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The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression
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Korean J Adult Nurs : Korean Journal of Adult Nursing

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Original Article

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 Shin2
Korean Journal of Adult Nursing 2014;26(5):563-572.
Published online: October 31, 2014

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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: May 15, 2014   • Accepted: October 2, 2014

Copyright © 2014 Korean Society of Adult Nursing

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.

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  • 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.
  • Key Words: HIV; Social stigma; Hope; Depression; Suicidal ideation
Figure 1.
Path diagram for the research model.
kjan-26-563f1.jpg
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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    DOI: https://doi.org/10.7475/kjan.2014.26.5.563
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    DOI: https://doi.org/10.7475/kjan.2014.26.5.563
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    The Effect of Social Stigma on Suicidal Ideation of Male HIV Infected People: Focusing on the Mediating Effect of Hope and Depression
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    Figure 1. Path diagram for the research model.

    Figure 1.

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

    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    

    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.

    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

    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.
    Table 1. Descriptive Statistics of the Observed Variables (N=180)

    Table 2. Correlations among Social Stigma, Hope, Depression, and Suicidal Ideation (N=180)

    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)

    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)

    SMC=squared multiple correlations.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Korean J Adult Nurs : Korean Journal of Adult Nursing

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