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The applicability of the theory of planned behaviour in predicting adherence to antiretroviral therapy (ART) among a South African sampleSaal, Wylene Leandri 03 1900 (has links)
Thesis (MSc)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The primary aim of the study was to determine the applicability of the theory of
planned behaviour (TPB) in predicting adherence to ART among South African
patients attending public health clinics. The second aim was to determine the
relationship between self-reported adherence and viral load. The results from the
hierarchical multiple regression analyses revealed that the linear combination of the
variables of the TPB significantly explained 12% of the variance in intentions to
adhere to ART. Perceived behavioural control was the only variable that significantly
predicted intentions to adhere to ART. The inclusion of perceived stigma was not a
useful addition to the model. The results also reflect the relationship between
intentions to adhere to treatment and self-reported adherence, which was not
significant. The TPB was unable to significantly account for variance in self-reported
treatment adherence. When perceived stigma was added to the TPB, the model was
still unable to significantly explain variance in self-reported adherence. Nonetheless,
attitudes towards treatment were the only variable that significantly accounted for
variance in self-reported treatment. It was concluded that interventions aimed at
improving adherence among South African patients attending public health clinics,
should aim to encourage positive attitudes towards treatment, should aim to increase
perceived subjective norms, should increase the patients’ perceptibility that they are
able to be adherent and should aim to decrease perceived stigma. Improving
adherence to ART can result in increasing the quality of life of patients living with
HIV/AIDS. / AFRIKAANSE OPSOMMING: Die primêre doel van die studie was om vas te stel of die teorie van beplande gedrag
(TPB soos voorgestel in die studie) antiretrovirale terapie (ART) nakoming onder
Suid-Afrikaanse pasiёnte by publieke gesondheidsklinieke kan voorspel. Die
sekondêre doel was om die verhouding tussen self-gerapporteerde volgehoue
behandeling en virale lading te bereken. Die uitslae van die hiёrargiese veelvuldige
regressie analise het getoon dat die linêere kombinasie van die veranderlikes van TPB
12% van die verandering in ART voornemens akkuraat kon voorspel. Waargenome
gedragsbeheer was die enigste veranderlike wat ART voornemens akkuraat kon
verklaar het. Die insluiting van waargenome stigma was nie beduidend ten opsigte
van die model nie. Geen beduidende verband tussen voorneme om met behandeling
vol te hou en self-gerapporteerde volgehoue-behandelingsgedrag word uitgebeeld.
Waargenome gedragsbeheer kon wel ‘n bydrae lewer om verandering in die
voorneme om met behandeling vol te hou verklaar. Die TPB kon egter nie ‘n
verduideliking bied vir die verandering in self-gerapporteerde volgehouebehandelingsgedrag
nie. Toe waargenome stigma by die TPB gevoeg is, was die
model steeds nie daartoe instaat om die verandering in self-gerapporteerde volgehouebehandelingsgedrag
te verklaar nie. Nietemin, houdings teenoor behandeling was die
enigste veranderlike wat verandering in self-gerapporteerde gedrag verklaar.
Daar is tot die gevolgtrekking gekom dat intervensies gerig op die verbetering van
volhoubare gedrag onder Suid-Afrikaanse pasiёnte wat openbare gesondheidsklinieke
bywoon,positiewe houding teenoor behandeling moet aanmoedig, subjektiewe norme
verhoog, die pasiёnte se persepsie dat hulle instaat is om volhoubare gedrag kan toon
moet verhoog en ook waargenome stigma moet verminder. Beter ART nakoming kan
lei tot ‘n toename in die MIV/VIGS pasiёnt se kwaliteit van lewe.
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Impact of highly active antiretroviral therapy (HAART) on body composition and other anthropometric measures of HIV-infected women in a primary healthcare setting in KwaZulu-Natal : a pilot studyEsposito, Francesca 12 1900 (has links)
Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Background and objectives:
An understanding of the effect of HAART on different aspects of health, including
nutritional status, of HIV-infected individuals in South Africa is needed to ensure that
appropriate population-specific guidelines and policies can be developed. This study aimed to investigate the impact of HAART on nutritional status, focusing on changes in anthropometric measures, and to explore the relationship between these measures and immunological and virological response to HAART.
Methods:
A prospective study of 30 adult females was carried out at a clinic in Cato Manor,
KwaZulu-Natal. Anthropometric measurements, including weight, mid-upper arm circumference (MUAC), waist circumference, hip circumference, body mass index (BMI) and waist-to-hip ratio (WHR), were performed at baseline and 12 and 24 weeks after commencing HAART. Laboratory values, including CD4 lymphocyte count, viral load, albumin and haemoglobin as well as bioelectrical impedance analysis data, including lean body mass (LBM), fat mass (FM) and body fat percentage (BF%), were collected at baseline and after 24 weeks on HAART.
Results:
Overall, there was a statistically significant increase in all anthropometric measures,
except WHR and LBM. The mean weight change was 3.4±5.8kg (p=0.006). Fifty percent of the subjects had a BMI above normal at baseline and mean BMI increased from 25.6±5.7kg/m2 to 27.3±5.6kg/m2 (p=0.007). Seventy percent of subjects gained weight, 18.5% had a stable weight and 11.1% lost weight. The weight gain in most
subjects was attributable to a gain in FM while in subjects who lost weight, the loss consisted mainly of LBM. Some patients with stable body weight experienced changes in the relative proportions of fat and lean mass. Six patients showed evidence of disproportionate gains and losses in body circumference measurements which may be indicative of fat redistribution. Subjects with lower CD4 lymphocyte counts experienced greater increases in weight, BMI, FM and BF%. The strongest correlation was observed with FM (rs=-0.53; p=0.00). Greater increases in weight, BMI, MUAC, waist circumference, hip circumference, FM and BF% were seen in those with lower baseline haemoglobin. Baseline viral load and albumin did not correlate significantly with changes in any anthropometric variables. Change in CD4 count was only significantly associated with baseline MUAC (rs=0.40; p=0.04). Change in viral load was significantly correlated with baseline weight, LBM, FM, BF% and MUAC with the strongest correlation being with weight (rs=0.44; p=0.01). No significant association was found between anthropometric changes and changes in CD4 count and viral load between baseline and the 24-week visit.
Conclusion:
Overall, subjects experienced a significant increase in most anthropometric measures. There appears to be a relationship between some anthropometric and laboratory measures but this needs clarification. The findings of this study
demonstrate the value of including circumference measurements and body composition techniques as part of nutritional status assessment and demonstrate the need for studies to determine the prevalence and significance of overweight and
obesity in the HIV-infected population. Research is needed to determine the best methods of bringing about the most favourable anthropometric changes to enhance the health of patients on HAART.
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Identifying structural barriers to antiretroviral therapy adherenceVermeulen, Jacomina Hendrina 03 1900 (has links)
Thesis (MA)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The topic of antiretroviral adherence remains a subject of continued importance, as it is
associated with positive health outcomes amongst patients attending public healthcare
facilities. Available literature on adherence behaviour mainly focuses on the psychological
and behavioural barriers, while overlooking the multitude of structural barriers within the
patient’s environment affecting the patient’s adherence to antiretroviral treatment and care.
The present study provides a unique perspective on adherence behaviour amongst persons
living with HIV and receiving antiretroviral treatment, as it identifies important structural
barriers to clinical attendance and pill-taking.
The sample for this study were selected from patients attending an infectious diseases
clinic at a major peri-urban secondary hospital and receiving antiretroviral therapy, nurses
and doctors providing health services to patients, and patient advocates providing
psychosocial support to patients under the auspices of a local non-governmental organisation.
The participants included in this study were selected by means of convenience sampling to
participate either in semi structured interviews or focus group discussions. Participants were
assured of the confidentiality of the process and their anonymity in both cases. Both semi
structured interviews and focus groups were digitally recorded and transcribed after which
transcriptions were entered into Atlas.ti for textual analysis. Transcriptions were thematically
analysed according to the perceptions of various participants. The main themes that emerged
from the present study included individual barriers, poverty-related barriers, institutionrelated
barriers, and social and community-related barriers.
The results of the present study were triangulated by considering the concurrences and
discrepancies between the patients, clinicians and patient advocates on the main, and
subthemes. These themes were then discussed according to Bronfenbrenner’s (1972)
Ecological Systems Theory, which divided the main themes identified according to the different systems operating within the patient’s environment, i.e. the micro-, exo-, and
macrosystem. The microsystem included both individual psychological and behavioural
barriers and poverty-related barriers. Institutional barriers were considered within the exosystem
of the patient’s ecological environment. And the social and community-related
barriers were considered within the macrosystem of the patient’s ecological environment.
The significance of this study lies in the identification of adherence behaviour as the
product of the patient’s environment through the examination of triangulated data. Future
research may include effective ways in which patients can be assisted in developing the
necessary skills to cope with their environment and to enhance social support. The
development of strategies to support newly-enrolled patients also still needs investigation. / AFRIKAANSE OPSOMMING: Volgehoue antiretrovirale behandeling bly ‘n onderwerp van voortdurende belang omdat dit
geassosieer word met positiewe gesondheidsuitkomste onder pasiënte wat van openbare
gesondheidsfasiliteite gebruik maak. Beskikbare literatuur oor volhoudings gedrag fokus
grootliks op sielkundige en gedragshindernisse, terwyl veelvuldige strukturelehindernisse
binne die pasiënt se omgewing steeds misgekyk word. Dié studie bied ‘n unieke perspektief
op volhoudingsgedrag onder MIV-positiewe pasiënte wat tans antiretrovirale terapie ontvang,
aangesien dit belangrike strukturele hindernisse tot kliniek bywoning en die neem van
medikasie identifiseer.
Dié steekproef sluit pasiënte in wat tans antiretrovirale terapie by ‘n aansteeklike
siektes-kliniek by ‘n peri-stedelike sekondêre hospitaal ontvang. Dit sluit ook dokters en
verpleegsters in wat gesondheidsdienste aan dié pasiënte verskaf, en pasiënt- advokate wat
psigo-sosiale ondersteuning aan pasiënte verskaf onder die vaandel van ‘n plaaslike nieregerings
organisasie. Dié deelnemers is deur middel van gerieflikheidssteekproef geselekteer
om aan semi-gestruktureerde onderhoude of fokusgroepbesprekings deel te neem.
Deelnemers van albei groepe is van hul anonimiteit en die vertroulikheid van die proses
verseker. Beide die semi-gestruktureerde onderhoude en die fokusgroepbesprekings is
digitaal opgeneem en transkripsies is daarvan gemaak, waarna die transkripsies in Atlas.ti
gelaai is vir tekstuele analise. Transkripsies is tematies geanaliseer volgens die persepsies van
die verskeie deelnemers. Die hooftemas wat na vore gekom het, sluit in individuele
hindernisse, armoedeverwante hindernisse, institusieverwante hindernisse asook sosiale en
gemeenskapsverwante hindernisse.
Resultate van dié studie is getrianguleer deur die verskille en ooreenkomste te vind
tussen pasiënte, klinici en pasiënt-advokate oor die hoof- en subtemas. Die hooftemas is toe
volgens Bronfenbrenner (1972) se Ekologiese Sistemeteorie verdeel in die verskillende sisteme teenwoording in die pasiënt se omgewing, naamlik die mikro-, ekso-, en
makrosisteem. Die mikrosisteem het individuele sielkundige en gedragshindernisse asook die
armoedeverwante hindernisse ingesluit. Institusieverwante hindernisse is binne die
eksosisteem van die pasiënt se ekologiese omgewing beskou en sosiale en
gemeenskapsverwante hindernisse is beskou binne die makrosisteem van die pasiënt se
ekologiese omgewing.
Die belang van dié studie lê in die identifisering van volhoudingsgedrag as produk
van die pasiënt se omgewing, soos beskou deur die Ekologiese Sistemeteorie. Toekomstige
navorsing kan fokus op effektiewe maniere waarop pasiënte bygestaan kan word om die
nodige vaardighede te ontwikkel om hul omgewing beter te kan hanteer en beskikbare sosiale
ondersteuning te kan verbeter. Die ontwikkeling van strategieë om nuwe pasiënte by te staan,
benodig ook verdere navorsing.
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The effect of highly active antiretroviral therapy on Human Papilloma Virus Infection and Cervical Dysplasia in women living with HIVZeier, Michele D. 04 1900 (has links)
Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Title
The Effect of Highly Active Antiretroviral Therapy on Human Papilloma Virus Infection and Cervical
Cytological Abnormalities in Women Living With HIV
Background
Human Papillomavirus (HPV) infection causes cervical cancer. The prevalence of HPV-related
dysplastic lesions is significantly higher in patients co-infected with the HI virus and thought to be
linked to possible more persistent HPV infection. There is, however, conflicting evidence as to
whether treatment of Human Immunodeficiency Virus (HIV) infection with antiretroviral agents may
influence cervical HPV infection and the behaviour of Squamous Intraepithelial Lesions (SIL).
Aims
To examine the effect of the initiation of combination antiretroviral therapy (cART) on: 1) the
persistence of cervical Low-grade SIL (LSIL); 2) The progression of cervical LSIL to High-Grade
SIL (HSIL); 3) The effectiveness of excision treatment of HSIL 4) HPV genotypes detected, in HIVinfected
and uninfected women at the Infectious Diseases Clinic and the Colposcopy Clinic,
Tygerberg Teaching Hospital, Cape Town, South Africa.
Design and Methods
We conducted a retrospective cohort analysis of 1720 women with LSIL of the survival of
progression-free-time or time-to-clearance. Time to progression or persistence was compared
according to HIV status, antiretroviral treatment and CD4 count. In another retrospective cohort
analysis, we investigated the effectiveness of excision treatment in 1848 women who underwent
LLETZ or CKC biopsy was used. Logistic regression and survival analysis were used to compare
excision treatment failure and recurrence-free time between groups according to HIV status,
antiretroviral therapy and CD4 count.
To investigate the effect of antiretroviral therapy on the cervical HPV infection, 300 HIV-infected
women were prospectively enrolled and followed at 6-monthly interval. Cytological testing and
cervical HPV sampling were done at each visit. Biopsy of suspicious lesions and excision treatment
were done at colposcopy clinic according to standard a protocol. The Roche Linear array HPV
genotyping test was used for HPV detection. Generalized Estimating Equation (GEE) multivariate
analysis was applied to investigate the effect of cART on the detection of HPV infection, while
adjusting for time-dependent covariates such as CD4 count, sexual activity and excision treatment.
The effect on each HPV type was then also compared to the effect on HPV16.
Results
Overall, we found that there was no difference between the progression of LSIL to HSIL by HIV
status. However, among HIV-infected patients, those who started ART before first LSIL had a
significantly lower risk for progression (HR 0.66, 95% CI 0.54-0.81). CD4 count did not have an
impact on the risk for progression. We also found lower persistence of SIL in the HIV uninfected
group (HR 0.69, 95% CI 0.57-0.85) and that cART was independently associated with decreased
persistence of LSIL. On the other hand, a higher CD4 count at the time of first LSIL was not
associated with lower persistence of the lesion. HIV infected women with HSIL experienced much higher excision treatment failure than uninfected
women (53.8% vs. 26.9%, p<0.001). Factors that improved outcome were higher CD4 count and
complete excision.
cART reduced the risk of detection of any HPV type by 47% (OR 0.53, 95% 0.49-0.58, p<001).
When adjusted for covariates, time of exposure to cART and CD4 had a stronger effect. Every month
of cART exposure reduced the risk detection of any HPV type with 7%. The effect was also
significant on HPV16 alone (OR 0.93, 95% CI 0.90-0.95). All non-oncogenic subtypes were
influenced similarly or more strongly than HPV16, as well as oncogenic HPV52. Only one oncogenic
subtype HPV subtype, HPV39, was influenced marginally less (ratio of OR 0.95, CI 0.90-0.99,
p=0.04).
There was an increased risk for any HPV detection at CD4 count<200 (OR 1.63, 95% CI:1.50-1.77),
but when adjusted, the time of cART exposure again remained the strongest predictor of risk (OR
0.94, 95% CI:0.93-0.95).
Conclusion
cART impact the outcome of cervical HPV infection by increasing clearance, decreasing progression
of LSIL and recurrence after excision treatment. This effect is time dependent and also associated
with CD4 count. Specifically, HPV16 detection risk is also reduced by cART, and all HPV types are
influenced at least as much as HPV16, except possibly HPV39. It seems that increased cervical HIVproviral
load is associated with HPV detection risk, and both are lowered by cART time. / AFRIKAANSE OPSOMMING: Titel
Die Effek van Kombinasie Antiretrovirale Terapie op Menslike Papilloomvirusinfeksie en Servikale
Sitologiese Abnormaliteite in Menslike Immuniteitsgebrekvirus-geïnfekteerde Vroue
Agtergrond
Menslike Papilloomvirusinfeksie (MPV) veroorsaak servikale kanker. Die prevalensie van MPVverwante
displastiese letsels is betekenisvol hoër in pasiënte wie ook met Menslike
Immuniteitsgebrekvirus (MIV) geïnfekteer is en dit word gereken dat dit te wyte is aan meer
persisterende MPV infeksie. Daar is egter teenstrydige bewyse oor of die behandeling van MIV
infeksie met antiretrovirale (ART) middels die infeksie met MPV en die gedrag van Plaveisel
Intraepiletiële letsels (PIL) kan beïnvloed.
Doelwitte
Om die effek van die inisiasie van kombinasie ART op: 1) die persistering van Laegraadse PIL
(LPIL); 2) die progressie van servikale LPIL na hoëgraadse PIL (HPIL) 3) die sukses van
eksisiebehandeling van HPIL; 4) MPV genotypies waarneembaar, in MIV-geïnfekteerde vroue by die
Infeksiesiektekliniek en die Kolposkopiekliniek,Tygerberghospitaal, Kaapstad, Suid-Afrika, te
ondersoek.
Studie-ontwerp en Metodes
`n Retrospektiewe kohort-analise op 1720 vroue met LPIL van die oorlewing van progressive-vrye
tyd en tyd tot opklaring van PIL is gedoen. Tyd tot progressie of opklaring is vergelyk na aanleiding
van die pasiënt se MIV status, behandeling met antiretrovirale terapie en CD4-telling. In nog `n
retrospektiewe kohort-analise is die effektiwiteit van eksisiebehandeling in 1848 vroue wie LLETZ or
Kouemeskonus eksisie ondergaan het, ondersoek. Logistiese regressie en oorlewingsanalise is
toegepas om die voorkoms van onsuksesvolle uitkoms en tyd sonder herhaling van letsels tussen
groepe te vergelyk na aanleiding van MIV status, ART en CD4-telling.
Om die effek van antiretroviral therapie op servikale MPV infeksie te ondersoek, is 300 MIVgeïnfekteerde
vroue opgeneem in `n prospektiewe studie en sesmaandeliks opgevolg. Sitologiese en
MPV servikale smere is met elke besoek geneem. Biopsies van verdagte letsels en eksisiebehandeling
is by die Kolposkopiekliniek gedoen volgens die standaardpraktyk. Die Roche Linear Array HPV
Genotyping toets is gebruik vir MPV deteksie. Algemeen-beraamde vergelyking (GEE)
meerveranderlike analise is toegepas om die effek van die anti-MIV terapie op die teenwoordigheid
van MPV op die serviks te ondersoek. Die aangepaste effek is ook getoets deur die CD4-telling, die
seksuele aktiwiteits- en eksisiebehandelingstatus by elke besoek in ag te neem. Die effek op elke
MPV genotipe is laastens dan ook vergelyk met die effek op ‘n spesifieke basislyn genotype; in
hierdie geval was MPV16 gekies.
Resultate
Daar was geen statisties beduidende verskil tussen die progressie van LPIL na HPIL na aanleding van
HIV status nie, maar pasiënte wie met ART begin het voordat hulle vir die eerste keer met LPIL
gediagnoseer was, het ‘n laer risiko gehad vir progressie (HR 0.66, 95% VI 0.54-0.81). Daar is ook
gevind dat dit onafhanklik van die CD4 telling was. Die persistering van PIL was laer in die MIV
negatiewe groep (HR 0.69, 95% VI 0.57-0.85), maar ook hier was antiretrovirale behandeling
geassosieer met verminderde persistering. Weer eens was daar nie ‘n verband met die CD4 telling nie. MIV-geinfekteerde vroue met HPILwas baie meer geneig tot gefaalde eksisiebehandeling (53.8%
teenoor 26.9%, p<0.001). Verbeterde uitkoms was geassosieer met ‘n hoër CD4-telling en ‘n eksisie
wat as volledig beskryf was. ART wat reeds voor die eksisiebehandeling begin was, het nie die risiko
vir onsuskesvolle uitkoms statisties beduidend verminder nie, maar het egter die risiko vir herhaling
van letsels na die eksisie sterk verlaag.
ART het die kans dat enige MPV tipe waargeneem sou word, met 47% verlaag (OR 0.53, 95% VI
0.49-0.58, p<001). Wanneer aangepas vir ander faktore, was die tyd wat verloop het sedert ART
begin was, sowel as vir die CD4 telling, sterker. Vir elke maand sedert ART begin was, het die kans
dat enige MPV tipe waargeneem word, met 7% verminder. `n Soortgelyke effek is op HPV16 alleen
gevind (OR 0.93, 95%, VI 0.90-0.95). Die effek was net so sterk of sterker op alle subtipes. Slegs een
onkogeniese subtipe, MPV39, was gering minder beïnvloed (ratio van OR 0.95, VI 0.90-0.99,
p=0.04).
Die kans vir waarneming van enige MPV subtype is hoër wanneer die CD4 telling laer as 200 selle/ɥl
is (OR 1.63, 95% VI: 1.50-1.77), maar wanneer aangepas, was die tyd van ART weer eens die sterkste
voorspeller van MPV infeksie (OR 0.94, 95% VI:0.93-0.95).
Gevolgtrekkings
ART verbeter die uitkoms van servikale infeksie met MPV deur progressie en persistering van LPIL
en herhaling van PIL na eksisie te verminder. Die effek is tydsafhanklik en word ook deur die CD4
telling beïnvloed. Die kanse dat MPV16 spesifiek waargeneem word, word ook deur ART verminder,
en all MPV tipes ondervind dieselfde of groter verlaging van waarnemingsrisiko as MPV16, behalwe
miskien MPV39. Ons kon aandui dat verhoogde teenwoordigheid van servikale MIV verband hou met
die risiko vir die waarneming van MPV infeksie, en beide word verminer deur die tyd waarmee die
pasiënt met ARV terapie behandel is.
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An assessment of the effectiveness of primary health care services in addressing HIV/AIDS by providing anti-retroviral treatment : the case of Du Noon clinic in the Western health sub-district of the city of Cape TownSifanelo, Gloria Monica 12 1900 (has links)
Thesis (MPA (Public Management and Planning))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The accessibility of anti-retroviral drugs to patients and families affected by HIV and
AIDS, and the affordability of these drugs, have been challenges to the Du Noon
community in the Cape Peninsula. The aim of the study was to assess the
effectiveness of primary health care services in addressing HIV/AIDS in the light of
these challenges.
The focus was on patients registered on the ARV programme and who were
receiving treatment at Du Noon Clinic. Interviews were conducted with 15 groups of
10 patients each using a patient questionnaire. During these interviews qualitative
and quantitative data were gathered and secondary data was used for quantitative
analysis. The results that the data analysis yielded are in keeping with the
hypothesis that the HIV/AIDS programme is effective in meeting the needs of the
HIV/AIDS patients of Du Noon.
After content analysis of qualitative data, two themes related to patient satisfaction
emerged: positive and negative feelings that were categorised as satisfied and not
satisfied with the service. Most often noted was the feeling of satisfaction with the
services rendered at the clinic and that the staff were helpful. The staff rendering the
service were also satisfied with the kind of service offered to the patients, but were
dissatisfied with the allocation of resources. An increase in enrolment figures of
patients was noted in the statistical analysis for the period 2004-2008 with 1,018
patients registered. The statistics illustrate the linear tendency in the enrolment of
patients, which indicated the accessibility and affordability of the service. / AFRIKAANSE OPSOMMING: Geredelike toegang tot en die bekostigbaarheid van anti-retrivorale middels (ARM’s)
vir pasiënte en families wat deur MIV en VIGS aangetas is, is ‘n uitdaging vir die Du
Noon-gemeenskap in die Kaapse Skiereiland. Die doel van die studie was om die
doeltreffendheid van primêre gesondheidsorgdienste te bepaal wanneer MIV/VIGS
aangespreek word.
Die fokus is op geregistreerde pasiënte wat die ARM-program volg en behandeling
by die Du Noon Kliniek ontvang. Met behulp van ‘n pasiëntevraelys was onderhoude
met 15 groepe van 10 pasiënte elk gevoer. Tydens hierdie onderhoude is
kwalitatiewe data versamel en vir kwantitatiewe analise was sekondêre data
aangewend. Die resultate wat uit die data analise verkry was, strook met die
hipotese dat die MIV/VIGS-program doeltreffend is om die behoeftes van die
pasiënte en die gemeenskap van Du Noon aan te spreek.
Nadat ‘n inhoudsanalise van die kwalitatiewe data onderneem was, het twee temas
rakende positiewe en negatiewe gevoelens – gekategoriseer as tevrede en nie
tevrede nie – ten opsigte van die gelewerde diens na vore getree. Veral die gevoel
van tevredenheid teenoor die diens gelewer by die kliniek en die personeel as
behulpsaam, is opgemerk. Die personeel wat die diens lewer, was ook tevrede met
die diens wat aan die pasiënte gelewer word, maar was ontevrede oor die
toekenning van hulpbronne. By die statistiese analise is ‘n toename in die
inskrywingsgetalle deur pasiënte waargeneem. Toename in inskrywingsgetalle deur
pasiënte is gemerk in statistiese analise van 2004 - 2008, met 1,018 pasiënte
geregistreer. Die statistiek het die lineêre tendens toegelig ten aansien van die
inskrywing van pasiënte wat die toeganklikheid en bekostigbaarheid van die diens
uitbeeld.
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ART : the views of counsellors about skills needed in counselling HIV/AIDS patientsFrans, Nocawe R. 12 1900 (has links)
Thesis (M Social Work (Social Work))--Stellenbosch University, 2008. / South Africa is experiencing a serious HIV/AIDS (Human Immunodeficiency Virus/Acquired
Immune Deficiency Syndrome) epidemic, with millions of its people living with the disease and
dying from related diseases. As there is no cure as yet, counselling as a form of intervention is one
of the most powerful ways to address the psychosocial aspects of HIV/AIDS.
The motivation for this study was the lack of research concerning skills needed by counsellors in
counselling HIV/AIDS patients who are on antiretroviral treatment (ART) or are about to
commence antiretroviral treatment. To add to the knowledge that is lacking, the study was
approached by means of both quantitative and qualitative research methods. The purpose of the
research was explorative and descriptive. The discussion on the literature that was studied provides
an overview of the implications of HIV/AIDS for the individual and the family, and of the
psychosocial implications, in addition to describing antiretroviral treatment and the nature of HIV
and adherence counselling processes and skills.
A sample of 16 adherence counsellors who were between the ages of 27 and 57 years was
interviewed. These adherence counsellors were employed by Sothemba Aids Action, placed at the
different ART sites, trained at the Aids, Training, Information and Counselling Centre (ATTIC) and
have gained one or more years’ experience in HIV/AIDS counselling. A semi-structured
questionnaire was used as research instrument. It contained both open- and closed-ended questions.
All the interviews took place at the clinics where the counsellors were employed or worked.
The results of the study showed that an equal number of respondents from two different ethnic
groups were interviewed; all the participants had received high school education; and a few
obtained tertiary level qualifications. They all received training in basic counselling skills and
adherence counselling skills. A few indicated additional training in Voluntary Counselling and
Testing (VCT), as well as Prevention of Mother-to-child Transmission Counselling (PMTC). A
minority of counsellors indicated making use of a translator and that their experience was that the
message was always misinterpreted. All the adherence counsellors indicated a need for further
training involving social problems and counselling of children at different ages and stages of
development. It was also found that the adherence counsellors lack skills in counselling intervention
processes and in intervention. All the adherence counsellors raised concerns regarding their
working conditions and salaries.
In light of the above it is recommended that patients be counselled in their preferred language, that
all counsellors receive the same training in counselling and in the additional areas where they
experience a shortcoming.
Data on HIV/AIDS and adherence counselling, including the views of counsellors and patients are
limited. It is recommended that more research be done on HIV/AIDS and adherence counselling,
including the different disciplines that are involved and the views of patients about services rendered to them by those in the different disciplines, and counsellors.
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