Abstract
This study investigated the effect of
group counseling on the psychosocial adjustment of people living with HIV/AIDS
in the Lagos metropolis. The research was carried out in two centers which
offer treatment, care and support for people living with HIV/AIDS.120
respondents were used as sample. A psychological adjustment questionnaire was
used to elicit response from the sample. Three hypotheses were formulated to
guide the study. The t-test and chi-square statistics were used to test these
hypotheses. Results from the study indicated a significant effect of group
counseling on the psychosocial adjustment of people living with HIV/AIDS and
also a significant difference in psychosocial adjustment of subjects exposed to
group counseling compared to those exposed to individual counseling. However,
no significant gender difference was recorded in the psychosocial adjustment of
people living with HIV/AIDS. Consequent upon this study, it was concluded that
group counseling could have a significant effect on psychosocial adjustment of
people living with HIV/AIDS. With care, and assistance, through the use of
group counseling HIV infected people can eventually develop positive sense of
self. It is therefore suggested that group counseling should be made an
integral part in the management, care and support of people infected and affected
by HIV/AIDS.
CHAPTER
ONE
INTRODUCTION
1.1
Background of the study
HIV/AIDS
has become a threat to public health in Nigeria as a result of its devastating
consequences, which are manifested in forms of prolonged sickness, deaths and
increase in number of orphans and widows/widowers. Nigeria has an estimated
population of about 150 million of which about 3.5 million are infected by
HIV/AIDS (FMINO, 2007). HIV/AIDS was first identified in Nigeria in 1985 and
reported at an International Conference in 1986 (Adeyi et al, 2006). The
HIV/AIDS pandemic led to the death of 170,000 Nigerians in 2007 (UNAIDS, 2008).
According to Edewor (2010), Nigeria has already surpassed the 5 percent
explosive prevalence phase and the disease has killed more than 1.3 million
people and orphaned more than 1 million children (FMINO, 2007). The infection
rates of HIV/AIDS vary across the six geopolitical zones of Nigeria. According
to Edewor (2010), the mode of HIV transmission in Nigeria is mainly through
unprotected sex, and other factors which contribute to the spread of the virus
include poverty, Sexually Transmitted Infection (STI), social and religious
norms and political and social changes (National AIDS/STD Control Programme,
1999). Parke and Aggleton (2007) noted that negative social attitudes toward
marginalised populations, policies mandating the testing of high risk groups
and limited legal protections based on HIV status may exacerbate stigma. They
stressed further that increase vulnerability to discrimination complicates the
social and psychological adjustment of Persons Living With HIV/AIDS (PLWHA).
The victims require necessary assistance to be able to live happily and
contribute meaningfully to the development of the society. Thus, they need
psychosocial supports to be able to cope with their challenges. Psychosocial
needs can be described as social, mental and spiritual requirements of PLWHA in
order to live quality life and contribute to development of the society. The
needs can be viewed from a psychological theory propounded by Abraham Maslow in
1943. According to Maslow (1954), the hierarchy of needs is often portrayed in
the shape of a pyramid, with the largest and most fundamental levels of needs
at the bottom, and the need for selfactualization at the top. The most
fundamental and basic four layers of the pyramid contain what Maslow called
“deficiency needs” or “d-needs”, esteem, friendship and
love, security, and physical needs. With the exception of the most fundamental
(physiological) needs, if these “deficiency needs” are not met, an
individual’s body gives no physical indication but the individual feels anxious
and tense. Maslow’s theory suggests that the most basic level of needs must be
met before an individual strongly desires (or focuses motivation upon) the
secondary or higher level needs. Maslow also coined the term “Meta-motivation”
to describe the motivation of people who go beyond the scope of the basic needs
and strive for constant betterment. “Meta-motivated” people are driven by
B-needs (Being Needs), instead of deficiency needs (D-Needs)(Wikipedia, 2011).
For the purpose of this study, the psychosocial needs adopted comprise
physiological needs, safety needs, belongingness needs, esteem needs, aesthetic
needs and self-actualization as propounded by Maslow. Physiological needs
include food, air and water; safety needs involve housing and security;
belongingness implies social interaction and group affiliation; esteem needs
involve high regard for self and others; aesthetic needs deal with love of
beauty while self-actualization involves becoming what one desires to be in
life. Since the discovery of HIV/AIDs in the 1980s, more than 20 million people
have died from the disease. The disease killed three million people in 2003 and
is now the leading cause of death and lost years of productive life for people
aged ranging from 15 to 59 worldwide (WHO Report, 2004). HIV/AIDS epidemic has
become a worrisome phenomenon and individual carrier of the infection suffers
from several mental health consequences. The infection is associated with
enormous trauma of which stigma and discrimination against people living with
HIV/AIDS remain the major psychological stresses. It is perhaps no news that
HIV/AIDS patients suffer from psychosocial and neuropsychiatric problems even
their health care workers sometimes develop burn-out syndrome that is
characterized by emotional distress, lowered job productivity and spread of
work problems to family and conjugal relationships. The potential impact of
stigma and discrimination has been of ongoing concern to counselors and
agencies involved in addressing the HIV/AIDS epidemic. Discrimination at
individual, community and national levels have major implications for the
epidemic, as divides or separation is created between those who are vulnerable
to infection and those who are not. Stigmatization in any magnitude has
multiple effects on the lives of people living with HIV/AIDS and more broadly
on members of society, creating disruptions in social functioning, and
increasing people’s vulnerability to infection and reducing the overall caring
capacity of communities. Stigma is perhaps a pervasive problem that affects
health globally, threatening an individual’s psychological and physical
well-being. HIV/AIDS epidemic has significant effect on the economic and
sociological wellbeing of victims. The psychological aftermaths of HIV test
mostly if positive prevent majority of the people in Nigeria and Yakurr Local
Government area in particular to be tested. As such, counseling of people living
with HIV and how to deal with the psychological as well as the social effects
of the infection in the area remains a challenge to counselors and corporate
bodies alike. However, the problem of how best to counsel infected people is
perturbing especially with the rate at which HIV and AIDS are spreading in the
state.
1.2
STATEMENT OF THE PROBLEM
HIV/AIDS
has become a threat to public health in Nigeria as a result of its devastating
consequences, which are manifested in forms of prolonged sickness, deaths and
increase in number of orphans and widows/widowers. Nigeria has an estimated
population of about 150 million of which about 3.5 million are infected by
HIV/AIDS (FMINO, 2007). HIV/AIDS was first identified in Nigeria in 1985 and
reported at an International Conference in 1986 (Adeyi et al, 2006). The
HIV/AIDS pandemic led to the death of 170,000 Nigerians in 2007 (UNAIDS, 2008).
According to Edewor (2010), Nigeria has already surpassed the 5 percent
explosive prevalence phase and the disease has killed more than 1.3 million
people and orphaned more than 1 million children (FMINO, 2007). The infection
rates of HIV/AIDS vary across the six geopolitical zones of Nigeria. It is in
this respect that the researcher intend to investigate the effect of counseling
on the psychological adjustment of people living with HIV/AIDS.
1.3
OBJECTIVE OF THE STUDY
The
main objective of this study is to ascertain the effect of counseling on the
psychological adjustment of people living with HIV/AIDS in Nigeria. But for the
successful completion of the study the researcher intend to achieve the
following objective;
i)
To ascertain the effect of counseling on the psychological adjustment of
HIV/AIDS patient
ii)
To investigate the relationship between counseling and psychological adjustment
of HIV/AIDS patient in Nigeria
iii)
To ascertain the impact of counseling on the psychological well-being of
HIV/AIDS patient.
iv)
To investigate the role of counseling on the life span of people living with
HIV/AIDS
1.4 RESEARCH
HYPOTHESES
The
following null hypotheses were formulated to guide the study:
I. There is no significant effect of group
counseling on psychosocial adjustment of people living with HIV/AIDS.
II. There is no significant difference in
psychosocial adjustment of subjects exposed to group counseling and those
exposed to individual counseling
III. There is no significant gender difference in
psychosocial adjustment due to group counseling.
1.5
SIGNIFICANCE OF STUDY
As
with medical practitioners, the upsurge of HIV/AIDS is also a challenge to
psychologists and counselors who have to develop strategies for preventing and
treating psychosocial problems the infected people face. Psychosocial problems,
if left unattended to, can stand in the way of these individuals leading normal
lives and contributing their own quota to the society.
This
study seeks to provide information to assist counselors in adopting effective
techniques in the counseling of people living with HIV/AIDS. The study will
also help in suggesting the way forward in the counseling of these individuals
in the light of the rate at which HIV/AIDS infection is spreading, and the
client/counselor ratio is increasing. It will also contribute to the body of
knowledge on the effects of group counseling on the psychological adjustment of
people living with HIV and AIDS.
1.6
SCOPE AND LIMITATION OF THE STUDY
The
scope of this study covers the effect of counseling on the psychological
adjustment of people living with HIV/AIDs in Nigeria. However, in the cause of
the study the researcher encounters some constrain which limited the scope of
the study;
a)
AVAILABILITY OF RESEARCH MATERIAL:
The research material available to the researcher
is insufficient, thereby limiting the study.
b)
TIME: The time frame allocated to the study
does not enhance wider coverage
as the researcher has to combine other academic activities
and examinations with the study.
c)
FINANCE: The finance available for the
research work does not allow for wider coverage as
resources are very limited as the
researcher has other academic bills to cover