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).<br /> <br /> 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.<br /> <br /> 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. <br /> <br /> 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.

This dissertation, employing an array of theoretical approaches under the rubric of Systems Thinking, explores the reality and experiences of family members that mainly provide care at home for their loved ones who live with or are directly affected by HIV & AIDS. Employing a multidisciplinary approach, the dissertation demonstrates how Systems Thinking, feminist and indigenous knowledge principles can be employed for a better understanding of the contemporary construction of family and experiences of caregivers in an HIV & AIDS context. The discussion of the dissertation is based on data analysed following in-depth interviews with fifteen caregivers of the Bhambayi community. The findings of the study reflect a significant change in the definition and practice of parenting. It was found that HIV & AIDS forces a re-definition of the concept and practice of parenting beyond the traditional boundaries of age, sex and gender. Aligned with this main finding was that parenting practices and coping strategies are largely influenced by a strong commitment to the well-being of the children as well as societal constructs. The thesis of this dissertation is that the HIV & AIDS context and associated gender and cultural stereotypes are principally responsible for a significant shift in the understanding of the concept and practice of parenting within an African context. The study thus submits that a Systems Thinking approach ought to be used by interventionists to better understand and thus contribute towards improving the lives of families or communities in similar circumstance as that of the Bhambayi families. / Thesis (M.Com.)-University of KwaZulu-Natal, Westville, 2009.

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).<br /> <br /> 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.<br /> <br /> 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. <br /> <br /> 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.

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

Thesis (DTh (Practical Theology and Missiology))--University of Stellenbosch, 2005. / The basic premise of this study is that the congregation is the key to providing homebased pastoral care support to HIV-positive people in poor contexts. In so doing, the church does not only perform a social function to poor HIV/AIDS-affected families, but it also acts in accordance with the calling of mediating God’s Kingdom (diakonia), thus spreading the gospel, and showing unconditional sacrificial love and compassion. The Church embodies the gospel, which is the instrument of hope and salvation to despairing HIV/AIDS-people in the community.

HIV/AIDS is a global challenge and its impact is evident. This places a burden on hospitals and health professionals. To ease this burden there are home-based care programmes which, through home-based caregivers, provide patients living with HIV/AIDS with physical and palliative care. However, these HBCGs face various challenges such as poverty, discrimination and stigma when caring for PALHIV, and their own emotional strain, which becomes burdensome without sufficient support from the home-based care centre. The qualitative study undertaken investigates the challenges and coping mechanisms of the HBCGs. Thirteen research participants were drawn from a centre in Mamelodi. Data was gathered through interviews and observations, categorised into themes and analysed. Major findings revealed that social challenges faced by HBCGs include poverty, stigmatisation and discrimination. Emotions experienced by HBCGs include guilt, anger, hopelessness, but they have spiritual reliance through prayer as one of their coping mechanisms. / Sociology / M.A. (Social Behaviour Studies in HIV/AIDS)

Volunteer caregivers provide essential services to people in the terminal stages of AIDS and their families. Volunteers are exposed to stress and burnout. This study investigated the relationships between stress, coping strategies, levels of burnout and resilience in this population. Volunteers from Societas ‘O Sosiale (SOS) Children Villages and community based organisation (CBO) partnerships, were selected using non-probability purposive convenience sampling. A total of 110 participants were given the Experience of Work and Life Circumstances Questionnaire (WLQ), Brief-Cope, Maslach’s Burnout Inventory (MBI), a Resilience scale and the Living Standard Measure to complete. Statistical analyses were performed on the data. This includes descriptive statistics, reliability analysis, factor analysis, correlations and multivariate analysis of variance. The study found that volunteer caregivers experience high stress levels and burnout related to stressors outside work, remuneration, personnel policies and high resilience. High burnout is associated with all forms of coping. Further it is shown that training in problem-solving skills, counselling, government and public lobbying for support, registration with relevant professional bodies, furnished offices, reasonable recruitment requirements and compensation are needed to help the care givers avert the effect of stressors and control stress by stopping it from turning to burnout. / Psychology / M.A. (Psychology - Research Consultation)

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.

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.

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.