IMPACT OF SUPERVISOR SUPPORT AND HEPATITIS C STIGMA ON EMPLOYEE PERFORMANCE WITH MEDIATING EFFECT OF SELF EFFICACY AND PREJUDICE: EVIDENCE FROM PAKISTAN

Background: Stigmatization also excessively upsetting the people who are suffering from Hepatitis C. In employees perspective they suffers more when those patients stigmatizes in the working environment at this point they are at risk and any exploitation from their supervisors effect worsen then in normal condition. Lack of resources, damage health and negative behaviour can directly impact the efficacy of employee. Objective: to determine the impact of supervisor support and hepatitis C stigma on employee performance with mediating effect of self-efficacy and prejudice. Methodology: A cross-sectional correlational study was conducted at different private and government hospitals of the Rawalpindi and Islamabad. The sample of n=242 hepatitis C (HCV) patients with age between 25-50 years, having 5-year experience and positive with HCV were included in the study were taken during June 2020 to March 2021. The HCV stigma scale, Supervisory support scale, prejudice scale, self-Efficacy scale and employee performance scale was used for data collection. . This data was analysed by SPSS version 20. Results: The mean age of participants was 33.3 ±10.5 years. A total of n=242 (85.10%) were males and n=36 (14.90%) were females. HCV stigma has negative correlation (with r=.45 p =.05 ) performance of employees through increased prejudice (r=.45, p=.04 ) and lower self-efficacy whereas (r=.45, p=.05 ) supervisory support can moderate this relationship to enhance the performance at the workplace (r=.45, p=.05). Conclusion : The positive effect of Supervisor Support is clear from the results. Hence, if the Supervisor Support invades the relationship of HCV Stigma and Self Efficacy and Prejudice and their ultimate impact on Employee Performance, it alters their impact.


INTRODUCTION
The impact of communicable disease-stigma based can be highlighted, as populations susceptible to disease may already face stigma because of several others personal characteristics such as race, age, poverty, or sexual inclination. 1 According to different research studies, the effects of Hepatitis C-related stigma on people dealing at the workplace with the virus haven't been well documented thus showing that limited analysis concentrates the systems underpinning the social stigmas. 2 Hepatitis C is coming into sight as a bloodborne viral disease that is affecting nearly 3% of the whole population. 3Only in Pakistan there are more the 10 million people who have been infected from these diseases.Individuals whose social stigmas are in their knowledge will develop a perception that society will help them, thus revealing that stigma has both social and psychological aspects associated with it. 4Therefore, according to attribution theory, and the infected individual is considered flawed and solely responsible for a certain illness which ultimately results in discrimination and social exclusion.5   According to the study, work is considered as the major indicator of identity, and the participation of the individual in the workforce is considered as the significant aspect of mental and social well-being.
6 So, stigma is also considered as an attribute that links an individual with adverse stereotypes and successive discrimination and as a blend of labelling, separation, loss of status, and discrimination. 7Stigma is intricately and deeply woven into the composition of human behaviour and interactions. 8Stigma may have functional value for individuals, groups, and societies by delineating between acceptable and unacceptable behaviour.The phenomenon of stigma occurs amongst individuals, groups, cultures, and societies.
9 Some of the advantages of higher employees' performance had been quoted in various researches are increased individual productivity, job satisfaction, psychological wellbeing, employee's involvement in a job, sense of commitment.Management of the Performance, evolve, flourish, and persuade different people at a workplace that will give the commendable results.
10 Employee performance management includes assuring the goals of employees according to giving them such activities which are persistently helpful for being efficiently and effectively.Managers can also face different frequent challenges of This study improvised the behaviour of the society towards HCV patients which are increasing on yearly basis.The increasing number of patients justifies the need of this study as its recommended approach showed that how the behaviour of patients surroundings especially office environment affects the health of patients suffering from hepatitis C. As there is no study have been conducted yet using these variables, So objective of this study was to determine the impact of supervisor support and hepatitis C stigma on employee performance with mediating effect of self-efficacy and prejudice.The effect of HCV Stigma, Prejudice, and Self Efficacy has been checked according to the different analysis values e.g., In the regression analysis model initially R 2 values have been analysed which shows the proportion of different proposed variables that are used in research work.
In the regression analysis model, firstly R 2 values showed that supervisory support 25 % fits in the model, while HCV stigma and Self efficacy is 17% and 30% fit in the model.The Beta show that if supervisory support increases by 1% then employee performance increased by .054.By far, the results have shown a negative relationship of independent variable and Prejudice with dependent variable while Self Efficacy and Supervisor Support show positive relation with Employee Performance.The mediating impact of Self Efficacy and Prejudice can be investigated by changes in the value of R 2 (ΔR²).(Table 2)  Firstly, examine the mediation, which is selfefficacy and, to check the relation between the two more variables which is HCV Stigma and Employee Performance.The results showed partial mediation with p<0.001 and R 2 50%.While examining the Mediation of Prejudice between HCV Stigma and Employee Performance, the results showed p<0.005.
Hence, Prejudice mediates the relationship between HCV Stigma and Employee Performance.(Table 3) While examining the moderated relationship of supervisor support with HCV Stigma and selfefficacy, which suggested that, the relationship between HCV stigma and employee performance will be weaker when supervisor support moderates the relationship between HCV Stigma and selfefficacy.Supervisor support has been observed to be a strong moderator between HCV stigma and self-efficacy and shows a significant positive impact on employee performance.The positive effect of supervisor support is clear from the results.Hence, if the supervisor support invades the relationship of HCV stigma and self-efficacy and prejudice and their ultimate impact on employee performance, it alters their impact.(Table 4)

DISCUSSION
The purpose of this study was to determine the impact of supervisor support and hepatitis C stigma on employee performance with mediating effect of self-efficacy and prejudice.According to the current study there was a strong and significantly positive relationship is found between supervisor support and HCV stigma at the workplace and prejudice.It indicates that when an employee comes up with disclosing the secret of his illness then the supervisor/manager tends to exploit and dominate the stigmatized individual to have norms enforcement and disease avoidance.The significant association between HCV stigma and self-efficacy indicates that when PWHCV perceive that their organization is not giving them enough opportunities to work and pieces of training to improve their task performances this would lead to lessening the belief of PWHCV in their abilities thus decreasing the self-efficacy.People living with HCV may be assumed to engage in negligent or unsafe behaviours and may even be considered a threat capable of spreading the disease to others.Lack of awareness about modes of transmission through which HCV spreads may further fuel HCV stigma in the workplace.HCV is not spread through casual contact, yet participants of this study informally told one of the authors that their co-workers avoid eating and sharing utensils with them. 13Stigma associated with HCV is similar to stigma associated with HIV in workplaces in Pakistan, with both HCV and HIV stigma associated with negative workplace outcomes. 14HCV stigma is an important, yet understudied, issue in many Asian countries.Stigma associated with HCV is similar to stigma associated with HIV in workplaces in Pakistan, with both HCV and HIV stigma associated with negative workplace outcomes. 15A study reported experiencing workplace supervisor support and internalizing stigma associated with HCV.HCV stigma is strong in Pakistan.HCV is viewed as highly controllable, and people are considered personally responsible for acquiring HCV. 16People living with HCV may be assumed to engage in negligent or unsafe behaviours and may even be considered a threat capable of spreading the disease to others.Lack of awareness about modes of transmission through which HCV spreads may further fuel HCV stigma in the workplace.Another practical implication of this study suggests that by having the knowledge of stigma process in this part of culture can help in clarifying the stigma aspects as stigma is a very complex process.And it has been suggested that by having enhanced awareness of stigma prevalence across different cultures makes it possible to formulate approaches in order to decrease the level of stigma.17 Self-efficacy positively influences employee performance and partially mediates HCV stigma and employee performance.It demonstrates that social identity theory is another crucial method or structure that, in consolidation with learning prospect and social correspondence that can help to intimate the complex HCV stigma-employee performance relationship.Here it was tested whether supervisory support moderates the relationship between HCV stigma and self-efficacy.The positive effect of Supervisor Support is clear from the results.Hence, if the Supervisor Support invades the relationship of HCV Stigma and Self Efficacy and Prejudice and their ultimate impact on Employee Performance, it alters their impact.This is psychological support to the employee suffering from HCV thus leading to improve his performance.This study provides a promising way to understand the impact of supervisor support and hepatitis C stigma on employee performance.However, the results are not without limitations.The first limitation is the small sample size.Participants were from a convenience sample of hospitals as only some of the hospitals of twine cities of Pakistan are engaged to collect data.Secondary the current study was its cross sectional nature.Now the new preferred trend in the research is towards the longitudinal studies.CONCLUSION Results reveal the fact that HCV stigma negatively affects the performance of employees through increased prejudice and lower self-efficacy whereas the supervisory support can enhance the employee performance at workplace.Future studies should seek to explore these associations among a more representative sample of people living with HCV from various work settings.Future studies may further explore the role of these demographic characteristics to better understand internalized stigma and self-esteem among employees living with HCV in Pakistan.

Table 1 :
Correlation Analysis among study variables (n=242) METHODOLOGYA Co-relational study was pursued at welldeveloped gastroenterology department hospitals of Rawalpindi and Islamabad were during June 2020 to March 2021.The sample size was n=242 collected through non probability convenience sampling technique.The full time employees between 25-50 years, having 5 year experience and positive with HCV were included in the study.

Table 3 :
Mediated regression analysis of HCV stigma, self-efficacy, prejudice and employee performance (n=242)

Table 4 :
Combined moderated multiple regression results for employee performance (n=242)