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Results, Discussion and Conclusion
This week, you should be working on your Discussion and Conclusion section of your research proposal. In a proposal such as this, what you will also need to include are your expected results. The expected results are based on several factors including what you learned from your literature review on similar research as well as what you learned from your course readings thus far.
The difference between a great research paper and a marginal one is the depth and originality of the discussion and conclusions section. The discussion/conclusion section is where you bring together what you learned from the literature review (as well as through the course) in your concluding remarks regarding your topic.
Provide an overview of the expected results
Develop a conclusion of your research proposal
Include information on the ramifications of the study, its limitations, and the potential for future research studies
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UNFORMATTED ATTACHMENT PREVIEW
Factors Associated With Depression Among People Living With HIV University Factors Associated With Depression Among People Living With HIV Introduction Despite the plenty of efforts that have been put in place to curb the stigma associated with HIV virus, the upsurge of this humiliating subject has continued to psychologically oppress many victims of the infection. Stigma is still a major challenge even to those who have ever publicly declared their statuses. One vital and most common negative effect of stigma is the feeling of depression (Chukhraev et al., 2017). There are many factors associated with depression especially in people living with the HIV virus. They may range from the constant medications to emotional and physical factors. If the factors are studied and understood, the end results would be helpful to many people who have been outwitted by depression. Depression is a psychological disorder in which a given person loses interest in various activities, ways of thinking and all other normal activities of the given moment. The person often feels low and is always sad. At times such people contemplate committing suicide. There are three important types of depression which include mild depression, moderate depression and severe depression. Mild depression is the least complex of the types of depression. Most of the time the remedy often involves nothing since the condition often just disappears without any form of complex management. Moderate depression is one that often requires more of psychological counseling and then it heals by itself without any medication. Severe depression on the other hand is one that is so much and the affected party is often disturbed and without the peace of mind (Segal et al., 2018). This type of depression is always intervened against by ensuring the affected party takes the best medication (anti-depressants) and is left to relax. All these types of depressions affect those who feel overburdened the fact that they live with the HIV virus and can do nothing about it. This paper is focused in finding out the factors that contribute to such a poor condition. References Chukhraev, N., Vladimirov, A., Zukow, W., Chukhraiyeva, O., & Levkovskaya, V. (2017). Combined physiotherapy of anxiety and depression disorders in dorsopathy patients. Journal of Physical Education and Sport, 17(1), 414. Segal, Z. V., Williams, M., & Teasdale, J. (2018). Mindfulness-based cognitive therapy for depression. Guilford Publications. Running head: LITERATURE SECTION 1 Factors Associated with Depression among People Living With HIV University April 18th 2019 LITERATURE SECTION 2 Factors Associated with Depression among People Living With HIV Bhatia et al. (2014). Article In the article, Bhatia and Munjal (2014) sought to assess the association between depression and HIV/AIDS in an Indian hospital setting. The article interviewed 160 participants (both male and female patients) using a questionnaire comprising factors, which affect depression. The authors found that the depression prevalence increased with the severity of clinical manifestations. They also found that unemployment, lack of education, divorced/singlehood, living in joint families, low income, immigration status, marital problems, lack of social support and involvement with commercial sex workers are associated with higher depression prevalence. Regardless of age or gender, these factors have an equal impact on patients. This article relates to my course in that it highlights the risk factors of depression. Liu et al. (2018). Article Liu et al. (2018) sought to find out the depression prevalence and its related factors among HIV-positive male patients in China. They used a cross-sectional questionnaire survey (the SPIEGEL questionnaire, the Berger HIV Stigma, and the Burns Depression Checklist) to gather info from 200 participants in Harbin, China. The authors also examined demographics, hostility, the antiretroviral therapy side effects, and family support of HIV/AIDS-positive male patients. They found that sleep quality to be strongly linked to depression among HIV-positive male patients. Demographic variables (age, genders, and ethnicity), illness duration, CD4+ cell count, and HIV infection route were not significantly associated with depression. This article relates to my readings and course since it highlights the negative impact of sleep disorders on patients long-term illnesses. Akena et al. (2010). Article LITERATURE SECTION 3 In this article, the author made a comparison of the clinical manifestations of major depression between HIV-negative and HIV-positive patients with regards to interventions. They conducted a comparative, descriptive, cross-sectional research on 66 HIV-negative and 64 HIVpositive patients with depression in a hospital setting. The finding was that HIV-positive patients with depression had irregular sleep patterns, experienced fatigue, cognitive impairments, and frequent appetite changes. They also found that low CD4 count was not significantly linked to depression. The findings of this article are coherent with what i have studied in my course. Kinyanda et al. (2011). Article The authors sought to examine the risk factors and prevalence of MDD in HIV-positive patients in Uganda’s semi-urban area. They undertook the cross-sectional researcher on 618 participants visiting two HIV/AIDS hospitals. At univariate analysis, family history of mental disorder, female gender, alcohol dependency disorder, negative coping style, stress, and food insecurity were the only factors linked to major depressive disorder. Neurocognitive impairment, social support, BMI, and CD4 counts. This article relates to my course as it goes into exploring a different type of depression, the MDD. LITERATURE SECTION 4 References Bhatia, M. S., & Munjal, S. (2014). Prevalence of depression in people living with HIV/AIDS undergoing ART and factors associated with it. Journal of clinical and diagnostic research: JCDR, 8(10), WC01 Liu, H., Zhao, M., Ren, J., Qi, X., Sun, H., Qu, L., … & Cui, Y. (2018). Identifying factors associated with depression among men living with HIV/AIDS and undergoing antiretroviral therapy: a cross-sectional study in Heilongjiang, China. Health and quality of life outcomes, 16(1), 190. Kinyanda, E., Hoskins, S., Nakku, J., Nawaz, S., & Patel, V. (2011). Prevalence and risk factors of major depressive disorder in HIV/AIDS as seen in semi-urban Entebbe district, Uganda. BMC Psychiatry, 11(1), 205. Akena, D. H., Musisi, S., & Kinyanda, E. (2010). A comparison of the clinical features of depression in HIV-positive and HIV-negative patients in Uganda. African Journal of Psychiatry, 13(1). Running head: PSYCHOLOGY 1 Literature Review PSYCHOLOGY 2 Literature Review Summaries According to Hammond et al. (2016), people with HIV and substance use disorders experience major depression as a primary co-morbidity, which represents a multifactor relationship. While depression increases the patients’ risk of getting HIV and substance use disorders, both depression and substance abuse trigger mortality in HIV patients (Hammond et al. 2016). Depressed people have higher chances of contracting HIV due to indulgence in risky behaviors. Consequently, the likelihood of non-adherence to medications increases in such populations. Persons living with comorbid HIV and depression conditions may alter their biological pathways due to use of stimulants like cocaine, which leads to increased susceptibility of T-cells to HIV, as well as high rates of viral integration into the host cells. Studies have also established a positive association of altered cytokine IL-4 and IL-10 with cocaine use. Therefore, the use of cocaine, frequency, and duration results in increased odds for depression. On the other hand, Do et al. (2014) revealed that with the emergence of effective treatment that has led to increased life expectancy, HIV has become a chronic condition whose complications may arise due to comorbid depression. As such, serious concerns have emerged regarding the adverse effects of depression on the affected people’s quality of life (Do et al., 2014). Therefore, most depressed individuals may become non-adherent to treatment, leading to higher levels of infectiousness and viral load, as well as poor clinical outcomes. Analysis Hammond et al.’s article aimed at analyzing the relationship between HIV infection and depression. As such, the authors conducted a study involving 447 participants with a mean age of 46 years. The prevalence of cocaine use in depressed individuals was 81.4 percent compared to PSYCHOLOGY 3 the 69.3 percent who were not depressed. The study established that depressed people had more extended periods of HIV infections and high chances of being on protease inhibitor biased ART regimens (Hammond et al., 2014). The relationship of this analysis to the text readings is that using the research method approaches described in the text made it easier to analyze the provided information and gain in-depth knowledge regarding the data and statistics. It also helped in comprehending how to identify and involve the most appropriate population in primary research. Do et al. (2014) aimed at establishing the prevalence of depression among HIV-infected persons receiving care, and evaluating their depression burden with relation to that of the general population. The authors applied data from the Medical Monitoring Project (MMP) and the Behavioral Risk Factors Surveillance System (BRFSS) (Do et al., 2014). They observed that depression remains a comorbidity among the HIV-infected individuals, and an overall excess burden of those receiving care is thrice that of the general population. Since the challenges emanate from the variations in household incomes per annum between the two groups, it is vital to implement strategies that will help in its reduction. The relationship of this article with the course readings is that it made it easier to conceptualize the ideas and establish the best ways of researching while being ethical in analyzing data and reporting results. It also helped in comprehending methods of identifying, using and interpreting secondary data in research. Gender/Cultural Diversity Issues In Hammond et al.’s article, the research focused on African-American cocaine users living with HIV/Aids. As such, the observation that racial disparity of HIV infections remains prevalent could be unreliable because the information about white individuals was from other studies and not actual participants. On the other hand, Do et al. incorporated nationwide PSYCHOLOGY 4 information; thus they ensured incorporation of data from a significant gender and culture population. References Do, A. N., Rosenberg, E. S., Sullivan, P. S., Beer, L., Strine, T. W., Schulden, J. D., Skarbinski, J. (2014). Excess Burden of Depression among HIV-Infected Persons Receiving Medical Care in the United States: Data from the Medical Monitoring Project and the Behavioral PSYCHOLOGY Risk Factor Surveillance System. PLoS ONE, 9(3), 1–10. https://doi.org/10.1371/journal.pone.0092842 Hammond, E. R., Lai, S., Wright, C. M., & Treisman, G. J. (2016). Cocaine use may be associated with increased depression in persons infected with HIV. AIDS and behavior, 20(2), 345-352. Leary, M. R. (2016). Introduction to Behavioral Research Methods, 7th edition . Upper Saddle River, NJ: Pearson Education, Inc. ISBN: 9780134414409 5 Running head: RESEARCH PROPOSAL 1 Factors Associated with Depression among People Living with HIV University RESEARCH PROPOSAL 2 Factors Associated with Depression among People Living with HIV Methodology Participants The research will recruit 200 HIV patients, including 100 males and 100 females. The inclusion criteria demand that the participants must not be experiencing any form of physical injury and mental illnesses at the time of the research. Also, they must be people who must have contracted the infection for more than two years, that is, before 2017. The study will involve victims who demonstrate that they are genuinely infected through various test evidence like certificates. However, the research will exclude HIV patients who suffer from physical injuries and mental illnesses that can aggravate their depression levels. Besides, it will not engage people who contracted the virus between January 2018 and the time of the research. To eliminate the confounding factors like age, only individuals between 18 and 30 years who form the majority of the youth population will participate in the experiment. Procedure The study proposes a qualitative research approach where random participants will respond to questionnaires, surveys, and interviews, among other techniques concerning the topic of study. The process will involve presenting various causes of depression among people who have HIV on a piece of paper and requesting them to mark in order of severity. A Likert scale of 1 to 5 will gauge such to determine which of the factors cause a lot of depression to the victims of HIV infection. In the Likert scale, 1 will represent ‘not severe’, 2 = ‘somehow severe’, 3 = ‘moderately severe’, 4 = ‘severe’ and 5 = ‘Most Severe.’ Factors causing depression, which the study will survey include but not limited to, stigma, unemployment, lack of education, relationships, marital problems, and lack of social and family support. Data Collection Methods RESEARCH PROPOSAL (i) 3 Surveys The study will use surveys to collect data from a predefined group of participants to gather information and insights about the significant factors that cause depression among HIV patients. The technique will enable respondents to answer questions at level playing field thereby eliminating biases that can influence outcomes of the research. It will involve seeking information through questionnaires in the form of physical papers and private emails. The process will ask to know about the rampant causes of depression among people who have HIV. The essential advantage of such survey method is that it maintains the privacy of the participants hence encouraging them to give more accurate and sincere answers. Besides, surveys that researchers administer through emails are faster as they can cover a large population within a short period. However, surveys can be costly in cases of telephone calls. (ii) Interviews The research will use interviews to obtain high personal data or information from the participants because they allow researchers to probe the interviewees to get the underlying factors. For instance, the participants will respond to the level in which stigma, lack of employment, lack of education, relationships, and marital problems impact on their depression levels. Interviews help in giving information which the interviewee considers private. They also provide extra information from which interviewers can draw meaningful conclusions. On the contrary, they can be expensive, especially if the interviewers have to travel long distances to collect data. Also, there can be a backlash if the participants feel coerced in giving out information. Data Analysis The study will use simple statistical measures like mean and standard deviations to determine which of the stress causing factors gets the highest mention from the participants. RESEARCH PROPOSAL It will calculate the number of mentions from the surveys through the Likert scale and the interviews. Results If stigma has the highest mean from the surveys in the Likert scale, then it will be the primary cause of depression among the HIV patients. Similarly, many patients mention stigma as the chief cause of their distress, then it will be regarded as the critical cause of depression to HIV patients. 4