms on adherence of anti HIV-medication adherence. Thestudy was based on homosexual patients (66 HIV-infected men who have sex with men) in an outpatient infectiousdisease clinic. The investigation did not reveal about the types of design employed however the outcome showed asignificant impact in terms of stigma-related experiences. It was positive with depressive symptoms and negativetowards adherence. Similar to preceding outcomes and methods, the investigators did not covered otherpsychological disorders.Turan et al., (2015) attempted to fill the gap of the researchbetweeninternalized stigma and anti retroviral therapy. The investigation was carried in more than 1000 women patients.The researchers used an old method for the assessment of depression and are on grading. Novel methods such asPreguntas con Cartas(Caplan, 2016)should have been used to avoid the bias of the old method. The studywas based on multicenter however inter comparisons of the study was missing. In addition, the aspects of emotionand anxiety are not covered. A cross-sectional study (Medha et al., 2011) based on southeastern United Statescovered the relationship between social bolster, HIV exposure, and melancholy. A part from the dermatographicdata, the investigators (Medha et al., 2011) investigated the effect of independent variables (nine-item scale with a 3-point Likert-type) on dependent variables, depression. The relationship between independent and dependentvariables is missing. However, the outcome reveals that the rural women from southeastern United States are oftenunder-diagnosed and inadequately treated for depression. No details are captured from emotion and otherpsychological disorders2.3. Effect of HIV/AIDSon emotionIn absence of adequate preventive measures before diagnosing the HIV infection, the individuals cansurvive for the couple of years. Once the disease is diagnosed for the AIDS, individuals can undergoemotional distress leading to significant reduction of life span.Okulicz et al., (2009) reported therole of viral load on the reduction of victim immunity however, why and how the individual isundergoing for emotional distress is not explained. The link between the ‘suppression of immunity’and its repercussions on emotions is missing. To prolong life, investigators (Mocroft et al., 2002)recommended using either single or multiple regimens from novel source for the mitigationof diseases. The study was conducted in about numerous patients and found that the2
‘dropping’ rate was comedown with the treatment. They talk about the use of drugs in thetreatment but no details been covered pertaining to the emotional distress. Thephysiological mediators contribute for emotional distress it appears. Moneyham et al.,(1997) investigated the impact ofHIV-related stressors on emotional distress in HIV positivewomen. The findings indicate that how HIV+ women think about HIV-related stressors is animportant factor that may account for individual variability in the ability to maintain a sense ofsubjective well-being in the face of a devastating fatal disease. The possible modes by which thereduction of emotional distress are missing in the report. However, it is possible to from the insight ofthe outcome (Moneyham et al., 1997) to reduce the emotional distress to the intensity of thedisease.Numerous reports are not available to link the emotional distress and their mechanisms.However, the available report (Wei et al., 2016) coversthe relation between stigma, stereotypedattitudes and emotional behavior. The researchers (Wei et al., 2016)utilized data from youngchildren (age, 6-17 years) affected by HIV for the analysis and mediation of the model. Compared toyoung children, the thinking capacity and thus emotional distress in adults and geriatrics could differ.Therefore, the focus was missed in the adults and elderly patients pertaining to emotional distress. Theenvironment and scoity also contributes for the emotional distress due to lack of adequate moralsupport from surroundings. Especially for children who are in schooling stage adequqtae supportfrom teachers is needed to reduce the emotional distress. This is not happening all the cases, at someof the schools the children are getting isolated from the non-HIV children leading to discrimination ofthe infected students. It further potentiates them for the development of emotional distress. Fewreports are available in this direction. Among, the relevant one is based on the findings from thearticle (Asikhia & Mohangi, 2015).The researchers conducted a study in small group ofadolescents with HIV infection. The depth analysis is missing from the study with respect tomechanisms, statistical assessment between infected and normal population.2.4. Effect of socioeconomic conditions on anxiety in HIV infected patientsThe education background, employment status and society can certainly influence themedical interventions on the disease management. The outcome of Robinson et al., (2015)from a randomized controlled trial indicates that the patients with below poverty are morevictims and the lifespan of those patients is low compared to the individuals with soundeconomic status. No study dealt with psychological interventions. Few studies arecomparative evaluations for HIV+ persons on ART therapy to healthy controls. It indicatesthat neither cited report nor available sources dealt with the assessment of mental illnesses inHIV infected patients.3
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