Determination of Quality of Life and Their Perceived Social Support from
Family of Patients with HIV/AIDS
Article in Sexuality and Disability · June 2013 DOI: 10.1007/s11195-013-9304-x CITATIONS 5 READS 146 7 authors, including:
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O R I G I N A L P A P E R
Determination of Quality of Life and Their Perceived
Social Support from Family of Patients with HIV/AIDS
Evs¸en Nazik•Sevban Arslan•Hakan Nazik•Behice Kurtaran•
Selc¸uk Nazik•Aslıhan Ulu•Yes¸im Tas¸ova
Published online: 21 June 2013
Ó Springer Science+Business Media New York 2013
Abstract Acquired immunodeficiency syndrome (AIDS) is a significant disease which affects the individual physically, emotionally, and socially. The aim of this study was to determine the relationship between the quality of life and social support of patients with HIV/AIDS. 49 patients with HIV/AIDS who applied to the Infectious Diseases Polyclinics of the university hospital between November 2010 and December 2011 were enrolled in study. All the data were collected using a personal information form, SF 36 quality of life scale (QOL) and perceived social support from the family scale (PSS-Fa). Average age of patients was 41.23 ± 10.62, 65.3 % of them were male. It was found that the diagnosis period for 55.1 % of patients was 24 months or longer, and 55.1 % of them were diag-nosed at a university hospital, 81.6 % received a treatment. When the average scores of QOL was analyzed, it was found that the average score of functional status subscale was 39.35 ± 8.90, well-being subscale was 42.59 ± 14.70, general health perception subscale was 19.18 ± 6.25 and global quality of life score was 33.70 ± 9.31. The mean PSS-Fa score of patients was 28.65 ± 9.56. Comparing socio-demographic and clinical charac-teristics of patients and average scores of QOL and PSS-Fa, there was not a statistically significant relation (p [ 0.05). No statistically significant correlation was found between the average scores of QOL and PSS-Fa. These results showed that quality of life was poor and perceived social support was moderate in patients with HIV/AIDS. According to these results, it is recommended that patients with HIV/AIDS should be supported in this regard.
Keywords HIV/AIDS Quality of life Social support Turkey
E. Nazik (&) S. Arslan
Nursing Department, C¸ ukurova University Adana Health School, Adana, Turkey e-mail: eceevsen_61@hotmail.com
H. Nazik
Department of Obstetrics and Gynecology, Adana Research and Educational Hospital, Adana, Turkey B. Kurtaran S. Nazik A. Ulu Y. Tas¸ova
Department of Infectious Diseases, Faculty of Medicine, Cukurova University, Adana, Turkey DOI 10.1007/s11195-013-9304-x
Introduction
The acquired immunodeficiency syndrome (AIDS) is a public health problem on a global scale. Since the identification of human immunodeficiency virus (HIV), indicators of quality of life of HIV carriers and AIDS mortality rates have suffered wide variations, especially with the advent of combined antiretroviral therapy. Nowadays, with the pres-ence of the highly active anti-retroviral therapy, people living with HIV/AIDS are living longer; however, a diagnosis of HIV infection brings with it a lot of physical and emotional suffering, which may lead to a diminished quality of life (QOL) [1–3].
The World Health Organization (WHO) defines QOL as the individual perception of the position in life within the context of the culture and value systems and in relation to individual goals, expectations, standards and concerns. There are various measures for QOL. The SF-36 is a multi-purpose, short-form health survey with 36 questions. It consists of a profile of functional health and wellbeing scores, as well as general physical and mental health self-assessments. Accordingly, the SF-36 has shown to be useful in surveys of the general population and specific subpopulations, thereby comparing the relative burden of diseases in order to evaluate the health benefits offered by a wide range of different treatments. The SF-36 has been translated for use in more than 40 countries [4].
Social support is a person’s perception that he/she is a member of a complex network of affection, mutual aid, and obligation. The perception of received and offered social support is associated with improved survival in the wide variety of illnesses [5]. Family support is one of the most important factors affecting how patients adapt to illness [6]. Family support provides better psychological being, reduced stress or better emotional well-being [7,8].
Protection against the negative impacts caused by social support is very critical in improvement of health, acceleration of improvement and overcoming the difficulties of life. In a number of studies, it was reported that patients with higher social support used the problem-based methods to overcome their problems [9], while patients with lower social support used emotion-based methods to overcome their problems [10]. One of the aims of healthcare is to increase the power of patients to overcome their problems. Nurses/doctors should activate the social support systems of patients to help them overcoming the stress.
The importance of social support in the psychological adjustment to living with HIV/ AIDS is documented with greater perceived support consistently associated with better psychological adjustment [11, 12]. There are no published studies about the QOL and social support of people living with HIV/AIDS in Turkey.
This study is aimed at determining the relationship between the quality of life and the social support they receive from their families of patients with HIV/AIDS.
Methods
Study Design and Participants
The cross-sectional study was conducted on a cohort of 49 patients attending the infection outpatient clinic, a university Hospital, Adana, between November 2010 and December 2011. It was determined that there were 130 patients with HIV/AIDS admitted to the Infection clinic at the beginning of the study. Patients having 3 months or more diagnosed
with HIV/AIDS were included in the study. We tried to include all patients in the study but it was completed with a total of 49 patients, since 8 patients were diagnosed within the last 3 months, 63 patients who were already enrolled have died, 2 patients did not accept to take part in the study, and 8 patients discontinued the surveys.
Formal permission was taken from the place where the study was carried out. First of all, the patients included in the study were informed about the purpose of the study. They were also informed that the information collected on the issue would not be read by anybody apart from the researchers, and that they would be used for scientific purposes, and, in this way, their verbal permission was taken.
Instruments
A 3-part survey was used for data collection. The questionnaire included a section related to social-demographics and clinical characters, SF-36 quality of life scale and the per-ceived social support from the family scale (PFS-Fa).
Social-demographic and clinical characters are age, gender, education level, income level, marital status, family type, place of residence, employment status, time since diagnose, place of diagnose, route of infection and CD4? cell count.
Quality of life was measured with the 36-item Short Form (SF-36). The SF-36 is a 36-item, self-administered questionnaire that yields scores for eight domains of life: physical functioning (PF), role limitations–physical (RP), role limitations–emotional (RE), bodily pain (BP), general health perceptions (GH), vitality (VT), social functioning (SP) and mental health (MH). It also has four summary scores: functional capacity, well-being, general health perception and global quality of life. Each of the domains is scored on a scale of 100, with higher scores indicating better functioning. The reliability and the validity of the SF-36 Scale for the Turkish population have been demonstrated by Pınar [13]. The total Cronbach’s alpha parameter was determined to be 0.94; the alpha param-eters of sub-dimensioned Cronbach were determined to be as follows: 0.89 for functional status, 0.90 for well-being and 0.75 for general health perception. The internal reliability in the present study was 0.95.
Perceived social support was measured with the PSS-Fa, developed by Procidano and Heller [14]. The scale was translated into Turkish by Eskin [15], and the reported alpha coefficient in a Turkish population was 0.85 for the PSS-Fa. The scale contains 20 items to mark either true, false, or I do not know. The average score of the PSS-Fa for each participant was calculated. The level of family support that patients and spouses perceived they had received were further judged as high or low by the average rating scores, based on being below or above the median point of the PSS-Fa scale scores. In this study, alpha coefficient of the PSS-Fa for patients was 0.70.
If a patient was unable to complete the questionnaire on his/her own, the investigator read the questionnaire items to the patient and recorded the answers. The time taken to complete the questionnaire was approximately 25–30 min.
Statistical Analysis
The data were evaluated using SPSS 13.0. Kruskal–Wallis variance analysis and Mann– Whitney U test were applied to examine the difference between the mean score of quality of life and that with regard to each patient’s socio-demographic/medical factors. Kruskal– Wallis and MW-U variance analysis were applied to examine the difference between the mean score of perceived social support and that with regard to each patient’s
socio-demographic/medical factors. Percentage was used to evaluate the parameters of sex, marital status, educational status, employment, economic status, place of residence, family type, duration of diagnose, received treatment, transmission route of disease and CD4? cell count of patients. Pearson’s correlation analysis was applied to determine the relation between SF-36 scores and point means of perceived social support from the family. Sig-nificance in all statistical analyses was defined as p \ 0.05.
Results
Average age of patients was 41.23 ± 10.62, 65.3 % them were male, 44.9 % were living at city centers and 83.7 % were living in a nuclear family. It was found that the diagnosis period for 55.1 % of patients was 24 months or longer, 55.1 % were diagnosed at a university hospital, 81.6 % received a treatment and 65.3 % responded to treatment. The CD4 cell counts of 46.9 % of patients were from 200 to 500.
53.1 % of patients reported that they were infected by sexual intercourse, 8.2 % reported that they were infected by blood and 36.7 % reported that they did not know the reason of infection. It was determined that 98 % of patients did not have IV substance dependence and 91.8 % of them did not have homosexual intercourse. 34.7 % of the patients were smokers, 20.4 % took alcohol, 36.7 % complained about having sleep dis-order and 10.2 % of them indicated that they use antidepressants. It was found that 65.3 % of patients told their diseases to their families.
When the average scores of QOL was analyzed, it was found that the average score of functional status subscale was 39.35 ± 8.90, well-being subscale was 42.59 ± 14.70, general health perception subscale was 19.18 ± 6.25 and global quality of life score was 33.70 ± 9.31. The mean PSS-Fa score of patients was 28.65 ± 9.56 (Table1).
The mean scores for global quality of life and general health perception, well-being and functional capacity subscales were high in patients aged 36–45 years, females and those living with nuclear family. Mean scores for global quality of life and general health perception, well-being and functional capacity subscales were higher in patients with 10–16 months diagnosis duration, those received treatment and those with 200–500 CD4 cell counts. Age and marital status were also associated with significant differences with respect to well-being subscales (Table2).
There were no correlation between the perceived social support from the family and the areas of quality of life such as functional capacity (r = 0.225, p [ 0.05), well-being (r = 0.139, p [ 0.05), general health perception (r = 0.124, p [ 0.05) and global quality of life (r = 0.172, p [ 0.05) (Table3).
Table 1 Quality-of-life scores and perceived social support scores of patients with HIV/AIDS
Min–Max X ± SD
Quality-of-life instrument
Functional capacity 8–82 39.34 ± 8.90
Well-being 10–89 42.59 ± 14.70
General health perception 3–90 19.18 ± 6.25
Global quality of life 13–80 33.70 ± 9.31
Perceived social support from family scale
Ta ble 2 Comp arison of QO L and PSS-Fa scores rel ated to socio dem ograph ic and clinical characteristics of patie nts wit h HIV/AI DS Ch aracteristics S % Functiona l cap acity W ell-being Gene ral health per ception G lobal qual ity of life PSS-F a X ± SD X ± SD X ± SD X ± SD X ± SD p value p value p valu e p va lue p valu e Age 18–2 5 5 10.2 41.0 0 ± 5.33 39.6 0 ± 12.1 3 17.8 0 ± 3.70 32.8 0 ± 6.96 31.40 ± 5.02 26–3 5 1 0 20.4 37.1 0 ± 8.59 30.8 0 ± 13.6 7 16.2 0 ± 6.21 28.0 3 ± 9.06 30.80 ± 6.68 36–4 5 1 5 30.6 42.0 0 ± 8.21 47.6 6 ± 13.6 1 20.8 0 ± 6.42 36.8 2 ± 8.76 26.40 ± 10.9 4 46 and over 19 38.8 38.0 0 ± 10.2 0 45.5 7 ± 13.9 9 19.8 4 ± 6.46 34.4 7 ± 9.64 28.57 ± 10.6 8 KW = 4.06 4 KW = 9.36 5 KW = 4.900 KW = 6.13 1 K W = 1.429 df = 3 df = 3 df = 3d f = 3d f = 3 p [ 0.05 p < 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Sex Fema le 17 34.7 40.7 6 ± 8.17 43.8 2 ± 15.6 5 19.8 2 ± 6.31 34.8 0 ± 9.59 30.41 ± 8.26 Male 32 65.3 38.5 9 ± 9.30 41.9 3 ± 14.3 9 18.8 4 ± 6.29 33.1 2 ± 9.26 27.72 ± 10.1 9 MW-U = 229. 500 MW-U = 241. 000 MW-U = 246.500 MW-U = 243. 000 MW-U = 246. 000 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Marita l stat us Mar ried 29 59.2 39.1 7 ± 9.95 43.9 3 ± 15.0 8 19.6 5 ± 6.25 34.2 5 ± 9.93 30.06 ± 9.13 Unm arried 11 22.4 36.8 1 ± 6.70 33.9 0 ± 12.8 8 16.2 7 ± 5.71 29.0 0 ± 7.31 28.90 ± 6.37 Divo rced 9 18.4 43.0 0 ± 6.94 48.8 8 ± 11.8 1 21.2 2 ± 6.33 37.7 0 ± 7.69 23.77 ± 13.1 3 KW = 4.93 6 KW = 6.20 9 KW = 4.242 KW = 5.10 0 K W = 2.580 df = 2 df = 2 df = 2d f = 2d f = 2 p [ 0.05 p < 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Educat ion Liter ate 4 8.2 44.7 5 ± 4.27 53.2 5 ± 15.1 5 23.5 0 ± 4.50 40.5 0 ± 7.87 31.00 ± 5.29 Pri mary schoo l 2 7 55.1 39.0 3 ± 9.82 44.2 5 ± 14.3 5 19.4 8 ± 6.32 34.2 5 ± 9.48 27.40 ± 11.6 8 High schoo l 1 1 22.4 37.7 2 ± 9.17 38.0 9 ± 14.8 8 16.9 0 ± 6.57 30.9 0 ± 9.64 28.27 ± 6.54
Ta ble 2 continu ed Ch aracteristics S % Functiona l cap acity W ell-being Gene ral health per ception G lobal qual ity of life PSS-F a X ± SD X ± SD X ± SD X ± SD X ± SD p value p value p valu e p va lue p valu e Univ ersity 7 14.3 40.0 0 ± 6.37 37.1 4 ± 13.9 2 19.1 4 ± 5.92 32.0 9 ± 8.32 32.71 ± 5.02 KW = 2.64 0 K W = 5.62 2 K W = 3.892 KW = 4.71 9 K W = 1.547 df = 3d f = 3d f = 3d f = 3d f = 3 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Empl oyment Ye s 2 8 57.1 39.1 7 ± 9.54 42.8 9 ± 13.8 0 19.0 3 ± 6.09 33.7 0 ± 9.18 29.53 ± 9.39 No 21 42.9 39.5 7 ± 8.18 42.1 9 ± 16.1 7 19.3 8 ± 6.61 33.7 1 ± 9.71 27.47 ± 9.90 MW-U = 286. 000 MW-U = 291. 000 MW-U = 276.000 MW-U = 286. 000 MW-U = 236. 000 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Econo mic status Ove r minim um w age 17 34.7 41.2 3 ± 7.31 44.6 4 ± 13.4 9 19.9 4 ± 5.72 35.2 7 ± 8.44 29.58 ± 9.01 Below minim um w age 32 65.3 38.3 4 ± 9.59 41.5 0 ± 15.4 0 18.7 8 ± 6.57 32.8 7 ± 9.77 28.15 ± 9.95 MW-U = 230. 500 MW-U = 243. 000 MW-U = 251.000 MW-U = 243. 000 MW-U = 250. 500 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Plac e o f res idence City 22 44.9 39.9 0 ± 9.02 43.3 6 ± 16.2 0 19.7 7 ± 6.37 34.3 4 ± 9.95 28.40 ± 10.3 6 Town 17 34.7 37.2 3 ± 9.52 41.0 5 ± 13.4 6 18.4 1 ± 5.83 32.2 3 ± 8.79 26.64 ± 9.75 Vil lage 10 20.4 41.7 0 ± 7.45 43.5 0 ± 14.5 4 19.2 0 ± 7.17 34.8 0 ± 9.36 32.60 ± 6.60 KW = 1.31 8 K W = 0.29 3 K W = 0.479 KW = 0.60 7 K W = 3.543 df = 2d f = 2d f = 2d f = 2d f = 2 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Family typ e Nuc lear 41 83.7 40.0 9 ± 7.65 42.6 0 ± 14.8 0 19.1 9 ± 6.37 33.9 6 ± 9.02 28.70 ± 9.90 Exte nded 8 16.3 35.5 0 ± 13.7 2 42.5 0 ± 15.1 9 19.1 2 ± 6.01 32.3 7 ± 11.2 9 28.37 ± 8.17
Ta ble 2 continu ed Ch aracteristics S % Functiona l cap acity W ell-being Gene ral health per ception G lobal qual ity of life PSS-F a X ± SD X ± SD X ± SD X ± SD X ± SD p value p value p valu e p va lue p valu e MW-U = 143. 500 MW-U = 163. 500 MW-U = 161.500 MW-U = 154. 500 MW-U = 150. 000 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Dura tion of diag nose 3–9 mo nth 14 28.6 39.0 7 ± 8.49 38.3 5 ± 13.0 1 18.9 2 ± 5.69 32.1 1 ± 8.67 29.64 ± 6.12 10–1 6 m o nth 3 6.1 43.6 6 ± 6.65 55.0 0 ± 8.71 25.0 0 ± 2.64 41.2 2 ± 4.94 34.66 ± 4.16 17–2 3 m o nth 5 10.2 34.4 0 ± 7.73 34.0 0 ± 13.2 6 16.4 0 ± 6.54 28.2 6 ± 8.43 26.80 ± 6.83 24 and above 27 55.1 39.9 2 ± 9.50 45.0 0 ± 15.2 9 19.1 8 ± 6.59 34.7 0 ± 9.75 27.81 ± 11.6 4 KW = 3.32 1 K W = 6.06 2 K W = 4.269 KW = 4.44 4 K W = 2.820 df = 3d f = 3d f = 3d f = 3d f = 3 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Received treatment Ye s 4 0 81.6 39.6 2 ± 8.81 42.9 0 ± 15.1 9 19.1 5 ± 6.40 33.8 9 ± 9.53 28.90 ± 9.52 No 9 18.4 38.1 1 ± 9.72 41.2 2 ± 13.0 2 19.3 3 ± 5.91 32.8 8 ± 8.76 27.55 ± 10.2 8 MW-U = 160. 500 MW-U = 166. 000 MW-U = 177.500 MW-U = 164. 000 MW-U = 158. 000 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 CD4 ? cell count \ 200 13 26.5 38.2 3 ± 8.81 40.6 9 ± 12.8 4 17.7 6 ± 6.67 32.2 3 ± 8.69 29.38 ± 10.6 7 200– 500 23 46.9 41.5 2 ± 7.51 44.6 5 ± 15.3 3 20.2 6 ± 5.77 35.4 7 ± 8.96 30.52 ± 7.85 [ 500 13 26.5 36.6 1 ± 10.8 2 40.8 4 ± 15.9 3 18.6 9 ± 6.79 32.0 5 ± 10.6 2 24.61 ± 10.6 9 KW = 2.72 2 K W = 1.02 7 K W = 1.615 KW = 1.75 3 K W = 2.478 df = 2d f = 2d f = 2d f = 2d f = 2 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 p [ 0.05 Bo ld values ind icate statistical signifi cance
Discussion
Quality of life is a complex concept which constitutes integrity. One of the most important factors in this concept is health. However, many factors such as the health status, eco-nomical status, relationships with family and friends, business opportunities, freedom in determining spare time or life style, educational opportunities, place of living and envi-ronment, environmental conditions are decisive on the quality of life [16].
In this study, the quality of life of patients with HIV/AIDS was found to be poor. Similar to findings of this study, Meng et al. [17] (in China), Arpinelli et al. [18] (in Italy), and Fan et al. [19] (in Malawi) found that the quality of life of patients with HIV/AIDS was low. In Lopez-Bastida et al. [20] study conducted in Spain (2009), it was also found that the mental and physical health SF-36 scores of the patients with HIV/AIDS were about 38.80–48.30. Yu et al. [21] found that the quality of life scores of patients with HIV/AIDS were 41.92 ± 12.01 to 45.34 ± 8.77 in their study conducted in China. There are also many other studies in the literature which report the quality of life of patients with AIDS using different scales [22–24]. Individuals with chronic diseases suffer from physical and social limitation caused by the disease and they can lose their jobs, freedom, social power and self-confidence. This may affect negatively quality of life of patients. In Turkey, one of the most significant problems faced by HIV/AIDS patients is to be stigmatized. Especially, since HIV infection is associated with sexual intercourse and intravenous drug dependence and it is perceived as a disease specific to homosexuals, compared to other chronic dis-eases, people is more prejudiced about HIV/AIDS in Turkey. Therefore, patients with HIV/ AIDS feel that they have to hide their disease. All such reasons affect the quality of life of HIV/AIDS patients and decrease their quality of life.
In this study, it was found that quality of life of women was higher than that of men. Similarly, Skevington et al. [22] and Peltzer and Phaswana-Mafuya [25] also found that the quality of life of women were higher in their study using a different quality of life scale. In contrary of such findings, Lopez-Bastida et al. [20], Mahalakshmy et al. [26], Kohli et al. [27] found that the quality of life of women was lower. It has been decided that the quality of life of women patients within the sample having HIV/AIDS better lever than men is related to their perception of ‘‘gender role’’. A women accepting the role of imposed womanhood on her in Turkish society can be strong in a disease as well such as HIV/AIDS, and continues to carry out her all responsibilities in with her abilities.
In this study, it was found that the quality of life of older AIDS patients was higher than younger patients. It was found that a statistically significant relationship was not found between age of patients and QoL, except well-being subscale of QoL. Skevington [28] found that the quality of life of older AIDS patients was higher. Contrary to our finding, Pereira and Canavarro [29], Razavi et al. [24] found that the quality of life of younger patients was higher.
Table 3 Correlation between quality of life and social support
Quality-of-life instrument Social support (PSS-Fa)
r p
Functional capacity 0.225 [.05
Well-being 0.139 [.05
General health perception 0.124 [.05
In the study, it was found that the quality of life of AIDS patients who had literate was higher than the other education. Contrary to our study, Pereira and Canavarro [29], Reis et al. [23], Marcelin et al. [30] found that the patients with higher education had higher quality of life scores. In our study, it was found that the quality of life of divorced patients was higher than married and unmarried patients. Friend-du Preez and Peltzer [31] also found similar results in their study conducted in South Africa.
The mean QoL scores of patients with low monthly incomes were lower than those of patients with high monthly income. Similarly, Reis et al. [23] found that the quality of life scores were higher in patients with higher income levels in their study conducted on Brazilian women with HIV/AIDS. It may be concluded that this result might be associated with the fact that the quality of life increases with the increased income level, since such patients are more comfortable and live under better conditions and are able to bear the economical load caused by the disease.
It was found that the average scores of quality of life were higher in patients receiving ART treatment, but a statistically significant relationship was not found between ART and QoL. ART reduces morbidity and mortality due to AIDS. With reduced mortality and longer survival, quality of life becomes an important goal of treatment. Similar to the findings of this study, some other studies report that ART does not have any impact on the quality of life [24,32].
Treatment with ART generally results in the restoration of the immune system function with the associated increase in CD4 count. But, in this study, no significant relation was found between CD4? cell count and average quality of life scores. Miners et al. [33] also found in their study that there was no significant relation between CD4? count and quality of life. Contrary to our study, Chariyalertsak et al. [34], Fan et al. [19], Ferreira et al. [35] reported that the patients with higher CD4? count had higher average quality of life scores.
In the study, it was found that socio-demographics and characteristics of the disease did not affect the quality of life. Razavi et al. [24] found that the marital status, number of family members, employment status and education level did not affect the quality of life in their study conducted in Iran. Mahalakshmy et al. [26] found that the education level, economic status and the marital status did not affect the quality of life in their study conducted in India.
In this study, it was found that the average score of perceived social support from family of patients with AIDS was higher than the general average. Ncama et al. [36] found that the social support of HIV patients was moderate. In this study, it was found that the average scores of social support was higher in married patients, patients with university degree and employed patients. Social support provided by family domains can have a positive influence on patients’ general health and well-being. Social support leads to development of positive coping methods in patients. Social help and solidarity is dominant in the Turkish community. Traditionally, relatives are in close contact in the Turkish family structure. In the event that a family member is in trouble, such as having cnronic disease, other members make a great effort to help the troubled member. This is the cornerstone of a Turkish family. As a result, we think that patients with HIV/AIDS is provided social support by their family despite their diagnosis but perceived social support is insufficient.
No significant relation was found between the quality of life and social support. Con-trary to our study, Mahalakshmy et al. [26] found that the social support affected the quality of life. Adewuya et al. [37] found that the patients with lower social support had a lower quality of life. According to this result, in this study, it was found that the quality of
life of patients was low even if they told their diseases to their families and social support is not towards to cope with the disease or it is not sufficient for the patients.
Limitations and Future Directions
The limitation of this study was that the patients were drawn from among the HIV/AIDS living in southern Turkey; therefore, generalization of these findings to individuals living in other geographic regions is limited. The findings of this study are limited by the small sample size. However, the findings provide information and hypotheses for future work in this area. In addition, we did not measure the perceived social support from friends in our study. Future studies can use a measure of social support that captures both ‘‘structure’’ and ‘‘function’’ of social support to in learning more about certain social support mechanisms.
Conclusion
Present study is the first assessment of QOL and social support of people living with HIV/ AIDS in a Turkish population. In this study, it was found that the quality of life of HIV/ AIDS patients was low and the perceived social support from family they receive was moderate. Findings of this study advance knowledge about the relationship between so-ciodemographic characteristics, clinical variables and QOL and PSS-Fa in Turkish patients with HIV/AIDS, and they provide a basis for future studies. According to these results, it is recommended that the families and caregivers will need some support/education training on dealing with their loved who have a disease stigmatized by the rest of the world.
Acknowledgments The authors grateful to all the patients who participated in this study. Conflict of interest None.
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