THE IMPACT OF SOCIO-ECONOMIC STATUS ON LIFE STRESS
AND ADJUSTMENTAL PROBLEMS OF HIV POSITIVE PATIENTS
*CHANDRAKANT JAMADAR **PROF. S.P. MELKERI
ABSTRACT
Background
: The individual is devised the basic
necessities. They cannot cope effectively with the demands of the social
environment. Because of socio-economic inequality, social interaction,
negatives, lack of motivation will definitely have high impact on the positive
people live the healthy life. And it is more evident and visible in the Indian
context, where sizeable part of the population is suffering from lot of SES and
cultural handicaps and the HIV people in India are not exception to this phenomenon, therefore, an attempt is
made to study the impact of SES status on the life stress and adjustmental
problems on HIV positive patients.
Objectives
: To
examine the contribution of life stress and adjustment to adverse SES events.
Methods
: To meet the objective of the present
study the data was collected at Gulbarga, Bidar, Raichur and Belgum (Karnataka)
District ICTC and NGOs centres, by personally interviewed the each clients by
help of inventory SES scale, life stress
and adjustment inventory.
Stage
– 1: SES scale was administered to the total
600 respondents to categorize them into the low SES groups (200) and high SES
groups (200) taking the first and third quartile as cut off points
respectively.
Stage
-2 : Life stress scale and adjustment
inventory were administered an the groups of high SES and Low SES. The response
were scored and terminated.
Results:
The results reflects the SES of life
stress of HSES and LSES of t-value is 3.95, (significant at 0.01 level) Male
& Female of t-value of life stress M/F is 3.00 (significant at 0.01 level).
Another scale adjustment of M/F t-value is 11.53 (significant at 0.01 level).
Conclusion:
There
is significant difference in the life stress of HSES and LSES OF HIV +ve patients.
HSES of HIV +ve patients have high life stress compare to LSES HIV +ve
patients. Female patient having high stress than the male, Adjustment of HIV
+ve patients male having the better a djustment than the female.
Keywords
: Life
stress, Adjustment, Socio-economic-status HIV and AIDS.
Abbreviations
and Acronyms : Acquired
immune deficiency syndrome (AIDS), Human immunodeficiency virus (HIV), High
Socio-economic-status (HSES), Life stress (LS), Low Socio-Economic Status
(LSES).
* Asst. Prof. P.G.
Studies in Psychology, Maharani Arts and Commerce College for Women’s Mysore. (mscbrain@gmail.com)
** Professor,
Department of Psychology, Gulbarga University, Gulbarga.
Introduction
Man is just as
truly a social as a biological creature and the socialization and development
of the personality of an individual is a highly complex process. But the
research undertaken all over the world indicate the fact that, the development
of a personality of an individual is entirely influenced by his socio-economic
cultural atmosphere to which he is exposed in his primitive years. Because, the
social dimensions of the individuals personality are largely determined by his
perception of social objects. His interactions and adjustments mainly depend on
the interpersonal relations as well as the social, cultural, educational
economic and psychological factors.
However,
there is a evidence to suggest that environmental factors are of great
significance in facilitating or inhibiting given needs, in conceiving the goals
as well as in determining the extent to which ones needs are gratified support
for this assumption comes from the studies on different aspects of
socio-cultural disadvantage/ deprivation, carried out in different parts of the
world. When these conditions create force of isolation from society, social
problems of personality development arise and a person may lose not only
advantageous personality traits but suffer from the risk of stagnating in the
development process that would lend to deprivation.
Likewise,
the HIV affected person also the products of socioeconomic and cultural milieu
in which they are born and brought up. And certainly these conditions and
atmosphere would have a big impact on their psychological and personality
traits, in his/her daily life in society. When the HIV affected people from
well in economically, they are maintaining healthy life. In India, Rath (1974)
has analyzed the relationship between social conditions and personality
dimensions. He argues that the biosocial needs of the people are integrated
with the external social demands. The latter are gradulized by internalized and
the former are steadily socialized in course of socio cultural adjustment.
There
is a clear moral and humanitarian obligation to provide appropriate care and
support to each person infected with and affected by HIV/AIDS. The benefits of
investing on care are manifold suffering is reduced and improvement is seen in
the quality of life; economic and socially productive activity is likely to be
prolonged. However, is that the majority of women infected today are married
and monogamous, having never had a sexual partner other than their husbands.
Mortality at YRG care dropped from 25 deaths per 100 patients year to just 5
deaths per 100 patients years in under six years. This provides hope that
Indian HIV patients can take ARV medications.
Just as efficiently at their western counterparts, in a manner that
saves lives. While access to ART may not be the solution to HIV in India, it is
definitely one critical component of dealing with this epidemic and an ethical
imperative in today’s world.
Stress in major source of hurting human
being over ambition and search for identity has given rise to overall stress.
In common prevalence stress is expressed when an individual becomes incapable
to cope with the demands of environment, which results in pressure and strain,
brings the person to feel tense and uncomfortable. In a stressful situation the
individual is threatened beyond his capacity to endure men he adopts coping
strategies to manage his behavior as the situation demands.
No
doubt, that stress is a common cold of modern living which is a prominent
feature of each and every work field. Stressful event lead to disruptive and
pathological states that invariably impair performance (Levin and Sctoch, 1970)
according to Burke and Weir (1980) “stress exists as a real problem in work
world with serious implications for the health and well being”.
Adjustment in a fast changing society
is an important socio pshychological aspect to be constantly studied. The
problem of adjustment especially during the most crucial phase of HIV positive
people. It should be given a through
probing. Today given the globalization process the value structure etc., which
traditionally gave a mooving to adjustment are being fast eroded and in their
place the new ones are developing through their structure is not clear. Hence,
the process of adjustment is becoming more and more complex and stressful in
HIV affected people.
Further, the low
SES conditions are preventing the individual from developing skills to cope
with the adjustmental demands through restricted experience would expose the
individual to differential problems. In other words HIV affected people limits
the behavioural efficiency of an individual. This socio psychological
variables, life stress, and adjustment. Therefore, assumes all the more
importance vis-à-vis the changing social order. In view of the above it is very
important to study the impact of SES on LS and adjustment of HIV positive
people.
Now
to elaborate a little about The concept of adjustment. The concept of
adjustment is used to denote the personality of the individual. It is also used
to refer to ones behavior, psychological conditions (normal or abnormal),
sociability etc. This epithet is also used to describe the quality and success
of life. However, the concept of adjustment as a research variable needs to be
explored. The concept of ‘adaptation’ which is the key term of Darwin’s theory of evolution was
borrowed and renamed as ‘adjustment’
by psychologist. Though the concept of adjustment was in usage for a long time
to explain certain process referring to the human behavior, the scientific
study of adjustment started only in the twenty first century.
Adjustment
is a process in which the needs of the individual on one hand and the claims of
the environment on the other are fully satisfied. A plethora of definition is
given to the term adjustment by several scholars. These definitions relate
mainly to the two aspects of adjustment 1) Individuals efforts to meet his
needs and 2) adapting himself to the environment. William Coa (1972) states
that, adjustment is a “process by which an individual applies his resources to
fulfill his personal need while at the same time maintaining harmony with his
environment”. According to Fredenberg (1971) adjustment involves transactions
with the environment which may result in a change in ones behaviors, or a
change in environment or both. Each one of us experience both external as well
as external needs. Thus, different definitions of adjustment speak of the
satisfaction of ones needs, in relations to the environment and establishment
of harmonious relationship with his environment. Needs are satisfied within the
framework of the society to which he belongs, physical psychological and
socio-cultural environments are of greater significance in the adjustment
process at a given moment. For the satisfaction of a persons need and
successful survival, he has to modify his behavior or modify the environment or
both. The need satisfaction and adjustment to environment are interdependent.
If the environmental conditions are not conductive to satisfactions of ones
biogenic and sociogenic needs. Adjustment to the surrounding becomes difficult.
The individual faces adjustmental problems in the areas like home, health,
social and emotional adjustment.
HIV/
AIDS :Acquired immune deficiency syndrome
(AIDS) is a life threatening syndrome of illness attributed to the human
immunodeficiency virus (HIV). HIV infection ranges from asymptomatic infection
to severe forms of the disease. Although clinical presentation varies, HIV
typically infects human ‘T’ cells that are essential to normal functioning of
the immune system with immune deficiency, the HIV infected person becomes susceptible
to opportunistic organisms that normally would be harmless (Centres for Disease
control (CDC), 1987).
According
to the 1987 definition of the CDC, AIDs is characterized by HIV encephalopathy,
HIV wasting syndrome, or certain diseases due to immunodeficiency in a person
with laboratory evidence for HIV infection and without certain other causes of
immunodeficiency (CDC, 1987). The later 1992 CDC, AIDS definition includes
people who meet the 1987 definition and adds. HIV infected adults and adolescents
with DC4 lymphocyte counts under 200 (CDC, 1991b). This definition moves the
AIDS diagnostic label earlier onto the disease continuous, which is intended to
be more inclusive of women and injecting drugs users (Chang, Katx, and
Hernandez, 1992, Murphy, 1991d).
HIV
disease is transmitted by sexual, parental and prenatal routes involving
exchange or body fluids with an infected person. Common routes include engaging
in sexual intercourse with an infected person, using an infected needle to
inject adding and receiving an infected blood product (CDC, 1992a). Lifestyle
environmental conditions, other viruses, drug abuse, and other cofactors can
affect the progression of HIV infection. A person may be HIV infected for many
years before developing AIDS. Medication can inhibit HIV and help to treat
opportunistic diseases (National center for Nursing Research, 1990). Indeed,
AIDS is a leading cause of death for some inner city children and for women and
men who are 25 to 44 years of age, surpassing heart disease, cancer, suicide
and homicide (CDC, 1992a). HIV disease rates are increasing among women, people
of colour and persons who inject drugs. These increasing rates and higher death
rates from AIDS for Indians are associated with poverty, drug abuse, teen pregnancy,
prostitution, child abuse, spouse battering, and inadequate education, health
care and social support.
HIV
infection is spreading throughout the world, particularly in developing
countries, which have the fewest available resources for preventing and care.
The complex needs of HIV infected persons are adding additional strain to
already overloaded health care systems. In the absence of a vaccine or cure,
effective educational programs appear to be the most useful tools for
preventing HIV transmission. The impact of HIV disease will depend on present
efforts to prevent HIV transmission and treat HIV infected persons.
Methodology
:
Statement
of the problem: to study the impact of
socio-economic status on life stress and adjustmental problems of HIV +ve
patients.
The
objectives of the study
1. To
know the significant difference between male and female HIV +ve patients in
life stress and adjustment
a) To
know whether male HIV +ve patients have low life stress, compare to female HIV
+ve patients
b) To
know whether male HIV + ve patient have better adjustment then female HIV + ve
patients
2. To
know the significant impact of SES on life stress and adjustment
a) To
know whether high SES have low life stress than the low SES HIV +ve patients
b) To
know whether high SES have better adjustment than the low SES HIV +ve patients
3. To
know the significant difference between rural and urban HIV +ve patients in
life stress and adjustment
a) To
know whether rural HIV +ve patients have low life stress than the urban HIV +
ve patients
b) To
know whether rural HIV + ve patients have better adjustment compare to the
urban HIV + ve patients.
Variables
: The SES and Sex are independent
variable and dependent variables are life stress and adjustmantal problems.
Sample
: The total sample consists of 400 HIV
positive patients belonging to HSES and LSES from Gulbarga, Bidar, Raichur,
Belgum, district in Karnataka. The age level ranging from 18-45 were selected
randomly. The sample design is given below;
Sample
Design
|
Sex
|
HSES
|
LSES
|
Total
|
||
|
Rural
|
Urban
|
Rural
|
Urban
|
||
|
Male
|
50
|
50
|
50
|
50
|
200
|
|
Female
|
50
|
50
|
50
|
50
|
200
|
|
Total
|
100
|
100
|
100
|
100
|
400
|
Tools
:-
a. Personal
data schedule; This is framed to collect information regarding the personal and
social-demographic status of the sample
b. Socio-economic-status
scale by Dr. Meena Kashi (2004) The scale is comprehensive in nature and does
not discriminate between rural and Urban of male /female subjects. It has
standardized on a sample of 1127 rural / urban participants.
Reliability :
On 153 participants is senior secondary school. The test-retest reliability has
been found to be r = .82, with a time interval of 10 days.
Validity :Two
samples of N1 = 37 and N2 42 of participants of a reputed
institution and ordinary institution respectively were taken to have an idea of
the validity of the school The average scores of these two groups of
participants were found to be 116.8 & 54.8 with S.Ds of 35.9 & 20.1 and
differentiating ‘t’ standing at 9.29,
significant at 0.1 level. Interalia it shows the discriminating power of the
scale.
c. Holmes
– Rahe life stress inventory (1967).
In
1967, psychiatrist. The mass Holmes and Richard Rahe examined the medical
records of over 5,000 medical patients as a way to determine whether stressful
events might cause illness. patients were asked totally a list of 43 life
events based on a relative score. A positive correlation of 0.118 was found
between their life events.
Statistical
analysis : Keeping the objectives of the study
in view, the following statically technique were applied. Mean, SD were
calculated the t-test was used to assess the significant difference between
SES, Rural / Urban and gender with dependent variables.
Discussion
: AIDS Patients are socially discriminated
in every field of life. They are looked down upon with negative attitude and
disliked by the society. They are not offend any social status or importance in
any situations. They are isolated from all important occasion in the society
and left alone without any support from friends and relatives. Even the family
members do not accept this infected, person in the family circle. The present
and future is fogged with darkness once the patient is diagnosed as HIV / AIDS
rest of his / her life is effected. He / she is unable to take nay decision due
to the stress he/she is facing due to social rejection. The stressful situation
effect his health also. The immune which effected by HIV is still more effected
by stress. Hence, formulated hypothesis is that HSES HIV / AIDs patients have
more life stress than the LSES HIV / AIDS patients
Tables
No. 1: Showing mean, SD and t-value of life stress of HSES and LSES HIV / AIDS
patients
|
|
HSES
|
LSES
|
|
Mean
|
8.85
|
7.94
|
|
SD
|
2.35
|
2.44
|
|
t-value
|
3.95**
|
|
** Significant at 0.01 level
Table No. 1: The
means score of HSES and LSES in life stress is 8.85 and 7.94 and the SD is 2.35
and 2.44 respectively. The calculated t-value is 3.95 which is significant at
0.01 level. It shows that there is significant difference in the life stress of
HIV / AIDS patients belonging to HSES and LSES. The hypothesis that there is
significant difference between life stress of HSES and LSES is accepted.
HIV / AIDS is
one of the dangerous disease. Without any discrimination, whether the infected
person is male / female, Rich / poor living in city or village. There are many
reasons by which person are infected. The general view about HIV / AIDS
infection is by only illegal sexual contact. Due to this they are neglected and
socially rejected. There are different views about male and female HIV / AIDS
infected. Women is perceived by as a mother of the India. Which has respect and
dignity in the same way. If she infected by HIV / AIDS disease, she is refused
and rejected. In the sick conditions she is not treated as she supposed to be
treated. Due to this condition, she will be forced to live in stressful
condition, which leads to anxiety, depression and carelessness.
Hence the hypothesis is formulated
that male HIV / AIDS patients have more life stress compare to female HIV /
AIDS patients.
Table
No. 2: Showing mean, SD and t-value of stress of male / female HIV AIDS
patients (N = 400)
|
|
Male
|
Female
|
|
Mean
|
19
|
17.86
|
|
SD
|
3.37
|
4.17
|
|
t-value
|
3.00**
|
|
** Significant at 0.01 level
Table No. 2
reflects the difference between the life stress of male and female HIV / AIDS
patients. The mean score of life stress of male and female is 19 and 17.86
respectively. Whereas the SD is 3.37 and 4.17 respectively. The calculated
t-value is 3. Which is significant at 0.01 level. It shows that there is
significant difference in the life stress of male and female HIV / AIDS
patients. Therefore, the hypothesis that there is significant difference
between life stress of male and female is accepted.
People who are
living in urban areas they are aware of daily way of life. They are socially,
culturally, educationally better than the Rural people. Urban people are
usually expose to mass media and modern life due to this they lead less
stressful life. Comparatively rural people. They are aware of HIV / AIDS and
its consequences. Hence, the hypothesis is formulated that rural HIV / AIDS
patients have a low life stress than urban HIV / AIDS patient.
Table
No. 3: Showing mean, SD and t-value of stress of urban and rural HIV / AIDS
patient (N = 400)
|
|
Urban
|
Rural
|
|
Mean
|
32.1
|
33.3
|
|
SD
|
1.18
|
4.36
|
|
t-value
|
0.45
|
|
** Significant at 0.01 level
Table No. 3
shows the mean SD and t-value obtained from the sample. The mean value is 32.1
and 33.3, and SD is 1.18 and 4.36 respectively. The mean score of rural HIV /
AIDS patients is more than the urban, which indicates that the rural have more
stress than the urban. The t-value is 0.45 is not significant.
People suffering
from HIV / AIDS either coming from rural / urban area are aware of different
problems. Different problematic situation they may face in their life. Due to
this there is no difference between rural / urban HIV / AIDS patients the level
of stress.
Adjustment
: Adjusting with a AIDS patient is an
ongoing process in which the patient learns to cope with emotional and HIV
related problems and gain control over related life events. AIDS patients are
facing many challenges its treatments. Common challenges includes hearing the
diagnosis, receiving treatment (For example, ART). Completing treatment,
hearing that the concerns is in remission, hearing that to come back and
becoming a HIV / AIDS survivor. Each of these events involves specific coping
the questions about life and death and common emotional problems.
Patient are
better able to adjust to a HIV / AIDS diagnosis if they are able to continue
fulfilling the responsibility, cope with emotional distress and stay actively
involved in activities that are the important to them.
Coping is the
use of thoughts and behavior to adjust to life situations. A persons coping
with stress related to his or her personality (for example, always expecting
the best, always expecting the shy or reserved or being outgoing).
The man is
social animal, without society cannot survive. We are bounded with so many
rules and regulation of the society. He / She should follow the norms of the
society. All our liking and disliking wants and needs are to be satisfied under
social conditions. It is very difficult to survive with breaking the rules of
the society. In one or the other way HIV / AIDS patients violated the social
norms and invited suffering for long live life.
Socioeconomic
status influence on the adjustment and leads to live in different way. Hence,
the formulated hypothesis is that low SES have better adjustment than the high
SES HIV / AIDS patients.
Table
No. 4 : Showing mean, SD and t-value of adjustment of high and low SES HIV /
AIDs patients (N = 400)
|
|
HSES
|
LSES
|
|
Mean
|
82.57
|
70.57
|
|
SD
|
65.97
|
10.29
|
|
t-value
|
2.53*
|
|
*Significant
at 0.05 level
Table
No. 4. The mean score is 82.57 and 70.57 and SD is 65.97 and 10.29
respectively. The t-value is 253 indicates significant, difference at 0.05
level of significant. The above scores explain the facts that there is
significant difference between the adjustment level of HSES and LSES HIV / AIDS patients.
Therefore, the hypothesis is
accepted.
Men dominated
society has restricted the women within the four walls. She has been not
allowed to interact with others easily. She has been deprived by her rights or
education, socialization due to this conduces environment. She is not aware of
her own way of life. She has been appreciated, respected in the place of mother
India. But natural facilities not extended to her naturally. Therefore, she is
made ignorant and not brought on the main strains. She has been not made
awarded of HIV / AIDS replication on her life and family. Hence, she is facing
so many problems. Simply compromising with system.
Hence,
formulated hypothesis is female HIV / AIDS patients have better adjustment than
the male HIV / AIDS patients.
Table
No. 5 : Showing mean, SD and t-value and adjustment of male and female HIV /
AIDS patients.
|
|
Male
|
Female
|
|
Mean
|
32.64
|
29.63
|
|
SD
|
4.49
|
5.67
|
|
t-value
|
11.53**
|
|
**Significant
at 0.01 level
The table
reveals the mean score of male and female patient is 32.64 and 29.63 and SD is
4.49 and 5.67 respectively. The high
mean score of male patient indicates the fact that, the male patients are
having better adjustment than the female, patient. The obtained t-value is
11.53 it is significant at 0.01 level. Therefore, the hypothesis that there is
significant difference between adjustment of male and female is accepted.
Awareness of HIV
/ AIDS either in Rural / Urban area makes the individuals to cope with this
problem successfully. HIV infected has to make many adjustment in their social
life. Hence, formulated hypothesis is Urban HIV / AIDS patients have better
adjustment compare to the Rural HIV / AIDS patients.
Table
No. 6 : Showing mean, SD and t-value of adjustment of urban and rural HIV /
AIDS patients (N = 400)
|
|
Urban
|
Rural
|
|
Mean
|
35.63
|
39.56
|
|
SD
|
7.43
|
5.70
|
|
t-value
|
8.93**
|
|
**Significant
at 0.01 level
The table No. 6
shows, mean SD and t-value of adjustment of urban and rural HIV/ AIDS patients.
It can be seen from the above table that, the mean scores urban and rural
patients is 35.66 and 39.56 respectively. The high mean score of rural patients
indicates that, the rural patients are adjustable than the urban patients. The
obtained t-value is 8.93 which is significant at 0.01 level. Therefore, the
hypothesis that, the rural HIV positive patients have better adjustment compare
to the urban HIV / AIDS patients, accepted.
HIV / AIDS urban
patients are comparatively better adjusted to the social situation in their
life. The urban dwellers are not worried about others and won’t interface in
the personal life of other’s. Due to which the urban HIV / AIDS patients do not
worry about the social status and adjust properly were as the rural atmosphere
makes people to take keep interest in the personal matters of each and every
person.
SUMMARY
AND CONCLUSION
1. There
is significant difference in the life stress of High Socio Economic Status and
Low Socio Economic Status HIV / AIDS patients. High Socio Economic Status HIV /
AIDS patients have high life stress compare to Low Socio Economic Status HIV /
AIDS patients.
2. There
is significant difference in the life stress of male and female HIV / AIDs
patients. Male HIV / AIDS patients have
high life stress compare to female HIV / AIDS patients.
3. There
is no significant difference in the life stress of urban and rural HIV / AIDS
patients.
4. There
is significant difference in the adjustment of High Socio Economic Status and
Low Socio Economic Status HIV / AIDS patients. Low Socio Economic Status HIV /
AIDS patients have better adjustment
than High Socio Economic Status HIV / AIDS patients.
5. There
is significant difference between adjustment of male and female HIV / AIDS
patients. Female HIV / AIDS patient have better adjustment than female HIV AIDS
patients.
6. There
is significant difference between adjustment of urban and rural HIV / AIDS
patients. Rural HIV / AIDS patients have better adjustment compare to the urban
HIV / AIDS patients.
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