Watson, Robert; (2001) Psychosocial factors associated with vocational activity and quality of life in people living with human immunodeficiency virus (HIV) infection. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

This research attempted to determine the association between self-efficacy and quality of life and establish the specific contribution of vocational activity to quality of life in people living with HIV. In this cross-sectional study sixty five participants were recruited from Genitourinary Medicine Clinics and voluntary sector HIV services using non-random sampling methods. The main independent variables were self-efficacy (vocational specific and general), personality, and coping. The dependent variables were vocational activity and quality of life. Data on anxiety and depression was also collected. Participants completed questionnaire measures of relevant constructs. Overall there was a high level of psychological morbidity. Over half the sample reached caseness for anxiety and one quarter reached caseness for depression. Furthermore over half the sample were classified as low or very low on quality of life. This means they fell between the first and twentieth percentiles that distinguish clinical from non-clinical samples. Only a small proportion of participants were engaged in paid employment. Higher levels of vocational self-efficacy and lower levels of depression were associated with higher degrees of vocational activity. Logistic regression failed to show independent effects for either vocational self-efficacy or depression but together they were powerful predictors of vocational activity, suggesting that the two constructs may be related. Although higher levels of general self-efficacy was associated with better quality of life, general self-efficacy failed to demonstrate independent effects in linear regression analyses. On both conceptual and empirical grounds general self-efficacy did not appear to be a unitary construct but a poor relation of problem-focused coping. Only neuroticism and problem focused coping were independent predictors of quality of life. The presence of paid employment was associated with greater quality of life highlighting the psychological costs associated with unemployment in people with HIV infection. The clinical implications of these findings were discussed. It was proposed that psychological interventions for people living with HIV needed to be designed within a quality of life framework. Interventions were likely to fall into two broad categories - those that assist people return to work and thereby improve quality of life, and those that improve quality of life through other strategies when return to work is not feasible. (Abstract shortened by UMI.)

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