When we talk about the use of self-management skills, we usually refer to how they can be used to help control the outcomes that occur in having a chronic condition. They are just as helpful, however, in coping with different thoughts and behaviors that accompany a given illness. This was shown in a large study conducted by Kemppainen and colleagues with HIV patients. The research looked at the frequency and effectiveness of commonly used strategies for self- management of anxiety in an international sample of 502 participants from Norway (n=42), Taiwan (n=35), and the U.S. (n=426). An activities checklist filled out by the patients summarized five categories of self-care behaviors including activities/thoughts, exercise, medications, complementary therapies, and substance use determined self-care behaviors. Ratings of frequency and effectiveness for each self-care activity were also included.

The findings showed that praying received the highest overall rating of effectiveness of any self-management strategies included in the study, followed by meditation, exercising, using relaxation techniques, cooking, and walking. An analysis of effectiveness scores for each self-care strategy by country reflected a wide variation. The three most effective anxiety self-care strategies reported by participants from Norway included exercise, walking, and reading. The highest ratings of effectiveness by participants from Taiwan included talking with others with HIV, attending support groups, and exercising. U.S. participants reported highest ratings of effectiveness to complementary/alternative therapies, including praying, meditating, and using relaxation techniques. Regardless of the country, watching television and talking with family and friends were the two most frequently reported strategies.

COMMENT: This is an interesting study because it looked at how patients in three countries--Norway, Taiwan, and the United States--coped with the anxiety related to HIV. The most frequently used strategies--viewing TV and talking with others--were not the most effective strategies used by patients. This reflects the uniqueness of individual patients in deciding how best to cope with anxiety surrounding their condition and independent of what might work for others. A patient's decision, however, appears to be partially dependent upon where he or she lives. This is especially true for the patients from Taiwan. The authors concluded that strategies for self-management of HIV-related anxiety are important for clinicians to be aware of in the care of persons with HIV/AIDS. We echo this conclusion.

Do you have any comments or questions?

J.K. Kemppainen et al. Strategies for self-management of HIV-related anxiety. AIDS Care, 2006;18:597-607.