Thesis (Ph.D.(Educational Psychology))--University of Pretoria, 2008. / Includes bibliographical references.

Thesis (M. Communication Pathology)--University of Pretoria, 2004. / Includes bibliographical references.

Thesis (M. Communication Pathology)--University of Pretoria, 2006. / Summary in English and Afrikaans. Includes bibliographical references.

A quantitative, descriptive, explorative survey was conducted to explore and describe nurses’ perceptions of disclosure to children of their HIV positive status in Addis Ababa. 100 nurses working in six conveniently sampled health centres participated by completing a self-administered questionnaire. The findings revealed that the majority of participants were of the opinion that children have the right to know their HIV status, participate in their own treatment, and that disclosure contributes towards improved adherence. Forty-one of the participants said that it is nurses’ role to support caregivers in the disclosure process. But 56.3% felt they lacked the training to disclose to children that they are infected with HIV. Accordingly, it is recommended that relevant and applied training is required to equip nurses with the knowledge and skills to disclose to children their status. The importance of nurses’ proactive role in disclosure to children of their HIV status needs to be emphasised. / Health Studies / M.A. (Public Health)

Thesis (M.Sc. (Environmental Science)) - Rhodes University, 2008.

Made available in DSpace on 2016-08-19T18:16:09Z (GMT). No. of bitstreams: 1 margareth jamil maluf.pdf: 274360 bytes, checksum: 1e5a674a4b59a8cbedc63088a789de2a (MD5) Previous issue date: 2007-09-13 / Vertical transmission constitutes the main via for children infection by the HIV-1 virus (Human Immune Deficiency Virus), which is responsible for about 80% to 90% of AIDS cases (Acquired Immune Deficiency Syndrome) in children from Brazil and worldwide. Vertical transmission became the main prophylaxis target with the ACTG 076 Protocol (AIDS Clinical Trial Group), which implicates the use of Zidovudine during the pregnancy, delivery and newborn. This research aimed at studying the laboratory and clinical evolution of children born from mothers acknowledged as HIV + infected, at the HIV/AIDS pediatric Specialized Assistance Service of the Hospital Materno-Infantil da Universidade Federal do Maranhão, highlighting the report on the use of the ACTG 076 Protocol, from January 1998 to June 2006. Information were obtained from the medical chants, through the protocol form with data related to the identification, laboratory and clinical evolution of 181 selected children via the inclusion criterion (born from mothers known to be HIV /AIDS infected that had their case diagnosis defined during the follow-up until June 30, 2006). In 36.5% of the mothers the diagnosis was done after delivery, the ACTG 076 Protocol was not used in 54.7% of the cases during pregnancy or delivery, and 49.2% did not use the protocol during the newborn period. Vaginal delivery occurred in 40.3% of the mothers and breastfeeding was practiced by 38.1% of the babies. The use of the full ACTG 076 Protocol (in all of the prescribed stages) was observed in 15.5%; partial usage of the protocol was conducted just with the newborns in 5.5%; partial usage just during pregnancy and/or delivery occurred in 1.1%, and the incomplete use was observed in 23.7%; 45% did not use the protocol in any of the prophylaxis stages. Out of the babies who had AIDS (41.9%), one could observe that 12.1% of the cases were classified in the clinical class A; 13. 7% in the class B and 10% in the class C, and they evolved with a variety of signs and symptoms, whose the most frequent were: hepatomegaly, splenomegaly, adenomegaly, neuropsychomotor development delay, and infection of the upper respiratory tract. The anti-HIV ELISA, the viral load determination, and the T CD4+ Lymphocytes counting were not routinely performed in many cases, at the first medical consultation. Infection diagnosis was mainly done by ELISA and, then, by confirmatory lab tests, without determining the viral load. The lymphocytes counting was restricted to classify the AIDS cases and to the follow-up treatment. Thus, in our study, several relevant factors were observed that demonstrate great improvements in the reduction of HIV vertical transmission, but also advise the importance of the continuous maintenance of intervening actions, principally with the organizational improvement of the reference services for clinical attendance and the conduction of laboratory exams. / A transmissão vertical constitui a principal via de infecção infantil pelo vírus HIV-1 (Vírus da Imunodeficiência Humana) e é responsável por cerca de 80% a 90% dos casos de AIDS (Síndrome da Imunodeficiência Humana Adquirida) em crianças no Brasil e no mundo. A transmissão vertical tornou-se o principal alvo da profilaxia com o Protocolo ACTG 076 (AIDS Clinical Trial Group), que implica na utilização da Zidovudina durante a gestação, parto e recém nascido. A presente pesquisa tem como objetivo estudar a evolução clínica e laboratorial de crianças nascidas de mães HIV Positivas, no Serviço de Assistência Especializada para HIV/AIDS Pediátrico do Hospital Universitário Materno Infantil - da Universidade Federal do Maranhão (UFMA), destacando-se o relato de uso do Protocolo ACTG 076, no período de janeiro de 1998 a junho de 2006. Foram coletadas informações dos prontuários, através de ficha protocolo com dados relativos à identificação, evolução clinica e laboratorial de 181 crianças selecionadas pelos critérios de inclusão (filhos de mães sabidamente HIV /AIDS e que tiveram definição de caso ao longo do seguimento até 30 de junho de 2006). O diagnóstico materno se deu após o parto em 36,5% dos casos, sendo que em 54,7% o protocolo ACTG 076 não foi usado na gestação ou no parto e em 49,2% não foi usado no período neonatal. O parto vaginal ocorreu em 40,3% das mães e o aleitamento materno foi utilizado em 38,1% das crianças. O uso do Protocolo ACTG 076 de modo completo (em todas as fases preconizadas) foi observado em 15,5%, modo parcial apenas no recém nascido em 5,5%, parcial apenas na gestação e/ou parto 1,1% e uso incompleto em 23,7%; 45% não usaram o protocolo em nenhuma das fases de profilaxia. Das crianças que desenvolveram AIDS (41,9%), observou-se 12,1% de casos classificados na categoria clínica A, 13, 7% na categoria B e 10% na categoria C e evoluíram com variedades de sinais e sintomas sendo os mais freqüentes: hepatomegalia, esplenomegalia, adenomegalia, atraso no desenvolvimento neuropsicomotor e infecções de vias aéreas superiores. O ELISA anti-HIV, a carga viral e a contagem de Linfócitos T CD4+ não foi feito rotineiramente em sua grande maioria na primeira consulta. O diagnóstico de infecção foi primordialmente feito a partir do ELISA e de exames confirmatórios, não se contando com a carga viral. A contagem de linfócitos ficou restrita a classificação do caso de AIDS e seguimento de tratamento. Assim, na presente pesquisa, observaram-se vários fatores relevantes que demonstram os avanços obtidos na redução da transmissão vertical pelo HIV, mas alertam também para a importância da manutenção contínua das ações de intervenção, fundamentalmente com melhoria na organização dos serviços de referência para atendimento e realização de exames.

The purpose of this study was to explore the lived experiences of older caregivers of adult AIDS ill children in Umlazi Township in the province of Kwa- Zulu Natal. A qualitative research design which was exploratory was executed with a sample of purposively selected participants who are the members of the organization that provides support to the older caregivers. Data saturation occurred after focus group and in depth individual interview with ten participants. The findings revealed that older caregivers experience lot of challenges which ranges from emotional, physical, financial, psychological, social and time constraints when caring for their adult AIDS ill children .The study further revealed that older caregivers developed a wide range of coping strategies to face their challenging caregiving task and most of the older caregivers utilized positive coping strategies. Recommendations that are described focus on the inclusion and consultation of older caregivers in all decisions and programmes about them. / Appendix C (Interview guide) in English as well as in Zulu / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

The purpose of this study was to explore the lived experiences of older caregivers of adult AIDS ill children in Umlazi Township in the province of Kwa- Zulu Natal. A qualitative research design which was exploratory was executed with a sample of purposively selected participants who are the members of the organization that provides support to the older caregivers. Data saturation occurred after focus group and in depth individual interview with ten participants. The findings revealed that older caregivers experience lot of challenges which ranges from emotional, physical, financial, psychological, social and time constraints when caring for their adult AIDS ill children .The study further revealed that older caregivers developed a wide range of coping strategies to face their challenging caregiving task and most of the older caregivers utilized positive coping strategies. Recommendations that are described focus on the inclusion and consultation of older caregivers in all decisions and programmes about them. / Appendix C (Interview guide) in English as well as in Zulu / Social Work / M.A. (Social Behaviour Studies in HIV/AIDS)

The study investigates the welfare of children in crisis with Unaccompanied Refugee Minors (URMs) from Zimbabwe and the models of pastoral care that are extended to them in a context of HIV and AIDS. URMs are children who have been forced to migrate by the socio-economic and political conditions prevalent in Zimbabwe. Other than the socio-economic and political conditions these children are vulnerable to HIV and AIDS. Many of the children are received at the Central Methodist Church in Johannesburg. They are taken care of by caregivers from Zimbabwe. Some of URMs reside in the Methodist church community centre in Soweto and some reside in the Central Methodist Church building in Johannesburg. This study is done from an African perspective of pastoral care in a context of HIV and AIDS. It seeks to study pastoral care that is organic using the reality of URMs in a context of HIV and AIDS. The Central Methodist Church received URMs as a form of pastoral care, but it is not clear what models of pastoral care are used to care for them. This grounded theory study used data collected through interviews and narrative research (story telling) from 20 URMs and 3 Care givers from Zimbabwe and Bishop Paul Verryn the head of the Central Methodist Church in Johannesburg. Analyzed data was used to describe in detail URMs and their Care givers‟ understanding of pastoral care as well as the models of pastoral care offered to URMs in a context of HIV and AIDS. Finally, the findings lead to a contextual pastoral care model with children in crisis in a context of HIV and AIDS. This study formulated this contextual model as a cultural-gendered pastoral care model with children in crisis in a context of HIV and AIDS. The model was established to develop a practical method to use in practical theology and pastoral care in the care for children in crisis without adult guidance in a context of HIV and AIDS. The results of the study describe the significance of culture and gender in caring for children in a context of HIV and AIDS. / Practical Theology / D. Th. (Practical Theology)

The study investigates the welfare of children in crisis with Unaccompanied Refugee Minors (URMs) from Zimbabwe and the models of pastoral care that are extended to them in a context of HIV and AIDS. URMs are children who have been forced to migrate by the socio-economic and political conditions prevalent in Zimbabwe. Other than the socio-economic and political conditions these children are vulnerable to HIV and AIDS. Many of the children are received at the Central Methodist Church in Johannesburg. They are taken care of by caregivers from Zimbabwe. Some of URMs reside in the Methodist church community centre in Soweto and some reside in the Central Methodist Church building in Johannesburg. This study is done from an African perspective of pastoral care in a context of HIV and AIDS. It seeks to study pastoral care that is organic using the reality of URMs in a context of HIV and AIDS. The Central Methodist Church received URMs as a form of pastoral care, but it is not clear what models of pastoral care are used to care for them. This grounded theory study used data collected through interviews and narrative research (story telling) from 20 URMs and 3 Care givers from Zimbabwe and Bishop Paul Verryn the head of the Central Methodist Church in Johannesburg. Analyzed data was used to describe in detail URMs and their Care givers‟ understanding of pastoral care as well as the models of pastoral care offered to URMs in a context of HIV and AIDS. Finally, the findings lead to a contextual pastoral care model with children in crisis in a context of HIV and AIDS. This study formulated this contextual model as a cultural-gendered pastoral care model with children in crisis in a context of HIV and AIDS. The model was established to develop a practical method to use in practical theology and pastoral care in the care for children in crisis without adult guidance in a context of HIV and AIDS. The results of the study describe the significance of culture and gender in caring for children in a context of HIV and AIDS. / Philosophy, Practical and Systematic Theology / D. Th. (Practical Theology)