South Africa has one of the highest country HIV/AIDS statistics in the world. The large number of ill individuals has created an unprecedented care work crisis in the country. In the absence of an adequate state supported care work response, the task of caring for people living with HIV/AIDS has fallen on community members. Under-resourced communities often do not have the capacity to engage in such intensive care work, and this shift has resulted in deleterious emotional, physical and financial consequences. This study sought to create greater understanding of the support available and accessible to friends and family members who serve as informal carers of people living with HIV/AIDS. Methodologically, this is a qualitative study. Nine participants from KwaNgcolosi, a periurban area in KwaZulu Natal, were interviewed. A semi-structured interview schedule was directed to elicit participants’ perceptions of the support that is available and accessible to them. Data was thematically analysed. Perceptions of support were understood in the context of the elements of social capital, namely trust, reciprocity, norms and networks, as well as the sociological strata in which these elements function, the bonding, bridging and linking levels. Findings suggest that informal carers perceive low levels of support. Participants reported poor support from local community and extra-community members which include friends and family members, local political and traditional leadership and leadership at a governmental level. Low levels of social capital exist in the community evidenced by lack of reciprocity, norms that isolate the carer, mistrust, lack of control over resources, and weakened networks which inhibit the participants’ pool of human resources. Stigma, discrimination and conditions of extreme poverty were major impediments to the availability and accessibility of beneficial social capital and thus the social support inherent in it. On the converse, the home-based carer (HBC) emerged as the strongest source of assistance to informal carers. The support reportedly received by the HBC 6 include emotional, instrumental and informational assistance. However, these contributions were insufficient, evidenced by the testimony from all participants that they were still experiencing extreme hardships in their care work. The findings suggest that development, project and policy initiatives should focus on empowerment, greater involvement of all stakeholders ranging from individual community members to government policy makers, greater networking and participation and finally that there should be greater investment in the HBC and the informal carer in terms of resources and capacity building. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

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

Background: Despite the prevalence of HIV/AIDS stabilizing and slightly decreasing in certain provinces, there are a number of People Living With HIV/AIDS (PLWHA) in South Africa. Many people seek help at primary health clinics and hospitals and receive chronic care at these facilities. Caring for these chronic patients and new patients entering the health system can be stressful to the health professionals who are involved. Many studies that have been conducted have focused on the clinical aspects of individual patients, while few studies have focused on the experiences and stressors of health professionals looking after PLWHA. To ensure quality of care for patients with HIV/AIDS, it is important to understand the experiences of health professionals looking after HIV/AIDS patients and how stressful experiences may influence their attitude towards these patients. Aim: The aim of this study is to report the factors health professionals perceive as occupational stressors caring for people living with HIV/AIDS in the public health sector of the Nelson Mandela Metropolitan Municipality. Research design and Methodology: A quantitative, descriptive and non-experimental research design was followed. A pilot study was conducted to determine the clarity of questions, effectiveness of the instructions, completeness of the response sets, the time required to complete the questionnaires and the success of the data collection. The primary method of data collection was self-administered questionnaires. The questionnaires were dispatched to 30 health professionals at the public health facilities in the Nelson Mandela Metropolitan Municipality. A descriptive statistical analysis was done using a Statistical Package. This revealed the following findings. Findings: The following are the findings that were perceived to be occupational stressors: organizational factors, job design factors, career and promotional factors, role-related factors and cultural factors. iv Conclusion and recommendations: There are occupational stressors that affect health care professionals working in an HIV/AIDS setting. The following are the recommendations to rectify or to improve the situation: • Improve the communication of goals and objectives; • Redesign the job; • Human-resources development ; • Improvement of salaries; • Career planning and mentoring; and • Sensitisation of employees to cultural differences.

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.

Thesis (MPH.) -- University of Limpopo, 2015 / Background: The introduction of Antiretroviral Therapy (ART) has shown a tremendous reduction in HIV-related mortality and morbidity in people living with HIV / AIDS. Adherence to ART is the key to a successful treatment outcome. This study investigates the adherence of people living with HIV who are on ART. Since high levels of adherence of more than 95% are required to achieve effective suppression of the viral load, the researcher finds it very important to establish whether the people are pursuing what is expected of them. While the use of ART has brought much excitement and hope to both patients and medical practitioners in the world, it has also brought many new questions and challenges, including adherence issues. Adherence is, therefore, essential to achieve the success of ART. Aim: The main objective was to determine which factors influence adherence to ART among HIV and AIDS patients. Methods: This study utilised a quantitative cross-sectional descriptive design that was conducted at the Kwa-Thema Clinic, Ekurhuleni District, Gauteng Province. Data was collected using a structured questionnaire with open- and closed-ended questions where a total of 290 respondents were interviewed. Data was analysed using SPSS software version 22 and the analysed data was presented by means of charts, graphs, and frequency tables. Results: The findings indicated that the adherence to ART at the Kwa-Thema Clinic was 77%. Factors that were significantly associated with adherence were gender ((χ2 = 3.78, df = 1, p < 0.05).), level of education ((χ2 = 3.52, df = 3, p = 0.032), co-treatment of HIV and other infections (χ2 = 5.46, df = 4, p = 0.019).), ability to follow ART ((χ2 = 12.82, df = 1, p = 0.000 < 0.05), and types of ARV drugs. Recommendation: To enhance ART adherence the study recommends intensification of health education campaign against stigma and gender discrimination. Providing feedback to the patients by the healthcare providers regarding the benefits of ART is important. ix Conclusion: It was concluded that the adherence to ART at the Kwa-Thema Clinic was sub-optimal (less than 95%) at 77% but comparable to the adherence levels in other developing countries.

Background. Meaning of working studies suggest that working, beyond providing an opportunity to make money, contributes to an employee’s identity, fulfilment, self-esteem and other important psychological needs. The Meaning of working model offers one approach to explore how social and cultural norms shape what work means to individuals. The current study is situated within in the context of the recent global financial crisis which has caused turmoil in many organisations including those in the non-profit sector. The study explores the meanings workers in AIDS care non-profit organisations in the midst of the crisis and the subsequent socio-economic context. Aim. This is an interpretative phenomenological study which aims to explore how workers in AIDS care organisations make sense of their work within a unique socio-economic context occasioned by the financial crisis. Method. The study was conducted in semi-rural areas and townships of Durban Metropolis and the vicinity. Using a snowballing technique, project managers, HBC facilitators and a nurse (N=14) were recruited and interviewed using a topic guide containing semi-structured questions drawn from Westwood and Lok (2003) MOW model. Findings. Findings suggest that due to the financial crisis these organisations have undergone restructuring causing them to apply various strategies including social entrepreneurship strategies in order to survive. It was also found that participants generally regard working as central to their lives and complementary to other important life roles due to the fundamental nature of AIDS care work being linked to religion, community and family. Findings also caution that due to the high value they attach to working, there are various negative consequences for worker’s well-being and health which should be considered by health care policy makers. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

More than three decades after the outbreak of the AIDS pandemic, sub-Saharan Africa is home to the largest epidemic in the world. Over 70% of infected people live in this region and are aged 15–49 years. Given that it is at this age that young adults are more likely to start families, their death as a result of AIDS gives rise to the crisis of AIDS-orphaned children. Several studies show that the number of AIDS orphans is on the rise and can reach up to 18 million throughout the continent. Generally, patients expect to be admitted in formal health care facilities for adequate treatment but the absence of cure and an increasing number of infected make it difficult for them to be treated as in-patients. In order to fill the gap, the elderly care for AIDS patients and take on the parenting role of AIDS orphans. However, there is not much information on the implications of caregiving on the well-being of the elderly. This dissertation aims at shedding light on this issue – using data from an informal settlement in the province of KwaZulu-Natal – in order to highlight the risks to the health of elderly caregivers. The elderly are the primary caregivers to thousands of AIDS patients and AIDS-orphaned children across sub-Saharan Africa. Their caregiving activities are strenuous and repetitive on a daily basis. Through qualitative data collected from 14 elderly caregivers, this project found that their well-being was compromised by several caregiving activities and the expectations placed upon them were unbearable. The vulnerability of caregivers was emphasized by the high number of dependents that resulted in lowered standard of living. There was also the risk of contracting HIV during caregiving since the elderly were not able to afford protective equipment. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

The onset and rapid spread of the HIV/AIDS pandemic in Sub-Saharan Africa has challenged and continues to challenge the church in its doctrine as well as its practical ministries. The Evangelical Lutheran Church in Namibia has been no exception. The disease challenges the theological and pastoral disciplines, especially in the area of contextuality. This thesis is developed at the very site of the struggle to care for the infected and affected individuals and families in the ten Evangelical Lutheran Church parishes in the Oshana Region, Namibia. Healing and caring for the sick is the primary mission of this church. Therefore, the quest of this study is to investigate how ELCIN through pastoral care and counselling helps HIV/AIDS infected and affected family members cope with their situation. The study concentrated mainly on ten ELCIN parishes in the Oshana Region, Namibia. Chapter one is an introduction to the whole thesis. Included is the statement of the problem, the methodology used to collect data and the literature review. Chapter two deals with pastoral care and counselling of HIV/AIDS infected and affected families. The African understanding of heath and illness is also considered as well. Chapter three is about the Church and HIV/AIDS in the Oshana Region, Namibia. This chapter investigates the responses of ELCIN's pastors towards HIV/AIDS affected families in the Oshana Region, and how they understand HIV/AIDS biblically. Chapter four deals with the impact of HIV/AIDS on affected families in Oshana Region, Namibia. This chapter discusses how HIV/AIDS affects the family members, nurses, and community ministers and how pastoral care and counselling help the widowers, widows, orphans, caregivers of orphans and nurses to take care of orphans. This is the main chapter of this thesis. Chapter five is about data analysis, recommendations and research findings using the Christian theoretical framework of Mwaura, van Dyk, Msomi, Snidle and Welsh, and Dube. Chapter six is the conclusion of the whole thesis. / Thesis (M.Th.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.

This study explores the challenges posed by the HIV-AIDS epidemic on the Holiness Union Church leadership in Pietermaritzburg KwaZulu-Natal: towards a holistic Pastoral care model. South Africa has the highest prevalence rate of HIV infection in Sub-Sahara Africa and the province of KwaZulu-Natal is the epicentre of the epidemic. This motivated the researcher to investigate the role of the HUC-PMB leadership in the struggle against the HIV-AIDS epidemic within and outside the Church. The Church leaders in this context of the HIV-AIDS are expected to play a significant role, so that the campaigns of HIV prevention, intervention, care and support for those living with the HIV-AIDS should have positive impact in the Church and the community. The literature review argues that this can be achieved when church leaders are well trained and equipped with all necessary skills and acquire comprehension information about the HIV-AIDS. The study adopted an empirical research using qualitative using interview schedule, focus group discussion and church archives for data collection. Five Church leaders and four church members participated in the study. The investigations were led by the following research question: What are the challenges posed by the HIV-AIDS epidemic on the HUC leadership in Pietermaritzburg KwaZulu-Natal? In order to address the main question of this study, the following questions were formulated. What is the current situation of the HIV-AIDS epidemic in the HUC-PMB? How is the HUC-PMB leadership response to the HIV-AIDS epidemic? What kind of Pastoral care model that would enhance the HUC leadership holistic response to the HIV-AIDS epidemic? The study findings show that the Church leaders at HUC-PMB do not officially engaged in the struggle against the HIV-AIDS epidemic in the church and in the local community. This implies that the HUC-PMB has limited spiritual and support work for those who are HIV infected and affected within and without the church. The study thus recommends that knowledge on the HIV-AIDS epidemic is vital to all people especially the church leaders; and the church must use its pastoral approach to pursue this goal; the leaders must be thoroughly educated and equipped on the HIV-AIDS related issues, so that to be able to minister (w)holistically in the light of the HIV-AIDS epidemic; the Church and its leaders is also recommended and called to be HIV-competent in terms of their belief approach in dealing with epidemic and stigma within and outside the church context. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

The aim of the study was to gain an understanding on the experiences of enrolled nurses with regard to caring for people living with HIV and AIDS in one of the rural hospital in Vhembe district, in order to make recommendations for guiding and supporting those enrolled nurses. This study followed qualitative approach using interpretative phenomenological analysis design. Data were collected from 11 purposively selected participants using semi structured interviews. Data were analysed using interpretative phenomenological analysis framework for data analysis. Three super-ordinate themes emerged from data analysis namely: resources, support and impact of working with HIV positive patients. The study revealed that enrolled nurses are failing to provide proper care to people living with HIV and AIDS due to inadequate resources and lack of support. This situation has negative impact on the health of enrolled nurses providing care to people living with HIV and AIDS. Recommendations are put forth to improve resources, enhance support and for mitigating impacts experienced by enrolled nurses when caring for people living with HIV and AIDS at a rural hospital in Vhembe district of Limpopo province. / Health Studies / M.P.H.