Goodness of Fit model and Mentoring versus Psychological Capital analysis
Value df
Value/df
Deviance
17.670
20
.883
Scaled Deviance
17.670
20
Pearson Chi-Square
13.886
20
.694
Scaled Pearson Chi-Square
13.886
20
Log Likelihood -26.257
Akaike's Information Criterion (AIC)
76.515
Finite Sample Corrected AIC (AICC)
77.490
Bayesian Information Criterion (BIC) 122.212
Consistent AIC (CAIC) 134.212
Dependent Variable: Have you ever tested for HIV
Model: (Intercept), Depression, Avoided, Sleepless
a. Information criteria are in smaller-is-better form.
b. The full log likelihood function is displayed and used in computing information
criteria.
The Model Chi-Square, 13.886 with p value of 0.694, is the same as the likelihood-ratio
chi-square obtained in the crosstabs analysis. This implies that, in terms of predicting
depression, avoidance, sleeplessness the model containing all these variables is
a significant improvement over the model with just a constant.
To explain if the variance in the set of data is significantly greater than the unexplained
variance an omnibus test was done, table 4.14 shows the results. Table 4. 14 Omnibus
Test
Likelihood Ratio Chi-Square df Sig.
.841 11 1.000
Dependent Variable: Have you ever tested for HIV
Model: (Intercept), Depression, Avoided, Sleepless
a. Compares the fitted model against the intercept-only model.
The omnibus Tests of Model Co-efficient table gives the result of the Likelihood Ratio
(LR) test which indicates whether the inclusion of this block of variables contributes
significantly to model fit. Since the p-value (sig) is greater than 0.05 for block, it means
that the block model is a significant. To find out if explanatory variables in the model are
significant a Wald test was conducted in order to determine if the variables add something
to the model those that do not can be deleted without affecting the model in any meaningful
way as indicated in table 4.15.
Table 4. 15 Test of Model Effects
Type III
Source Wald Chi-Square Df Sig.
(Intercept) 37.832 1 .000
Depression .072 3 .995
Avoided .479 4 .976
Sleepless .280 4 .991
Dependent Variable: Have you ever tested for HIV
Model: (Intercept), Depression, Avoided, Sleepless
ln(p/1-p) = 37.832+ 0.072x1+ 0.479x2+ 0.28x3
The Wald test indicate in the sig column, the p-values are all above 0.05 apart from the
test for the variable educational level, (p = 0.033). This means being avoided or avoiding
doing something because of one’s HIV status contributes significantly to stigma and
discrimination followed by having sleepless nights and depression in that order.
Further investigation through FGDs revealed that even when they seem so stuck with
prostitution, the CSWs hold deep fears inside. It is for this reason that CSWs test for HIV
several times for fear of having been infected. Furthermore, they fear information on their
HIV status becoming public knowledge, especially if it is positive, to clients, colleagues,
friends, and family, since CSWs share clients. In fact, the percentage would even be
higher than what is reported. Non-testers cited fear of facing the results if it turned
positive, due to stigma and losing the clients as the primary reasons for not testing.
Among the CSWs 60% of them neither ask nor disclose to their clients, colleagues,
friends, and family their HIV status for fear of being rejected. This implies that CSWs
and their clients are likely to infect and re-infect each other. Although majority of the
HIV positive individuals are on drugs; they fear taking them in public due to stigma and
discrimination having not disclosed their status publicly.
An interview with the medical experts revealed that stigma is among the leading factors in
the spread of HIV; especially, enacted stigma. Enacted stigma makes one reluctant to test for
HIV for fear of the result and people knowing their HIV status. If they are put under care and
treatment they do not want to disclose it to their partners or relatives and friends. Social
stigma then follows leading those infected with HIV to hate being associated with those not
infected. There are reported cases of job discrimination based on an employee’s HIV
status which has made it difficult for people to seek care and treatment.
In conclusion, this study found that, although HIV infected persons do not suffer higher
levels of discrimination as compared with their HIV negative colleagues, they
nonetheless suffer higher levels of stigmatisation. This is the cause of their being avoided
and their avoiding to perform important roles leading to depression, loneliness, upset and
sleepless. Also, the study found that all variables under inquiry were positively associated
with the participants’ HIV status except for depression and upset which showed a
negative association. But, the Results were not significant; implying that enacted stigma
was positively correlated to internalized stigma, loneliness and sleepless but not
depression and upset. In addition, internalised stigma was positively correlated to all the
variables investigated. Depression was positively correlated to loneliness, upset and
sleeplessness; while loneliness was positively correlated to upset and sleeplessness; and
finally, upset was positively correlated to sleeplessness.
These results show that enacted stigma (that is, stigma experienced by an individual for
being discriminated against by others) may lead to internalised stigma, loneliness and
sleeplessness but not to depression and upset. However, internalised stigma is worse in
that it may lead to depression, loneliness, upset, and sleeplessness. Consequently, care
providers should endeavour to create an environment that does not drive a person
infected with HIV to develop internalised stigma.
Mentoring versus Psychological Capital
The extent to which mentoring mediates between an individual’s psychological capital
and behaviour change was the third issue that the study sought to investigate. In other
words, the question of interest was to find out the role mentoring plays in mediating
psychological capital towards behaviour change in the context of HIV. To answer this
question, the study analysed items that were used to probe psychological capital and
correlated their scores with those obtained from analysing mentoring.
In this study, psychological capital was represented by hope, self-efficacy, resiliency, and
optimism. These constructs account for resources that an individual can summon to assist
surmount serious life challenges. Furthermore, the study employed both mentors and
mentees. On the one hand, the term ‘mentor’ refers to someone having accepted his or
her positive HIV status and come out publicly about it. This brings out the notion of a
peer. On the other hand, the term ‘mentee’ refers to someone who tested positive of HIV
recently and is in their early stages of care and treatment. For instance, the mentor would
be of much help having undergone through a similar experience and understands the
problem the mentee is still struggling to come to terms with. The mentors that the study
inquired into their role were professional counsellors, peer educators and physicians.
Results from the analysis showed that 268 (73.2%) participants indicated their preference for
mentors. Of that number, 118 (44%) preferred professional counsellors while 111 (41.4%)
preferred peer educators. The preference was nearly on an equal basis except for a two-
percentage point difference in favour of professional counsellors. Fewer participants 39
(14.6%) preferred to be mentored by physicians. The study attributes the reasons for this
preference to the perception that, on their part, professional counsellors inspire hope to the
dejected as a result of the HIV infection. As for peer educators, they are likely to offer
positive motivation on how to develop resiliency despite testing positive or how to
continue staying negative, if one has not already tested positive. Also, many do not trust
physicians due to confidentiality breaches. Table 4.16 shows the preference of the kind of
mentor for participants. Participants ranged between 100 and 115.
Table 4. 16 Mentor Preference
Mentor Description HIV - +ve HIV - -ve Total
Number 31 84 115
Counsellor % within Mentor 27.0 73.0 100.0
% within HIV status 44.9 43.3 43.7
Number 8 31 39
Physician % within Mentor 20.5 79.5 100.0
% within HIV status 11.6 16.0 14.8
Number 30 79 109
Peer educator % within Mentor 27.5 72.5 100.0
% within HIV status 43.5 40.7 41.4
Table 4.16 shows that majority of the HIV positive participants (31 or 44.9%) preferred
professional counsellors compared with peer educators (30 or 43.5%) and Physicians (8 or
11.6%). A trend like what was observed with HIV positive participants was repeated with
HIV negative participants. A total of 84 (43.3%) HIV negative participants preferred
professional counsellors, while 79 (40.7%) preferred peer educators, and 31 (16%) preferred
Physicians. The management of KTRH have initiated a support group for PLWHA where
they meet on Mondays and Thursdays—incidentally, these happen to be the same days that
they collect their drugs. In the morning before they see a physician they are taken through a
session where they share experiences and encourage each other. There is also a programme
for the youth especially those in school where they meet during the holiday and also share
experiences guided by the professionals and social workers.
To examine how Psychological capital is associated with an individual’s HIV status, the
study anchored its investigation using four items derived from the 24 item positive
psychological strengths questionnaire (PPSQ) developed in 2007 by Luthans, Youssef, and
Avolio. Each sub-measure has six items and includes Self-efficacy, hope, optimism and
resiliency. By employing a five-point scale ranging from one (1) [strongly agree] to five
(5) [strongly disagree]; the study measured the psychological capital of the participants
using item 11. The sub-items included
o I feel confident helping someone who has recently tested positive of HIV to
accept their status (Self-efficacy);
o I can think of many ways to reach my current goals (hope);
oWhen things are uncertain I usually expect the best (optimism), and
oI usually continue with life despite feeling weak from the effects of the
disease” (resiliency).
Item eleven (11) consisted of six sub-items forming the sub-scale. Reliability for the sub-
scale on this sub-component was estimated at approximately, α = .67. Although the scales
coefficient is slightly below the recommended standard, it is close enough to be used for
research purposes. The study performed a factorial analysis in examining the differences
in psychological capital between HIV positive and HIV negative individuals. The results
are depicted in Table.
Table Variables, HIV status, number, mean Score, Standard deviation &
Significance
Variable HIV status N Mean SD F α
Hope Positive 71 4.39 .99 .412 .522
Negative 250 4.31 .94
Resiliency Positive 70 3.93 1.10 3.98 .047
Negative 243 3.62 1.16
Self-efficacy Positive 70 4.21 .95 1.73 .189
Negative 250 4.02 1.10
Optimism Positive 70 2.34 1.27 1.98 .160
Negative 245 2.60 1.34
The F values represent the one-way ANOVA tests for group differences
Table depicts the participants’ HIV status and number of participants on the mean score
of the outcome variables (hope, resiliency, optimism and self-efficacy) representing the
psychological capital. The F tests undertaken showed that there were:
Slightly higher levels of hope among HIV -positive participants (Mean = 4.39,
SD = .99) than HIV negative participants ((Mean = 4.31, SD = .94) (F = .412,
p<.52).
Slightly higher levels of resiliency among HIV -positive participants (Mean =
3.93, SD = 1.10) than HIV negative participants ((Mean = 3.62, SD = 1.16) (F
= 3.98, p<.047).
Slightly higher levels of self-efficacy among HIV positive participants (Mean
= 4.21, SD =.95) than HIV negative participants ((Mean = 4.02, SD = 1.10) (F
= 1.73, p<.189).
Slightly lower levels of optimism among HIV positive participants (Mean =
2.34, SD = 1.27) than HIV negative participants ((Mean = 2.60, SD = 1.34) (F
= 1.98, p<.160).
The results revealed that HIV negative participants had lower mean scores on three variables
of the psychological capital: hope, resiliency and self-efficacy. This is because PLWHA have
a host of problems to contend with: they range from poverty, unemployment, and stigma
through to wasting away. HIV infected persons desperately need to fight against their looks,
stigmatization and discrimination. Furthermore, most of them are poor, lack skills and are in
desperate need for resources to support themselves and their dependents.
All these require the summoning of higher psychological resources to continue living.
Otherwise, if they lose optimism and hope in living, they may desire to die earlier than
later. The explanation seems to contradict research evidence showing that PLWHA do
not have much hope for the future (Cutcliffe& Zinck, 2011), and although HIV treatment
has improved, their lack of resources to purchase medicine tends to dampen their
optimism of ever getting well. The answer seems to lie on whether one does an intro-
inspection or intra-inspection. This may help explain why PLWHA hold negative
attitudes towards themselves compared with HIV negative individuals.
AIDS is a disease that affects notably the both physical and mental health as well as the
social conditions of the infected due to the negative attitudes that society develops towards
these people. In addition, society stigmatizes and discriminates against them; particularly in
the developing countries (Peltzer & Ramlagan, 2011). As a result, the infected may feel
socially dejected; change their sexual behaviours and their self-image. Also, they are likely to
get dismissed from employment, leading them to lack finances and eventual rejection by even
family and friends as major sources of support (Roberts-Pittman, 2006).
Evidence from existing literature indicates that positive psychological strengths are
closely associated with subjective well-being (Khan & Husain, 2010) or that people
having a positive outlook regarding life, tend to enjoy a subjective well-being. This
implies that positive psychological strengths are important in improving the subjective
well-being of individuals. For that reason, Snyder, (2000), defines hope as “the fuel to
achieve motivation and an enemy of despair”.
Likewise, positive psychological resources are important in helping individuals cope with
life stresses in adversity thereby providing a positive outlook. Positive psychological
strengths can be improved through mentoring. If PLWHA are mentored, they are likely to
develop a positive worldview. Indeed, it is likely to enable them to approach their daily
problems plus coping with their future challenges using much better ways. In so doing, it
might be possible to discard the word ‘impossible' from their vocabulary and view life
challenges as opportunities. Mentoring aims at promoting positive outcomes among
PLWHA.
This study investigated the correlation between mentoring, and, the psychological capital
of the participants. The study utilized structural equation modelling to test the existence
of any relationships between the variables under inquiry. To explore the mediating roles
of mentoring on the four psychological capital components (i.e., Self-efficacy, hope,
optimism, and resilience), asymptotic and re-sampling strategies were performed. Table
shows the results of the analysis.
Table Correlations between Mentoring and Psychological variables
Variables Mean (SD) 1 2 3 4
1.Mentoring 4.11 (1.02) 1.00
2. Hope 4.31 (0.96) 0.18** 1.00
3. Resilience 3.70 (1.15) 0.24** 0.23** 1.00
4. Self-efficacy 4.04 (1.09) 0.14* 0.33** 0.25** 1.00
5. Optimism 2.53 (1.33) -0.09 -0.18** -0.13* -0.15**
* Correlation is significant at the 0.01 level (2—tailed).
* Correlation is significant at the 0.05 level (2—tailed).
Table 4.18 shows that mentoring was positively correlated to hope, resiliency and self –
efficacy, but not to optimism to which it was negatively correlated. Hope was positively
correlated to resiliency and self-efficacy but not optimism, to which it was negatively
correlated. Lastly, resiliency was positively correlated to self-efficacy and not optimism
to which it was negatively correlated.
In a general sense, hope is a positive resource that individuals can use to combat stress and
anxiety while at the same time protecting them against perceptions of vulnerability and
unpredictability (Avey, Luthans, & Jensen, 2009). For example, results from studies
involving cancer survivors have suggested a positive association between higher levels of
hope and lower levels of depression and anxiety (Rajandram et al., 2011; Tae, Heitkemper,
& Kim, 2012). Likewise, optimism is also a positive psychological resource referring to a
positive attribution of success that includes positive emotions and motivation. Towards
that end, optimistic people tend to develop a positive outlook about the future; believing
that the future holds better and positive prospects than the present. PLWHA may not be
as optimistic since, they do not see a successful future. This correlates well with research
evidence which has shown that optimism is negatively associated with the levels of
depression and anxiety in nurses and cancer patients (Chang, Wang, Li, & Liu, 2011;
Rajandram et al., 2011; Zenger, Brix, Borowski, Stolzenburg, & Hinz, 2010).
In summary therefore, the study found that 44% of the participants compared to 41% and
15% preferred professional counsellors, peer educators and physicians as mentors
respectively. The study further found HIV negative participants to have lower mean scores
for hope, resiliency and self-efficacy meaning that mentoring was positively correlated to
hope, resilience and self –efficacy, but not to optimism to which it was negatively correlated.
Hope was positively correlated to resilience and self-efficacy but not optimism, to which it
was negatively correlated. Lastly, resilience was positively correlated to self-efficacy and not
optimism to which it was negatively correlated. This means that mentoring can mediate upon
the psychological resources to bring about behaviour change.
