Abstract
Risk factors and potential treatments for depression in HIV-infected youth in Southern Africa: A systematic reviewDepression is common in those with HIV and is associated with lower quality of life, reduced adherence to medication, worse disease progression and higher risk of transmission to other. The majority of HIV-infected youth live in Southern Africa, but research predominantly focuses on adults from Western countries, with limited generalisability across these populations. This review aimed to identify and synthesise research on the risk factors for depression in HIV-infected youth in Southern Africa, and to summarise the available evidence on psychosocial interventions to reduce depression. Papers from 2004–2017 were searched using Embase, PsycNet, PubMed and Scopus. Six studies met inclusion criteria for assessing risk factors, but only three focused exclusively on HIV-infected youth (n=1,113; age 9–19 years). Two studies met inclusion criteria for assessing psychosocial interventions, but only one focused exclusively on HIV-infected youth (n=33; age 10–13 years). Overall, study quality was low and methodology was heterogeneous, limiting comparability and conclusions. The findings indicate some evidence for demographic factors; social and community support factors; reduced immunosuppression; past traumas/stressors; and psychosocial factors as potential risk factors for depression. Neither of the intervention studies successfully reduced depression, demonstrating a need for low-cost, large scale interventions to be developed and trialled. HIV status should be acknowledged as an important factor in future psychosocial research in Southern Africa.
An evaluation of group supervision for nurses working in cancer care
National guidelines outline that clinical staff working in cancer services should be provided with clinical supervision. In Great Western Hospital Trust, clinical psychologists run supervision groups for clinical nurse specialists working in cancer and palliative care using the Structured Approach to Collaborative Supervision (SACS) model. This project aimed to evaluate the implementation of this supervision model based on literature about the functions of supervision and mechanisms of change within those functions. A mixed methods design was used. Results indicated that, generally, supervisees felt the normative, formative and restorative functions of supervision were being well met by the SACS model. Guidance, reinforcement, structure, and learning through others were all identified as mediators for achieving supervision outcomes within these functions. Based on the results, several recommendations were made to the service to offer potential improvements to the SACS supervision groups.
Illness perceptions in adolescents with chronic fatigue syndrome and other physical health conditions: Application of the common sense model
Background: Chronic fatigue syndrome (CFS) in adolescents is associated with severe functional impairment. CFS is distinct from other physical health conditions in that individuals can experience high levels of uncertainty, stigma and disbelief from others. Illness perceptions in CFS are therefore of particular interest and have implications for treatment. However, research on illness perceptions in adolescents is limited. This study compared illness perceptions in adolescents with CFS with other physical health conditions.
Method: Adolescents (aged 11–18) with CFS (n = 49), type 1 diabetes (n = 52) and juvenile idiopathic arthritis (n = 42) were recruited through NHS clinics and online and completed a series of questionnaires.
Results: Adolescents with CFS differed on the perceived consequences, timeline, personal control, treatment control, identity and understanding dimensions of illness perceptions. Except identity, these dimensions were predicted by health condition even when accounting for age, gender, fatigue, physical functioning, anxiety and depression.
Conclusions: Results offer preliminary evidence for the applicability of the CSM in adolescents, with implications for supporting adolescents with physical health conditions. Results suggest that psychological interventions targeting perceived control, understanding and identity may have particular utility for adolescents with CFS.
| Date of Award | 1 May 2018 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Maria Loades (Supervisor) |
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