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1
Uwimana, Jeannine. "Met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The aim of this study was to investigate met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda. The achieve this aim, the study, firstly, identified the palliative care needs of people living with HIV/AIDS, secondly, it identified the health care services available to meet these needs, and thirdly, it determined the extent to which palliative care needs were met.
2
Leaney, Alison Ann. "An evaluation of the Buddy/home Care Program : a palliative care program operated by AIDS Vancouver." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28717.
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Acquired Immunodeficiency Syndrome (AIDS) is presenting a real challenge to our Canadian health care system. As the numbers of infected grow, the greater the realization that health care and social services as they currently exist, are unable to adequately address the overwhelming need. With a special emphasis on hospice/palliative care services, which are seen as essential and very appropriate in the care of persons with AIDS (PWAs), this study seeks to evaluate one such service - the Buddy/Home Care Program offered by AIDS Vancouver - as a means of improving this program and illustrating the need to establish others to achieve an integrated hospice/palliative care service.
To evaluate the effectiveness of the Buddy/Home Care Program, four PWA Social Networks composed of four Persons With AIDS, five of their buddies, three Home Care Volunteers, two Buddy/Home Care Client Care Case Managers, and four Outside Agency Affiliated Persons, were interviewed using an interview guide approach. The interview guide was designed to tap the individual experiences of everyone associated with the Program, as well as their perceptions of the Program's strengths and weaknesses. Limitations in the study design and implementation arose from sampling, incomplete data, and
researcher-related issues. Data analysis followed the dimensional model of the Glaser and Strauss grounded theory.
The results are presented utilizing pertinent social network characteristics as a framework. First, each of the four PWA Social Networks are presented and described in relation to size and density. The networks vary in size from 12 to 25, and are characterized by low levels of density. Since the literature indicates that there is a positive association between network size and health status, it follows that the PWA with 12 individuals in his social network would have the lowest health status, while the PWA with 25 would have the highest. But this has not been found to be the case in this study. What is also unclear, is whether larger sized networks cause improved health, or whether health status determines network size. Although low density is far from the ideal prescribed by the hospice/palliative care approach, the literature is conflicting on the association between density and health status, suggesting that this low density is not necessarily undesirable. Second, an examination of the volunteer-client relationship subsystems reveals that the relationships fulfill the Client Care Case Managers expectations, in that the relationships between volunteers and clients range in intensity from being volunteer-client, to friend-friend, to parent-child oriented, and are characterized by a wide
variety of emotional, informational, instrumental, and companionship support functions consistent with these relationship dynamics. And third, an examination of the volunteer-agency relationship subsystems reveals high levels of appreciation of informational support provided by the agency through its volunteer training, relatively infrequent contact between volunteers and Client Care Case Managers, variable experiences of emotional support received from Client Care Case Managers, minimal amounts of emotional support received from the Buddy Support Group, and some confusion about which staff members are responsible for volunteers pre- and post-assignment.
Recommendations designed to improve volunteer-client and volunteer-agency relationships in the Buddy/Home Care Program, as well as others designed to promote the establishment of an integrated Canadian
hospice/palliative care service are presented in conclusion.Arts, Faculty of
Social Work, School of
Graduate
3
Demling, Jennifer. "Family caregiving for persons with AIDS." Virtual Press, 1995. http://liblink.bsu.edu/uhtbin/catkey/962800.
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This study examines the experience of individuals who participated or did not participate in the caregiving process for a family member who died within approximately the past three years of an AIDS-related illness. The focus of this study is on the adjustment of the caregivers and non-caregivers after the death of the PWA. It was hypothesized that due to their direct involvement in the caregiving process, caregivers would differ significantly from non-caregivers on a number of measures designed to evaluate adjustment. It was hypothesized that caregivers would report better overall adjustment than non-caregivers.Participants completed the Symptom Checklist 90 (SCL-90; Derogatis, Lipman, & Covi, 1973), as well as a semi-structured interview about their experiences. A two-tailed t-test revealed no significant differences between groups. However, effect sizes computed for these variables revealed moderate to large diff ererences between caregivers and non-caregivers on the somatization and interpersonal subscales of the SCL-90. Comparisons to a standardization sample showed that caregivers differed significantly on all subscales from that standardization sample: Non-caregivers differed only on the depression and interpersonal sensitivity subscales. Analysis of the interview data revealed a significant difference in reported stress, with caregivers reporting significantly more stress during the illness of the PWA than non-caregivers. Effect sizes were computed for nine other interview categories; these suggested that caregiversreported substantially less social withdrawal, fewer feelings of guilt, fewer problems resolving issues with the PWA, substantially more physical illness, and more life affirming statements than their non-caregiver counterparts. Several other noteworthy trends that emerged in the interview portion of the study are discussed.Small sample size and pre-existing characteristics of the participants are explored as possible factors affecting the outcome of the study. More controlled studies exploring the adjustment of caregivers and non-caregivers are needed in order to better understand the possible differences that may exist between caregivers and non-caregivers in terms of adjustment after the death of their loved one from an AIDS-related illness.Department of Psychological Science
4
Wong, Wa-kit, and 王華潔. "The needs of and care for persons with HIV/AIDS in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31250300.
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5
Baylor, Rita Atkins. "Nurses' attitudes toward caring for patients with AIDS." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845956.
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The main purpose of this study was to examine nurses' attitudes toward caring for patients with Acquired Immune Deficiency Syndrome (AIDS). The study also compared the attitudes of nurses who had cared for AIDS patients with the attitudes of nurses who had not cared for AIDS patients. Educational background was also examined to see if education influences attitudes. The Ajzen-Fishbein Model of Reasoned Action was the framework used for this study.A descriptive design was used for the purpose of gaining more information regarding nurses' attitudes toward caring for patients with AIDS. A random sample of all registered nurses in the state of Indiana was used for this study. The data obtained were analyzed using frequency distributions, independent t-tests, and analysis of variance.Nurses in general are sill uncomfortable with caring for AIDS patients. Between 40% and 50% of nurses are fearful of contracting the AIDS virus and fearful of putting their family at risk. On the other hand, approximately the same percentage are comfortable caring for AIDS patients. Furthermore, nurses believe that health care agencies should care for AIDS patients, but believe that nurses should have the right to refuse to care for AIDS patients.Results of this study indicated that educational background does not influence nurses' attitudes toward caring for patients with AIDS. However, as nurses have more experience caring for patients with AIDS, they appear to develop more positive attitudes.School of Nursing
6
Tutani, Lumka. "Nurses' experience of contesting discourses in HIV/AIDS activities in the primary health care setting." Thesis, Rhodes University, 2001. http://hdl.handle.net/10962/d1002583.
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This paper explores the experience of nurses who work both as Primary Health Care Providers and counsellors trained in the narrative model of counselling in primary health care settings. Five focus groups were conducted in both Xhosa and English. Discourse analysis was used as a method of analysing the data. Training nurses in the narrative counselling model introduced an alternative discourse, which was experienced as contradicting their usual way of working. Two dominant discourses were the “not knowing” approach, assumed by the narrative model of counselling, and the “knowing” stance, assumed by health education. The institutionalised construction of counselling by doctors and matrons, and their power versus the power of the nurse counsellors was also cited as sources of conflict. Despite the tensions, narrative model of counselling seems to be offering new positions, which may benefit people living with HIV and improve HIV/AIDS activities in the Primary Health Care (PHC) context.
7
Newman, Linda C. "Maintaining self integrity in the care of AIDS patients : a grounded theory approach." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/834521.
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The purpose of the study was to explore barriers hospital nurses perceive in the care of AIDS or HIV positive patients. According to the Center for Disease Control, the total number of AIDS cases reported in the United States as of December 1991 was 206,392. The Center for Disease Control reported of the known AIDS cases in the United States 59% have resulted in death.A grounded theory approach was used in the study of sixteen nurses working with AIDS patients in a medical surgical area of the hospital. Results of the study showed nurses had a need to maintain self integrity. All barriers found as a result of the study related to the nurses need to maintain self integrity. Barriers found as a result of the study include the following: fear of contagion, family concerns, fear of the unknown, issues in confidentiality, issues in universal precautions, and emotional and spiritual aspects.School of Nursing
8
Peltier, Cécile. "Prévention de la transmission du VIH-1 par le lait maternel au Rwanda et dépistage précoce des enfants infectés." Doctoral thesis, Universite Libre de Bruxelles, 2012. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/209572.
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Ce travail est réparti en deux parties différentes issues de deux études différentes.La première partie décrit l’étude AMATA conçue en 2005 au Rwanda, étude prospective basée sur le suivi d’une cohorte répartie en deux groupes d’intervention postnatale. Cette étude avait pour objectif de tester l’hypothèse que l’allaitement maternel (AM) sous trithérapie antirétrovirale maternelle (HAART) pouvait être une prévention aussi efficace que le lait artificiel (LA) afin de réduire drastiquement la transmission du virus VIH de la mère à l’enfant avec une moindre mortalité infantile. Cette intervention permettait de préserver les avantages de l’AM, connue pour offrir une prévention naturelle minimisant les infections graves, en particulier les gastro-entérites et diminuant le taux de malnutrition protéino-énergétique (MPE). Dans la cohorte « AMATA », un groupe d’enfants était allaité exclusivement durant six mois, les mères étant sous trithérapie antirétrovirale systématique et un autre groupe d’enfants était nourri au LA durant les six premiers mois de vie. L’intervention débutait durant la grossesse à partir de la 28ème semaine d’âge gestationnel, une trithérapie antirétrovirale étaient donnée à toutes ces femmes enceintes infectées par le VIH participant à l’étude, quel que soit leur stade immunitaire ou clinique. Cette trithérapie était poursuivie à vie pour les femmes nécessitant cette combinaison de traitements antirétroviraux pour des raisons cliniques et/ou immunitaires et non poursuivie pour les autres femmes, avec un schéma d’interruption minimisant les résistances aux ARVs.
Les critères d’évaluation de comparaison des deux interventions postnatales étaient la survie à 9 mois des enfants non infectés, le taux d’infection par le VIH et la mortalité des enfants dans chaque groupe. La présence de facteurs confondants a été recherchée en effectuant une analyse de variance car la randomisation était impossible pour des raisons éthiques.
Dans l’étude AMATA, parmi les 532 enfants inclus, 227 (43%) étaient allaités et 305 (57%) recevaient du LA, 7 enfants furent infectés par le VIH (1,3%) dont 6 in utero (3 enfants par groupe). Un enfant fut infecté par l’AM correspondant à un risque cumulatif postnatal de 0,5% [IC95% 0,1–3,4%; P 0,24]. Ce taux de transmission reste parmi les plus bas dans un pays à ressources limitées même en comparant avec d’autres études où la trithérapie fut aussi utilisée durant l’AM. Ces études furent publiées après le début de l’enrôlement des patientes dans l’étude rwandaise AMATA en 2005.
La différence de mortalité à 9 mois n’était pas statistiquement différente dans les 2 groupes avec 3,3% (95% IC 1,6–6,9%) pour les enfants allaités et 5,7% (95% IC 3,6–9,2%) pour les enfants recevant du LA (P= 0,20).
Cette étude renforce la notion que l’AM sous trithérapie antirétrovirale (HAART) reste une approche à recommander dans les contextes où la mortalité infantile est élevée. Cette prévention postnatale permet non seulement de réduire très efficacement la transmission du VIH de la mère à l’enfant en préservant les avantages de l’AM et en évitant les risques du LA distribué dans des contextes d’hygiène précaire où un accès à l’eau potable est difficile.
Dans cette étude, l’efficacité de ces 2 interventions postnatales était comparable avec des taux de transmission et de mortalité semblables statistiquement.
La deuxième partie de ce travail, basée sur les résultats d’une cohorte d’enfants âgés de moins de 18 mois nés de mères infectées par le VIH permettait d’évaluer les signes cliniques présomptifs proposés par l’OMS en 2005. Ces signes
étaient créés afin de pouvoir effectuer le diagnostic clinique d’infection par le VIH chez les enfants exposés au virus VIH
dans les pays où les techniques moléculaires de PCR n’étaient pas accessibles. Les enfants nés de mères infectées par le
VIH gardent parfois des anticorps anti-VIH maternels jusqu’à l’âge de 18 mois sans être pourtant contaminés par le VIH/SIDA. Avant cet âge, la confirmation de l’infection par le VIH repose sur la démonstration de la présence d’ADN proviral ou ARN par la technique PCR. La mortalité précoce des nourrissons infectés par le VIH est élevée, il est important de pouvoir bénéficier d’ARVs dès le diagnostic précoce de l’infection.
Les signes cliniques de présomption d’infection par le VIH chez l’enfant exposé (sérologie VIH +) de moins de 18 mois ont été proposés en 2005 par l’OMS et modifiés en 2006 mais ne furent jamais évalués.
Cette étude transversale comprenant 236 enfants de moins de 18 mois ayant une sérologie VIH positive consistait à évaluer la sensibilité (76,6%) et la spécificité (52,7%) de ces signes cliniques en confirmant leur statut infectieux réel par le test PCR pour le VIH, test de référence.
Cette spécificité basse inquiétante était liée aux enfants présentant des signes cliniques similaires bien que non infectés par le VIH mais souvent carencés par manque d’apport calorique et/ou souffrant d’une forme avancée de tuberculose extra pulmonaire ou d’autres affections chroniques. Ces enfants cachectiques pouvaient présenter les mêmes signes cliniques que les enfants infectés par le VIH car ils avaient une baisse de leur immunité cellulaire due à la MPE.
Dans la première partie de ce travail, l’étude AMATA a montré 2 façons efficaces de diminuer la transmission du VIH de la mère à l’enfant.
Dans la deuxième partie, on a évalué une méthode de diagnostic clinique précoce proposé par l’OMS afin de détecter les enfants infectés par le VIH en l’absence de test virologique PCR mais la basse spécificité indique la nécessité d’améliorer cette méthode diagnostique.
Doctorat en Sciences médicales
info:eu-repo/semantics/nonPublished
9
Naidoo, Sherina. "The sense of coherence and coping resources of adult family caregivers of HIV/AIDS patients in the Kwazakhele area of Port Elizabeth." Thesis, Nelson Mandela Metropolitan University, 2009. http://hdl.handle.net/10948/1021.
Full textAbstract:
Human Immune Deficiency Virus (HIV), which results in Acquired Immune Deficiency Syndrome (AIDS), has many manifestations. Literature reveals that some of these manifestations may compromise the infected individual’s sense of well-being and negatively impact on health related quality of life. As the number of people living with HIV/AIDS disease grows, so does the need for their care. In the early days of the AIDS epidemic, care was primarily handled by special agencies, hospitals and clinics. These agencies have been inundated with the demands of people living with HIV/AIDS, while their resources are shrinking. As it stands now, the total assistance given to people living with HIV/AIDS is provided by relatives and this responsibility of caregiving will more increasingly rest with families. This situation is particularly salient for the rural community in South Africa, which has been disproportionately affected by the AIDS epidemic. AIDS has a tremendous impact on the entire family system, particularly on the individual who has primary responsibility for caregiving. The caregiver must cope with many circumstances that are frustrating and often beyond their control. Caring for a Person Living with HIV/AIDS (PLWHA) appears to be a major stressor in the lives of caregivers, and can be very demanding, impacting on carers financially, physically, emotionally and socially. Given the lack of research on HIV/AIDS family caregiving from a salutogenic approach, this study aimed to explore and describe the sense of coherence and coping of family caregivers of HIV/AIDS patients in the Kwazakhele area in Port Elizabeth. The sample consisted of 50 participants aged between 21 and 65 years, recruited via the Kwazakhele Masizakhe Project. An exploratory-descriptive design was employed. Data was obtained by a biographical questionnaire, the Coping Resources Inventory (CRI) and the Sense of Coherence (SOC-29) Questionnaire. A non-probability convenience sample of adult male and female family caregivers were sampled. Descriptive statistics and correlation coefficients were utilized to describe and explore the coping and sense of coherence of the family caregivers and the correlation between these constructs, respectively. The data obtained from the biographical questionnaire was analysed by using descriptive statistics and frequency counts. Key findings include the following: Results from the coping resources measure indicated that this sample perceived themselves as having an average level of coping resources. The sample tended to rely more readily on spiritual resources and less on cognitive resources. Results from the SOC-29 revealed fairly high mean scores. There is no positive relationship between the SOC-29 and the CRI for the current sample. No significant relationship existed between the SOC and the subscales of the CRI. Suggestions are made for future research, the limitations and value of research were outlined.
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Wichman, Heidi Sandra. "Stigma within health care settings: an exploration of the experiences of people living with HIV and AIDS." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_3785_1255514529.
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South Africa has one of the highest HIV and AIDS prevalence rates and the pandemic shows no signs of abating. Challenges facing South Africa in combating this pandemic include the social responses of fear, denial, stigma and discrimination. Stigma related to HIV and AIDS poses a major barrier to treating and managing HIV and AIDS. Stigma is defined as involving an attribute which significantly discredits an individual in the eyes of others or society. This attribute is therefore seen by others as being negative, something which devalues, spoils or flaws an individual. Perceived or felt stigma is described as being the anticipation of rejection and the shame of having the stigma, whereas enacted stigma refers to actual incidents of discrimination. The aim of this study was to determine, from the experiences of people living with HIV and AIDS, whether stigma manifests within the South African primary health care system.
11
Behardien, Nashreen. "Oral mucosal and facial manifestations of HIV/AIDS in children (Cape Peninsula, South Africa)." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&.
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Currently, HIV/AIDS is one of the greatest threats to child survival in South Africa. It is estimated that approximately 6000 newborn babies become infected with the HIV virus monthly i.e. approximately 200 babies per day. During a 24 month period (October 1999 &ndashOctober 2001), a descriptive prevalence study of the oro-facial manifestations affecting HIV-positive children was conducted in the Cape Peninsula, South Africa. The study population consisted of 268 vertically infected HIV-positive children. The study was motivated by the lack of data regarding oral mucosal lesions in children with vertically acquired HIV-infection.
The study design was descriptive, and the population included consecutive, vertically infected HIV-positive patients sourced from out-patient clinics, hospital wards and special child-care facilities. The children were examined once consent was obtained from caregivers. The findings were documented using data capturing sheets. The data was captured on the Microsoft Excel program and analysed using the Epi 2000 program. The results indicated that a large proportion of HIV-infected children presented with orofacial manifestations at some stage during the course of HIV-infection. Oro-facial manifestations were observed in 70.1% of the study population. The prevalence of the most commonly observed manifestations were: oral candidiasis, 38.8%
parotid gland enlargement, 10.8%
oral ulceration, 5.6%
molluscum contagiosum, 7.8%
periodontal conditions, 3.4%
and herpes simplex infection, 0.7%.It can be concluded that in this sample of HIV-infected children, the prevalence of orofacial manifestations is higher than, and comparable with the findings of similar studies conducted in other regions of the world.
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Williams, Margaret. "The experiences of caregivers in formal institutions caring for terminal AIDS patients." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/644.
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One of the greatest challenges facing sub-Saharan Africa, which incorporates South Africa, is the AIDS pandemic. The devastation wrought by this disease is unsurpassed in recent times. The health and social development structures, already overburdened, are totally overwhelmed by the needs of povertystricken households and communities affected by AIDS. Caregivers attempting to support those affected and infected are also facing unique challenges and demands, particularly relating to dealing with the large numbers of deaths due to this disease. Experiences for these caregivers are likely to be varied, ranging on a continuum from positive to negative, for instance, the recovery of patients versus the death of patients. The objectives of this study are to explore and describe the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is grounded in a phenomenological approach to inquiry. Caregivers working fulltime in a formal institution caring for patients who are dying from AIDS were interviewed in an in-depth, unstructured manner in order to gather spontaneous, rich descriptions of their experiences. Through this study the researcher wants their voices to be heard, the potential richness of their reflections acknowledged and the generated data to be applied to the benefit of the field of HIV/AIDS – both for staff and patients. Thirteen in-depth, unstructured interviews provided saturated data, which was then transcribed and coded to yield the central and sub-themes that were identified in this study. One central theme identified the fact that in their daily duties (at their place of work), caregivers experience various challenges as a result of having to deal with the death and dying of their patients suffering from AIDS. These caregivers face the death of their patients daily, from a disease that causes untold suffering to the patient, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. ii By describing the lived experiences of these caregivers by means of the research interviews, the researcher gained a clear picture of the AIDS environment. The information shared by the participants formed the foundation of the broad guidelines that were formulated. These are intended to provide support for the caregivers centering around the equipping of mentors of the caregivers, to enable them to support the caregivers in their daily task of caring for patients dying from AIDS. These caregivers, thus supported, will then be in a position to provide optimal care for these dying patients. These broad guidelines are intended to provide support by focusing firstly on the physical environment in which these caregivers work; secondly in providing education for the caregivers to enable them to fulfill their duties, and thirdly to provide adequate counselling to ensure that they do not succumb to caregiver fatigue/burnout, a constant threat in this type of environment. The study concludes with recommendations regarding the areas of nursing practice, education and research.
13
Reynolds, Carol A. (Carol Ann). "Attitudes of Nursing Faculty Toward Patients With AIDS and Patients With a Homosexual Lifestyle." Thesis, University of North Texas, 1991. https://digital.library.unt.edu/ark:/67531/metadc332811/.
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The purposes of this study were (1) to determine whether patients with AIDS are stigmatized by nursing faculty, (2) to determine whether practicing homosexuals are stigmatized by nursing faculty, (3) to determine whether faculty attitudes toward AIDS patients are influenced by the patients' sexual preference, and (4) to determine whether faculty attitudes toward practicing homosexual patients are influenced by the patients' disease. This study is a modified replication of studies by Kelly et al.
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Mumba, Mumba. "Physical disabilities among adults with HIV/AIDS being managed by the Makeni home-based carers in Lusaka, Zambia." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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HIV and AIDS are now being considered as a chronic disease. As people live longer the possibility of physical disability increases. This study aimed to investigate the nature of physical disability among HIV/AIDS adults cared for by the Makeni home-based carers in Lusaka, Zambia. Disability was measured based on the World Health Organisation International Classification of Functioning, Disability and Health. This study demonstrated that mostly mild impairments and mild to moderate activity limitations and participation restrictions exists among patients in the Makeni home-based care programme. This study concluded that physiotherapists and other health professionals will have to be more involved in the community home-based programs that are suited for people living with HIV/AIDS so that they are also provided with clinical assessments and rehabilitation services.
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Pendukeni, Monika. "The impact of HIV/AIDS on health care provision: Perceptions on nurses currently working in one regional hospital in Namibia." Thesis, University of the Western Cape, 2004. http://etd.uwc.ac.za/index.php?module=etd&.
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Studies on the impact of HIV/AIDS on health workers conducted in the health sector in different countries in Southern Africa have shown that health workers are affected and infected by HIV/AIDS. This has affected the provision of care rendered by nurses negatively. The high workload emanating from increased numbers of patients contributed to the situation. As a result, a number of nurses suffer from stress related illnesses caused by many factors such as fear of contracting the HIV virus. Low staff morale has also been observed among nurses. The aim of this study was to study nurses perceptions, views and suggestions on the impacts of HIV/AIDS on the provision of health care in terms of increased workload, stress, low morale and fear of contracting HIV/AIDS in two medical wards and a TB ward in one regional hospital in Namibia.
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Chaava, Thebisa Hamukoma. "Skills, training and support for carers in HIV/AIDS community home-based care: a case study of carers in Chikankata, Zambia." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The high prevalence of HIV/AIDS in Zambia has led to the development of innovative ways of coping with sickness related to this infection. HIV/AIDS home-based care is one such innovation designed in Chikankata Hospital in 1987. Home-based care depends on the availability of family members and community volunteers in the provision of care and support for People Living with HIV/AIDS (PLWHA).This minithesis is based on a qualitative descriptive case study exploring perspectives regarding skills, supervision and support mechanisms for carers in the Chikankata HIV/AIDS Community-Home Based Care (CHBC) program. The study utilized documented research, focus group discussions with carers and structured interviews with local CHBC supervisors, national experts in CHBC, and PLWHA and their families, to collect data from 32 study participants.
The findings were that CHBC was being delivered by community volunteers with limited involvement from the local health services
that carers were highly motivated, personally and collectively mobilizing resources to meet the needs of CHBC clientele
that local arrangements for training, skills and support of carers were not aligned to national guidelines regarding process, content and duration of programmes
and that carers acquired skills in CHBC through formal and informal training processes and were facing challenges related to inadequate skills, poor infrastructure and extreme poverty in households caring for PLWHA.
Based on the findings the local arrangements for coordination of CHBC need to be strengthened and linked to formal processes for technical support, financial resources and materials for delivery of CHBC in line with existing guidelines on CHBC. The picture of the real situation of the carers that emerges from this qualitative study might inform the supervising organizations and policymakers on the gaps in the training and support of this crucial cadre in the provision of quality care for People Living with HIV/AIDS (PLWHA) at community level.
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Zulu, Nompumelelo Patience. "The effect of an informal caregiver's programme on the care of patients infected with HIV/AIDS." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5382.
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Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: Background & rationale: South Africa is faced with the major challenge of HIV/AIDS. Every South African has a vital role to play in managing this public health problem. One of the best ways of managing it is by informing and educating the communities about HIV/AIDS, as the communities lack knowledge about it. Problem statement: Due to the increase in the number of patients infected with HIV/AIDS, an informal caregiver’s programme was introduced to ensure that patients are better cared for at home, in a familiar environment and by their family members. Purpose and objectives: The purpose of the study was to evaluate the effect of an informal caregiver’s programme on the care of patients with HIV/AIDS. The objectives included evaluating the effect of care, physically, socially, spiritually, emotionally, information and educational support given. Methodology: A phenomenological research design was applied to evaluate the effects of an informal caregiver’s programme implemented for the care of patients infected with HIV/AIDS at Mfuleni Township in the Cape Metropolitan area. Population and sampling: The population of this study were HIV/AIDS infected patients who were participating in the informal caregiver’s programme. Ten of these patients, who gave consent, participated in the study. Reliability, validity & pilot study: The trustworthiness of this study was assured with the use of Lincoln and Guba criteria of credibility, transferability, dependability and conformability. A pre-test study was also completed. Ethical considerations: Ethical approval was obtained from the Stellenbosch University and the required consent from the individual participants. Data collection, analysis and results: Data was collected through an interview using an interview schedule based on the objectives. Data was analysed and the findings show that the care given to patients infected by HIV/AIDS at home through an informal caregiver’s programme has a positive outcome. Recommendations and conclusion: On the spot training of participants and their family members is recommended. The community health workers form a very strong support base for the participants.
AFRIKAANSE OPSOMMING: Agtergrond en rasionaal: Suid-Afrika kom te staan voor ’n reuse uitdaging t.o.v. HIV/VIGS. Elke Suid-Afrikaner het ’n belangrike rol te speel in die beheer van hierdie openbare gesondheidsprobleem. Een van die beste maniere om dit te beheer, is om gemeenskappe in te lig en op te voed aangaande MIV/VIGS, aangesien daar ’n gebrek aan kennis hieromtrent is. Probleemstelling: Weens die toename in die aantal pasiënte wat deur MIV/VIGS geaffekteer word, is ’n informele versorgingsprogram daarop ingestel om te verseker dat pasiënte beter tuis versorg word in ’n bekende omgewing en deur hul familielede. Doel en doelwitte: Die doel van hierdie studie was om die effek van ’n informele versorgingsprogram in die versorging van pasiënte met MIV/VIGS te evalueer. Die doelwitte is uiteengesit om die effek van die versorging wat gegee is, te evalueer met verwysing na die fisiese, sosiale, geestelike, emosionele, inligting en opvoedingsondersteuning te evalueer. Metodologie: ’n Fenomenologiese navorsingsontwerp is toegepas om die effekte te evalueer van ’n informele versorgingsprogram wat geïmplementeer is vir die versorging van pasiënte wat deur MIV/VIGS geaffekteer is in die Mfuleni woonbuurt in die Kaapse Metropolitaanse area te evalueer. Bevolking en steekproef: Die bevolking van hierdie studie is MIV/VIGS geaffekteerde pasiënte wat deelgeneem het aan die informele versorger se program. Tien van hierdie pasiënte wat toestemming verleen het, het deelgeneem aan hierdie studie. Betroubaarhied, geldigheid en loodsondersoek: Die betroubaarheid van hierdie studie is verseker deur die gebruik van Lincoln en Guba se kriteria van geloofwaardigheid, oordraagbaarheid, afhanklikheid en ooreenstemmigheid. ’n Aanvoortoets is ook voltooi. Etiese oorwegings: Etiese goedkeuring is van die Stellenbosch Universiteit en die vereiste toestemming van die individuele deelnemers verkry. Dataversameling, analise en uitslae: Data is ingesamel deur gebruik te maak van ’n onderhoudskedule wat gebaseer is op die doewitte. Data is geanaliseer en die bevindinge het bewys dat versorging wat by die huis deur ’n informele versorgingsprogram aan pasiënte gegee word wat met MIV/VIGS geaffekteer is, ’n positiewe uitkoms het. Aanbevelings en gevolgtrekkings: Op-die-plekopleiding van HIV geïnfekteerde pasiente en hul familielede word aanbeveel. Die gemeenskap se gesondheidswerkers bied ’n sterk ondersteuningsbasis aan die deelnemers.
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Dutkowsky, Sandra Olivia. "Writing(s) on the ambiguity of care." Diss., Online access via UMI:, 2008.
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Albougy, Hany Ahed. "A systematic review of the management of oral candidiasis associated with HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52713.
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On t.p.: Degree MSc Dental Science (Community Dentistry)Thesis (MSc)--Stellenbosch University, 2002.
ENGLISH ABSTRACT: The purpose of this review was to investigate the management of oral candidiasis in HIV/AIDS patients and to evaluate the different guidelines that are available for its management. To achieve this aim, three objectives were identified: (i) to identify and report on the different interventions used to manage oral candidiasis, in patients with HIV/AIDS, (ii) to determine the efficacy of these interventions, and (iii) to provide guidelines for management. A thorough systematic search of the literature was carried out and all relevant papers were graded into three levels of evidence (A, B, and C) and scored for quality according to set criteria. A number of topical and systemic antifungal medications are used to treat oral candidiasis in HIV-positive patients. These include the poleyne antibiotics, nystatin and amphotericin B. Milder episodes of oral candidiasis respond to topical therapy with nystatin, clotrimazole troches or oral ketoconazole. Fluconazole has been extensively evaluated as a treatment for candidiasis. With HIV-infection, a cure rate of 82% has been achieved with a daily oral dose of 50 mg. Fluconazole was found to be a better choice of treatment for relapsing oropharyngeal candidiasis, resulting in either better cure rates or better prevention of relapse. Intravenous amphotericin B has been found to be effective therapy in azole refractory candidiasis where it was shown to be safe and well tolerated. Topical therapies were found to be effective treatment for uncomplicated oropharyngeal candidiasis, however patients relapsed more quickly than those treated with oral systemic antifungal therapy. Overall, nystatin appears less effective than clotrimazole and the azoles in the treatment of oropharyngeal candidiasis. With regard to the resolution of clinical symptoms, clotrimazole was found to be just as effective as the azoles, except when patient compliance was poor. Fluconazole-treated patients were more likely to remain disease-free during the fluconazole follow-up period than with those treated with other interventions. Relatively few studies were qualified to address the provision of guidelines for the management of oral candidiasis in primary health care settings. Most of the studies found were of moderate and low quality level of evidence. These studies included the assessment of different guidelines for identification, treatment and dental needs. They stressed that patients with HN need dentists who will act as primary health care providers, together with other providers to ensure adequate overall care. Given the level of interest and importance of candidiasis associated with treatment of HN -positive patients, it is surprising to find that little high quality research has been undertaken. As such, it is hoped that this review would provide researchers, oral health care workers and other health care providers with an overview of the management of oral candidiasis associated with HN/AIDS.
AFRIKAANSE OPSOMMING: Die doelstelling van die oorsig was om ondersoek in te stel na die hantering van orale kandidiase in HIV/AIDS pasiënte asook om die verskillende beskikbare riglyne vir die behandeling daarvan te evalueer. Ter verwesenliking van hierdie doelstelling is drie doelwitte geïdentifiseer: (i) om die intervensies wat gebruik word in die hantering van orale kandidiase behandeling te identifiseer, (ii) om die effektiwiteit van hierdie intervensies te identifiseer en (iii) om op grond hiervan riglyne vir die hantering voor te stel. 'n Sistematiese literatuursoektog is uitgevoer en alle relevante artikels is in drie groepe geklassifiseer (A, B en C) op grond van die data kwaliteit. 'n Verskeidenheid topikale en sistemiese antifungale middels word gebruik om orale kandidiase in HIV-positiewe pasiënte te behandel. 'n Sukseskoers van 82% is met die gebruik van 'n daaglikse dosis van 50 mg medikament gerapporteer. Fluconazole was die beter keuse van middel vir die behandeling van terugkerende orofaringeale kandidiase. Topikale behandeling was effektief in die behandeling van ongekompliseerde orofaringeale kandidiase, hoewel die kans op terugkeer van die toestand groter was as met die sistemiese middels. Pasiënte wat met flukonasool behandel is, het 'n groter kans gehad om siektevry te bly vergeleke met pasiënte op die ander intervensies. Meeste van die studies was van middelmatige tot lae kwaliteit en gevolglik was dit moeilik om behandelingsriglyne te stel. Wat egter wel duidelik is, is dat HIV pasiënte primêre mondsorg benodig wat saam met ander versorging omvattende sorg sal verseker.
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Nashandi, Johanna Christa Ndilimeke. "Experiences and coping strategies of women living with HIV/AIDS: case study of Khomas region, Namibia." Thesis, University of the Western Cape, 2002. http://etd.uwc.ac.za/index.php?module=etd&.
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This study focuses on the impact of HIV/AIDS on women in Namibia. Namibia, with a population of only 1.7 million people, is ranked as the seventh highest country in the world in terms of HIV/AIDS infections. The percentage of women living with HIV/AIDS in Namibia accounts for 54% of the total of 68 196 people in the country living with the virus. Women are also diagnosed with the disease at a younger age (30) in comparison to their male counterparts (35 years). Desoite their needs, women living with HIV/AIDS bear a triple burden of caring for those living with HIV/AIDS, caring for themselves and coping with the responses to their infection. There are few focused intervention strategies to support and care for women living with HIV/AIDS in Namibia.
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Pruitt, Zachary. "The Determinants of Antiretroviral Therapy Adherence and the Relationship of Healthcare Expenditures to Adherence among Florida Medicaid-insured Patients Diagnosed with HIV or AIDS." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4834.
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Research supports the clinical and societal benefits of antiretroviral treatment (ART) for people living with HIV or AIDS (PLWHA). However, factors associated with ART adherence and the relationship of ART adherence to total healthcare expenditures are not well understood.
The research data included Florida Medicaid claims for five years (July 2006 through June 2011). All subjects (n=514) were HIV-positive, adult, non-pregnant, and ART naïve for at least 12 months prior to their 24 month measurement period. Each subject was categorized as adherent (>90%#37;) or non-adherent (<90%#37;) based upon medication possession ratios (MPR). Total expenditures were payments Medicaid made to providers and pharmacies.
Objective 1 modeled the logit probability of a subject being non-adherent to ART (versus adherent). Certain factors were expected to have significant negative associations with non-adherence to ART, including females, older age group, AIDS diagnosis, adherence to antidepressants, severe mental illness, meeting the minimum recommended number of outpatient visits, ART regimen type, number of medications in the ART regimen, residing in a county with a high median income, and residing in a county with an urban population density. The variables expected to have significant positive associations included race/ethnicity, substance or alcohol abuse diagnosis, depression or anxiety diagnoses, disease progression from HIV to AIDS, discontinuous Medicaid coverage, Medicaid eligibility type, and co-morbidity count levels.
The Objective 1 results showed that all non-white race/ethnicity categories had at least twice the odds of being classified as non-adherent. Also, increasing numbers of concurrent ART medications significantly predicted non-adherence; the odds ratio for three to five ART medications was 2.04 (95%#37; CI=1.04-4.01, p<.05), and six or more prescriptions category odds ratio was 4.58 (95%#37; CI=1.82-11.56, p<.01), as compared to a single medication. Finally, a chronic diseases diagnosis was protective against non-adherence (OR=.46, 95%#37; CI=.26-.84, p<.01), as was adherence to antidepressants (OR=.28, 95%#37; CI=.14-.54, p<.01).
In Objective 2, it was expected that the ART adherence group, the explanatory variable, would have significantly less monthly mean total healthcare expenditures, the outcome variable. For each of the HIV-positive (n=232) and the AIDS-diagnosed (n=270) groups, a generalized linear model predicted the mean total expenditures for the ART non-adherence group (<90%#37; MPR) versus the ART adherence group, controlling for other factors. For the HIV-positive subjects, the predicted mean total healthcare expenditures for the ART non-adherent group was $1,291 (95%#37; CL $840-$2,004); the predicted mean for the adherent group was $1,926 (95%#37; CL $1,157-$3,231). The difference was statistically significant, but the hypothesis was not supported. The non-adherent group mean was less than the adherent group (-40%#37;, p<.001). However, for the AIDS-diagnosed subjects, there was no statistical difference between the non-adherent and adherent groups. The predicted mean for the non-adherent group was $2,279 (95%#37; CL $1,572-$3,322), and $2,005 (95%#37; CL $1,387-$2,913) for the adherent group.
The findings of this research support the need for translating evidence on racial/ethnic disparities in ART adherence, along with behavioral, social, or cultural barriers and effective interventions, into policy and practice. Also, certain medication management strategies should be implemented to reduce the number of medications in ART regimen. Finally, the results of the present study underscores the necessity for appropriate financial incentives and purposeful risk-adjusted capitation payment structures that would support ART adherence among Medicaid-insured PLWHA.
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Eichhorn, Eva Christina. "Terminal care as life care : a pastoral approach to death and dying." Thesis, Stellenbosch : Stellenbosch University, 2007. http://hdl.handle.net/10019.1/17748.
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Thesis (M. Th.)--University of Stellenbosch, 2007.ENGLISH ABSTRACT: The thesis introduces a spiritual understanding of terminal care as life care within a pastoral approach to death and dying. The presupposition is that life and death are unavoidably connected, and that a meaningful approach to death and dying in terms of a Christian theological hermeneutics needs to start with the question “What is life?” The concept of a theological hermeneutics serves as an overall paradigm, which is implied within the interplay of life and death. The aim of a hermeneutical approach is to find meaning in living and dying in the fundamental God-human relationship. The eschatological perspective plays a significant role, as it emphasises the already and not yet of eschatology that become evident in every life event. An analysis of the theoretical paradigms and philosophical presuppositions behind a widespread “psychology of death and dying” shows that the phenomenological, client-centred models suffer from an overreliance on inner human potentials in coping with dying. Although these models provide valuable insights into the needs of the dying, they fail to equip individuals with a meaningful paradigm that lasts despite the reality of death. As a result, I propose a “theology of death and dying” that opts for a much more holistic approach to terminal care. Based on the impact of a Christian spiritual concept of life and a pastoral anthropology on a pastoral approach to terminal care, I argue that we do not have to cope with dying by ourselves but can trust in the faithfulness of God who will keep us strong to the end (1 Cor 1:8). As fear of death can effectively only be coped with by caring for life, pastoral care to the dying needs to emphasise the fundamental God-human relationship that guarantees life in spite of death. A unique stance of hope follows from a Christian spiritual understanding of life that overcomes the paradigmatic gap left by psychological approaches to death and dying, and makes us aware that the new life in the Spirit is a quality that we already possess. Eventually, the life care approach is applied to a pastoral prevention strategy in the context of the HIV pandemic. I argue the thesis that prevailing HIV prevention programmes suffer from a lack of an overall frame of reference from which to reflect on the necessity for behavioural change. To fill this gap, a spiritual life care approach to the HIV pandemic emphasises the development of a Christian ethos based on an internalised assurance of the purpose and destiny of human life, which can function as an overall paradigm behind a prevention strategy. This pastoral prevention strategy is based on the assumption that positive change, the anticipation of a better future and true hope derive from an understanding of who we are as human beings before and in relationship with God.
AFRIKAANSE OPSOMMING: Hierdie tesis stel ʼn spirituele begrip van terminale sorg as lewensorg binne ʼn pastorale benadering tot dood en sterfte bekend. Die voorveronderstelling is dat lewe en dood onlosmaakbaar verbind is, en dat ʼn betekenisvolle benadering tot dood en sterfte in terme van ʼn Christelike teologiese hermeneutiek met die vraag “Wat is lewe?” ’n aanvang moet neem. Die konsep van teologiese hermeneutiek dien as 'n oorkoepelende paradigma, wat geïmpliseer word binne die wisselwerking van lewe en dood met die doelwit om betekenis te vind in lewe en dood in die fundamentele Godmens- verhouding. ’n Eskatologiese perspektief speel ’n beduidende rol, aangesien dit die alreeds en die nog nie van eskatologie beklemtoon, wat in elke lewensgebeurtenis duidelik word. ’n Ontleding van die teoretiese paradigmas en filosofiese voorveronderstellings rakende die wydverspreide “sielkunde van dood en sterfte” toon aan dat die fenomenologiese, kliëntgesentreerde modelle gebrek lei as gevolg van hul heftige aanspraak op die innerlike menslike potensiaal om sterfte te hanteer. Alhoewel hierdie modelle kosbare insigte ten opsigte van die behoeftes van die sterwendes bied, faal hulle daarin om individue toe te rus met ’n betekenisvolle paradigma wat volhoubaar is, afgesien van die werklikheid van die dood. Ek staan dus ’n “teologie van dood en sterfte” voor wat ’n veel meer holistiese benadering tot terminale sorg meebring. Gegrond op die impak van ’n Christelike, spirituele konsep van lewe en ’n pastorale antropologie op ’n pastorale benadering tot terminale sorg, argumenteer ek dat ons nie nodig het om die dood op ons eie te hanteer nie omdat ons op die getrouheid van God, wat ons sterk sal hou tot die einde (1 Kor 1:8), kan vertrou. Aangesien die vrees vir die dood slegs deur die omgee vir lewe hanteer kan word, is dit noodsaaklik dat pastorale sorg aan die sterwende die God-mens-verhouding, wat lewe te midde van dood waarborg, beklemtoon. ’n Unieke gesigspunt van hoop volg vanuit ’n Christelike, spirituele begrip van lewe, wat die paradigmatiese gaping wat gelaat word deur psigologiese benaderings tot dood en sterfte vul. Dit maak ons bewus dat die nuwe lewe in die Gees ’n kwaliteit is wat ons alreeds besit. Die lewensorg-benadering word uiteindelik in ’n pastorale voorkomingstrategie in die konteks van die MIV-pandemie toegepas. Ek argumenteer in die tesis dat heersende MIV-voorkomingsprogramme gestrem word deur ’n tekort aan ’n algehele verwysingsraamwerk, vanwaar oor die noodsaaklikheid van gedragsverandering nagedink kan word. Om hierdie gaping te vul, stel ek ’n spirituele lewensorg-benadering voor, wat die ontwikkeling van ’n Christelike etos beklemtoon, gegrond op ’n inwendige sekerheid van die doel en bestemming van menslike lewe, wat as ’n algehele paradigma vir ’n pastorale voorkomingstrategie kan funksioneer. Hierdie voorkomingstrategie is gegrond op die veronderstelling dat positiewe verandering, die verwagting van ’n beter toekoms, en ware hoop voortspruit uit ’n begrip van wie ons as mense voor en in verhouding met God is.
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Ko, Shuk-chun, and 高淑珍. "Exploration of Hong Kong nurses' perceptions and experiences towards HIV/AIDS caring." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45012076.
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Magezi, Vhumani. "Life beyond infection : home-based pastoral care to people with HIV-positive status within a context of poverty." Thesis, Link to the online version, 2005. http://hdl.handle.net/10019.1/1085.
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Tamirepi, Farirai. "HIV and AIDS within the primary health care delivery system in Zimbabwe : a quest for a spiritual and pastoral approach to healing." Thesis, Stellenbosch : Stellenbosch University, 2013. http://hdl.handle.net/10019.1/85760.
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Thesis (PhD)--Stellenbosch University, 2013.ENGLISH ABSTRACT: This qualitatively oriented Practical Theological research journey, informed by the philosophical ideas of postmodern, contextual, participatory and feminist theologies, postmodern and social construction epistemologies was based on a participatory action research through the therapeutic lens of narrative inquiry. The thesis is about the spiritual problems and spiritual needs of people living with HIV and AIDS and how they can be addressed as part of a holistic approach to their care within the primary healthcare delivery system in Zimbabwe. The research curiosity was prompted by the HIV and AIDS policy in Zimbabwe that advocates for a holistic approach to the care of HIV and AIDS patients within the primary health care delivery system. The recognition that healthcare has to be holistic for the best outcome for patients creates an expectation that spiritual care will also be incorporated into clinical practice. However there is a puzzling blind spot and a strange silence about the spiritual problems and spiritual needs of people living with HIV and AIDS within the HIV and AIDS policy. This has had the effects of reducing intervention programmes to purely medical, psychological and sociological. This research sought to correct such an approach by highlighting the role of spiritual care in the healing process of people living with HIV and AIDS as part of the holistic approach to their care. The core information, on which this research is based, comes from the experiences of people living with HIV and AIDS who are receiving care within the primary health care delivery system in Zimbabwe. It sweeps away statistics and places those questing for spiritual healing at the core of the study. All the participants in the study affirmed that the why me questions as a summation of their indescribable and unimaginable spiritual pain felt in the spirit were directed to God. They confirmed that their spiritual problem was spiritual pain and their spiritual need therefore was spiritual healing from the spiritual pain of which God is believed to be the healer. The belief that God is the ultimate healer of the spiritual pain stood out from the midst of problem saturated narratives of spiritual pain and suffering as the unique outcome to reconstruct the alternative problem free stories of healing. The research opted for an approach that is informed by the experiences of people living with HIV and AIDS. In the light of the stories shared by the participants in this study, it became evident that there is an existing need within the Primary Health Care delivery system in Zimbabwe to provide spiritual care to people living with HIV and AIDS. The research aimed at co-creating a spiritual care approach in which those living with HIV and AIDS as well as those working with them can be empowered to re-author the stories of patients‟ lives around their self preferred images. The narrative approach was explored in this research as a possible therapeutic approach that could be used to journey pastorally with people living with HIV and AIDS in a non-controlling, non-blaming, non-directive and not knowing guiding manner that would permit the people living with HIV and AIDS to use their own spiritual resources in a way that can bring spiritual healing to their troubled spirits. The research also emphasizes the position of the people living with HIV and AIDS which they can inhabit and lay claim to the many possibilities of their own lives that lie beyond the expertise of the pastoral caregiver. The strong suggestion emerging from this study is that a spiritual care approach to healing must of necessity be integrated into the holistic approach to the care of people living with HIV and AIDS in Zimbabwe. The wish of participants that their spiritual well-being be considered in their health care adds momentum to this suggestion. Hence the research argues for the inclusion of a spiritual and pastoral approach to spiritual healing which links the patient‟s spirituality and pastoral care. The research does not claim to have the solutions or quick fix miracle to the complicated spiritual pain of people living with HIV and AIDS and neither claims to have the power to bring any neat conclusions to the spiritual healing of people living with HIV and AIDS. However, the research has the potential to stimulate a new story of spirituality as a vital resource in the healing process of people living with HIV and AIDS and ignoring it may defeat the purpose of a holistic approach to the care of people living with HIV. The re-authoring of alternative stories is an ongoing process but like in all journeys, there are landmarks that indicate achievements, places of transfer or starting new directions or turning around. Hence this research process may be regarded as a landmark that indicated a new direction in the participants‟ journey towards spiritual healing.
AFRIKAANSE OPSOMMING: Hierdie kwalitatief-georiënteerde Praktiese Teologie navorsingsreis, geïnformeer deur die filosofiese idees van postmoderne, kontekstuele, deelnemende en feministiese teologie, postmoderne en sosiale konstruksie epistemologie, is gebaseer op deelnemende aksie-navorsing deur die terapeutiese lens van narratiewe ondersoek. Die tesis handel oor die spirituele probleme en navorsingsbehoeftes van mense wat met MIV en vigs leef en hoe dit aangespreek kan word as deel van ʼn holistiese benadering tot hul sorg binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die navorsing-belangstelling het ontwikkel na aanleiding van die MIV en vigs beleid in Zimbabwe wat ʼn holistiese benadering tot die sorg van MIV en vigs pasiënte in die primêre gesondheidsorg-diensleweringstelsel bepleit. Die erkenning dat gesondheidsorg holisties moet wees om die beste uitkoms vir pasiënte te bied, skep ʼn verwagting dat spirituele sorg ook by kliniese praktyk ingesluit sal word. Daar is egter in die HIV en vigs beleid ʼn raaiselagtige blinde kol, ʼn vreemde stilte oor die spirituele probleme en spirituele behoeftes van mense wat met MIV en vigs leef. Die gevolg is dat intervensie-programme gereduseer word tot slegs mediese, sielkundige en sosiologiese programme. Hierdie navorsing streef om dié benadering reg te stel deur die beklemtoning van die rol van spirituele sorg in die heling-proses van mense wat met MIV en vigs leef as deel van die holistiese benadering tot hul sorg. Die kerninligting waarop hierdie navorsing gegrond is, vloei voort uit die ervarings van mense wat leef met MIV en vigs en sorg ontvang binne die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Dit vee statistiek van die tafel af en plaas diegene wat soek na spirituele heling, in die hart van die ondersoek. Al die deelnemers aan die ondersoek het bevestig dat hul “Waarom ek?” vrae, as opsomming van hul onbeskryflike, ondenkbare geestelike pyn, aan God gerig is. Hulle het bevestig dat hul spirituele probleem spirituele pyn is, en dat hul spirituele behoefte dus spirituele genesing is van die spirituele pyn, die pyn waarvan geglo word dat God die geneser is. Die geloof dat God die opperste geneser is, het uitgestaan te midde van die probleem-deurdrenkte narratiewe van spirituele pyn en lyding as die unieke uitkoms om alternatiewe probleem-vrye verhale van heling te herkonstrueer. Die navorsing het ʼn benadering gekies wat geïnformeer is deur die ervarings van mense wat leef met MIV en vigs. In die lig van die verhale wat die deelnemers aan die studie gedeel het, het dit duidelik geword dat daar ʼn behoefte is dat spirituele sorg ook aan mense wat leef met MIV en vigs verskaf word in die primêre gesondheidsorg-diensleweringstelsel in Zimbabwe. Die doel van die navorsing was om saam ʼn spirituele sorg benadering te skep waarin diegene wat met MIV en vigs leef, sowel as diegene wat met hulle werk, bemagtig kan word om die stories van pasiënte se lewens te herskryf in terme van pasiënte se verkose beelde. Die narratiewe benadering is in hierdie studie ondersoek as ʼn moontlike terapeutiese benadering wat gebruik kan word om pastoraal te reis met mense wat leef met MIV en vigs op ʼn manier wat nie kontroleer, beskuldig, voorskryf of weet nie, maar wat mense wat met MIV en vigs leef eerder begelei en toelaat om hul eie spirituele bronne te gebruik op ʼn manier wat spirituele genesing vir hul gekwelde siele kan bring. Die navorsing beklemtoon ook die posisie van mense wat leef met MIV en vigs waarin hulle spirituele moontlikhede, areas van hul lewens kan eien en bewoon, moontlikhede wat buite die bereik van pastorale versorgers lê. Uit hierdie studie vloei ʼn sterk suggestie dat ʼn spirituele benadering tot genesing noodwendig geïntegreer moet wees in die holistiese benadering tot die sorg van mense wat leef met MIV en vigs in Zimbabwe. Deelnemers se wens dat hul spirituele behoeftes ook in hul gesondheidsorg oorweeg word, gee aan dié suggestie verdere momentum. Derhalwe argumenteer hierdie navorsing ten gunste van die insluiting van ʼn spirituele en pastorale benadering tot spirituele genesing wat die pasiënt se spiritualiteit en pastorale sorg verbind. Die studie maak nie daarop aanspraak dat dit antwoorde of ʼn wonderbare kits-oplossing bied vir die gekompliseerde spirituele pyn van mens wat leef met MIV en vigs nie, of spirituele genesing netjies afsluit nie. Die navorsing het egter wel die potensiaal om ʼn nuwe verhaal te stimuleer van spiritualiteit as ʼn deurslaggewende bron in die genesingsproses van mense wat leef met MIV en vigs. Om spiritualiteit te ignoreer, mag dalk die doel verydel van ʼn holistiese benadering tot die sorg van mense wat met MIV en vigs leef. Die herskryf van alternatiewe verhale is ʼn voortdurende proses, maar soos alle reise, is daar landmerke wat prestasies aandui, en ook punte van verplasing, rigtingverandering of selfs ommekeer. Hierdie navorsing kan beskou word as ʼn landmerk van ʼn verandering van rigting in deelnemers se reis na spirituele genesing.
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Sobuce, Ndabazovuyo Wellington. "The experiences of volunteers involved in home-based care for people living with HIV/AIDS." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/608.
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HIV/AIDS is a pandemic infecting and affecting millions of people worldwide. South Africa is also severely affected by this disease. Because hospitals cannot cope with patients admitted daily especially with the influx caused by HIV/AIDS patients, the government has introduced home-based care of people living with HIV/AIDS. Amongst those who practice home-based care are the volunteers. This study is aimed at exploring and describing the experiences of volunteers involved in home-based care of people living with HIV/AIDS in the Lusikisiki Magisterial district in the former Transkei area of the Province of the Eastern Cape. The researcher used a qualitative methodology with the aim of finding out what it is like to be a volunteer involved in home-based care in a rural area. The data was collected by means of semi-structured one-to-one interviews or guided interviews. A total sample of thirteen research participants was acquired through purposive as well as snowball sampling. The interviews were guided by a number of broad question themes. Data was analyzed using Tesch’s framework of data analysis as described in Creswell (1994). The researcher used Guba’s model as outlined in Krefting (1991) to ensure trustworthiness of the research findings. A literature control was undertaken to find out what other researchers and authors say about the issues raised by the study. There were five themes that came out of the data analysis process and these themes are: o The experiences of volunteers with home-based care. o Factors facilitating the work of volunteers. o Problems encountered by volunteers. o Possible solutions to problems encountered. o Views of volunteers regarding home-based care. These broad themes were further reduced into sub-themes and categories. Based on the discussion of themes, sub-themes, and categories, some research findings were presented. The discussion of the themes, sub-themes and categories was supported by verbatim quotations from the participants. On the basis of research findings, conclusions and recommendations were made.
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Reyneke-Barnard, Elisabeth. "Holistic care of vulnerable children determining the fundamental needs of children, orphaned and otherwise made vulnerable by the HIV/AIDS pandemic, in the household /." Diss., Pretoria : [s.n.], 2006. http://upetd.up.ac.za/thesis/available/etd-09112007-104242/.
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Symes, Camilla Anne. "An exploration of the experiences of the leaders of mentored community-based organisations in the Eastern Cape." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/615.
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The potential of community-based organisations (CBOs) to provide lasting solutions in the field of Human Immune Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has long been recognised. As interest in the role of CBOs has increased, so have attempts to build their capacity and increase their stability and sustainability. Capacity-building initiatives which aim to strengthen CBOs as if they were identical to formal, more established organisations have often proved ineffective, and even at times destructive, because they have ignored the very differences that make CBOs potentially the most effective agents of development change at community level. This study is a qualitative exploration of a new mentoring-based approach to CBO capacity-building, which is currently being used extensively with CBOs in the Eastern Cape of South Africa. The research is inductive, beginning with an exploratory, descriptive and contextual study of the personal experiences and perceptions of CBO leadership team members from four sample CBOs which have graduated from the Barnabas Trust mentoring programme. Data was collected using a combination of face-to-face unstructured interviews and focus group discussion, with the objective of exploring the subjects’ experiences and their perceptions of the impact of the Barnabas Trust mentoring programme on the sustainability of their organisations. The insights and findings arising from the research process are then applied as the basis for a series of recommendations for the adaptation of the Barnabas trust mentoring approach and materials. The findings of this study appear to show that the mentoring-based approach has been an effective strategy for capacity-building towards sustainability for the CBOs in the sample, bringing positive change at the individual, organisational and community levels.
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Moore, Alison Rotha. "The discursive construction of treatment decisions in the management of HIV disease." Australia : Macquarie University, 2003. http://hdl.handle.net/1959.14/46321.
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Thesis (PhD)--Macquarie University, Division of Linguistics & Psychology, Department of Linguistics, 2003.Bibliography: p. 397-424.
Introduction -- Models of shared decision-making in medicine -- Framing the study -- The analytic goals of modelling agency -- The context of treatment decision-making in HIV -- Agency and alignment -- Study conclusions and implications.
The quality of doctor-patient communication has been shown to influence treatment uptake, adherence and effectiveness in HIV medicine and elsewhere. Increasingly, it is considered essential that doctors and patients jointly participate in decisions concerning treatment. There is a growing body of literature describing joint decisionmaking and suggesting guidelines for its practice. Few of these studies, however, relate their descriptions of medical decision-making as a social process to the ways in which patterns of verbal interaction realize or foreclose on joint decision-making. -- Dominant models of medical decision-making view shared decision-making as a midpoint between enlightened paternalism and informed choice. Based on a corpus of HIV consultations audio-recorded in Sydney in the late 1990s, this thesis argues that it can be better modelled as a particular type of social process, which differs across a number of dimensions from other styles of medical decision-making, specifiable as contextual parameters of meaning. The thesis then identifies ways in which specific discursive practices realize these contextual parameters. -- A major component of the thesis focuses on agency, and a model is presented in the form of a socio-semantic network, drawing on work by van Leeuwen (1996) and others, which relates a range of grammatical features, not only transitivity patterns, to ways of construing social agency. The thesis then considers the way in which doctors and patients mobilise these and other resources for bringing together potentially conflicting points of view in framing and articulating treatment decisions. Here I draw on notions of mutual alignment (e.g., Goffman 1981) but expand the analysis of what is aligned to account for speakers' implicit discourse orientation, as well as more overt markers. -- Findings emphasise the relationship between representing and enacting agentive roles; the importance of doctors and patients mutually projecting each other's voices; and the variable and iterative character of shared decision-making. The research demonstrates how doctors and patients negotiate a complex, interactionally and symbolically mediated agency, and shows that patients often take the lead in developing more collaborative decision-making practice. There are still institutionally and socially determined limits to the degree of control patients may exercise within the consultation, many of which are of course well founded.
Mode of access: World Wide Web.
xvii, 533, [22] p. ill
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Terblanche, Hester Helena. "Die belewenisse en sosio-emosionele behoeftes van familielede as primere VIGS-versorgers binne 'n ekologiese perspektief : 'n kwalitatiewe studie." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/95929.
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Thesis (PhD)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Due to a lack of research, which, in turn, resulted in a shortage of applicable literature that focused on the experiences and socio-emotional needs of family members as carers of AIDS-patients, the researcher decided to undertake this research project. The aim of this was to investigate the experiences and socio-emotional needs of family members as AIDS care givers. To lead the research, the researcher made use of a qualitative research approach. Attention was also given to the description of HIV/AIDS, as well as the prevention and treatment of HIV/AIDS. The impact of HIV/AIDS was also given attention, and it was done from an ecological perspective. Within the qualitative research paradigm a phenomenological, explorative, descriptive and contextual research design was utilised. The boundaries for data collection were delineated to the George area. Semi-structured interviews were conducted with family members who acted as primary care givers of AIDS-patients who were recruited by means of purposive sampling and the snowball sampling technique. The data collected were analysed according to the steps for qualitative data analysis as proposed by Tesch (in Cresswell, 1994). To ensure the trustworthiness of the research findings, data verification was executed according to Guba’s model (in Krefting, 1991). The following twelve themes emanated from the process of data analysis: - Knowledge of the disease - Caring for people with AIDS - Risky behaviour - Other people’s reactions - Care givers’ feelings and reactions - Support that was received with the care giving - Effect of the care giving on the relationship between the care giver and the patient - Changes in the care givers’ life because of the care giving of AIDS patients - Experiences regarding the dying process - Needs regarding the caring of the patient - Services that are needed - Advice from the participants to other family members as AIDS care givers. The following recommendations were made based on the conclusions derived from the research findings: Information sessions by Social Workers in collaboration with the different clinics on certain days; a community based project to recruit volunteers to support family care givers on a regular basis; look at facilities, like old age homes and hospices, that can give respite for a week to three weeks; connect family care givers to support groups in the community; make use of the media to give information regarding HIV/AIDS to the broader community; a centralized food and clothes bank from which care givers can draw affordable food and clothes. An application for funding can be done at the Department of Social Development or the Department of Health. Another recommendation that is made is to investigate the possibility of a community based project that provides cleaning and washing services to family members as care givers, as well as the patients. This can even become a job creation project. Other recommendations are: to investigate an alternative form of transport that is wheelchair accessible and patient friendly; to train home based carers to help family members as AIDS care givers; to train home based carers to be of assistance with counseling of patients with regard to their medication; to train home based carers as AIDS care givers to help family members to reach out to other support services or groups; that care givers should be careful about expectations of other people and that they should be confident enough to verbalize their expectations; that Social Workers should investigate if the family member, as AIDS care giver, as well as the patient, gets the necessary support on all levels of the ecological perspective, and if not, he/she must look at ancillary sources and mobilize it to give support to the family care giver as well as to the patient; that professionals need to keep in mind the advice the participants was given to other family members as care givers when they are working with these families. A recommendation was also made to do a follow-up research on the same topic in the White, Indian and Black communities and especially that further emphasis should be placed on their needs, as participation by this population groups were scarce or could not be obtained at all.
AFRIKAANSE OPSOMMING: Weens ‘n gebrek aan navorsing, en gevolglik ook aan literatuur rakende die belewenisse en sosio-emosionele behoeftes van familielede as primêre VIGS-versorgers, het die navorser besluit om hierdie navorsingsprojek te onderneem. Die doel hiermee was om die belewenisse en sosio-emosionele behoeftes van familielede as primêre VIGS-versorgers te verken en te beskryf. Om die navorsing te rig, is ‘n kwalitatiewe navorsingsbenadering vir die doel gebruik. Aandag is ook gegee aan die beskrywing en voorkoms van MIV/VIGS, asook die voorkoming en behandeling van MIV/VIGS. Die impak van MIV/VIGS is ook breedvoerig bespreek en is dit vanuit ‘n ekologiese perspektief gedoen. Binne die kwalitatiewe navorsingsbenadering is daar van ‘n fenomenologiese, verkennende, beskrywende en kontekstuele navorsingsontwerp gebruik gemaak. Die grense vir data-insameling het binne die George-area geval. Semi-gestruktureerde onderhoude is gevoer met familielede wat as primêre VIGS-versorgers optree, en wat deur middel van ‘n doelgerigte steekproeftrekking en die sneeubaltegniek vir deelname aan die navorsing gewerf is. Die ingesamelde data is ontleed aan die hand van die agt stappe van kwalitatiewe data-ontleding van Tesch soos uiteengesit in Creswell (1994). Guba se model soos dit in Krefting (1991:214-221) uiteengesit is, is gebruik om die vertrouenswaardigheid van die navorsingsdata te verifieer. Twaalf temas het na aanleiding van die prosesse van data-ontleding na vore gekom, naamlik: - Kennis van die siektetoestand - Versorging van VIGS-lyers - Risiko-gedrag - Ander mense se reaksie - Versorger se gevoelens en reaksies - Ondersteuning wat ontvang is met die versorging - Effek van pasiënt se versorging op die verhouding tussen versorger en pasiënt - Verandering van versorger se lewe as gevolg van die versorging van die VIGS-lyer - Belewenisse ten op sigte van die sterwensproses - Behoeftes ten opsigte van die versorging van die pasiënt - Dienste wat benodig word - Raad deur deelnemers aan ander familielede as VIGS-versorgers. Voortspruitend uit die navorsingsbevindinge, is tot sekere gevolgtrekkings gekom waaruit die volgende aanbevelings gemaak is: dat inligtingsessies deur maatskaplike werkers in samewerking met die verskillende klinieke op sekere dae gehou sal word; dat ‘n gemeenskapsprojek van stapel gestuur word om vrywilligers te werf wat op ‘n gereelde basis aan VIGS-versorgers ondersteuning bied; dat daar gekyk word na respite by ouetehuise of ‘n hospice vir ‘n tydperk van ongeveer drie weke om aan versorgers ‘n ruskans te gee; dat versorgers betrek word by ondersteuningsgroepe in die gemeenskap; dat die media gebruik word om inligting oor VIGS aan die breë gemeenskap deur te gee; dat aandag gegee word aan ‘n gesentraliseerde voedsel- en klerebank waarvandaan versorgers voorraad kan onttrek. Aansoek vir befondsing kan gedoen word by Departement Maatskaplike Ontwikkeling of Departement Gesondheid. Verdere aanbevelings wat gemaak kan word, is: dat ‘n gemeenskapsprojek van stapel gestuur word om skoonmaakdienste en hulp met wasgoed was tot die beskikking van die VIGS-versorger te stel wat selfs as ‘n werkskeppingsprojek begin kan word; dat ‘n alternatiewe vorm van vervoer wat deur die familielid en pasiënt benut kan word, en wat geskik is vir pasiënt vervoer, ondersoek sal word; dat opleiding van tuisversorgers as hulp vir familielede as VIGS-versorgers aandag sal kry; dat opleiding van tuisversorgers om behulpsaam te wees met berading van pasiënte rakende hulle medikasie dringende aandag sal geniet; dat familielede as VIGS-versorgers uitreik na ander ondersteuningsbronne vir hulp; dat versorgers versigtig sal wees ten opsigte van verwagtinge van ander, maar dat hulle ook vrymoedigheid sal neem om hulle verwagtinge te verbaliseer; dat die maatskaplike werker sal ondersoek instel of die familielid as primêre VIGS-versorger, sowel as die pasiënt, vanuit al die vlakke van die ekologiese perspektief die nodige ondersteuning geniet, en indien nie, moet daar gekyk word na hulpbronne en dit moet gemobiliseer word ten einde hierdie noodsaaklike ondersteuning te bied; dat die raad wat deur die deelnemers aan die navorsing aan ander familielede as VIGS-versorgers voorsien is, in gedagte gehou sal word wanneer met hierdie families gewerk word. ‘n Aanbeveling is ook gemaak dat opvolg navorsing oor dieselfde onderwerp gedoen word onder die Wit, Indiër en Swart gemeenskappe, en dat veral klem gelê word op hulle behoeftes, aangesien deelname vanuit hierdie bevolkingsgroepe skraal was, of glad nie bekom kon word nie.
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Taruvinga, Kudakwashe. "Establishing a new home based care programme for the community of Swakopmund." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/8539.
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Thesis (MBA)--University of Stellenbosch, 2010.Since the first case was discovered in Africa in the late 80s, the HIV/AIDS epidemic has gradually increased at alarming proportions worldwide especially in sub-Saharan Africa which prompted the United Nations' World Health Organisation to declare it a global pandemic. This research undertakes to highlight the current composition of care given for HIV and Aids, and the strengths and weaknesses of such programmes. The aim of this is to establish a better home based care programme in Swakopmund, Namibia, for improving the quality of care as well as living conditions for the infected and affected. For this initiative to be of the highest quality there is need to pay special attention to various regional and national HIV/AIDS programmes and policies. As the HIV/AIDS epidemic continues to spread, organisations and communities are now considering engaging more programmatic approaches as sub-Saharan countries are looking for scaled-up responses and national strategies for home based care. Policy-makers and senior administrators must be involved in developing and monitoring home based care programmes, and the people who manage and run the programmes must share information and feedback with senior administrators. In this sense, policy and action are interrelated as each partner learns from and guides the other. The researcher saw the need to involve community members and home based care-givers in a participatory process to research this topic and engage them in a process on how to improve the programmes that already exist. 52 Pages.
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Kulu, Joyce Aliendar Nomvuyo. "Social workers perspectives on social support needed by people living with HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86481.
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Thesis (M Social Work)--Stellenbosch University, 2014.ENGLISH ABSTRACT: The South African government has laws and policies that forbid discrimination against individuals. These policies protect people from being discriminated against in the workplace due to sickness, race and many other factors. Discrimination against people living with HIV/AIDS has caused many people who suffer from this disease not to come forward with their illness because they fear being discriminated against and stigmatised; some even lose their jobs because they are infected with HIV. People infected with HIV are discriminated against not only in the workplace but also in their communities and families. This implies that people living with HIV/AIDS need support from all levels of society in order to live positive lives, which may lead infected people to live longer. This study explored HIV/AIDS as terminal illness and the stressors experienced by people infected with the virus. This was done by examining the support available to people living with HIV/AIDS, as well as identifying the support needed by these people. By adopting an ecological approach to the study, the need for support could be investigated on multiple levels. A combination of a quantitative and qualitative research design was used in the study. Data were gathered by means of a semi-structured interview schedule that was administered during individual interviews with service providers. This allowed for data that were both measurable as well as rich in description to be collected. The questions in the semi-structured questionnaire were based on the information retrieved from the literature review. The findings from the empirical investigation revealed that people living with HIV/AIDS receive limited support from their families, the South African government and society at large. The findings further indicated that informal sources of support such as family, friends and partners are relatively supportive of people living with HIV/AIDS. However, the relationships between people living with HIV/AIDS and their families and partners are often strained, especially when a person first discovers his or her status as HIV positive. Furthermore, people living with HIV/AIDS are stigmatised on multiple levels because of their status. There is stigmatisation from family, friends, in the workplace and in the community. The most important recommendations resulting from the study are that services such as counselling are needed for people living with HIV/AIDS together with their families. This is of particular significance to the South African government, especially the health sector, which needs to improve the health care system. In addition, recommendations emphasise the importance of promoting education and awareness, which could have great value for people living with HIV/AIDS, their families and communities. Knowledge about HIV/AIDS would empower people at all levels to support those who live with the disease and would also be of great value in helping those living with the disease to contribute something of value towards their health condition.
AFRIKAANSE OPSOMMING: Die Suid-Afrikaanse regering beskik oor wette en beleide wat diskriminasie teen individue verbied. Hierdie wette en beleide beskerm mense teen diskriminasie in die werkplek, diskriminasie op grond van siekte, gestremdheid, ras en vele ander redes. Diskriminasie teen mense wat met MIV/vigs leef, laat baie van hulle hul MIV/vigs-status geheim hou omdat hulle diskriminasie en stigmatisasie vrees. Sommige verloor selfs hulle werk wanneer dit rugbaar word dat hulle aan MIV/vigs ly. Diegene met MIV/vigs ervaar egter nie net in die werkplek diskriminasie nie, maar ook in hul gemeenskappe en families. Dít impliseer dat mense met MIV/vigs op alle vlakke ondersteuning nodig het om ’n positiewe lewe te lei en daarmee hul lewensverwagting so ver moontlik te verleng. Hierdie studie het die stresfaktore van terminale MIV/vigs-lyers ondersoek. Daar is voorts ondersoek ingestel na die ondersteuning wat mense met MIV/vigs ontvang, sowel as die ondersteuning wat hulle nodig het. MIV/vigs-lyers se ondersteuningsbehoeftes op etlike vlakke is deur middel van ’n ekologiese navorsingsbenadering bepaal. ’n Kombinasie van ’n kwantitatiewe en kwalitatiewe navorsingsmetodologie is vir die studie gebruik. Data is met behulp van ’n semigestruktureerde vraelys ingesamel, wat gedurende individuele onderhoude met diensverskaffers afgeneem is. Sodoende kon meetbare sowel as hoogs beskrywende data ingesamel word. Die vrae in die semigestruktureerde vraelys was gegrond op die inligting uit die literatuuroorsig. Die bevindinge van die empiriese ondersoek toon dat mense wat met MIV/vigs leef beperkte ondersteuning van hul familie, die Suid-Afrikaanse regering en die groter samelewing ontvang. Die bevindinge dui voorts daarop dat informele ondersteuningsbronne, soos familie, vriende en lewensmaats, betreklik ondersteunend is teenoor diegene met MIV/vigs. Tog is die verhouding tussen MIV/vigs-lyers en hul families en lewensmaats ook dikwels onder druk, veral net nadat die persoon ontdek dat hy/sy MIV-positief is. Daarbenewens word mense met MIV/vigs op verskeie vlakke gestigmatiseer – deur hul familie, vriende, in die werkplek en die gemeenskap. Die belangrikste aanbeveling uit die studie handel oor die behoefte aan dienste soos berading vir mense wat met die virus leef, sowel as vir hul familie. Die aanbeveling behoort veral van belang te wees vir die Suid-Afrikaanse regering, en in die besonder die gesondheidsektor, wat hierdie behoefte in gedagte moet hou om die gesondheidsorgstelsel te verbeter. Ander aanbevelings beklemtoon die belang van meer opvoeding en bewusmaking, aangesien dit uiters waardevol kan wees vir mense met MIV/vigs, hul familie en gemeenskappe. Kennis oor MIV/vigs sal mense op alle vlakke bemagtig om diegene met die virus te ondersteun, terwyl dit MIV/vigs-lyers self ook sal help om hul eie gesondheidstoestand beter te bestuur.
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Phashe, M. L. "Strategies utilized by professional nurses in the primary health care facilities regarding adherence of patients to antiretroviral theraphy, Capricorn District, Limpopo Province South Africa." Thesis, University of Limpopo, 2015. http://hdl.handle.net/10386/1736.
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Thesis (MPH.) -- University of Limpopo, 2015The success of antiretroviral therapy for HIV infection through widespread and resounding has been limited by inadequate adherence to its unforgiving regimens especially over a long term. While health care professionals may not be able to predict adherence, they can help overcome barriers to adherence and take steps to improve it. The aim of the study was to explore and describe the strategies that are utilised by professional nurses in the primary health care facilities regarding adherence to antiretroviral therapy, Capricorn District, Limpopo Province, South Africa. A qualitative research approach was used to describe the strategies that are utilised by professional nurses in the primary health care facilities in the Capricorn District Limpopo Province, referring to Mankweng Hospital. The descriptive qualitative design was used. Unstructured interviews were used to collect data until saturation was reached. Informed consent was obtained prior the data collection. The data was analysed qualitatively using Tesch’s open coding method. 18 (eighteen) professional nurses working in the primary health care facilities participated in the study. The findings revealed that the strategies utilised by professional nurses in the primary health care facilities to improve adherence to ART were described. Information and education, health worker and adherence guidelines, use of adherence partner or treatment buddy, addressing religious beliefs, communication skills, community mobilisation and continuous counselling, were the strategies that were utilised by professional nurses in the primary health care facilities to improve adherence of patients to ART.
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Ferreira, Clive J. "Churches as providers of HIV/AIDS care : a normative and empirical study." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71797.
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Thesis (PhD)--Stellenbosch University, 2012.ENGLISH ABSTRACT: There is, as yet, no cure for HIV/AIDS, a disease that has affected South African society profoundly. While antiretrovirals (ARVs) are now available and have stemmed the tide of AIDS deaths, medicines alone cannot be seen as a long-term solution. Treatment costs, finite resources, limited health-care capacity, morbidity and the unpleasant side-effects of ARVs, make treatment an untenable solution. The Christian church in South Africa continues to retain a powerful position; it has a significant affiliation; it is present in most geographic areas and inspires trust and confidence. Furthermore, in my view, the church, by its very nature and calling, is mandated not only to demonstrate and provide care, but also to inspire care-giving. In the light of HIV/AIDS, what does care mean? Can it only mean rendering care that is welfarist in nature? Or does the church have the mandate to look beyond immediate suffering, to examine and address those issues that lie at the core of suffering? Research has demonstrated that issues such as poverty, injustice, stigma, discrimination, gender inequality and patriarchy fuel the pandemic. Ultimately, it is the “othering” of people; the failure not to recognise God in another person and our common humanity, that lie at the heart of the problem. These then, I suggest, are the very reasons why the church must address these areas. But that is not all: if HIV/AIDS care is to be rendered in a developmental way, then there must be a thorough understanding of the disease: how is the virus transmitted, how can it be prevented and treated? It is also important to understand that there is not a single global epidemic but many local epidemics; the determinants and risk-factors of these need to be recognised, as must the cultural, economic, political and social contexts that fuel the spread of the disease. The changing nature of society, the effects of globalisation, the evolving nature of care owing to biomedical advances and even the “privatisation” of sex all need to be comprehended. Furthermore, any meaningful rendering of care requires the churches to examine why they should be giving it and the values that underpin such care-giving. I make the case that the churches are required to do nothing less than drive social change in situations of suffering, injustice and abuse. An examination of the history of HIV/AIDS in South Africa illustrates that the churches have often failed to meet up to this calling. An empirical study was conducted as to how the churches render care at a more micro, grassroots level, using a framework propounded by David Korten, who suggests that authentic development must be people-centred, rather than growthcentred. Essentially, development must seek to increase personal and institutional capacities, guided by principles of justice, sustainability and inclusiveness. In these respects, I argue, it accords very strongly with the Christian message. Korten suggests that there are four orientations (or generations) of rendering help but it is only the fourth generation that is truly developmental. Through the use of case study methodology, I sought to examine the manner in which the churches render care, in a region of the Western Cape, outside Cape Town, known as the Helderberg Basin. The area is representative of many peri-urban areas in the Cape: it is predominantly Christian, with a mix of different denominations and racial and socio-economic groupings. It allowed for an assessment of care initiatives afforded by mainline, charismatic and African Independent Churches and in particular, sought to answer the question of whether churches engage with HIV/AIDS in a way that Korten would identify as developmental. From the research, it is clear that the church is hampered by its inability to talk of sex and sexuality; its knowledge of the issues surrounding HIV/AIDS is limited; it has not done a sufficient amount to conscientise its followers; the church has yet to learn to utilise its networks; it lacks technical know-how and is unwilling to engage in the political sphere. Social change is only possible if the church embraces a new vision of how to create a better world. Additionally, I recommend that the church looks to the emerging church movement to achieve radical transformation.
AFRIKAANSE OPSOMMING: MIV/VIGS is ‘n siekte wat Suid-Afrika onmeetbaar beїnvloed en waarvoor daar tot op hede geen genesing is nie. Antiretrovirale middels (ARVs) is weliswaar beskikbaar en het die gety van VIGS sterftes gestuit maar medisyne kan nie alleen as die langtermyn oplossing gesien word nie. Behandelingskoste, beperkte hulpbronne en vermoë om gesondheidsorg te lewer, morbiditeit en die negatiewe newe-effekte van ARVs bring mee dat slegs mediese behandeling ‘n onhoudbare oplossing is. Die Christelike kerk in Suid-Afrika behou steeds ‘n magsposisie; dit het ‘n beduidende lidmaatskap asook ‘n teenwoordigheid in meeste dele van die land en boesem vertroue en sekerheid in. Dié kerk is na my mening gemandateer deur haar besondere aard en roeping om nie alleen sorg te bewys en te voorsien nie maar ook om versorging aan te moedig. Maar wat beteken sorg, gegewe die aard van MIV/VIGS? Kan dit slegs die lewering van welsyngerigte sorg beteken? Of sou die kerk die mandaat hê om verder as onmiddellike lyding te kyk en ondersoekend die kwessies wat aan die wortel van lyding lê, aan te spreek? Navorsing het aangetoon dat kwessies soos armoede, onreg, stigma, diskriminasie, geslagsongelykheid en patriargie die epidemie aanvuur. Uiteindelik is dit die objektivering (“othering”) van mense - dit is die onvermoë om God nie in ‘n ander persoon en ons gemeenskaplike mensheid te herken nie - wat die hart van die probleem is. Ek betoog dat hierdie die redes is waarom die kerk hierdie kwessies moet aanspreek. Om ondersoek in te stel of en tot watter mate die kerk sorg verskaf in verband met MIV/VIGS het ek die raamwerk van David Korten gebruik. Dié raamwerk stel voor dat outentieke ontwikkeling mensgesentreerd eerder as groeigesentreed sal wees. Ontwikkeling moet essensieel streef na ‘n toename van persoonlike en institusionele vermoë, gerig deur beginsels van geregtigheid, volhoubaarheid en inklusiwiteit. Ek toon aan dat hierdie beginsels baie sterk ooreenkom met die Christelike boodskap. Korten stel vier hulplewerende oriëntasies (ook genoem generasies) voor maar dit is eintlik slegs die vierde generasie van hulp wat werklik ontwikkelingsgerig is. Maar dit is nie al nie. Indien MIV/VIGS versorging ontwikkelingsgerig gaan wees, moet dit gegrond wees op ‘n diepgaande verstaan en kennis van die siekte soos onder andere, hoe die virus versprei word en hoe die siekte voorkóm en behandel kan word? Dit is ook belangrik om te verstaan dat daar nie slegs ‘n enkele globale epidemie is nie maar verskeie lokale epidemies. Die veroorsakende en risiko faktore van hierdie epidemies moet daarom geїdentifiseer word en so ook die kulturele, ekonomiese, politieke en sosiale konteks wat die verspreiding van hierdie siekte aanhelp. Die veranderende aard van gemeenskappe, die effek van globalisering, die ontwikkelende aard van gesondheidsorg vanweë die vooruitgang in die mediese wetenskap en die “privatisering” van seks moet alles in ag geneem word. Betekenisvolle versorging vereis dat kerke ondersoek instel na waarom die versorging aangebied word en die waardes onderliggend daaraan. Ek stel die saak dat daar van kerke verwag word om sosiale verandering te stuur waar mense swaarkry, onregverdig behandel en misbruik word. ‘n Ondersoek na die geskiedenis van MIV/VIGS in Suid-Afrika illustreer dat kerke dikwels misluk het om aan hierdie roeping gehoor te gee. In opvolging van die bostaande argumente het ek navorsing uitgevoer oor hoe kerke sorg op ‘n mikro of voetsool-vlak aanbied. Hiervoor het ek die genoemde mensgesentreerde ontwikkelingsraamwerk van David Korten gebruik. ‘n Gevalstudie benadering is gevolg in die Helderbergkom wat geleë is in ‘n streek van Wes- Kaapland buite Kaapstad. Hierdie gebied is verteenwoordigend van baie buitestedelike gebiede van die Kaap: dit is oorwegend Christelik en sluit ‘n verskeidenheid van denominasies, rasse en sosio-ekonomiese groeperings in. Die gebied maak ‘n oorsig moontlik van die sorg-inisiatiewe van hoofstroom, charismatiese en Afrika onafhanklike Kerke, en in die besonder van ‘n identifikasie daarvan of kerke betrokke by MIV/VIGS dit doen op ‘n wyse wat Korten sou tipeer as ontwikkelingsgerig. Uit hierdie navorsing het dit duidelik geword dat die kerk gekniehalter word deur ‘n onvermoë om oor seks en seksualiteit te praat; die kerk se kennis beperk is wanneer dit kom by kwessies wat handel oor MIV/VIGS; dit nie genoeg doen om lidmate bewus te maak van VIGS kwessies nie; dit nog veel te leer het oor hoe om netwerke aan te wend; dit tegniese kennis kort en onwillig is om met sake van politieke belang om te gaan. Sosiale verandering is alleen moontlik indien die kerk ‘n nuwe visie voorhou oor hoe om ‘n beter wêreld te skep. Ek beveel ten slotte aan dat die kerk let op die ontluikende kerkbeweging om radikale transformasie te verwesenlik.
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Ramela, Thato. "An illustrated information leaflet for low-literate HIV/AIDS patients on antiretroviral therapy : design, development and evaluation." Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1007563.
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South Africa's HIV prevalence rate is estimated to be 5.7 million and at the end of2007 a total of 45845 HIV/AIDS adult patients were taking antiretroviral therapy (ART). The global incidence of HIV/AIDS has been slowly decreasing over the years but is still widespread. This disease is still more prevalent in sub-Saharan Africa than in other parts of the world, with more than 60% people living with HIV/AIDS. Highly active antiretroviral therapy (HAART), the treatment of choice, slows the progression of the human immunovirus but demands a high adherence rate in excess of 95%. Patients who are poorly informed about antiretrovirals (ARVs) and misunderstand medicine-taking instructions or experience unexpected side effects may interrupt therapy, predisposing them to the development of resistance. Such patients need information but, given the poor literacy skills prevalent in South Africa, written information is often not fully comprehended and is often written at too high a reading level. The objectives of this research project were to design, modify and evaluate HIV / AIDS patient education materials for low-literate isiXhosa speaking adults residing in Grahamstown and to examine their impact on the understanding of various aspects of the disease and its treatment. Pictograms illustrating common side effects of ARVs (e.g. stavudine, efavirenz, lamivudine), as well as various sources 'for purchasing nonprescription medicines, storage and medicine-taking instructions were designed and evaluated both qualitatively, using group discussions, and quantitatively through individual interviews where interpretation of the pictograms was assessed. These pictograms were incorporated in a patient information leaflet (PIL) which had been specifically designed for people with limited reading skills and was a simple document containing the minimum of essential text. A previously developed PIL was modified in collaboration with the target population and two versions were produced, one incorporating pictograms illustrating side effects, the other with none. Pictograms were used in both to illustrate other medicine-taking instructions. The PILs were tested objectively to assess the readability, format, content, and general design. They were translated into isiXhosa prior to being qualitatively and quantitatively evaluated in a low-literate isiXhosa speaking population. Understanding of the PILs was assessed by asking a series of questions about the PIL content. Participant opinion of the readability and appearance of the PIL was recorded. The relationship between PIL understanding and selected demographic variables was investigated. Findings from this study illustrated that well designed pictograms assist in the location of information in written leaflets and they may enhance understanding of the information. It was further demonstrated that education influences total understanding of PIL content thus emphasizing the need for tailor-written information in accordance with the education level of the target population. A desire to receive PILs incorporating pictograms was expressed by the majority of participants. Collaboration with the intended target population is essential to design culturally acceptable, easily interpreted pictograms and to produce user-friendly, easy-to-read, comprehensible patient education materials. The rigorous, iterative design, modification and testing process described in this study is one that should be adopted in producing all health-related education materials.
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Smit, Stefan. "A study of the differences in the relationship between HIV/AIDS prevalence and related costs in the mining and financial sectors in South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/1024.
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Thesis (MBA (Business Management))--University of Stellenbosch, 2009.ENGLISH ABSTRACT: By understanding the costs of HIV/AIDS, businesses can understand the incentives for preventing and treating the disease better. This report primarily investigates whether there is a difference in the relationship between HIV/AIDS prevalence rates and related costs in different sectors in South Africa. With an HIV prevalence ratio of approximately 10:1 for the mining and financial sectors, it is difficult to motivate that more research should be done on the impact of HIV/AIDS on the financial sector. However, if the study indicates a higher cost ratio between the two sectors it could increase the priority of the epidemic in the financial sector, giving rise to a bigger incentive to fight the epidemic. The estimated HIV/AIDS-related cost of an infected manager is R120 000 compared to the cost of R4 600 for an infected unskilled employee. From this analysis it is estimated that the HIV prevalence ratio between highly skilled and semi- and unskilled labour is 1:2.5, while the HIV cost ratio between the different skill levels is 1:0.2. This clearly indicates that there could be a significant difference between the HIV prevalence ratio and the HIV cost ratio for different levels of skills. From the Absa and AngloGold average salary information reviewed, the assumption was made that the Absa employees are more skilled than the AngloGold employees. With the knowledge of this difference in skill levels between the two companies in the different sectors, and the information above regarding the difference in HIV/AIDS-related costs for different skill levels, it is possible that the HIV/AIDS-related costs in the financial sector could be in line with the costs in the mining sector. Using HIV prevalence as an indication of the impact of the disease on the financial sector, a high-level cost estimate could be R150.9 million, compared to R3 985 million if the difference in the relationship between HIV/AIDS prevalence and related costs are taken into account. These materially different estimates could cause companies in the financial sector to make incorrect decisions regarding HIV/AIDS budgets for HIV/AIDS prevention and treatment, as incorrect indicators of the impact of the epidemic on the profit of the organisation are used.
AFRIKAANSE OPSOMMING: Deur die koste van MIV/vigs te verstaan, kan besighede die dryfvere vir die voorkoming en behandeling van MIV/vigs beter verstaan. Die verslag ondersoek hoofsaaklik of daar ’n verskil is in die verhouding tussen die voorkomsyfer en verwante koste van MIV/vigs in verskillende sektore in Suid Afrika. Met die MIV-voorkomsverhouding van ongeveer 10:1 vir die mynwese en finansiële sektore, is dit moeilik om verdere navorsing oor die impak van MIV op die finansiële sektor te regverdig. Indien hierdie studie egter ’n hoër kosteverhouding tussen die twee sektore aantoon, kan dit die prioriteit van die epidemie in die finansiële sektor verhoog, wat sal lei tot dryfvere om die epidemie te beveg. Die beraamde MIV/vigs-verwante koste van ’n besmette bestuurder is R120 000, vergelykend met die koste van R4 600 vir ’n besmette ongeskoolde werknemer. Uit ontledings kan beraam word dat die MIV-voorkomsyfer tussen hoogs geskoolde en half- en ongeskoolde werknemers 1:2.5 is, terwyl die MIV-kosteverhouding tussen die verskillende vlakke 1:0.2 is. Die inligting toon dat daar beduidende verskille tussen die MIV-voorkomsverhouding en die MIV-kosteverhouding vir verskillende vlakke van geskooldheid kan wees. Volgens Absa en AngloGold se inligting oor gemiddelde salarisse is die aanname gemaak dat Absa-werknemers meer geskoold is as AngloGold-werknemers. Met die kennis van hierdie verskil in vaardigheidsvlakke tussen die twee maatskappye in die onderskeie sektore en die inligting hierbo rakende die verskil tussen MIV/vigs-koste vir verskillende vaardigheidsvlakke, is dit moontlik dat die MIV/vigs-verwante koste in die finansiële sektor in ooreenstemming met dié in die mynwesesektor kan wees. As MIV-voorkoms as ’n aanwyser van die impak van die koste op die finansiële sektor gebruik word, kan ’n hoëvlak-kosteberaming R150.9 miljoen wees, vergelykend met R3 985 miljoen, as die verskil in die verhouding tussen MIV/vigs-voorkoms en verwante koste in berekening gebring word. Die wesenlik verskillende beramings veroorsaak dat maatskappye in die finansiële sektor foutiewe besluite rakende MIV/vigs-begrotings vir MIV/vigs-voorkoming en -behandeling maak, aangesien foutiewe aanwysers van die impak van die epidemie op die wins van die organisasie gebruik word.
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Raza, M. Sajjad. "A survey to explore factors that delay patients from accessing antiretroviral treatment at an East London hospital complex clinic." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/80459.
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Thesis (MFamMed)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Introduction This cross-sectional study assessed factors affecting access to antiretroviral therapy (ART) among HIV patients. The aim of this study was to explore factors that delay patients from accessing antiretroviral treatment at an East London Hospital Complex clinic and to determine the pathway that people from communities in the surrounding area take in order to access antiretroviral treatment at the referral hospital ART clinic Methods The study design was a descriptive cross-sectional survey using both open and closed questions to generate qualitative and quantitative data. The survey used a questionnaire administered via a face to face interview. 200 Adult patients (>18years old) from the local population with a CD4 count of ≤100/mm3 referred to the ART clinic at East London Hospital Complex for the first time during May to October 2011 were interviewed. Results With the health system, some issues were structural (staffing, availability of CD4 counts) and most were process related and reflected a poor patient experience and lack of trust in the quality of care. Contextual related issues were mainly geographic accessibility (cost and lack of transport, distance to health care facility), stigma and discrimination about HIV. Patients related factors included misperceptions and false beliefs about HIV, low level of education, socioeconomic factors, lack of family and social support such as unavailability of treatment supporter and status of patient’s general health discouraged people from seeking ART. Coping strategies such as denial of results and reluctant to disclose results to other people came out as a distrust of patients in community. Conclusions This study gives evidence that people living with HIV experience health system, patient and contextual related barriers to access HIV treatment. The majority accessed care via their local primary care clinic and traditional or alternative practitioners did not appear to play a major role. The distance from and cost of transport to the referral hospital ART service was a major issue compounded by the difficulty of travelling when acutely sick. The expectation of long waiting times and sometimes negative staff attitudes reduced motivation. A number of other factors related to the patient, the health service and the community context were also identified. Many of these factors that reduce access to ART are amenable to change.
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Bambani, Nomfezeko. "The utility of Weingarten's witness positions in the understanding of compassion fatigue in people who care for their own family members with AIDS." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1004465.
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This paper explores the utility of Weingarten's (2003) witness positions in the understanding of compassion fatigue in people who care for their own family members with AIDS. The research is embedded in Weingarten's theory of witnessing and narrative theory and practice. The literature review explores the shift from hospital-based care to community/home-based care which has led to family members assuming the role of caring for their family members with AIDS, an overview of the effects of caring for AIDS patients on caregivers and an overview of Weingarten's (2003) theory of witnessing with special emphasis on the witnessing positions and their consequences. Interviews, based on narrative theory and practice in which Weingarten's theory is rooted, gave access to the participants' experiences, which were then analysed and interpreted through a framework developed from the witnessing theory. This article demonstrates the utility of Weingarten's (2003) theory of witnessing to people who are caregivers to their own family members with AIDS. I argue that witness positions occupied by caregivers during witnessing determine whether the caregivers will experience compassion fatigue. The negative consequences related to compassion fatigue that will be reviewed could probably be prevented through active, intentional, compassionate witnessing.
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Le, Roux Rhonddie. ""Acts of disclosing" : an enthnographic investigation of HIV/AIDS disclosure grounded in the experiences of those living with HIV/AIDS accessing Paarl Hospice House seeking treatment." Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/16610.
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Thesis (MPhil)--University of Stellenbosch, 2005.ENGLISH ABSTRACT: Paarl, in the Western Cape, has been identified as one of the 15 national sites where antiretroviral treatment (ARVs) would be made available to people living with HIV/AIDS. Paarl Hospice initiated a support group for people to deal with this disease in 2003. Since February 2004 Paarl Hospice has been recruiting people from the surrounding informal settlements for ARVs. By means of participant observation I explored how HIV/AIDS-related disclosure experiences unfolded in places, spaces and events associated with the support group in the context of factors enabling and preventing people from accessing Hospice House. I did this by considering the insights drawn from an anthropological approach. I found the meanings of disclosure in the majority of studies to be limited and restricted. Available studies approached disclosure in a top-down fashion by regarding the definition of disclosure as the announcement of HIV-positivity at the time of diagnosis only. These studies have not considered social differences relating to disclosure neither did they focus on the actual process of disclosure. By means of a constructivist approach to grounded theory I seek to broaden the definition of disclosure to account for the range of ways in which disclosure practices take place. I found that disclosure could not be separated from the situational context in which it occurs and that it can only be understood in relation to the circumstances and relationships in which it takes place. In this study, disclosure was an ongoing process, situated somewhere between active, public announcement of an HIV-status and complete secrecy and somewhere between voluntary and involuntary revealing of the disease.
AFRIKAANSE OPSOMMING: Paarl in die Wes-Kaap is geïdentifiseer as een van die 15 nasionale areas waar antiretrovirale medikasie beskikbaar gestel sou word aan mense wat leef met MIV/VIGS. Paarl Hospice het gedurende 2003 ʼn ondersteuningsgroep geїnisieer om aan MIV/VIGS aandag te gee. Sedert Februarie 2004 is Paarl Hospice in die proses om mense te werf uit die omliggende informele behuisingsgebiede vir antiretrovirale behandeling. Met behulp van antropologiese insigte en deelnemende waarneming kon ek nagaan hoe verskillende maniere van MIV/VIGS-verwante bekendmaking ontvou in plekke, ruimtes en gebeurtenisse wat verband hou met die ondersteuningsgroep. MIV/VIGSverwante bekendmaking is ondersoek te midde van inhiberende en fasiliterende faktore wat mense verhoed of aanhelp om Paarl Hospice te besoek. Ek het bevind dat die definisie van bekendmaking in die meeste navorsing gebrekkig is. Beskikbare navorsing het bekendmaking volgens ‘n bo-na-onder-wyse benader as die openbare bekendmaking van ‘n MIV-status na afloop van diagnose alleenlik. Met behulp van ‘n konstruktiewe benadering van die begronde teorie het ek gepoog om die definisie van bekendmaking uit te bou om sodoende die verskeidenheid maniere waarop bekendmaking plaasvind te akkommodeer. Ek het vasgestel dat bekendmaking onlosmaakbaar deel is van die situasionele konteks waarin dit plaasvind en dat dit slegs begryp kan word in verband tot die verhoudings en omstandighede waarin dit plaasvind. In hierdie studie was bekendmaking ʼn voortdurende proses, gesitueer tussen aktiewe openbare bekendmaking en volledige geheimhouding van ʼn MIVstatus, asook tussen volkome vrywillige en onvrywillige bekendmaking van ʼn MIVstatus.
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Kgaphola, Kholofelo Lebogang. "The effectiveness of home community based care programmes in Victor Khanye sub-district in Nkangala district, Mpumalanga." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/3909.
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The Home and Community Based Care (HCBC) and Support programme has been established as a cost effective response for communities to tackle HIV and AIDS and many other chronic conditions and vulnerabilities which are faced by individuals, families and communities. In terms of the Framework for Home and Community Based Care and Support Programme (2012: 4) HCBCs create an enabling platform for “individuals, families and communities to have access to holistic and comprehensive services nearest to home, which encourages participations by people, responds to the needs of the people, encourages traditional community life and strengthens mutual support opportunity and social responsibility”. Victor Khanye Local Municipality, IDP (2010-2011: 116) states that VKLM is faced with: a high incidence of HIV and AIDS due to poverty, ignorance and a lack of proper entertainment facilities; shortage of clinics and professional staff members, which makes it difficult for patients to access treatment and maximum care and support; and an increase in the number of OVCs which results in a lack of parental care and guidance, poverty, illiteracy, lack of access to medical care, school drop-outs and ultimately an increase in criminal activity and the further spread of HIV and AIDS. The research will assess the effectiveness of Home Community Based Care programmes (HCBCs) on orphaned and vulnerable children with specific reference to the Victor Khanye sub-district in Nkangala District, Mpumalanga Province. The research was conducted in Delmas and its surrounding farming areas. Victor Khanye sub-District has nine wards, most of which are predominantly farming rural areas. The field research took place during June and August 2013 and represents observations recorded at the field interviews, the local AIDS committee and one-on-one interviews with beneficiaries The study is concluded with conclusions drawn from the field study and recommendations.
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Nkhebenyane, Jane Sebolelo. "Microbial hazards associated with food preparation in Central South African HIV/Aids hospices." Thesis, Bloemfontein : Central University of Technology, Free State, 2010. http://hdl.handle.net/11462/135.
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Thesis (M. Tech.) -- Central University of Technology, Free State, 2010South Africa currently faces one of the highest HIV prevalence rates in the world. As this prevalence rises, the strain placed on its hospitals is likely to increase due to the shortage of beds. The devastating effects of HIV/AIDS initiated the establishment of a hospice which is a non-governmental organisation whose goal is the provision of care for terminally ill patients, either in their homes, in hospitals or in a hospice’s own in-patients wards. Part of the hospice’s mission is to offer palliative care without charge to anyone who requires it. The basic elements of hospice care include pain and symptom management, provision of support to the bereaving family and promoting a peaceful and dignified death. This also includes the provision of cooked foods to the patients using the kitchen facilities of the hospices for this activity. It is well known that the kitchen is particularly important in the spread of infectious disease in the domestic environment due to many activities that occur in this particular setting. Food and water safety is especially important to the persons infected with the human immunodeficiency virus (HIV) or with immunodeficiency syndrome (AIDS).It is estimated that food-borne pathogens (disease–causing agents) are responsible for 76 million illnesses, some resulting in death, in the United States alone every year. In one study of patients with AIDS, two-thirds had diarrhoeal disease and in two-thirds of these, the following enteric pathogens were identified: Salmonella, Shigella, Listeria, Yersnia, Cryptosporidium, Entamoeba histolylica and Campylobacter sp. In an epidemiological study of patients with HIV infection a close association was found between consumption of raw or partially cooked fish and antimicrobial-resistant Mycobacterium avium complex. Antibiotic resistance in food-borne pathogens has become a reality and this poses a serious threat to the medical fraternity since it diminishes the effectiveness of treatment. This study was undertaken to determine the prevalence of foodborne pathogens including bio aerosols isolated from the kitchen surfaces and food handler’s before and after cooking. The antibiotic resistance of the isolated pathogens was further determined to assess their impact on treatment. The following microbiota were isolated: Total viable counts (TVC), Coliforms, Escherichia coli, Staphylococcus aureus, Pseudomonas and presumptive Salmonella. The hospices had high counts of E.coli and S.aureus on the cutting boards for the breakfast session compared to the traditional home based kitchens. It was speculated that this could have originated from crosscontamination via the foodhandler’s hands and the food served. It is evident from the results that hospices lack a management system regarding the prevalence of E. coli as it was present on the cutting boards throughout the food preparation sessions. Gram negative organisms (coliform and P. aeruginosa) were in particular both resistant to oxacillin and this pose a great challenge in this particular setting. This can be addressed by putting emphasis on hygiene as a strategy per se for reducing antibiotic resistance.
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Mahasele, Phehello Anthony. "Monitoring and evaluation indicators of the HIV & AIDS programme in Grahamstown's public sector health care system." Thesis, Rhodes University, 2011. http://hdl.handle.net/10962/d1003248.
Full textAbstract:
South Africa is one of the countries hardest hit with the Human Immunodeficiency Virus (HIV) and Acquired Immuno Deficiency Syndrome (AIDS) epidemic. In response to the epidemic, the South African government adopted the Comprehensive HIV & AIDS Care, Management and Treatment programme strategic plan (CCMT) in 2000 (1) and developed the Operational Plan for CCMT for antiretroviral therapy rollout in 2003 (2). In order to monitor the progress of the implementation of CCMT, the National Department of Health (NDOH) adopted the Monitoring and Evaluation (M & E) framework in 2004 (3). The aim of this study was to assess the HIV & AIDS programme in Grahamstown‘s public sector health care system by using the national M & E indicators of the HIV & AIDS programme. The national M & E framework was used as the data collection tool and available information was collected from various sources such as the District Health Office (DHO), Primary Health Care (PHC) office, accredited antiretroviral sites and the provincial pharmaceutical depot. Group interviews were conducted with key stakeholder health care professionals at the District Health Office, Primary Health Care office, Settlers Hospital and the provincial Department of Health personnel. A one-on-one interview was conducted with the Deputy Director of HIV & AIDS Directorate, monitoring and evaluation in the National Department of Health. Available indicators such as budget and expenditure including antiretroviral procurement; human resources; nutrition-related indicators; prevention care and treatment indicators were collected. A group interview was conducted to document current practices, or where there was a lack of documentation, for indicators such as traditional medicines and pharmacovigilance. Most of the national M & E indicators are not required to be collected or collated by the district because the reporting format designed by the provincial Department of Health is different. Facilities, districts and provinces in South Africa are at different levels of implementation of the antiretroviral programme and hence a common format of the M & E indicators is not used by all provinces. Uniform data collection is not achieved due to human resources‘ constraints and other challenges such as continued use of manual reporting systems by the clinics. Districts are expected to report according to the formats drawn up by the provincial Department of Health (DOH) and there is a lack of awareness regarding the national M & E document amongst the Grahamstown Health Care Professionals. There is a need for training on the use of the M & E national framework so that the HCPs at the primary and secondary levels of the health care system are proficient with the process of M & E, and can provide inputs as well as take ownership of the process. The establishment of an M & E unit in Grahamstown is essential so that data collection and submission of the HIV & AIDS programme in the public sector according to the National M & E framework is addressed. However, despite all constraints and challenges in the public sector health care system in Grahamstown, available human and financial resources are being used effectively to maintain the HIV & AIDS programme.
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Sondlane, Johan Senias. "The role of community health workers in the HIV/AIDS Programme." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/3015.
Full textAbstract:
Thesis (MPA (School of Public Management and Planning))--Stellenbosch University, 2008.The role of Community Health Workers (CHWs) in the HIV/AIDS Programme is directly dependent on the support systems provided by nurses, NGOs, the community, institutional frameworks, and government funding and stress management institutions. The Home-based caregivers that work in the HIV/AIDS Programme are CHWs who need maximum support from the above- mentioned institutions. The community is also reeling with the aggravating consequences of HIV/AIDS. CHWs play a role in trying to take care of the HIV patients within the home environment. People are cared for by the people they associate with and people who live with them. In order for CHWs to maximise their contribution to the HIV/AIDS Programme, there should be commitment from all stakeholders involved in the programme. Forty-one people from formal and non-formal structures took part in the study. The formal structures refer to clinics and hospitals, whereas informal structures refer to Home-based care (HBC) groups, volunteers, NGOs and international donor agencies. The study was conducted over a period of eight weeks. The study was conducted at Cork, Calcutta and Mkhuhlu clinics, and Mkhuhlu Home-based care and on USAID field officers. The results of the study suggested that with support systems from the relevant institutions, CHWs are able to carry their community obligations in an effective and efficient manner. These findings have positive relationship implications towards the reduction of HIV infections in the community. Hospitals that are faced with overcrowding also benefit in a way, when terminally ill patients are cared for at HBC centres.
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Joseph, Vanessa Belinda. "Care, caring and coping: attitudes of children orphaned by HIV/AIDS and their caregivers towards schooling in a South African Township." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_2383_1256282262.
Full textAbstract:
In many countries, the scale of poverty, and the alarming number of children now being orphaned by HIV and AIDS, has increased the roles and responsibilities of grandparents as caregivers in their grandchildren's lives. Not only do grandparents have to care for their grandchildren on a daily basis but they also carry the burden of seeing them through school, possibly with the fear that they might not be able to see them achieve all their dreams. This study examined the complex issues surrounding school attendance for orphaned children in Mbekweni, a township in the Western Province, in South Africa. The study explored the relationship between the attitudes of orphaned learners and their caregivers towards education and schooling itself, uncovering the struggles and the strengths of caregivers and orphaned children that directly relate to success or faiolure in school.
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Mashele, Steven Charles. "Psychosocial care of people living with HIV : the case of Tzaneen, South Africa." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/19978.
Full textAbstract:
Thesis (MCur)--Stellenbosch University, 2012.ENGLISH ABSTRACT: The overall objective of this study was to ascertain whether lay counsellors offer psychosocial counselling to clients at antiretroviral therapy clinics. The study was conducted at two clinics in the Greater Tzaneen municipality, Limpopo province, South Africa. The sample of 14 consisted of seven female lay counsellors and seven HIV positive clients, three females and four males, at Xihlovo and Nyeleti antiretroviral clinics. They were interviewed using 11-item and 12-item interview guides, respectively. Interviews were conducted in the local languages. Qualitative data were collected for the study. The data were audiotaped, translated, transcribed and then categorised into a thematic framework. HIV positive participants were found to be suffering from psychosocial consequences of living with HIV, such as shock, denial, anger and blame, fear of death, fear of disclosure, and intimate-partner violence. However, lay counsellors did not offer effective counselling that could relieve the psychosocial consequences. They instead used religion to console clients, discouraged clients from expressing their feelings, and minimised their clients’ concerns. It is recommended that lay counsellors be taught basic counselling theories as part of their training so that they are better able to screen their clients for psychosocial problems and provide basic counselling.
AFRIKAANSE OPSOMMING: Die algehele doelwit van dié studie is om te bepaal of leke-beraders psigo-sosiale berading aan kliënte by die die anti-retrovale terapie klinieke bied. Kwalitatiewe data is vir dié studie versamel. Die studie is by twee klinieke in die groter Tzaneenmunisipaliteit in Limpopo provinsie in Suid‐Afrika gedoen. Die eksperimentele groep van 14 het bestaan uit sewe vroulike leke-beraders en sewe MIV-positiewe kliënte: drie vrouens en vier mans, by Xihlovo en Nyeleti anti-retrovale klinieke. Daar was onderskeidelike onderhoude met hulle gevoer en die 11-item en 12-item onderhoudriglyne is toegepas. Onderhoude is in inheemse tale gevoer. Die data was opgeneem, vertaal, getranskribeer en in 'n tematiese raamwerk vasgevang. Daar is gevind dat die MIV-positiewe persone negatiewe psigo-sosiale gevolge ervaar: skok, ontkenning, woede, blaam, vrees vir die dood, vrees dat hul status openbaar sal word, asook geweld binne hul verhoudings. Leke-beraders het egter nie doeltreffende berading gegee om bogenoemde psigo-sosiale gevolge te verlig nie. Hulle het eerder godsdiens gebruik in 'n poging om hul kliënte te vertroos, nie die kliënte aangemoedig om hul gevoelens uit te druk nie en hul gevoelens en kommer afgemaak. Daar word aanbeveel dat leke-beraders basiese beradingsteorie as deel van hul opleiding ontvang sodat hulle psigo-sosiale probleme in hul kliente kan uitken en beter basiese berading kan verskaf.
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Munthali, Spy Mbiriyawaka. "An institutional analysis of community and home based care and support for HIV/AIDS sufferers in rural households in Malawi." Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1002719.
Full textAbstract:
Standard economic models often emphasize inputs, outputs and an examination of the structures in order to conduct an economic performance evaluation. This study applies the Institutional and Development Framework (IAD) in the broader context of New Institutional Economics (NIE) in order to examine the transaction costs of delivering Community and Home Based Care and Support (CHBC) to HIV/AIDS sufferers. For purposes of unveiling the empirical reality guiding decision making processes in the CHBC service delivery, comparative qualitative research techniques of normative variable and concept formation have been adopted to draw out the relative institutional influences from the HIV/AIDS national response partnerships. The study identifies the conflict between the predominantly standardized and more rigid formal management techniques adopted by key members of the national response and the informal cultural techniques familiar to the rural communities, and a lack of motivational incentives in the CHBC structures as the key factors against CHBC capacities to draw external funding for service delivery. CHBCs are also weakened by incoherent governance structures at the district level for facilitation of funding and information flow exacerbating the community vulnerability. Rationalization of the institutional arrangements and a clarification of roles from district to community levels, a shift of focus to facilitation of informal techniques and an integration of performance enhancing incentives are the critical policy insights envisaged to spur CHBCs to work better.
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Benoite, Umubyeyi. "Exploring depression among people living with HIV/AIDS and attending a primary health care centre in Kigali, Rwanda : a descriptive, cross-sectional study." Thesis, 2010. http://hdl.handle.net/10413/893.
Full textAbstract:
HIV is major public problem in the world and in Sub-Saharan Region in particular. The literature
has shown that mental disorders and particularly depression are common among people living
with HIV/AIDS, but that little is known about the prevalence of depression and factors
associated with it, among people living with HIV/AIDS in Rwanda.
A descriptive, cross-sectional study was done to assess the prevalence of depression, the clinical
profile and the factors associated with depression among people living with HIV and attending a
primary health care centre in Kigali-Rwanda. This study was informed by the stress and
vulnerability framework. A questionnaire was used to collect socio-demographic and HIV
related medical information, while depression was assessed using the Beck Depression Inventory
Scale, with a cut off of less than 10 for no depression and above 10 scoring positive for
depression. Respondents were randomly selected from the patient appointment list for patients
who were scheduled during the period of data collection and according to the sample selection
criteria. The sample consisted of 96 people living with HIV. Permission to conduct the study was
requested and obtained from the University of Kwazulu-Natal Ethics Committee, from the CNLS
Research and Ethics Committee in Rwanda and from the management of the health care centre to
consult patients' files.
Data was analyzed using the Statistical Package for the Social Sciences (SPSS for window, 15).
Descriptive data was analyzed by means of frequencies, mean and standard deviation. Cross
tabulation using Pearson' chi-square test was performed to test the association between sociodemographic
factors and HIV related medical information and depression for categorical
variables, while t-test for independent simple test was performed for continuous variable. Multi
logistic regression analysis was performed to test further association between the above
mentioned factors with depression, while controlling for confounders. The results were presented
by means of tables, histograms and graphs.
The findings of the study revealed that depression is very high among HIV-infected patients
attending a primary health care centre in Kigali, with a prevalence of 41.7%. The most frequent
depressive symptoms presented were pessimism, fatigability, sad mood; lack of satisfaction,
somatic preoccupation, loss of libido, crying spells, work inhibition, irritability, social
v
withdrawal and loss of appetite. The majority of respondents scored mild to moderate
depression, whereas few had moderate to severe depression and only very few scored severe
depression. Having considered all other socio-demographic and HIV related medical factors that
were studied, being a female, having presented many HIV-related symptoms in the month prior
to data collection, and having less than 250 CD4 counts were statistically associated with
depression. On the other hand, having high social and family support was a protector factor to
depression.
Although the results of this study are not generalizable to the Rwandan population living with
HIV, they underscore the importance of integrating mental health in HIV/AIDS services for the
care of those who present mental problems related to HIV such as depression.Thesis (MN)-University of KwaZulu-Natal, Durban, 2010.
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Sliep, Yvonne. "Care-counselling model for AIDS patients in rural Malawi." Thesis, 2014. http://hdl.handle.net/10210/10253.
Full textAbstract:
D.Cur. (Psychiatric Nursing)Malawi has a population of 9 million people with AIDS the leading cause of death in the age group of 20 • 40. The HIV prevalence rate, estimated at 23% in urban areas and 8% in rural areas, is one of the highest in the world (AIDSEC, 1994: I). Evaluation of counselling practices showed poor results with counsellors feeling ineffective and inadequate. Patients are mostly tested on medical indication but testing is increasingly refused by patients who do not see the benefit of knowing their HIV status. The counselling practice as it is known in the Western world is a foreign concept for patients living in rural Malawi. The high stigma of AIDS complicates support of the patients. The goal of this research study is to describe a model of counselling that would meet the needs of an AIDS patient in a rural community in Malawi. A qualitative research design that is explorative, descriptive and contextually specific to rural Malawi was used for the study. In order to describe a counselling model it was important to understand the illness experience of HIV reactive patients. The patients are seen in group context congruent with the African culture and therefore the experience of the primary care giver of AIDS patients is also examined. The experience of counsellors of AIDS patients is explored as the other major factor in the phenomenon examined. In the first phase of the study in-depth phenomenological interviews were conducted with identified groups. Focus interviews were conducted with a hundred AIDS patients to identify the needs and resources of the patients and to compile a demographic profile. Focus group discussions were conducted with counsellors for more complete comprehension. Data analysis and a literature control were undertaken. In the second phase of the study theory generation was used in order to develop a counselling model for AIDS patients and guidelines for implementing the model were generated. Based on the results of the analysis the major concept enable was identified as the essence of a model for counselling AIDS patients in rural Malawi.
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Uwizeye, Glorieuse. "An analysis of the mental health of families affected by HIV/AIDS in Rwanda." Thesis, 2004. http://hdl.handle.net/10413/9009.
Full textAbstract:
HIV/AIDS is no longer seen as an individual problem as it also affects the family as a
whole. The purpose of this study is to purpose of analysing the mental health of family
affected by HIV/AIDS in Rwanda. It should be noted that there were not studies
conducted on the mental health of the affected families in Rwanda.
A qualitative approach using case study design was used to describe the mental health
of affected family in Rwanda. HIV/AIDS-related stressors, emotional reactions of
family members and coping strategies they adopt to deal with those stressors and
emotional reactions were studied. The effects of those reactions and strategies on the
infected family member as well as the entire family were analysed. A purposive
sampling was used to select two families from Mwana Ukundwa Association for the
study.
The findings of the study showed multiple losses, care, and socio-economic demands as
the main stressors for both cases. Emotional reactions to those stressors included shock,
anger, sadness, hopelessness, depression, fear and shame. Participants reported using
both emotional and problem-focused coping strategies. Compassion, caring and
showing concern had positive effects on the infected and affected as well as family
members, whereas emotional reactions such as anger, unhappiness, and discouragement
had negative effects on the entire family. Positive effects of family reactions and
strategies to cope were associated with coping strategies such as; having opportunity to
talk: to someone, distraction, family relationships, spiritual support, treatment, and
socio-economic support. Ineffective strategies included family communication
dysfunction due to withdrawal behaviour, alcohol abuse and going to nightclubs. These
strategies had negative effects on both infected and affected family members.
The results suggest that health professionals such as nurses, doctors and other healthcare
providers should use a holistic approach in caring for infected family members.
They should not only provided family care, but also include the family in planning to
care for the infected family member. This will empower them to play a more effective
role in home care-based.Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2004.
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Ntsuntswana, Vuyokazi. "HIV/AIDS and home-based care: experiences of patients and households." Thesis, 2008. http://hdl.handle.net/10210/676.
Full textAbstract:
M.A.The challenge of HIV/AIDS is a global issue, instead of decreasing the number of people infected with the disease the number is increasing. Fortunately we have men and women who are volunteers to fight the increase of this pandemic. These heroes are the voluntary caregivers who are the mainstay of people with AIDS. However the fact that the caregivers suffer from loneliness and social isolation related to stigma and discrimination cannot be ignored. Voluntary caregivers can benefit form the opportunity to express basic emotions concerning, financial, emotional and physical issues and open line of communication should be in place. Providing an avenue foe emotional expression may enhance both physical and mental health to voluntary AIDS Caregivers. The qualitative study undertaken to explore the experiences of AIDS patients and their families regarding the home based care as service delivery. An explorative and qualitative design was used to determine the experiences of the AIDS caregivers, and aids patients concerning the support that they receive. AIDS patients and the families were selected from the organisations that are funded by the Department of Social Development in the Free State, Bloemfontein area. Pilot study was conducted prior to the commencement of the study comprising of ten participants in each group. Participants were requested to give information during the interviews. Data was collected and analysed and it was in followed by the literature control. The findings did not differ significantly in emotional and social aspects. The researcher drew conclusion and recommendations. Limitations were discussed.
Dr. Oliphant Ms. A. Vermeulen
M.A.