Relationships Between Self-Reported Function, Quality-of-Life and Occupational Therapist Assessed Real-World Performance in HIV-Associated Neurocognitive Disorders

  • Camilla Hawkins

Student thesis: Doctoral ThesisProfessional Doctorate (ProfD)


The Human Immunodeficiency Virus (HIV) causes multisystem disease, affecting people of all ages and backgrounds. The number of people living with HIV continues to increase in the United Kingdom. Although in resourced settings such as the UK significant progress in disease management has been achieved through the use of antiretroviral therapy, people living with HIV continue to face myriad challenges.

HIV disease is characterised by a wide range of symptoms, including cognitive dysfunction. Dysfunction arising from the effects of HIV-associated neurocognitive disorder (HAND) presents in many ways. Research classifications have been developed to characterise HAND, however, in clinical practice presentation of cognitive dysfunction and its impact varies.

There is a paucity of literature relating to HIV, HAND and occupational therapy.Consequently limited investigation has been reported regarding the impact of HAND upon occupational performance. It is important that assessments have ecological validity, and adequately reflect the challenges of real-world environments, which are often unpredictable and novel.

This thesis comprises a cross-sectional pilot study involving 40 adults living with known or suspected HAND. Self-reports from participants regarding their quality-of-life, and function, were collected by means of two standardised questionnaires. Occupational therapy assessment of occupational performance in real-world environments was conducted using a criterion-referenced occupation based tool. The research aim was to investigate whether relationships between the outcomes of the tools existed. An additional aim was to investigate self-reported quality-of-life, function and occupational performance with age, gender and ethnicity.

Results provide evidence that adults affected by HAND demonstrated dysfunction in occupational performance. Additionally, age-related and ethnicity-related differences in self-reported quality-of-life, self-reported function and occupational performance were identified. Evidence was also found that an association existed between sensory perceptual dysfunction, and pain in that they negatively affected occupational performance. Self-report of quality-of-life was not found to be associated with less effective occupational performance.

This thesis has generated new knowledge regarding HIV-associated neurocognitive disorder, self-reports of adults regarding their quality-of-life and function, and occupational therapy assessment. It has identified differences in occupational performance, quality-of-life, and function between people living with HIV, and has informed future occupational therapy assessment and practice.
Date of Award2016
Original languageEnglish
Awarding Institution
  • Glasgow Caledonian University
SupervisorBen Stansfield (Supervisor) & Jennifer Preston (Supervisor)

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