WORK ADJUSTMENT IN PERSONS LIVING WITH HIV/AIDS (PLWHA)

204 Pages·2004·0.52 MB·English

ABSTRACT

Title of dissertation: WORK ADJUSTMENT IN PERSONS
LIVING WITH HIV/AIDS (PLWHA): A
BIOPSYCHOSOCIAL PERSPECTIVE

Lisa M. Baker, Doctor of Philosophy, 2004

Dissertation directed by: Professor Mary Ann Hoffman
Department of Education

While there is evidence that Persons Living with HIV/AIDS (PLHWA) have
unique and changing needs and concerns in their workplaces, such as changes in health
status, high medical costs, emotional consequences of the disease, and concerns about
discrimination, no previous studies could be found on work adjustment (e.g., job
satisfaction) in PLWHA. However, past research has linked employment disruption and
decisions to disease progression, cognitive impairment, physical symptoms,
depression/anxiety, concern about discrimination, and medical costs (e.g., Ezzy et al.,
1999; Heaton et al., 1994; Martin, Brooks, Ortiz, & Veniegas, 2003). Therefore, this
study tested a biopsychosocial model of work adjustment in employed PLWHA (N =
57), based on Hoffman and Driscoll’s (2002) Concentric Biopsychosocial Model. It was
hypothesized that physical health (fatigue and pain), psychological adjustment, and work
support/environment would uniquely predict work adjustment (e.g., job satisfaction),
where psychosocial variables were expected to account for the most of the variance
explained.
With the exception of pain symptoms, the predictor variables in the model were
found to correlate with the primary outcome, job satisfaction. A hierarchical block-wise
regression was then utilized to test the model, where the physical health variable (i.e.
energy/fatigue) was entered first, followed by the entry of the psychological adjustment
variable in the second block. The work environment variables (i.e., perceived supervisor
support, perceived discrimination) were entered in the third and final block. Results
partially supported the proposed model with 25% of the variance in job satisfaction
explained in the third step, where perceived supervisor support and workplace
discrimination accounted for a statistically significant amount of the variance. These
findings support the importance of examining perceptions of workplace environment
when addressing work adjustment and employment concerns of PLWHA.
WORK ADJUSTMENT IN PERSONS LIVING WITH HIV/AIDS
(PLWHA):
A BIOPSYCHOSOCIAL PERSEPTIVE

By

Lisa Marie Baker

Dissertation submitted to the Faculty of the Graduate School of the
University of Maryland, College Park, in partial fulfillment
of the requirements for the degree of
Doctor of Philosophy
2004

Advisory Committee:
Professor Mary Ann Hoffman, Chair
Professor Ellen Fabian
Professor Dennis Kivlighan
Professor Katherine Klein
Dr. Linda Tipton
© Copyright by
Lisa Marie Baker
2004
Dedication

To my loving husband, Sam, and to my family and friends who supported me in
completing this dissertation.
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Acknowledgements
I would to thank my mentor, Dr. Mary Ann Hoffman, for her creativity and support
during this process, and thanks to my dissertation committee for their valuable input. I
also have several people and groups to thank for helping me reach out to the HIV/AIDS
community: Carol Horwitz for her inspiration and assistance in helping me better
understand and reach out to the HIV/AIDS community; the advocates and workers in
HIV/AIDS communities in New York City, Washington, D.C., Illinois, and Northern
Virginia; Nancy Colberg for her continuous recruitment efforts. Also, thanks to Dr. Brad
Brenner for his helpful input and for his on-line survey assistance, and thanks to Lis
Graves for her invaluable editing help. Special thanks to the individuals who participated
in this study, for without them, none of this would have been possible.

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Table of Contents

List of Figures........…......................................…………………………...……..Page vii

List of Tables.........…...............................................………….……….....……..Page viii

Chapter 1: Introduction..…….....................................................……..................Page 1

Chapter 2: Review of the Literature......….................................……..................Page 7
Overview...........…............................…………...............……................Page 7
Overview of Work Adjustment…..……………………….…………….Page 7
Background of Biopsychosocial Perspective ...........…….......................Page 9
Biomedical Contributors in HIV...........................……...………............Page 10
Biosocial Contributors in HIV.........................…….....………..........…..Page 26
Psychosocial Contributors in HIV..................……........………....…......Page 30

Chapter 3: Statement of the Problem....…......…......………................................Page 55

Chapter 4: Method.........….......................................…….............................…...Page 67
Participants….......………..…...........…………..…..................……........Page 67
Measurement of Demographics.………...............................……............Page 72
Measurement of Physical Health.......................................……...............Page 73
Measurement of Cognitive Functioning........……….......……................Page 76
Measurement of Psychological Adjustment....………....……................ Page 77
Measurement of Social Support........….........……….....……................ Page 77
Measurement of Workplace Discrimination............…….........….......…Page 79
Measurement of Job Satisfaction.......................……............…….......…Page 81
Measurement of Organizational Commitment....…….............….…....…Page 82
Measurement of Turnover Intentions.......................……........….…....…Page 84
Procedure..………...........................................………..…..………..........Page 84
Online Survey Page 85
Mail-In Survey Page 87
Chapter 5: Results…………..…...........................……........................................Page 89
Data Analyses…….......…………..................……............................…..Page 89
Description of Sample.....................……..............……............................Page 89
Primary Analyses......................…................................……............……Page 94
Correlational Analyses: Hypotheses 1 to 4 Page 94
Biopsychosocial Model Analyses Page 107
Additional Analyses Page 113
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Chapter 6: Discussion ...…...............…………………............……..................Page 117
Overview........….............................................…………………..……..Page 117
Work Adjustment...................…..............................................……..….Page 118
Biomedical Factors....................….............................................……….Page 119
Psychological Factors.........................…........................................…….Page 125
Social/Environmental Factors........................................……........……..Page 126
Biopsychosocial Model ...............................……….…………….……..Page 132
Limitations of the Study......….....................................................….…...Page 147
Implications and Recommendations...............................................……..Page 140

Figure Caption..........................................................................................……...Page 148

Figure...............................................................................……............................Page 149

Appendix A: Demographic Form........…..............................……......................Page 150

Appendix B: MOS-HIV Health Survey......................................….........….......Page 152

Appendix C: Social Support Questionnaire..........…...........................…..….....Page 153

Appendix D: Work Discrimination-HIV/AIDS........…......….................….......Page 154

Appendix E: Workplace Discrimination/Prejudice Inventory..........…....…......Page 156

Appendix F: FACES Job Satisfaction Scale.......................................…….…....Page 157

Appendix G: Job Satisfaction Questionnaire..............................................……..Page 158

Appendix H: Organizational Commitment Scales..............………............…......Page 159
Appendix I: Intention to Quit Measure..........….................................…..............Page 161
Appendix J: Example of Recruitment Email.……........…...…....….....................Page 162
Appendix K: Flyer Advertisement......….........……......….......…........................Page 163
Appendix L: Newspaper Advertisement............…...........…..............…...............Page 164
Appendix M: Online Advertisement..................…..............….......…...................Page 165
Appendix N: Online Informed Consent Letter...…................……........................Page 166
Appendix O: Online Debriefing Statement.........…..................…................…......Page 167
Appendix P: Resource List.................................….....................….................…...Page 168
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Appendix Q: HIV/AIDS Network Meeting Script.........................…..................Page 169
Appendix R: Revised Consent Form (mail-in version).....................…...............Page 170
Appendix S: Revised Debriefing Form (mail-in version)....................….............Page 172
Appendix T: Revised Consent Form (online version)............................…..........Page 173
Appendix U: Drawing Entry Instructions (online version).......................…........Page 175
Appendix V: Revised Debriefing Form (online version)............................…......Page 176
References…………...........……………………………………….....……..…...Page 177
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List of Figures

1. Proposed model of work adjustment in employed PLWHA. 135
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