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

II Ok Kim; Sun Hwa Shin

doi:10.7469/kjan.2014.26.5.563

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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

Original Article

Korean J Adult Nurs 2014;26(5):563-572.

Published online: NaN October 2014

DOI: https://doi.org/10.7469/kjan.2014.26.5.563

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

II Ok Kim¹, Sun Hwa Shin^2,

^¹Department of Nursing, Sahmyook University, Seoul

^²Graduate School of Division of Nursing Science, Ewha Womans University, Seoul, Korea

Corresponding author: Shin, Sun Hwa Graduate School of Division of Nursing Science, Ewha Womans University, 275-33 Junghwa 1-dong, Jungnang-gu, Seoul 131-875, Korea. Tel: +82-2-3399-1593, Fax: +82-2-3399-1594, E-mail: ffssh@hanmail.net

Received 15 May 201430 September 2014 Accepted 2 October 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: HIV, Social stigma, Hope, Depression, Suicidal ideation

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Figure 1.

Path diagram for the research model.

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
Variables	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
Dependent	Independent	b	p	Direct (p) Indire	ct (p) Total (p)	SMC
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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