Fatigue and sleep disturbance related to perceived stress in Chinese HIV-positive individuals

A mixed methods study

Wei Ti Chen, Cheng Shi Shiu, Joyce P. Yang, Shih Yu Lee, Szu-Hsien Lee, Jane M. Simoni, Mei Juan Bao, Hong Zhou Lu

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Few studies of HIV+ individuals in China have examined the associations between HIV-related stress with sleep disturbance and fatigue, which are common complaints among people living with HIV/AIDS (PLWHA). We carried out this study to examine the relationships among perceived stress, sleep disturbance, and fatigue in PLWHA in China. Methods: A mixed methods study design was used during data collection in Shanghai, China, from December 2009 to March 2010. Qualitative in-depth interviews were conducted with 19 HIV+ females. Additionally, crosssectional audio computer-assisted self-interviews (ACASI) were conducted to collect quantitative data from a convenience sample of 107 HIV+ patients (84% were male) including the following scales: 1) Perceived Stress Scale for PLWHA, 2) General Sleep Disturbance Scale, and 3) Fatigue Scale. Results: The major themes that emerged from the in-depth interviews were around life stress with HIV, sleep disturbance, and fatigue. Participants presented varying amounts of stress around worrying about whether to disclose their diagnosis and whether they might transmit the disease to their family. In addition, in the cross-sectional data, 40% of the participants reported clinically significant sleep disturbances (GSDS > 3) with an average of 3 nights of disturbed sleep in the past week (M=2.87, SD=1.21) and moderate fatigue severity (M=5.24, SD=2.27). In mediation analyses, the data suggests that the relationship between perceived stress and fatigue was largely (53%) mediated through sleep disturbance. Conclusions: Chinese PLWHA described how stress had caused them to become sleepless and fatigued. The quantitative data also demonstrated significant levels of sleep disturbance and fatigue, where were due to perceived stress with HIV disease. A systematic self-management intervention to decrease perceived stress should be designed and implemented in mental health resource-limited settings such as China in order to reduce sleep disturbance and fatigue.

Original languageEnglish
JournalJournal of AIDS and Clinical Research
Volume4
Issue number6
DOIs
Publication statusPublished - 2013 Aug 6

Fingerprint

Fatigue
Sleep
HIV
China
Acquired Immunodeficiency Syndrome
Interviews
HIV-2
Health Resources
Self Care
Psychological Stress
Mental Health

Keywords

  • China
  • Cronbach alpha coefficient
  • Fatigue
  • PLWHA
  • Perceived stress
  • Sleep disturbance

ASJC Scopus subject areas

  • Immunology
  • Dermatology
  • Infectious Diseases
  • Virology

Cite this

Fatigue and sleep disturbance related to perceived stress in Chinese HIV-positive individuals : A mixed methods study. / Chen, Wei Ti; Shiu, Cheng Shi; Yang, Joyce P.; Lee, Shih Yu; Lee, Szu-Hsien; Simoni, Jane M.; Bao, Mei Juan; Lu, Hong Zhou.

In: Journal of AIDS and Clinical Research, Vol. 4, No. 6, 06.08.2013.

Research output: Contribution to journalArticle

Chen, Wei Ti ; Shiu, Cheng Shi ; Yang, Joyce P. ; Lee, Shih Yu ; Lee, Szu-Hsien ; Simoni, Jane M. ; Bao, Mei Juan ; Lu, Hong Zhou. / Fatigue and sleep disturbance related to perceived stress in Chinese HIV-positive individuals : A mixed methods study. In: Journal of AIDS and Clinical Research. 2013 ; Vol. 4, No. 6.
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abstract = "Background: Few studies of HIV+ individuals in China have examined the associations between HIV-related stress with sleep disturbance and fatigue, which are common complaints among people living with HIV/AIDS (PLWHA). We carried out this study to examine the relationships among perceived stress, sleep disturbance, and fatigue in PLWHA in China. Methods: A mixed methods study design was used during data collection in Shanghai, China, from December 2009 to March 2010. Qualitative in-depth interviews were conducted with 19 HIV+ females. Additionally, crosssectional audio computer-assisted self-interviews (ACASI) were conducted to collect quantitative data from a convenience sample of 107 HIV+ patients (84{\%} were male) including the following scales: 1) Perceived Stress Scale for PLWHA, 2) General Sleep Disturbance Scale, and 3) Fatigue Scale. Results: The major themes that emerged from the in-depth interviews were around life stress with HIV, sleep disturbance, and fatigue. Participants presented varying amounts of stress around worrying about whether to disclose their diagnosis and whether they might transmit the disease to their family. In addition, in the cross-sectional data, 40{\%} of the participants reported clinically significant sleep disturbances (GSDS > 3) with an average of 3 nights of disturbed sleep in the past week (M=2.87, SD=1.21) and moderate fatigue severity (M=5.24, SD=2.27). In mediation analyses, the data suggests that the relationship between perceived stress and fatigue was largely (53{\%}) mediated through sleep disturbance. Conclusions: Chinese PLWHA described how stress had caused them to become sleepless and fatigued. The quantitative data also demonstrated significant levels of sleep disturbance and fatigue, where were due to perceived stress with HIV disease. A systematic self-management intervention to decrease perceived stress should be designed and implemented in mental health resource-limited settings such as China in order to reduce sleep disturbance and fatigue.",
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AU - Chen, Wei Ti

AU - Shiu, Cheng Shi

AU - Yang, Joyce P.

AU - Lee, Shih Yu

AU - Lee, Szu-Hsien

AU - Simoni, Jane M.

AU - Bao, Mei Juan

AU - Lu, Hong Zhou

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AB - Background: Few studies of HIV+ individuals in China have examined the associations between HIV-related stress with sleep disturbance and fatigue, which are common complaints among people living with HIV/AIDS (PLWHA). We carried out this study to examine the relationships among perceived stress, sleep disturbance, and fatigue in PLWHA in China. Methods: A mixed methods study design was used during data collection in Shanghai, China, from December 2009 to March 2010. Qualitative in-depth interviews were conducted with 19 HIV+ females. Additionally, crosssectional audio computer-assisted self-interviews (ACASI) were conducted to collect quantitative data from a convenience sample of 107 HIV+ patients (84% were male) including the following scales: 1) Perceived Stress Scale for PLWHA, 2) General Sleep Disturbance Scale, and 3) Fatigue Scale. Results: The major themes that emerged from the in-depth interviews were around life stress with HIV, sleep disturbance, and fatigue. Participants presented varying amounts of stress around worrying about whether to disclose their diagnosis and whether they might transmit the disease to their family. In addition, in the cross-sectional data, 40% of the participants reported clinically significant sleep disturbances (GSDS > 3) with an average of 3 nights of disturbed sleep in the past week (M=2.87, SD=1.21) and moderate fatigue severity (M=5.24, SD=2.27). In mediation analyses, the data suggests that the relationship between perceived stress and fatigue was largely (53%) mediated through sleep disturbance. Conclusions: Chinese PLWHA described how stress had caused them to become sleepless and fatigued. The quantitative data also demonstrated significant levels of sleep disturbance and fatigue, where were due to perceived stress with HIV disease. A systematic self-management intervention to decrease perceived stress should be designed and implemented in mental health resource-limited settings such as China in order to reduce sleep disturbance and fatigue.

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