Psychological Well-being And Mental Coping Training Among Adolescents Living In Family Suffering From HIV/AIDS

Objectives To study the psychological well-being and influence factors of mental health among adolescents living with HIV-positive parents in rural of Anhui province. Then to explore the influence of participating and interconvertible mental coping effectiveness training targeting those adolescents.Methods The investigation was involving 298 adolescents from 10 to 18 years old, including 54 adolescents living with both parents suffering from HIV or AIDS, 114 adolescents living with one parent was HIV infected and other 130 adolescents from normal families. Only one adolescent was studied peer family. All participants completed an anonymous questionnaire. Psychological health, satisfaction on life, self-esteem and coping style were evaluated by SCL-90, Multidimensional Students'Life Satisfaction Scale, Self-esteem Scale and Simplified Coping Style Questionnaire. We assessment the psychological well-being among the three groups, and analyzed the influence factors of mental health among them. 51 adolescents living with HIV-positive parents were selected to carry out mental coping effectiveness training. At the beginning and end of the intervention, 51 participants were estimated their knowledge of HIV/AIDS, mental health and coping style. AIDS awareness was evaluated by self-organized AIDS knowledge. Mental health and coping style were evaluated by SCL-90 and Simplified Coping Style Questionnaire. We estimated the efficacy of the intervention on those adolescents.Results The total score and 10 factors of the SCL-90 in the adolescents living in family suffering from HIV or AIDS was higher than the adolescents from normal families and those scores in the adolescents living with both parents suffering from HIV/AIDS were the highest. Those scores were significant different in the three different subjects (P<0.05). There were 27.8% of the adolescents living with both HIV-positive parents had the total score of the SCL-90 more than 160 or at lest one of the 10 factors'score more than 3. The detected rate of the adolescents living with one HIV-positive parent was 16.7%, higher than the adolescents from normal families (8.5%) and with significant difference (χ2=11.457,P=0.003). 37.0% of the adolescents living with both HIV-positive parents, were having one or more factor'score between 2.0 and 3.0, compared to the rate (29.8%) of adolescents living with one HIV-positive parent. The rate was higher than the adolescents from normal families (19.2%) and with significant difference (χ2=14.583, P=0.005). Among the students from normal families, the total score and the 5 dimensionalities'score of the MSLSS were lower than those adolescents of parents suffering from AIDS or HIV. In the friend dimensionality, the score of the adolescents from normal families was significantly higher than the adolescents of parents infected HIV. The scores of the self-esteem, positive coping style and negative coping style were not significantly different in the three different subjects.20.2% of the adolescents got the total score of the SCL-90 more than 160 or at lest one of the 10 factors'score more than 3, and the proportion became higher with the increase of aged. The scores of positive and negative cooping style were significantly related with the respective score of 10 factors of SCL-90. The higher score of positive cooping style and family support were protective factors for mental health of adolescents. While higher age, the estranged relationship with schoolmates or friends and the higher score of negative cooping style were risk factors for their mental health. Multinomial Logistic analysis showed that positive cooping style, negative cooping style, family support and relationship with schoolmates or friends were the main influential factors of mental health of adolescents in HIV/AIDS family.94.12% of the adolescents in those study subjects enjoyed taking part in the participating and interconvertible mental coping training. After a seven-day mental coping training, the average rate of understanding about those HIV/AIDS knowledge increased from 61.25% (baseline) to 82.25% and with significant difference (χ2=107.139, P=0.000). The percentage of each knowledge to be answered correctly increased. The percentage of those adolescents who having mental symptom (the total score of the SCL-90 more than 160 or at lest one of the 9 factor'score more than 3) reduced from 25.5% (baseline) to 9.8% and with significant difference (χ2=4.317, P=0.038). The 9 factor's score of SCL-90 were all lower after intervention, the factor of depression and anxiety were much lower and with significant difference (1.40±0.52/1.55±0.50, 1.39±0.49/1.55±0.61, P=0.046\0.041). The score of positive coping style became higher, negative coping style became lower after intervention, but not with significant difference (P>0.05).Conclusions The psychological status of the adolescents living in family suffering from HIV/AIDS indicated unoptimistic situation. Improving the cooping style of adolescents in AIDS family, promoting the mutual support of family members, changing the discrimination against AIDS in rural area are the importance approach to advancing the mental health of adolescents whose parents infected HIV. The participating and interconvertible health education is propitious to improve the knowledge of HIV/AIDS in adolescents. Short-term mental coping training can reduce mental symptom of those adolescents living in family suffering from HIV/AIDS.