coping styles

Coping styles, Perceived social support and Quality Of Life among HIV Infected People

 

Rukmini.S * Chandrakant jamadar

 

ABSTRACT

 

To examine the relationship of the coping styles and QOL of HIV infected people. To examine the relationship of the perceived social support and quality of life of HIV infected people. Methodology: subjected who had been tested HIV positive and had undergone pre and post test counseling were screened for eligibility using random sample method, the target group of 300 participants were selected from Bangalore ICTC(Integrated Counseling and Testing Centre). Coping checklist by Rao,Subbakrishna and Prabhu,WHO QOL by HIV BREF, Perceived Social Support (PSS) by Mary E. Procidano and Kenneth Heller were used to collect the data. The data were analyzed by using correlation. The result revealed that Distraction Positive and Distraction Negative coping strategies best predicted with Physical domain and Psychological domain (QOL) HIV infected people. Perceived social support from friend's best predicted social support domain quality of life of HIV infected people.

 

Keywords: Coping styles; Quality of life; perceived social support: HIV/AIDS; physical domain; psychological domain.

 

 

*Assistant Professor,Department of Psychology, Government Home Science College, Hassan, Karnataka. India.

**Professor of Clinical Psychology, Dept. of P.G.Studies and Research in Psychology, Kuvempu University. Shivamogga. Karnataka. India.

***Asst.Professor P.G.Studies in Psychology,Maharani Arts &commerce college Mysore

 

 

 

INTRODUCTION

 

HIV/AIDS is one of the main health and social challenged in the contemporary world. India is experiencing rapid and extensive spread of HIV infection India falls among the countries which have highest number of persons living with HIV/AIDS today. HIV transmission will increase among both adults and children in most parts of the country. Regional trends indicate increases in the occurrence of sexually transmitted infections. The spread of infection within the country is not uniform but heterogeneously spread across states and districts. The most common HIV subtype seen in India is HIV - 1 infection accounting for 86% of the total infections.

 

The World Health Organization (WHO) has defined Quality of life as "an Individual's perception of his or her position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns". It is considered to be a broad concept incorporating in a complex way an individual's physical health, psychological state, level of independence, social relationships, personal beliefs and his or her relationship to salient features of the environment (WHOQOL Group, 1995). However, health related QoL is more limited in substance and boundaries. It can be defined as "the value assigned to the duration of life as modified by the social opportunities, perception, functional states and impairments that are influence by diseases, injuries or treatment" (Patrick and Erickson 1988).

 

The perceived social support described in this report were designed to measures the extent to which an individual perceives that his/her needs for support, information and feedback are fulfilled by friends and by family. The distinction between friend support and family support is considered wii be important. Different population may rely on or benefit from friend or family support to different extents at a given time, there might be more change in an individual's friend network or family network. Friend relationship is often relatively shorter duration than family relationships, and while an individual's social competence probably plays a role in the maintenance of his/her support network (Heller, 1979).

 

J Fieaster and Daniel (2008) conducted a study using a HIV positive African American mothers samples. The investigators found that HIV positive African American mothers who had higher levels stressors perceived their stressors as a whole to be less controllable. Coping resources available social support and perceived control were positively associated with active coping and negatively associated with psychological distress. Avoidant coping was the most important predictors of psychological distress.

 

Tate, David C.; Van Den Berg, Jacob. J; Hansen, Nathan B ; (May 2006) examined the relation between race, social support and coping, particularly among HIV infected individuals. High levels of perceived social support were related to greater use of positive coping and seeking support. Lower levels of social support were related to greater use of self destructing coping. Those with increased social support, decreased hopelessness, and effective coping had increased QOL (Swindells et al, 1999).

Research investigating and documenting psychosocial consequences
of human immuno deficiency virus (HIV) infection has accumulated
during the past two decades. Several studies have pointed out
that psychiatric disorders may be diagnosed in a high percentage
of HIV-infected patients and that several variables, ranging
from medico biological to psychosocial ones, intervene in facilitating
the onset of emotional disturbances secondary to HIV infection. With reference to this fact, the relationship between coping
and psychosocial morbidity represents a field of specific interest
in HIV and AIDS literature. Coping, defined as the cognitive
and behavioral efforts made by a person to alter or manage the
problem(s) caused by a specific stressful situation, has been
repeatedly studied in HIV-infected subjects. From a psychosocial
perspective, it has been documented that coping styles greatly
influence the psychological impact of HIV infection. Early reports
indicated that active behavioral coping strategies were related
to lower mood disturbances in HIV-infected patients, whereas
avoidant coping was associated with higher emotional stress.
These data have been confirmed by more recent research,
which also showed significant interactions between less effective
coping styles and several variables, such as low social support;
personality factors (e.g., poor self-esteem, low control);
and high occurrence of stressful events. Furthermost,
effective coping has been found to be related with better quality
of life as well as reduction of risk-taking behavior.
From a psychobiological perspective, the way in which HIV-infected
subjects respond to their condition might also have a role in
molding disease parameters. In fact, some studies of HIV-infected
patients have shown that active coping was associated with higher
total lymphocyte, CD4+, and "Natural Killer" cell counts and that a rapid progression of HIV disease was more likely
in patients who adopted a passive or fatalistic–resigned
coping style, particularly if associated with depression and
occurrence of severe stressful events.

 

 

 

Aims and Objectives:

1. To examine the relationship of the coping styles and QOL of HIV infected people.

2. To examine the relationship of the perceived social support and quality of life of HIV infected people.

 

MATERIAL AND METHOD

 

The study was carried out on a sample of 300 (including 150 male and 150 female). The Subjects who had been tested positive and had undergone pre test and post test counselling were screened for eligibility, using random sample method. The study was conducted at Integrated Counselling and Testing Center (ICTC) Bangalore, Karnataka. Confidentiality was assured to each participant.

 

Tools :

 

The following questionnaires were used to collect the data and study the relationship between coping styles, perceived social support and quality of life among HIV infected people.
The data sheet was developed by the investigator after observing the need to examine the relationship of a few demographic variables and their role in contributing to coping styles, perceived social support and Quality of life of HIV infected people.

 

1. Coping check list (CCL: Rao, Subbakrishna and Prabhu 1989): The CCL is a self report inventory comprising 70 items, it covers wide range of behavioral, cognitive and emotional response to handle stress, items are scored in a yes/no format, the response indicating presence or absence of a particular coping behavior.
   
2. WHO QOL – HIV BREF (WHO 1995) Quality of life scale has 31 items. It measures the quality of life of person on various dimensions such as Environmental domain, Physical domain, Psychological domain, Social domain and Level of Independence and Spirituality domain.
   
3. Perceived Social Support (PSS) (Mary E. Procidano and Kenneth Heller, 1983).
   

   Perceived social support has 40 items, it measures perceived social support from friends and family. The PSS measures were internally consist and appeared to measure valid constructs that were separates from each other and from network measure. Friends (PSS – Fr), consist 20 items and family (PSS – Fa) consist 20 items.
   

 

 

Procedure : The study was conducted at integrated counseling and Testing Center (ICTC) in Bangalore region. Each participant was met individually. They were informed in detail regarding the nature of study. They were assured absolute confidentiality regarding their identity and the information provided by them.

 

 

 

RESULTS AND DISCUSSION

 

 

The Pearson correlation co-efficient were calculated to examine the relationship between Coping styles and Quality of life, perceived social support and Quality of life.

 

 

Table 1: Pearson correlation of Quality of life and Coping styles.

 

Quality of life		Problem solving	Social support	Dis- Pos	Dis- Neg	Acceptance	Religion	Denial
Physical	Pearson Correlation	.007	.072	-.019	.118	-.081	.067	.050
	P value	.904	.214	.745	.041	.163	.250	.388
Psychological	Pearson Correlation	.065	-.062	.156	.049	-.030	-.011	.000
	P value	.259	.283	.007	.398	.600	.847	.990
Level of Independence	Pearson Correlation	-.026	-.008	.083	.066	.057	.073	.036
	P value	.652	.893	.150	.256	.322	.205	.539
Social support	Pearson Correlation	-.071	.109	.021	.078	.021	.063	.029
	P value	.223	.060	.721	.177	.720	.278	.613
Environmental	Pearson Correlation	.033	-.021	.037	.069	-.033	.060	.050
	P value	.571	.723	.518	.234	.570	.303	.390
Spirituality	Pearson Correlation	-.023	.040	.084	.095	-.016	.031	.186
	P value	.689	.494	.144	.101	.785	.591	.001
Total Quality of life	Pearson Correlation	.004	.035	.132	.023	-.033	.099	.123
	P value	.948	.543	.022	.694	.566	.088	.033

 

 

Table 1 show that Distraction Negative coping strategies component related positively significant with Physical domain (QOL). The correlation coefficient was found to be significant at .041 levels. Distraction Positive Coping strategies component related positively significant with psychological domain (QOL). The correlation co-efficient was found to be significant at .007 levels. However Distraction Positive and Distraction Negative coping strategies component related positively significant with Physical domain and Psychological Domain (QOL). A finding supported by current literature O'Leary et al, 1998; Badia et al, 2000; J. Friedland, R. Renwick, M. Mcoll 1997. Distraction positive coping strategies positively significant with total Quality of life. The correlation coefficient was found to be significant at .022 levels. Denial coping strategies component related positively significant with total QOL. The correlation coefficient was found to be significant at .033 levels.

 

In summary Distraction Positive and Distraction Negative best predicted with Physical domain and Psychological domain (QOL) HIV infected people. Coping strategies component like Problem Solving, Social support, Acceptance and religion did not influence of Quality of life Domains like level of independence, environmental and spirituality domain (QOL).

 

 

Table 2: Pearson correlation of Quality of life and Perceived social support.

 

Quality of life		Friends	Family	Total
Physical	Pearson Correlation	.077	.103	.116
	P value	.186	.075	.044
Psychological	Pearson Correlation	-.069	.038	-.027
	P value	.231	.508	.645
Level of Independence	Pearson Correlation	.043	.080	.079
	P value	.455	.165	.172
Social support	Pearson Correlation	.143	.076	.147
	P value	.013	.192	.011
Environmental	Pearson Correlation	-.010	.047	.021
	P value	.869	.419	.715
Spirituality	Pearson Correlation	.095	.094	.124
	P value	.102	.106	.032
Total Quality of life	Pearson Correlation	.085	.150	.150
	P value	.143	.009	.009

 

 

 

 

Table 2 shows that perceived social support from friend's component related positively significant with Quality of life. The correlation coefficient was found to be significant at .013 levels which are significant either at .05 levels.However friends support component correlated significantly and positively with the social support domain (QOL). Supported by current literature Tate, David C.; Van Den Berg, Jacob. J; Hansen, Nathan B; May 2006; McDowell, Serovich 2007.

 

In summary, only perceived social support from friend's best predicted social support domain quality of life of HIV infected people. Only correlation coefficient between perceived social support from friends and Social support domain (QOL) were found to be positively related and significant. Perceived social support from family did not influence of Quality of life Domains like Physical, psychological, level of independence, environmental and spirituality.

 

 

 

Conclusion

 

The relationship between quality of life and coping styles was examined using Pearson correlation techniques. The results revealed that Distraction Positive and Distraction Negative coping styles are the significant predictor of Physical domain and Psychological domain (QOL) HIV infected people. (O'Leary et al, 1998; Badia et al, 2000 ; J. Friedland, R. Renwick, M. Mcoll 1997). The relationship between quality of life and perceived social support was examined using Pearson correlation techniques. The review support for present study of HIV persons' satisfaction with social support, degree of hopelessness, and coping style. Those with increased social support, decreased hopelessness, and effective coping had increased QOL (Swindells et al, 1999; Tate, David C.; Van Den Berg, Jacob. J; Hansen, Nathan B; May 2006; McDowell, Serovich 2007). The results revealed that perceived social support from friend's best predicted social support domain quality of life of HIV infected people. Perceived social support from family did not influence of Quality of life Domains like Physical, psychological, level of independence, environmental and spirituality. HIV infected people get support from the counsellor, NGO and adequate treatment from the doctors. Limitations of the study the sample was not representative of the rural population. Finding Distraction Positive and Distraction Negative best predicted with Physical domain and Psychological domain (QOL) HIV infected people. Coping strategies component like Problem Solving, Social support, Acceptance and religion did not influence of Quality of life Domains like level of independence, environmental and spirituality domain (QOL. The continuation of investigation is strongly suggested. Further research is needed in the area of QOL and gender to better understand the relationship or lack thereof. Suggestion for future research would be to control for variables such as age. The combination of further research, a heightened sensitivity to QOL, Coping strategies and perceived social support in those infected with HIV/AIDS, despite of gender and a determination to improve this population's existence, are all recommendations based upon these findings.

 

 

ACKNOWLEDGMENT

I convey my sincere thanks to the Karnataka Aids Prevention society for giving a permission to collect a data. I am grateful to all my ICTC Medical officer and counselor they have cooperated for my research work. I am thankful to my family and friends.

 

 

 

 

 

 

 

 

 

 

 

 

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