Journal List > Korean J Adult Nurs > v.26(5) > 1094586

Kim and Shin: The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression

Abstract

Purpose

The purpose of this study was to identify the mediating effect of hope and depression applied on the influence of social stigma on suicidal ideation of 108 HIV infected males.

Methods

This study was a descriptive, cross-sectional design that used a survey approach. Data collection was one-on-one interviews by a counseling nurse from July 2012 to January 2013. The survey included questions about social stigma, hope, depression, and suicidal ideation.

Results

Fitness of the hypothetical model was appropriate (x2/df=1.97, TLI=.97, CFI=.98, RMSEA=.07, SRMR=.04). Social stigma had no direct effect on suicidal ideation but had a significant indirect effect on suicidal ideation via hope and depression. Hope had a mediating effect the relationship between stigma and depression but no direct effect on the relationship between stigma and suicidal ideation. Hope had an indirect effect on suicidal ideation via depression. Stigma and hope accounted for 41% of depression was where as suicidal ideation was explained 56.3% by depression, hope, and stigma.

Conclusion

In order to reduce depression and suicidal ideation of HIV infected people, stigma improving strategies are required. And hope intervention for HIV infected people may decrease their suicidal ideation and depression.

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Figure 1.
Path diagram for the research model.
kjan-26-563f1.tif
Table 1.
Descriptive Statistics of the Observed Variables (N=180)
Variables Range M±SD Skewness Kurtosis Tolerance VIF
Social stigma 15~75 50.98±10.48 -.21 -.34 .85 1.18
Hope 8~32 21.61±4.91 -.08 -.24    
  Agency thinking 4~16 11.62±2.79 -.20 -.44 .44 2.28
  Pathways thinking 4~16 9.99±2.50 .09 .03 .39 1.53
Depression 0~60 18.55±13.87 .65 -.44    
  Depressed affect 0~27 8.25±7.07 .72 -.40 .16 6.16
  Interpersonal problems 0~15 4.11±3.77 .86 -.18 .16 6.08
  Positive affect 0~9 3.37±2.67 .34 -.86 .81 1.24
  Somatic complaints 0~9 2.82±2.46 .74 -.30 .34 2.92
Suicidal ideation 0~180 38.68±4.05 1.06 .33    
Table 2.
Correlations among Social Stigma, Hope, Depression, and Suicidal Ideation (N=180)
Variables Social stigma Hope Y1 Y2 Depression Y3 Y4 Y5 Y6
r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p) r (p)
Hope -.22                
  (.003)                
Y1 -.17 .94              
  (.026) (<.001)              
Y2 -.25 .92 .72            
  (<.001) (<.001) (<.001)            
Depression .34 -.56 -.47 -.57          
  (<.001) (<.001) (<.001) (<.001)          
Y3 .36 -.51 -.41 -.54 .96        
  (<.001) (<.001) (<.001) (<.001) (<.001)        
Y4 .32 -.53 -.47 -.52 .94 .90      
  (<.001) (<.001) (<.001) (<.001) (<.001) (<.001)      
Y5 .20 -.36 -.35 -.32 .54 .36 .39    
  (<.001) (<.001) (<.001) (<.001) (<.001) (<.001) (<.001)    
Y6 .21 -.47 -.39 -.50 .85 .78 .78 .33  
  (.004) (<.001) (<.001) (<.001) (<.001) (<.001) (<.001) (<.001)  
Suicidal ideation .29 -.37 -.33 -.35 .70 .71 .70 .26 .56
  (<.001) (<.001) (<.001) (<.001) (<.001) (<.001) (<.001) (<.001) (<.001)

Y1=Agency thinking; Y2=Pathways thinking; Y3=Depressed affect; Y4=Interpersonal problems; Y5=Positive affect; Y6=Somatic complaints.

Table 3.
Goodness of Fit on Research Model (N=180)
Model x2 df p x2/df TLI CFI RMSEA (90% CI) SRMR
Research model 31.57 16 .011 1.97 .97 .98 .07 (.03~.11) .04

TLI=Tucker-Lewis Index; CFI=Comparative Fit Index; RMSEA=root mean squared error of approximation; SRMR=standardized root mean-squared

Table 4.
Path Coefficient and Direct ․ Indirect Effect of Modification Model (N=180)
Dependent Independent Path coefficient Effect (standardized) SMC
b p Direct (p) Indire ct (p) Total (p)
Hope Social stigma -0.06 .001 -.28 (.002) -.28 (.002) .077
Depression Social stigma 0.15 .001 .22 (.006) .15 (. .002) .37 (.002) .407
  Hope -1.71 <.001 -.54 (.005) -.54 (.005)  
Suicidal Social stigma 0.20 .420 .05 (.391) .27 (. .002) .32 (.002) .563
ideation Hope 1.94 .153 .10 (.111) -.42 (. .003) -.32 (.002)  
  Depression 4.70 <.001 .79 (.002) .79 (.002)  

SMC=squared multiple correlations.

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