Resilience And Its Mediating Effect On The Relationship Between Life Stress And Health-Related Quality Of Life In Older Adult People Living With Hiv/aids

Author

Xindi Fang, Yale UniversityFollow

Date of Award

January 2013

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Debbie L. Humphries

Abstract

Background: By 2015, 50% of all HIV/AIDS cases in the United States will be persons 50-plus years of age. Very little, if any, research has examined resilience in older people living with HIV/AIDS (PLWHA). This research explored the conceptual construct of resilience and investigated the mediating effect of resilience on the relationship between life stress and health-related quality of life (HRQoL) in PLWHA over fifty.

Methods: Data from a sample of 299 PLWHA over 50 was analyzed using structural equation modeling (SEM) to define a hypothesized Resilience construct (represented by Coping Self-Efficacy, Active Coping, Hope/Optimism and Social Support) and to assess meditating effects of Resilience between Life Stress and three facets of HRQoL (Physical Well-Being, Emotional Well-Being, and Functional and Global Well-Being). In addition, the mediation model was further analyzed to examine moderating effects of demographic variables on the magnitude of mediating effects.

Results: The SEM results showed satisfactory model fit for the Resilience construct, χ2 (18, N = 299) = 41.2, p = .001, and comparative fit index (CFI) = .98, incremental fit index (IFI) = .98, Tucker-Lewis coefficient (TLI) = .96, root mean square error of approximation (RMSEA) =0.066 (95% CI: [.039, .092]), with all factor loading ranging from 0.61 to 0.86. The mediational model demonstrated adequate fit (χ2 (96, N = 299) = 226.9, p < .0001, CFI = .96, IFI = .96, TLI = .95, RMSEA = .068 (95% CI: [.056, .079]) and revealed a full mediating effect of Resilience between Life Stress and Functional and Global Well-Being, as well as partial mediating effects on the relationship between Life Stress and Physical and Emotional Well-Being. What's more, the study found that race and study sites moderated the mediating effects of Resilience, suggesting that Resilience may present differently across race/ethnicity, cultures, and other factors.

Conclusion: The model indicated a well-defined Resilience construct and suggested that resilience may reduce the negative influence of life stress on physical, emotional, functional and global well-being. Findings suggest that the development of culturally-sensitive interventions that build personal capacity and environmental support may contribute to better management of HIV/AIDS and may be more efficacious in increasing HRQoL in older adult PLWHA.

Comments

This is an Open Access Thesis.

Recommended Citation

Fang, Xindi, "Resilience And Its Mediating Effect On The Relationship Between Life Stress And Health-Related Quality Of Life In Older Adult People Living With Hiv/aids" (2013). Public Health Theses. 1083.
https://elischolar.library.yale.edu/ysphtdl/1083