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Perceived social support, coping, and stigma on the quality of life of people living with HIV in Nepal : A moderated mediation analysis

Shrestha, Sabina 東京大学 DOI:10.15083/0002001700

2021.09.08

概要

Background
Perceived social support has been linked to the quality of life (QOL) among people living with HIV (PLHIV). However, little is known about the ways through which perceived social support influences QOL. In particular, the mediating effect of a coping strategy between perceived social support and QOL among PLHIV has not yet been explored. Furthermore, no studies have examined the moderating effect of internalised stigma on the mediating role of coping strategy between perceived social support and QOL. The present study aims to explore whether coping strategy mediates the relationship between perceived social support and QOL as a function of the underlying level of internalised stigma.

Methods
A quantitative study was conducted on 599 PLHIV living in Kathmandu Valley, Nepal. The multidimensional scale of perceived social support, WHOQOL-BREF, Brief-COPE, and AIDS-related stigma scales were used to measure perceived social support, QOL, coping strategy, and internalised stigma, respectively. The data was analysed using structural equation modelling.

Results
The present study showed that the relationship between perceived social support and QOL was significantly and partially mediated by problem-focused coping strategy. Internalised stigma significantly moderated the mediating effect of coping strategies on the association between perceived social support and QOL. For the high internalised stigma group, perceived social support had indirect effect on QOL (β = 1.48; 61.0 % of total effects) through the mediating effect of coping strategy, especially problem-focused. For the low internalised stigma group, problem-focused coping strategy did not significantly affect QOL, and most perceived social support effects were direct (β = 1.24; 99.2% of total effects).

Conclusions
The mediating role of problem-focused coping strategy was detected between perceived social support and QOL among PLHIV with internalised stigma moderating this mediating effect. Better coping strategies should be developed among PLHIV reporting high stigma to improve their QOL. The attitudes of PLHIV with high stigma towards the use of problem-focused coping provide important clues for future interventions and education.

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