Biomedical subjects

A Nyamathi

Publications and source records attributed to A Nyamathi.

At least 19 recordsLinked to original sources

PubMed2001

Comparison of psychosocial and behavioral profiles of victimized and nonvictimized homeless women and their intimate partners.

The purpose of this study was to examine the psychosocial, behavioral, and environmental profiles of homeless women, both those with and without a history of victimization, and their intimate partners. Five hundred seven homeless women and their intimate partners participated in the study. Thirty-nine percent of the women reported being physically and/or sexually assaulted as adults. Controlling for potential confounders, victimized women were more likely than others to have a history of childhood sexual and physical abuse, lifetime substance use, greater mental health symptomatology, and current risky sexual activity. Thus, homeless women with mental health and substance abuse problems ought to be screened for violent experiences and encouraged to obtain treatment appropriate to their problems to reduce their ongoing risk of victimization.

Adolescent↗

PubMed2001

Evaluating the impact of peer, nurse case-managed, and standard HIV risk-reduction programs on psychosocial and health-promoting behavioral outcomes among homeless women.

Investigators examined the 6-month impact of three cognitive-behavioral HIV risk-reduction programs on behavioral factors (substance use and sexual risk behaviors) and cognitive and psychological resources of 325 women who resided in emergency or sober-living shelters and their 308 intimate sexual partners. Participants were randomized by shelter to a peer-mentored, a nurse case-managed, or a standard care HIV risk-reduction program. Significant improvements were observed in all groups in all behavioral factors and cognitive and psychological resources except for self-esteem. Participants in the peer-mentored and nurse case-managed groups did not differ significantly from the standard group in self-esteem, life satisfaction, psychological well-being, use of noninjection drugs, sex with multiple partners, and unprotected sex at 6 months (n = 633). It was concluded that a standard approach by health care professionals appears to effectively modify HIV risk behaviors for a majority of homeless participants and may have important economic and policy implications. Further, the impact of short-term programs that address psychological vulnerabilities of impoverished populations needs to be studied further.

Adolescent↗

PubMed2001

Perceptions about risk for HIV/AIDS among adolescents in juvenile detention.

Although progress has been made toward reducing risk-taking behavior among teens, adolescents confined in juvenile detention facilities and youths living in inner cities remain vulnerable. Reaching these populations with appropriate risk-reduction strategies continues to challenge health providers and educators. Crucial first steps in the design of relevant programs involve discovering how at-risk teens perceive risk and which risks and dangers within their communities occupy their attention. Participants in this study did not identify HIV/AIDS as a primary concern; instead, they described the dangers and risks they encountered in their home neighborhoods. Based on these findings, this discussion addresses the implications for the development of health education programs to empower teens for responsible behavior after release from detention.

Adolescent↗

PubMed2000

Gender differences in behavioural and psychosocial predictors of HIV testing and return for test results in a high-risk population.

We assessed gender differences in psychosocial and behavioural predictors of HIV testing and returning for results in a high-risk sample of 1,049 predominately minority, impoverished, homeless and/or drug-abusing women (n = 621) and men (n = 428). Predictors included latent variables representing injection drug use, self-esteem, social support, AIDS knowledge, poor access to health services, perceived risk for AIDS, sexual risk behaviour and the mediators of positive and negative coping styles. Significant predictors of test and return for women included injection drug use, greater social support, more AIDS knowledge, a higher perceived risk for AIDS and a positive coping style. Significant predictors for the men included injection drug use, greater AIDS knowledge, a higher perceived risk for AIDS and a positive coping style. Although greater social support was not significant for the men, the significant predictors of HIV testing and return were generally similar for the men and women. However, the men evaluated their risk of AIDS significantly lower than the women, although they reported more sexual risk behaviours and equally risky injection drug use behaviours. Results suggest that interventions designed to increase AIDS knowledge, to raise the perception of risk and to promote a positive coping style would be effective in encouraging more HIV testing for both men and women, but raising perceptions of what constitutes personal risk behaviours may need special emphasis when delivering prevention programmes to men.

AIDS Serodiagnosis↗

PubMed1999

Associations between homeless women's intimate relationships and their health and well-being.

The purpose of this study was to describe the associations between intimate relationships, characterized in terms of presence or absence of conflictive interaction with the partner, and the health and well-being of homeless women. A sample of 558 homeless women were administered structured interviews by trained nurses or outreach workers of the participants' ethnicity. Women answered questions about their general physical health, health-threatening behaviors (i.e., risky drug and sexual behaviors), health-promoting behaviors (i.e., TB and Pap testing), psychological well-being and symptomatology, self-esteem, coping, and life satisfaction. Women in nonconflictive relationships reported significantly greater psychological well-being, self-esteem, and life satisfaction and less hostility and noninjection drug use than women with conflictive relationships or those without an intimate partner. Women with conflictive relationships were significantly more anxious and depressed than those with nonconflictive relationships. Results suggest that, when possible, it is advisable to involve the intimate partner in programs to facilitate the emotional well-being of homeless women.

Adaptation, Psychological↗

PubMed1999

Perceived factors influencing the initiation of drug and alcohol use among homeless women and reported consequences of use.

A qualitative research approach was used to explore the factors that influence the initiation of drug and alcohol use among homeless women and the health and social consequences of drug and alcohol use. The sample consisted of 238 women; of whom 209 women reported drug and/or alcohol use in the past month and 29 women reported no history of drug or alcohol use. Findings of the study revealed homeless women who currently used drugs and alcohol, homeless women who currently used drugs only, and to a lesser extent current alcohol users only, had suffered traumatic childhood events and family dysfunction and had to cope with low self-esteem, emotional distress, and poor physical health. The initiation of drug and/or alcohol use was strongly affected by the social influence of other users. In comparison, homeless women who did not use drugs or alcohol reported a positive self-image, few traumatic events, and chose partners who did not use drugs or alcohol. Common among current drug and/or alcohol users were the reported social benefits of drug use. Quantitative analyses revealed homeless women who were current drug users were significantly more likely to have experienced childhood and adult victimization as compared with women in the other groups. Thus, the need for social interventions and positive social support early in the lives of these women are strongly implicated in these findings.

Adult↗

PubMed1998

Differences in personal, cognitive, psychological, and social factors associated with drug and alcohol use and nonuse by homeless women.

The purpose of this study was to compare differences in personal, cognitive, behavioral, psychological, and social variables among homeless women who were current drug or alcohol users, or both, past drug or alcohol users, or both, and those who never used drugs or alcohol. The sample consisted of 1,013 women residing in 73 Los Angeles homeless shelters. Depression, anxiety, hostility, emotion-focused coping, lower self-esteem, and less social support were more prevalent among homeless women who continued to use drugs and alcohol than among past users or those who never used. AIDS knowledge was higher among past users. The results contribute important knowledge regarding the pattern of cognitive, psychological, and social differences between users and nonusers.

Adult↗

PubMed1998

Effectiveness of a specialized vs. traditional AIDS education program attended by homeless and drug-addicted women alone or with supportive persons.

This research examined the impact of including a supportive person on the outcomes of two culturally sensitive AIDS education programs, an education-only (traditional) program and a program combining education with self-esteem and coping enhancement (specialized). Research participants in this quasi-experimental study included 241 homeless women, who were randomly assigned by residence (drug treatment program or shelter) to one of four treatment groups. The outcomes measured at baseline, 6, and 12 months were risk behaviors, cognitive factors, and psychological functioning. Study results demonstrated significant improvements at both 6 and 12 months for the entire sample in all psychological, behavioral and cognitive outcome variables except active coping. Women in the specialized program improved more on AIDS knowledge and reduction in non-injection drug use than did those in the traditional program, but their active coping scores declined. Participation of a supportive person did not appear to have any effect on outcome.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Reliability, validity, and composition of a subset of the Centers for Disease Control and Prevention acquired immunodeficiency syndrome knowledge questionnaire in a sample of homeless and impoverished adults.

OBJECTIVES: Measures of acquired immunodeficiency syndrome (AIDS)-related knowledge that have good psychometric properties are needed to evaluate the impact of educational interventions, particularly among impoverished populations. Few measures that satisfy these requirements are available. The authors describe the psychometric characteristics and composition of a subset of 21 AIDS knowledge items from the questionnaire used by the National Center for Health Statistics. METHODS: The study was conducted with a convenience sample of women and their significant others or close friends in nine homeless shelters and 11 residential drug recovery programs in the skid row area of Los Angeles from 1991 to 1993. Trained nurses and outreach workers collected data from 486 predominately African-American adults before delivery of well-established, culturally sensitive AIDS educational intervention. A subset of 334 participants were re-interviewed 6 months later. RESULTS: A total scale score was calculated from a one-factor solution, and two subscale scores were formed based on a two-factor solution. One subscale was composed of primarily cognitive items, whereas the second subscale contained mainly transmission-related items. The internal consistency reliability of the overall scale was 0.89; the two subscales had alphas of 0.80 and 0.92. The measures have face validity, and support for convergent validity was found. Further, even though AIDS knowledge in the sample was relatively high, all three measures showed marked improvement in the subsample of respondents who were re-interviewed after receiving AIDS-related educational information. CONCLUSIONS: These measures show promise for assessing AIDS knowledge and the efficacy of AIDS education programs in vulnerable populations. The findings reported here, however, are preliminary. Test-retest reliability needs to be examined, and additional studies are needed with samples that are more culturally diverse and include socially isolated individuals.

Acquired Immunodeficiency Syndrome↗

PubMed1997

Visual coping scenarios to facilitate discussion of coping responses with impoverished women at risk for AIDS.

1. Impoverished and homeless women are prone to coping with life stresses through drug and alcohol use. 2. Visual coping scenarios are culturally sensitive strategies to help impoverished minority women discuss effective coping responses. 3. A visual coping scenario redirects attention from a negative emotional event to an effective problem-focused coping strategy.

Acquired Immunodeficiency Syndrome↗

PubMed1996

Impoverished women at risk for AIDS. Social support variables.

1. Among impoverished and homeless individuals, little is known about the impact of social support, defined as emotional, informational, and tangible help that may have health-sustaining and stress-reducing functions. 2. A lack of positive social support, unemployment, and the prevalence of poor physical health and psychological distress may contribute to the extreme vulnerability of indigent populations. 3. Information is needed about the social support network of homeless and impoverished women related to personal and behavioral variables, particularly illegal drug use and risky sexual activity, and mental health status.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Psychosocial predictors of AIDS risk behavior and drug use behavior in homeless and drug addicted women of color.

The present study examined a causal model consisting of personal and social resources, threat appraisal processes, coping styles, and barriers to risk reduction as predictors of general AIDS risk and specific drug use behaviors among homeless African American (N = 714) and Latina (N = 691) women. The model, which was based on a stress and coping framework, supported many of the hypothesized relationships. Active coping was associated with fewer general AIDS risk behaviors for both groups and less specific drug use behavior among African American women. Specific drug use behavior was predicted by high threat appraisal and avoidant coping for both groups. Ethnic differences and implications for intervention are discussed.

Acculturation↗

PubMed1994

Risk-taking behaviors and AIDS knowledge: experiences and beliefs of minority adolescent mothers.

Using a qualitative focus-group methodology, this study investigated risk-taking behaviors and AIDS knowledge among minority pregnant and parenting adolescents at risk for heterosexual and perinatal transmission of HIV. Seven focus groups were conducted with a total of 48 young women recruited from alternative schools and residential facilities for pregnant adolescents and young mothers in Southern California. Participants also completed a background questionnaire soliciting sociodemographic information and an AIDS knowledge test. The sample included 33 Latinas and 15 African-Americans, ranging in age from 12 to 19 years. There were bipolar findings regarding risk-taking behaviors. At one end of the continuum were young women with a history of one of more of the following behaviors: multiple sex partners, drug and alcohol use, carrying weapons, and participating in gang-related activities. Contrasting with these, were those who had one or two sex partners and no history of alcohol or drug abuse. A majority of the participants were having unprotected sex. A variety of factors affected condom use, including gender inequality, embarrassment, and personal preferences and values. Risk-taking was also influenced by lack of security and safety in daily living, emotion-focused coping and peer pressure.

Acquired Immunodeficiency Syndrome↗

PubMed1993

AIDS-related knowledge, perceptions, and behaviors among impoverished minority women.

OBJECTIVES: The aims of this study were to (1) describe AIDS-related knowledge, perceptions, and risky behaviors of impoverished African-American and high- and low-acculturated Latina women; (2) delineate relationships involving high-risk behaviors; and (3) determine whether risky behaviors differ by race and levels of acculturation. METHODS: Survey instruments were administered to 1173 impoverished women of color residing in homeless shelters and drug recovery programs. RESULTS: Differences based on ethnicity and level of acculturation were found in AIDS-related knowledge, perceived risk of acquiring AIDS, and risky behaviors. Low-acculturated Latinas reported low perceived risk and were least likely to engage in illegal drug use and sexual activity with multiple partners. Intravenous drug use was most prevalent among high-acculturated Latinas, whereas nonintravenous drug use and high-risk sexual activity was most prevalent among African-American women. CONCLUSIONS: The data indicate the need for culturally sensitive AIDS prevention programs for women that deal with general issues of drug use and unprotected sex, and that include separate sessions for women of different ethnic backgrounds and acculturation levels to address specialized areas of concern.

Acculturation↗

PubMed1992

Coping and adjustment of spouses of critically ill patients with cardiac disease.

An acute cardiac illness represents a significant stressor to both patients and families. In a convenience sample of 100 spouses of critically ill adults, the relationships among personality factors, coping responses, social network, age, education, and emotional and physical distress were investigated. Results indicated a significant positive relationship between positive personality factors and problem-focused coping and between negative personality factors, emotion-focused coping, and emotional and physical distress. As expected, spouses who reported more negative personality factors and used greater emotion-focused coping scored higher on emotional and physical distress. Moreover, spouses who scored higher in emotional distress reported greater physical distress. No statistically significant relationships were found among the variables of personality factors, problem-focused coping, and support provided by the spouses' social network and the outcome variables of emotional and physical distress. Regression analysis revealed negative personality factors, emotion-focused coping, and education explained 52% of the variance in emotional distress. Future studies using experimental design are needed to evaluate the influence of a multitude of factors on coping and health outcome of spouses of critically ill patients with cardiac disease.

Adaptation, Psychological↗

PubMed1992

Comparative study of factors relating to HIV risk level of black homeless women.

A comparative study was conducted to assess factors that relate to level of HIV risk of black homeless women. The study examined whether 460 black women categorized as high, moderate, or low risk for HIV infection differed in environmental, demographic, and personal factors; appraisal of threat; resources; coping responses; and health outcome. Multivariate analyses of variance revealed high-risk homeless women reported statistically significant and greater concerns, appraisal of threat, emotion-focused coping, depression, and emotional distress, as well as less self-esteem and sense of coherence than moderate- and low-risk homeless women. Discriminant analyses revealed that women at high risk for HIV infection were best differentiated from moderate- and low-risk women by greater use of emotion-focused coping, greater severity of concerns, greater depression, and less self-esteem. An understanding of psychosocial factors most predictive of groups at highest risk for HIV infection provides impetus for interventional programs focused on altering the course of the disease in this population.

Adaptation, Psychological↗

PubMed1990

Focus group interview: a research technique for informed nursing practice.

AIDS has become a leading cause of death for women between the ages of 25 and 34. An overwhelming proportion of these women are Black (52%) or Hispanic (20%). Despite the disproportionate number of minority women who are HIV infected, the majority of AIDS educational programmes have been directed at the White gay male. The purpose of this paper is to present a qualitative research technique which used focus group interviews to promote the development of a programme devised to reduce risk behaviours in minority populations. A summary of the investigation and implications for nursing are also presented.

Acquired Immunodeficiency Syndrome↗

PubMed1990

Designing a culturally sensitive AIDS educational program for black and Hispanic women of childbearing age.

A disproportionate number of AIDS cases is seen among Hispanics and women. However, there is a lack of knowledge relative to effectively educating and motivating behavioral change among minority women at risk for HIV infection. Using the Health Belief Model as a framework to promote behavioral change, methods for designing a culturally sensitive AIDS educational program that appropriately addresses the needs of a population at risk, are given. A list of national resources relating to AIDS resources for the black and Hispanic community is also provided.

Acquired Immunodeficiency Syndrome↗