Coping
Coping is another variable influencing QOL. Pearlin and School have defined coping as the cognitive and behavioral effort made to tolerate, reduce, or master demands that challenge or exceed a person’s resources. Individuals who confronted stress with problem-solving and behavior-modifying approaches had a significantly better QOL than those not using such coping skills.[22] It has been proposed that education and behaviorally oriented interventions that enhance problem solving and active decision making are likely to be more beneficial than emotionally supportive interventions that encourage passive acceptance of the illness. Coping by denial (avoidance) was associated with a significantly lower QOL in a previous study. Although denial has been shown to be an effective coping method in non-HIV settings, the preponderance of studies in HIV settings has suggested otherwise.[22] Denial has been shown to correlate with low self-esteem and depression in HIV patients. Indeed, coping by denial may be an expression of helplessness, anger, or depression, and these patients may, in fact, be in need of psychological intervention.[22]