Rationale (Stein, A., Krebs, G., Richter, L., Tomkins, A.,

Rationale of the present
study

HIV/AIDS is an emerging area of research. Research on Indian HIV/AIDS orphans is limited. Present
research is being conducted for understanding the unique state of HIV/AIDS
orphans. In literature survey few studies were found related to HIV/AIDS children
but research on HIV/AIDS orphans is scarce in India. Lack of
social support owing to illness or death of family members lead to distorted
cognitions of themselves and others which itself lead to reduce perceptions of
social support. There is paucity of studies
explaining PSS among HIV/AIDS orphans. They experience
a number of stressors, and psychological, emotional and behaviour problems
because of life changes, related to parental deaths. Research on the psychological distress of HIV/AIDS orphans
living in Indian orphanages is limited. There is dearth of studies exploring the psychological consequences of
orphanhood specifically (Stein, A., Krebs, G., Richter, L.,
Tomkins, A., Rochat, T., &  Bennish,
M., 2005) and the effect of HIV/AIDS on orphanhood. HIV/AIDS orphans need to
think hopefully and plan imaging and embrace goals related to the successful
management and treatment of their illness. The role of hope in HIV/AIDS orphans on the psychological
problems is also required to be studied.

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On the basis of review of literature the following objectives were
formulated for the study.

1.   To assess the relationship between PSS and (a) psychosocial distress and
(b) hope among HIV/AIDS orphans and non-HIV/AIDS orphans.

2.   To assess the relationship between psychosocial distress and hope among
HIV/AIDS orphans and non-HIV/AIDS orphans.

On the basis of review of
literature the following hypotheses were formulated for the study:

H1. PSS
would be negatively related to psychosocial distress and positively related to
hope among HIV/AIDS orphans and non- HIV/AIDS orphans.

H2.
Psychosocial distress would be negatively related to hope among HIV/AIDS
orphans and non HIV/AIDS orphans.

Research
Design of the study

The study is an ex-post
facto research design. This is because the children were already orphaned. In the present study correlational approach was used to explain the
relationship between study variables within the two groups of orphans.

Sample

a total of 236 orphans were selected for the
study. Out of which 116were hiv/aIDS orphans (71 boys and 45 girls)
and 120 were non-HIV/AIDS orphans (60 boys and 60 girls). Mean age of HIV/AIDS
orphans was 11.98 years, SD 1.97 years mean age
of non-HIV/AIDS orphans was 11.78. years, SD
1.64 years living in the orphanages. They were studying in primary and
secondary school.There are limited orphanages related to HIV/AIDS orphans in
North India. Data were collected from different orphanages (Asha Sadan, Kashi Anadhalaya,
AB Bal Asharm, Ummeed, Lilawti Munshi Nirashrita Asharm, Udyan Care, Ramraj Seva
Sadan and Naz foundation)from urban areas(Varanasi, Allahabad, Lucknow and
Delhi NCR)with the approval from the authorities.

Measures

Existing scales were not sensitive for
children orphan by HIV/AIDS and living in orphanages. In present research to
assess PSS, Psychosocial Distress and Hope of HIV/AIDS orphans researcher used
self- developed scales of PSS, Psychosocial Ditress and Hope. Initially, literature reviews, review of scales and items pool were
constituted for PSS scale and 54 items were developed in English and it
comprised of three subscales assessing the source of the financial, physical
and emotional support (i.e. friends, teacher and family) using a 5-point
response option (ranging from 1 = ‘strongly disagree’ to 5 = ‘strongly agree’).For
psychosocial distress scale 78 items were developed in English with a 4-point
response option (ranging from 1 = ‘strongly disagree’ to 4 = ‘strongly agree’)
and hope scale 78 items were developed in English with a 5-point response
option (ranging from 1 = ‘strongly disagree’ to 5 = ‘strongly agree’). English
to Hindi and Hindi to English back translation procedure was used in scale
construction. Three researchers having knowledge and fluency in hindi and
english languages were requested to translate the perceived social support
scale in Hindi and again three researcher who had knowledge and fluency in
hindi and english language translated the perceived social support scale in
english. The three translations were than evaluated for accuracy and
representation of the psychological content of the items by present researcher.
The most suitable translations of each item were selected. Where a difficulty
in selecting the best translation was encountered the expert’s advice was
considered. They evaluated the adequacy of translation and gave suggestions
and/or provided alternative translations. Based on their
suggestions/alternative translations inadequate translations were accordingly
modified. After pilot study 30 items were finalized for all above scales.

Perceived
Social Support Scale for Children: Examination of the psychometric properties revealed that item-total
correlations (correlations ranged from .12 to .80) and none of the alpha- if-
item deleted values exceeded the overall alpha value of given sub-scale (Table
1a).

Table 1a

Psychometric properties of 30 items of
Perceived Social Support Scale for Children

 

Dimensions

No. of items

items

Alpha

Item-total correlation

Friend

10

1,2,3,4,5,6,7,8,9,10

.907

.75-.57

Teacher

10

11,12,13,14,15,16,
17,18,19,20

.917

.79-.57

Family

10

21,22,23,24,25,26,
27,28,29,30

.928

.76-.51

 

The internal consistency of
scale was determined using the Cronbach’s alpha. The Cronbach’s alpha coefficient for the total scale was .94.
Higher scores indicate higher levels of this construct.

Psychosocial
Distress Scale for Children: Examination
of  the psychometric properties revealed
that item -total correlations (correlations ranged from .08 to .66) and none of
the alpha- if- item deleted values exceeded the overall alpha value of given
scale (Table 1b).

Table 1b

 

Psychometric properties of 30 items of
Psychosocial Distress Scale for children

 

 
Psychosocial Distress

No. of Items

Alpha

Item-total correlation

30

.887

.66-.30

 

The internal consistency of
scale was determined using the Cronbach’s alpha. The Cronbach’s alpha coefficient for the total scale was .89.
Higher scores indicate higher levels of this construct.

Hope Scale for
Children: Examination of the
psychometric properties revealed that item-total correlations (correlations
ranged from .19 to .74) and none of the alpha- if- item deleted values exceeded
the overall alpha value of given scale (Table 1c).

Table 1c

 

Psychometric properties of 30 items of Hope
Scale for children

 

 
Hope Scale

No. of Items

Alpha

Item-total correlation

30

.957

.72-.29

 

The
internal consistency of scale was determined using the Cronbach’s alpha. The Cronbach’s alpha coefficient for the
total scale was .96. Higher scores indicate higher levels of this
construct.

Pilot Study

Pilot study was conducted on the research sample of 32 HIV/AIDS orphans,
age ranging from 10 to 17 years. The purpose of the pilot study was to examine
the appropriateness, understanding and finalizing the constructed scales. After
conducting the pilot study the reliability of all items was calculated with the
help of SPSS version
17.0. Range of item
total correlation of PSS scale for children was found to be .120 to .8010 items
were selected from each domain namely- friend, teacher and family thus finally total
30 items were retained in the final questionnaire. Range of item total correlation of psychosocial distress scale for children was
found to be .08 to .66 and finally a total 30 items
were retained in the final questionnaire. Range
of item total correlation of hope scale for children was found to be.19
to .74 and finally total 30 items were retained in
the final questionnaire.

Data Collection

Being assured of the appropriateness of the scales,
data collection for the main study was started. Before starting the data
collection consent was taken from the caregivers of the orphans. Data
collection took about six months. All information
related to study was given to the participants verbally and in written form in
Hindi. Further process was done only after their consent had been
received for participation in the study. A rapport was established with the
participants before the test administration, so that they may feel free to give
their response. They were encouraged to answer all items. No individual names
or other identifiers were used in the data sheets.  Demographic information completed by
researcher with the help of care takers and additional information collected by
office record. PSS scale for children, psychosocial distress scale for children
and hope scale for children in Hindi. The entire participant able to complete
the questionnaires on their own and helped wherever seeked.

Statistical
Analysis

The collected data were coded
and entered into the Statistical
Program for the Social Sciences
(SPSS version 17.0) for
analysis. Coefficient of correlation was done to know the relationship between
predictor variables and the criterion variables among HIV/AIDS orphans and non-
HIV/AIDS orphans. Hierarchical regression analysis was performed in order to
know how much percentage of variance was significantly contributed by the
predictor on the criterion variable.

Results

Demographic and background characteristics

Result
related to demographic characteristics of HIV/AIDS orphans and
non-HIV/AIDS orphans have been presented in the Table 2.

Table 2

 

Demographic and Background Characteristics
of HIV/AIDS Orphans and Non-HIV/AIDS Orphans (number and %)

 

 
 
Characteristics

Categories of orphans

HIV/AIDS
Orphans
(n=116)

Non
HIV/AIDS Orphans
(n=120)

Orphan
status

 

 

Maternal

09
(7.75%)

00

Paternal

13
(11.22%)

04
(3.33%)

Double

94
(81.03%)

116
(96.67%)

Orphanage
status

 

 

Maternal
orphanage

74
(63.79%)

60
(50%)

Paternal
orphanage

29
(25.00)

00

Mixed
orphanage 

13
(11.21%)

60
(50%)

Duration
of stay in orphanage

 

 

>5
years

30
(25.87%)

79
(65.83%)

3-4
years

19
(16.37%)

20
(16.67%)

0-2
years

67
(57.76%)

21
(17.50%)

Background
of family

 

 

Rural

94
(81.03%)

95
(79.17%)

Urban

22
(18.97%)

25
(20.83%)

Age
range

 

 

Puberty
10-14 years

102
(87.93%)

92
(76.67%)

Adolescence
15-18 years

14
(12.07%)

28
(23.33%)

Gender

 

 

Boys

71
(61.21%)

60
(50%)

Girls

45
(38.79%)

60
(50%)

Father’s
cause of death

 

 

Accidental

00

01
(0.83%)

AIDS

108
(93.10%)

00

Other
illness

00

02
(1.67%)

Other
cause

00

01
(0.83)

Unknown

03
(2.58%)

116
(96.67%)

Alive

05 (4.31)

00

Mother’s
cause of death

 

 

AIDS

105
(90.52%)

00

Unknown

00

116
(96.67%)

Alive

11
(9.48%)

04
(3.33%)

 

Table 2 shows that 9 (7.75%)
HIV/AIDS orphans were maternal orphans, 13 (11.22%) were paternal orphans and
94 (81.03%) were double orphans. In non-HIV/AIDS orphans, 4 (3.33%) were
paternal orphans and 116 (96.67%) were double orphans. 74 (63.79%) HIV/AIDS
orphan lived in maternal orphanage (female was caretaker), 29 (25%) lived in
paternal orphanage (male was caretaker) and 13 (11.21%) lived in mixed
orphanage (both female and male were caretaker). In non- HIV/AIDS orphans 60
(50%) lived in maternal (female was caretaker) and 60 (50%) lived in mixed
orphanage (both female and male were caretaker). Thirty (25.87%) HIV/AIDS
orphans were staying in orphanage for more than 5 years, 19 (16.37%) from 3 to
4 years and 67 (57.76%) were staying from 0 to 2 years. In non- HIV/AIDS
orphans 79 (65.83%) were staying in orphanage from more than 5 years, 20
(16.67%) from 3 to 4 years and 21 (17.50%) stayed from 0 to 2 years. 94
(81.03%) HIV/AIDS orphans were from rural background and 22 (18.97%) from urban
background. In non-HIV/AIDS orphans, 95 (79.17%) were from rural background and
25 (20.83%) from urban background. One hundred and two (87.93%) HIV/AIDS
orphans were from10 to 14 years and 14 (12.07%) were of 15 to18 years. In
non-HIV/AIDS orphans, 92 (76.67%) were of 10 to 14 years and 28 (23.33%) were
of 15 to 18 years. 71 (61.21%) were boys and 45 (38.79%) were girls HIV/AIDS
orphans. In non- HIV/AIDS orphans, 60 (50%) were boys and 60 (50%) were girls.
In HIV/AIDS orphans 108 (93.10%) father’s death was due to AIDS, 3 (2.58%) due
to unknown causes and 5 (4.31%) had one of the alive parent. In non-HIV/AIDS
orphans, only 1 (0.83%) had an accidental death, 2 (1.67%) died of some other
illness, 1 (0.83%) reported other cause except AIDS and 116 (96.67%) death
reason was unknown. In HIV/AIDS orphans 105 (90.52%) died due to AIDS and 11
(9.48%) had alive mothers. In non HIV/AIDS orphans 116 (96.67%) had unknown
cause of death and 4 (3.33%) had alive mothers. Due to low socioeconomic status
these children with
one parent alive were staying in orphanages.

 

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