Introduction
Social support and familial sustenance are critical in terms of fighting the deadliest and most challenging diseases in the world. Social connectivity enables a person to feel a certain level of happiness and confidence. Challenged individuals experience a significant level of anxiety and stress. However, they also need their families and friends to participate in the process of physical and psychological grieving. An ill person tends to long for intrinsic motivation to live a normal life. Social connections may drive oneself to embrace beauty of life wholeheartedly. On the other hand, one’s family and friends can cause the patient to die spiritually before experiencing physical terminality. Additionally, a dying person does not forego his or her right to happiness. Family should induce a terminally ill person to engage in artistic and musical works to express his or her grief in a very positive manner. A suffering personality may also emotionally need to vent his or her stress in form of ferocious anger.
At present, HIV and AIDS are among the burning problems of humanity. Despite opportunities for prevention (Kaufman, Cornish, Zimmerman, & Johnson, 2014), the disease strikes many people. National minorities constitute one of the most vulnerable categories when it comes to HIV incidence. In the United States, the situation with African American women with HIV is dangerous. According to the epidemiologic reports, African American women are at higher risk for HIV (Sharpe et al., 2012). It is not only the case of race. Other reasons for these statistics include poverty and poor access to healthcare facilities. African Americans make up 45% of new HIV diagnosed patients in the United States (Sharpe et al., 2012). Moreover, according to the information of the Centers for Disease Control and Prevention, in 2007 among 148,797 HIV-infected women 64% were black, and just 19% white (Sharpe et al., 2012). The situation is even more complicated since HIV patients often deny treatment which can help them lead the life of healthy people. Thus, there is a need for the study which will determine factors that can influence treatment compliance among African American women and provide support during the treatment process. One should live happily and satisfactorily after being diagnosed with such a dangerous disease. A patient must train him or herself to psychologically combat physical suffering by improving the level of happiness. One should engage with children to observe their improper but fulfilling attitudes and behaviors. A patient can extract divine messages by closely interacting with kids.
Children motivate a person to gain the firm belief that this world and life herein is temporary and fragile. A terminally ill person should not develop a depressive personality due to medical difficulties. Social support allows a person to feel useful and important (Lim, Hwang, Kim, & Bioccad, 2015). The perceived sensation of usefulness and importance increases one’s willpower and emotional resolve to fight any physical condition. There are spiritual methods that can effectively reduce the feeling of pain and emotional suffering (Adams, King, & King, 1996). A patient of HIV/AIDS should develop internal peace and satisfaction to counteract effects of physiological pain.
Research Topic and Background
Research Topic Rationale
The topic for the research is “A Study of the relationship between HIV treatment compliance and family support among African American women with HIV.” Thus, the supposition is that family can have a meaningful impact on HIV treatment compliance. The choice of the topic was conditioned by some reasons. First of all, it is the lack of research in the sphere of factors that have a positive influence on HIV treatment compliance and adherence. A study by Katz et al. (2013) reviews records on HIV adherence some of which report the importance of spouse, familial and peer support for HIV patients. The participants admitted this support as “critical for overcoming stigma and maintaining adherence, as was having a sense of obligation to family” (Katz et al., 2013, p.4). However, the research does not cover racial or gender aspects. Some research on the problem of the role of family network in the healthcare for HIV patients was conducted by Mexican researchers (Silva & Tavares, 2015). They focused on patient adherence to antiretroviral therapy. Since therapy needs alterations in daily routines of both patients and the surrounding people, the role of family is stated as important (Silva & Tavares, 2015). Their research revealed the necessity of “a relationship of trust, without judgment” from healthcare providers and support and help from the family which “has strengthened infected women allowing them to receive help to be treated” (Silva & Tavares, 2015, p.2).
Thus, further research is needed to investigate the role of family in support of HIV patients among African American women and their compliance to treatment. The research can be conducted with application of statistical analysis using database 1. The statistical data analysis can provide information on dependence of HIV treatment compliance on family support.
Background Information
HIV and AIDS are the burden of the contemporary society. Although this mortal disease is preventable, it affects many people all over the world. The situation is particularly dangerous among some national minorities. When it comes to the Unites States, African Americans are the most vulnerable ethnic group. African Americans make about 12 percent of the US population. However, among the patients with AIDS in the country 48 percent are African Americans (Koenig, Weatherford, & Weatherford, 2013). Another problem with African American population is their low access to healthcare. It is partially due to the low incomes and absence of insurance. However, a substantial role in denial of medical care belongs to historically formed beliefs, thus, African Americans show mistrust to healthcare providers due to the experiences of racism and conspiracy beliefs (Gaston, & Alleyne-Green, 2013). Moreover, they are afraid of racism. The neglect to own health leads to late diagnosing and, as a result, lower probability of positive outcomes. A timely diagnoses and following the doctor’s instructions are crucial for the successful treatment. Consequently, the means of influence on newly diagnosed HIV/AIDS patients should be found.
Descriptive Epidemiology
The epidemiologic reports show that African American women are at higher risk for HIV and other sexually transmitted diseases (Sharpe et al., 2012). Apart from race, some social and economic aspects determine this situation. These aspects include “poverty, loss of status and support linked to declining marriage participation, and female-headed single-parent household structure” (Sharpe et al., 2012, 249). The statistics show that gay and bisexual men still are the most numerous part of patients with HIV/AIDS. They make 53% of the infected population. In respect of race, 45% of new HIV diagnosed patients in the United States are African Americans (Sharpe et al., 2012). According to a study by the Kaiser Family Foundation (as cited by Sharpe et al., 2012, 249), non-white women have worse access to healthcare facilities than white. It is one of the reasons that as of 2007 according to the report of the Centers for Disease Control and Prevention among 148,797 HIV-infected women 64% were black, and just 19% white (Sharpe et al., 2012). Thus, factors that may change the situation are necessary. It is suggested that the family support may have positive influence on decisions to pass examinations and accept HIV treatment of African American women. The additional moving forces that assist the HIV patients to accept and cope with the diagnosis are the social support and religious institutions.
Research Question
The topic for the research is “A study of the relationship between HIV treatment compliance and family support among African American women with HIV.” A study by Katz et al. (2013) reports on some examples of HIV adherence some of which report the importance of support for HIV patients. Consequently, the research question can be formulated as “Does family support has a positive impact on HIV treatment compliance of African American women with HIV?” The researchers have already proved that the surrounding people are necessary for HIV patients. Thus, the participants of study by Grodensky et al. (2014) reported family and platonic relationships, romantic partnerships, and relationships with a church community and with God as crucial sources of support for patients with HIV. Also, Boyd-Franklin (2013) supposed the specific role of the family in the therapy of African Americans.
Research Methodology
This study uses a method of multiple regression to determine statistical validity of theoretically established philosophical links in the preceding section. Social Support may act as an independent variable to determine level of Social Engagement and Willingness to Seek Treatment. However, the statistical model may also test mediation hypothesis by running a multiple regression test to see if both independent variables predict the dependent construct significantly. At a second step, the testing system may control the mediating variable to gauge potential effects on the basic relation (Hayes, 2009).
To approach RQ 1: Does family support have a positive impact on HIV treatment compliance among African American women with HIV?
- H0: There is no statistically significant association between family support and HIV treatment compliance among African American women with HIV.
- HA: There is a statistically significant association between family support and HIV treatment compliance among African American women with HIV.
- DV: Treatment compliance
- IV or groups: voluntary
- Level of precision (alpha =.05)
- Power (Beta =.20) the same as 90% power
- Effect (Small to Medium =.08)
- Statistical test for analysis: t-test
- G power calculate minimum sample size: 34
Instruments
This investigation measures Social Support by using questionnaire proposed by Applebaum at al. (2014). Social Engagement is quantified with the help of instrument put forth by Lim et al. (2015). Willingness to Pursue Treatment for AIDS is guaged with assistance of an adapted tool suggested by Fu, Smith, Sansur, & Shaffrey, (2010).
Ethical Consideration
Researchers may inform respondents about complete nature of the survey before distributing relevant questionnaires. Additionally, every respondent reserves the right to opt out of the decision of participating at any time. Respondents can also refuse to cooperate if they consider questions and queries offensive in any sort.
Criteria for Including the Respondents
The study population includes African American women with HIV because they make one of the most vulnerable groups for this disease. When it comes to race, 45% of new HIV diagnosed patients in the United States are African Americans (Sharpe et al., 2012). According to a study by the Kaiser Family Foundation (as cited by Sharpe et al., 2012, 249), non-white women have worse access to healthcare facilities than white.
The sample size will be determined by the size of the population selected for the research. As it was mentioned, study population includes African American women with HIV. According to the Centers of Disease Control and Prevention, as of 2007 among 148,797 HIV-infected women 64% were black (Sharpe et al., 2012). Thus, more than 95 000 among HIV infected were African American. The sample size will be determined by the study design. The selected interview method will be suitable for the research purpose and will enable answering the research question. Database 1 will be applied to provide the statistical analysis of population.
Diagnosed patients with HIV/AIDS will be invited to take part in the designed survey. However, we also offer compensation to induce people to participate in the study. Similar investigations can produce detailed insights in the psychology of terminally ill population. Other diseases do not confirm futuristic death of a patient as AIDS/HIV does. Psychological process of people with HIV/AIDS is going to be different and therefore, this paper may generate very unique findings in a very special educational context.
Research Design
The study design should correspond the topic and provide opportunities for answering the research question. The topic for the current research is “A study of the relationship between HIV treatment compliance and family support among African American women with HIV.” The hypothesis is that family can have a substantial influence on HIV treatment compliance and the research question corresponds the topic. A similar research on the problem of the role of family network in the healthcare for HIV patients was conducted by Mexican researchers (Silva & Tavares, 2015). Similarly, this research will use interview as a method of data collection. The researchers will interview patients diagnosed with HIV, their relatives to discover the support they provide, and the health care providers to assess HIV treatment compliance.
Data Analysis Plan
The support that is given to individuals who have HIV/AIDS is essential for their well-being and also for those who live around them. There are many forms of support that can be given to individuals that have HIV and this mainly includes family support, psychological support, family therapies and organizational support. These forms of support have been seen to be very useful in alleviating the lives of patients, (Sharpe et al., 2012). Family members are seen to be at the forefront in providing psychosocial support for their members and other relatives that are facing the effects of HIV or AIDS.
Variables
The dependent variable for this study is HIV treatment compliance and the independent variable is family support among African American women with HIV. The World Health Organization is at the forefront of providing support to families and communities living with this disease and through their initiatives, they have been able to provide essential medication, psychological support and also education on the various methods that victims and families can live amicably (Silva, 2015). The World Health organization has set parameters that are used in supporting victims of HIV and they mainly dwell on the development of training and guidelines that are used in the sector of psychosocial care. Some of the measures that have been set entail the establishment of regulations that will push the governments and other parastatals to ensure that there are equitable provisions of medical services and other forms of support to the patients and to the families (Grodensky, 2014). This also covers implementation of better ways and avenues that help in streamlining the management of the disease. Similarly, the organization is in the forefront of providing the necessary information about AIDs through education of the public and individuals and it has become the norm that all members of the medical fraternity to provide the necessary information to their clients and immediate neighbors. This majorly bases on the need of sensitization about the effects of transmitting the disease to others as well as the precautionary and preventive measures that individuals can adapt to.
Statistical Procedures
One of the statistical procedures suitable for this study is linear regression. The linear regression is to predict the value of variable based on the value of another variable. The model summary and the coefficients are discussed with the variables in the next step.
Table 1 demonstrates the value of R and R square where R represents simple correlation. The value 0.810 indicates that there is a high degree of correlation. The value of R square indicates how much of the total variation there is in the dependent variable such as HIV treatment compliance described by the independent variable, family support among African American women with HIV.
Table 2 indicates the regression model that predicts the dependent variable which is significantly well. This indicates that the statistical significance of the model was run which indicates that the regression model is statistically and significantly well and shows the outcome variable which shows the good fit of the data.
Description of the Statistics to Include in the Descriptive Analysis for the Project
The topic for the research is “A study of the relationship between HIV treatment compliance and family support among African American women with HIV.” Consequently, the research question, variables and levels of measurements are shown below.
Research question: Does family support have a positive impact on HIV treatment compliance among African American women with HIV?
Dependent variable: Willingness to Pursue Treatment of HIV/AIDS or treatment compliance.
Independent variables: Social support and social engagement.
Null hypothesis (HO): There is no statistically significant association between family support and HIV treatment compliance among African American women with HIV.
Alternative hypothesis (HA): There is a statistically significant association between family support and HIV treatment compliance among African American women with HIV.
Description of the Statistics not to Include in the Descriptive Analysis for the Project
There are various types of statistical analysis. Selecting the most suitable method for analysis can be at times daunting. The choice of statistical approaches ought to be planned at the start of the project before any data is collected (Lacort, 2014). The topic for the research is “A study of the relationship between HIV treatment compliance and family support among African American women with HIV.” The statistics that I would prefer not to be used for this project are sample size determination. The following project entails large data sets and population. This implies that data collection will not necessarily be from every member of the population. A small sample can do the job as well. The bigger challenge comes in with selecting an accurate sample. In many cases, proportions and sample deviations have been used I making the data to be statistically significant.
The rationale for rejecting this statistic is that our project is studying an untested variable in a population. This means that the proportion equations have to largely rely on assumptions. The problem is that some of these assumptions might carry lots of inaccuracies. The errors will then be passed along to determine the size of the sample which will go on to the rest of the statistical data analysis.
Data Dictionary
Analyzed data is accessed from American Sociological Association’s central database. Different reliable and valid instruments are used to measure relevant constructs in the selected longitudinal samples.
The choice in which descriptive statistics to use is determined by the research question, variables, and level of measurement. Determination of mean, SD, minimum and the maximum is appropriate for continuous variables. Additionally, bar chart may can be used to determine if the assumption of normal distribution is violated or when dealing with large data sets. A stem and leaf chart may be used in small data sets. Categorical variables are presented by frequency and can be as well depicted visually using histogram or a bar chart. For the following project all independent variables and my dependent variable are categorical and therefore will be presented in frequency form with bar charts
Results and Interpretation
Table 1 demonstrates the value of R and R square where R represents simple correlation. The value 0.810 indicates that there is a high degree of correlation. The value of R square indicates how much of the total variation there is in the dependent variable such as HIV treatment compliance described by the independent variable, family support among African American women with HIV.
The coefficient table provides the essential information to forecast HIV Treatment compliance from family support among African American women with HIV. The equation seems to be like this:
HIV Treatment compliance = 15.472 +.098*Family support among African American women with HIV
Similarly, home care services and regulations have been developed and these strategies help in ensuring that they are confirmed to accordingly and as such, the rate of prevalence is drastically reduced. Some of the main and essential aspects of this organization are to ensure that the families and patients are well informed about what is going on. As such, there are many care givers that have been given the opportunity of providing the essential care, as well as the family members who are mainly close to the victims, this solely aims at creating a conducive environment that enables the patients, family members, and caregivers to interact positively, (Boyd-Franklin, 2013). This positively impacts the psychological well-being of the patient and the concerned family members.
On the other hand, medical practitioners and caregivers can provide training courses for families and volunteers (Sharpe et al., 2012). In the long run, there will be a positive impact on the patients, especially in the healing and recovery process in case there are adverse effects that have been experienced earlier. The community is also involved in some case because this is helpful in providing information to them so that they can become part of solving the existing problems. As a result, there will be reduced cases of transmitting AIDS and also psychological issues will be reduced drastically. This results from acceptance and positive living amongst the individuals (Katz et al., 2013).
Stigmatization has been seen to be a major factor that hampers the recovery rate of HIV patients. A community in many cases tends to create a negative environment that will make the victims feel like they are not wanted in the society. As a result, they create a negative environment that exposes them to risks due to the failure of adhering to medication, positive living, and a healthy regime (Katz et al., 2013). These factors are very important in the life of individuals who have HIV.
Social support, apart from family support, is perceived to be a contributing factor to the reduction of HIV related risks. This is mainly because victims will have the opportunity of interacting positively and sharing what they feel or want with those who are close to them. As such, friends and family members will be in the forefront of encouraging each other to take drugs and also visit health care personnel frequently.
Family support thereof helps those with HIV to be in an environment that is naturally positive. As such, they can be able to talk freely and share ideas, listen to each other especially on how they are feeling and also this provides them with a chance of learning new things and incentives that are beneficial in the healing process. Families also play a very important role in supporting patients and helping them to take medication and perform exercises as needed. This will boost the immune systems as well as the overall health. In many cases, support from family members has been known to be one of the best therapies compared to that which an individual can receive from other people. As such, it is indicative that there is a positive feeling when family supports individuals who have HIV/AIDs.
Limitations of the Study
Despite possible validity of this study which is supported by the results of the research, there can be some limitations. First of all, the research investigated the impact of family support on the treatment compliance among African American Women with HIV in general. The variables did not include marital status of the participants. Thus, families where the infected women act as children and those where they are wives and mothers can demonstrate different results. Secondly, the study did not focus on the stage of the disease. Consequently, it is not possible to generalize the research results and state that patients who have just been diagnosed with HIV and those who have had the diagnosis for some years will demonstrate the same level of compliance and be influenced by the family support. Finally, the research sample included only African American women and the results cannot be applied for other ethnicity or gender.
Recommendations for Future Research
Current research showed strong correlation between family support and treatment compliance among African American women diagnosed with HIV. Further research can consider the dependence of treatment compliance from the marital status of women. Another possible direction to develop the issue is the investigation of age impact on HIV/AIDS patients and their attitude to treatment. Moreover, further research can be dedicated to the role of family in HIV patients” self-management. The experience of self-management among aging African American women with HIV diagnoses was investigated by Warren-Jeanpiere, Dillaway, Hamilton, Young, and Goparaju (2014) and revealed some problems with women’s self-management behavior.
Discussion and Social Change Implications
There is a very strong possibility that this study may prove conceptually valid. Social Support can indeed predict significant level of changes in Willingness to Pursue Treatment. Patients may decide to medically prolong their lives to spend more quality time with their friends and families (Ross, 2016). Additionally, Social Engagement can provide dying people with another reason to live. Their prime concern may become to operate as facilitators to improve lives of others. Both variables interact to motivate people to live highly productive lives. Productivity causes patients to become extremely involved in their lives. However, they may die with incredible level of serenity. Social Engagement operates to lessen the sensation of pain and therefore, one develops the habit of helping others. Assisting others may provide a feeling of relief to the suffering patients (Adams et al., 1996).
However, current nature of this proposal is highly speculative. The readers can expect vague stature of underlying theory to subside after conduction of sophisticated statistical tests. The proposed study may produce very actionable findings which can be used by different healthcare facilities to improve lives of suffering persons around the world (Rubin, Munz, & Bommer, 2005). Scientific potential of this investigation is global in nature and therefore, one cannot understate contributory value of the project.
Table 5. Willingness to Pursue Treatment for HIV/AIDS.
***=p<=0.001 **=p<=0.01 *=p<=0.05
The research findings have some practical implications. First of all, they can be used to provide social change for the patients with HIV. There is a possibility to develop guidelines and recommendations aimed at help for families with infected people. It is necessary to advise people how to behave with their HIV-diagnosed relatives. It can have positive influence on patient’s disclosure which, according to the study by Hult, Wrubel, Branstrom, Acree, & Moskowitz (2012) can be a problem long tome after diagnosing. Such recommendations can be useful to assist patients’ struggles and resilience during the stages the women pass before they finally came to the acceptance of their disease and could manage their lives with it (Smith, 2015). The study results can stimulate change in the spiritual aspect. Thus, the research by Dalmida et al. (2012) proved that 95% of its participants diagnosed with HIV believe that spirituality is extremely and very important. Moreover, it is proved that African Americans visit church or religious meetings more frequently than other races (Koenig et al., 2013). Consequently, family which positively influences the attitudes of HIV-infected individuals to treatment can attract religious communities to support patients. Some scholars refer to aspects of psycho-emotional conditions of HIV patients. Illangasekare et al. (2014) report that the majority of participants in their research were diagnosed with depression together with HIV. This study can be also used in the development of recommendations for psychological support of HIV patients in the family.
Conclusion
This paper presents an adequately oriented and theoretically driven proposal to investigate about the influence of family support on the treatment compliance of HIV-infected African American women. Final version of the investigation can generate very practical findings. Findings of this study can redefine the nature of patients’ lives worldwide. Theoretical basis of the literature is also strong and therefore, readers may get original insights about psychology of patients worldwide.
The role of family is important in case of any illness, but it becomes critical for patients with diseases such as HIV. Family awareness of the treatment process and support can be a factor influencing HIV treatment compliance among African American women and thus result in better patient outcomes. The use of statistical analysis can give a more distinct picture of positive and negative family influence on female African American HIV patients’ treatment.
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