Development and Application of a Life Review Program to Support Mental Health Among Middle-Aged and Older Adults Living with HIV in Taiwan
Abstract
1. Introduction
2. Methods
2.1. Program Development
2.2. Research Design Justification
2.3. Participants and Setting
2.4. Ethical Considerations
2.5. Data Collection
2.6. Data Analysis
2.7. Trustworthiness and Rigor
3. Results
3.1. Participants’ Emotional Engagement During the Life Review Sessions
“When I talked about my past, I finally cried. I didn’t expect it, but it felt like something loosened inside me.”(Participant 3)
“The smell of the essential oils and the music brought up memories I had not thought about in years.”(Participant 5)
3.2. Social Connection and Peer Sharing as Emergent Processes
“I didn’t want to talk at first, but listening to others made me feel brave enough to speak.” This mutual encouragement fostered solidarity among the group.”(Participant 2)
“When others nodded while I was sharing, I felt understood. I wasn’t the only one with pain.”(Participant 4)
“We laughed and cried together. It reminded me that we’re all human, no matter what we’ve been through.”(Participant 6)
“Even if we came from different backgrounds, our struggles made us similar. I didn’t expect to feel connected like this.”(Participant 5)
3.3. Reframing Life Narratives and Renewed Perspective
“I always thought my life was a failure, but now I see how strong I’ve been to survive.”(Participant 3)
“If I could go back and talk to my younger self, I’d say: Don’t give up—you’ll make it.”(Participant 2)
“I felt like I had no value before, but after all these sessions, I realize I still have stories worth telling.”(Participant 6)
“Before this program, I didn’t think the future mattered,”(Participant 5)
“But now I have plans. I want to see my niece grow up. Even though I’m getting older, I don’t want to give up on myself again,”(Participant 1)
4. Discussion
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Week | Theme | Summary of Activities | Swanson’s Theory of Caring |
---|---|---|---|
1 | My story | 1. Introduce the program’s content, themes, and expectations through a video. 2. Present the first unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Instruct participants to fill out the “About Me” worksheet to document their background. 5. After completion of the worksheets, facilitate participants to share their background and offer mutual encouragement. 6. Use pictures to illustrate the researcher’s life journey—both positive and negative aspects—and lead participants to reflect on whether their life has been positive or negative, and why. 7. Introduce the history of HIV infection in Taiwan and yearly infection statistics. 8. Summarize the session and preview the second unit. 9. Give each participant a small gift and take individual and group photos. | Knowing |
2 | The moment I found out | 1. Review and discuss the content of the first unit with photos. 2. Introduce the second unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Play a song chosen by a participant and discuss its meaning. 5. Instruct participants to fill out the “The Moment I Found Out” worksheet by documenting how they were infected, and lead them to recall and share the moment of their HIV diagnosis and their psychological state at the time, including their experiences and mood at the moment. 6. Take a tea break together, with tea chosen by Participant A. 7. Instruct participants to fill out the “Lifeline” worksheet, sharing the happiest as well as saddest moments in life, and encourage mutual support. 8. Summarize the session and preview the third unit. 9. Give each participant a small gift and take individual and group photos. | Knowing |
3 | My honest feelings | 1. Review and discuss the content of the second unit with photos. 2. Introduce the third unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Play a song chosen by Participant C and discuss its meaning. 5. Introduce the development of HIV policy in Taiwan. 6. Drink “honest feelings” tea while the researcher shares their own honest feelings. 7. Invite participants to drink “honest feelings” tea and then recall and share their feelings at the time of HIV diagnosis, and discuss how it has affected their life, including relationships and work, and talk about their current feelings. 8. Take a break together, with a favorite fruit chosen by Participant A. 9. Instruct participants to fill out the “My Strengths” worksheet, sharing personal strengths, and encourage mutual support. 10. Summarize the session and preview the fourth unit. 11. Give each participant a small gift and take individual and group photos. | Being With |
4 | My blessing package | 1. Review and discuss the content of the third unit with photos. 2. Introduce the fourth unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Introduce the current state of HIV medical treatment in Taiwan. 5. Play a song of encouragement and support, discussing the meaning of the lyrics. 6. Take a break together, with the favorite juice chosen by Participant F. 7. Create a “Blessing Package,” writing down personal wishes on slips of paper and placing them inside. Encourage participants to share blessings and support for one another. 8. Summarize the session and preview the fifth unit. 9. Give each participant a small gift and take individual and group photos. | Being With |
5 | Write a letter to myself and someone important | 1. Review and discuss the content of the fourth unit with photos. 2. Introduce the fifth unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Play a song chosen by Participant C and discuss its meaning. 5. Introduce Taiwan’s government and social resources related to HIV, such as “Understanding AIDS for All” for eradicating discrimination, and the mandatory HIV education in schools for teachers and administrative personnel of at least 2 h per semester. 6. Use a video to explain an HIV diagnosis and its implications in personal life. 7. Encourage participants to share their understanding of HIV and discuss the impact on their lives, as well as strategies and resources that have been helpful in adapting to a life with HIV, and their concerns and expectations for the future. Participants are required to support each other. 8. Guide participants in conceiving and writing a letter to themselves and another letter to someone important as well as sharing the letters. 9. Summarize the session and preview the sixth unit. 10. Give each participant a small gift and take individual and group photos. | Doing For |
6 | Send a card of love | 1. Review and discuss the content of the fifth unit with photos, using an essential oil spray to fill the air with a floral scent. 2. Introduce the sixth unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Play a song chosen by Participant E and invite her to explain why she loves it. 5. Create an emotional support card. The researcher demonstrates how to design and write the card to convey support and encouragement, making sure every participant can feel the care and support of others. 6. Encourage participants to write words of support, gratitude, blessings, or encouragement for other members or themselves in the card. 7. Demonstrate how to design and write appealing cards and underscore the importance of letter content. Provide cards, colored pens, and sticks for card decoration. 8. Provide support and recommendations on conceiving and conveying ideas by the participants. 9. Take a break together, with a favorite tea chosen by Participant F. 10. Encourage participants (volunteers) to share the content on the cards and discuss their feelings while writing. Guide participants to share encouragement, thus enhancing interaction. 11. Hold the card delivery and blessing ceremony. Participants can opt to ask the researcher to deliver the letter or give it to someone they want to support in person. The researcher, on behalf of all the people, conveys blessings to the participants and invites everyone to give their best wishes to each other. 12. Summarize the session and preview the seventh unit. 13. Give each participant a small gift and take individual and group photos. | Doing For |
7 | Things I am proud of | 1. Review and discuss the content of the sixth unit with photos, using an essential oil spray to fill the air with a floral scent. 2. Introduce the seventh unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Discuss the challenges of middle-aged and older PLWH and health management. 5. Demonstrate how to share “Things I Am Proud of” and ask participants to do so briefly. Create a positive and safe atmosphere to build trust among participants. 6. Help participants imagine future goals while focusing on “Enabling.” Ask the following questions to guide thinking: What is the thing you would most like to do for yourself or others? What changes can you control or make in the future? 7. Celebrate Participant D’s birthday with cake and singing as a special event. 8. Summarize the session and preview the eighth unit. 9. Give each participant a small gift and take individual and group photos. | Enabling |
8 | My wish and blessing | 1. Use an essential oil spray to fill the air with a floral scent. 2. Introduce the eighth unit’s content and sequence of activities. 3. Instruct participants to perform finger exercises with essential oils for relaxation. 4. Review a video that summarizes all activities. Participants are guided to reflect on the eight-week experience and share what they have learned from each week’s activities. 5. Give each participant a commemorative booklet, encouraging them to share what they have written with each other. 6. Encourage participants to face future challenges with a positive attitude and apply what they have gained from the program to their daily lives. 7. Give each participant a small gift and take individual and group photos. | Maintaining Belief |
Characteristic | Range |
---|---|
Age (years) | 47–70 |
Gender | 3 Male (50%), 3 Female (50%) |
Duration of HIV Diagnosis (years) | 10–23 |
Mode of HIV Transmission | 5 Intravenous Drug Use (83.3%), 1 Sexual Transmission (16.7%) |
Living Arrangement | 6 in Long-Term Care Facilities |
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Hong, H. Development and Application of a Life Review Program to Support Mental Health Among Middle-Aged and Older Adults Living with HIV in Taiwan. Healthcare 2025, 13, 1698. https://doi.org/10.3390/healthcare13141698
Hong H. Development and Application of a Life Review Program to Support Mental Health Among Middle-Aged and Older Adults Living with HIV in Taiwan. Healthcare. 2025; 13(14):1698. https://doi.org/10.3390/healthcare13141698
Chicago/Turabian StyleHong, Hong. 2025. "Development and Application of a Life Review Program to Support Mental Health Among Middle-Aged and Older Adults Living with HIV in Taiwan" Healthcare 13, no. 14: 1698. https://doi.org/10.3390/healthcare13141698
APA StyleHong, H. (2025). Development and Application of a Life Review Program to Support Mental Health Among Middle-Aged and Older Adults Living with HIV in Taiwan. Healthcare, 13(14), 1698. https://doi.org/10.3390/healthcare13141698