Examining the Relationship between Perceived Social Support, Family Cohesion and Psychological Wellbeing of Children Orphaned By HIV/AIDS in Southwestern Uganda

Background: The relationship between perceived social support (PSS) and psychosocial well-being is a well-studied phenomenon globally. Evidence shows that PSS is highly correlated with children's psychological wellbeing. However, a limited number of studies have examined the relationship between PSS from multiple sources and children’s psychological outcomes. Even fewer studies have examined the relationship between PSS from multiple sources and the psychological outcomes of children orphaned by HIV/AIDS in Sub-Saharan Africa (SSA). This paper, therefore, examines the relationship between PSS from multiple sources, including parent/caregivers, teachers, friends, and classmates, family cohesion and psychological wellbeing, measured by depression, self-concept, and hopelessness, among children orphaned by HIV/AIDS in Uganda.

Methods: This study used baseline data from a National Institute of Health (NIH)-funded study known as Suubi-Maka (Hope for families), conducted in the Southwestern part of Uganda. A total of 346 child-caregiver dyads from 10 comparable primary schools were selected to participate in the study. Descriptive analyses were conducted on participants’ demographic and household characteristics and measures of PSS. Multivariate regression analyses were conducted to examine the relationship between family cohesion, PSS from multiple sources, and children’s psychological outcomes. Specifically, two multivariate regression models were conducted: Model 1 measured the combined PSS total score from multiple sources on depression, self-concept and hopelessness scores. Model 2 measured the PSS total score from each of the multiple sources on depression, self-concept and hopelessness scores.

Results: Results from multivariate regression analyses indicate that controlling for participants’ demographic and household characteristics, the combined measure of PSS from multiple sources score (model 1) was positively associated with self-concept (b=.32, 95% CI=.23,.41, p=.000) and negatively associated with hopelessness (b=-.19, 95% CI=-.29, -.09, p=.000) and depression scores (b=-.13, 95% CI=-.23, -.03, p=.009). Family cohesion was positively associated with self-concept (b=.37, 95% CI=.15, .58, p=.001) and negatively associated with depression scores (b=-.36, 95%CI=-.59, -.13, p=.002). In model 2, PSS from parents/guardians (b=.26,95% CI=.59, .07, p=.000) and PSS from teachers (b=.56,95% CI=.26, .86, p.000) were positively associated with self-concept. PSS from parents/guardians was negatively associated with hopelessness (b=-63,95% CI=-. 96, -30, p=.000). In addition, family cohesion was positively associated with self-concept (b=.36, 95% CI=.15, .57, p=.001) and negatively associated with depression scores (b=-33, 95% CI=. -57, -.10, p=.005).

Implications and Conclusions: Findings from this study indicate that family cohesion and perceived social support, especially from caregivers and teachers was associated with better children’s psychological outcomes. Strategies aimed at supporting and caring for orphaned children, especially in HIV-impact communities in sub-Saharan African should consider family strengthening components in order to offset children psychological wellbeing.