MPH, Faculty of Health Sciences, University of the Witwatersrand, 2007

The aim of this research was to determine the way in which informal caregivers of HIV/AIDS patients experience their task as caregivers as well as to identify factors, or general resistance resources, which exercise an influence on their psychological well-being, and more specifically on their sense of coherence. The stressors encountered by informal caregivers of HIVIAIDS patients have previously been investigated thoroughly in a number of studies. The tasks of informal caregivers very often encompass much more than what would be, for example, included in the nursing context and therefore exceed the limits applying to the formal sector. Stressors to which caregivers are exposed include physical, financial and emotional aspects. It has been proved that this state of affairs has a negative impact on their physical health conditions as well as their psychological well-being. Caregivers do, however, at times report a certain extent of growth experienced by them which can be related to the care giving situation. The salutogenic perspective allows for a study of the origin of health and has, for the purposes of this study, been applied to obtain an alternative description of the caregivers' experiences. According to this perspective health does not merely mean the absence of disease, but also refers to health being influenced by an individual's management of stressful events. When an individual, even if confronted with stressful circumstances, has adequate general resistance resources at his/her disposal, a strong sense of coherence can develop and this will have a positive influence on his/her psychological well-being. In the South African context little if any literature can be found on the salutogenic factors that may affect informal caregivers of HIV/AIDS patients. The investigation of this study was based on an availability sample consisting of 8 informal caregivers of HIVIAIDS patients. A one shot cross sectional design with triangulation of data assessment techniques was used. The researcher obtained data with regard to the caregivers' sense of coherence by means of the Sense of Coherence Scale (SOC) (Antonovsky, 1987). Semistructured interviews were conducted with all the caregivers involved and a qualitative analysis followed. The results revealed that informal caregivers' sense of coherence was much lower than- that of a group of nurses (formal caregivers) as described by Cilliers (2003). One of the reasons for this significant difference could be the lack of a structured setting or environment in which caregivers still have to perform their duties and responsibilities. According to the results a variety of factors exercising a negative impact on informal caregivers' sense of coherence could be identified. These included (a) stress, (b) exposure to unfamiliar situations, and (c) a lack of counselling skills. Within the framework of the salutogenic perspective there were, however, different factors also known as general resistance resources, that exercised a positive impact on the caregivers' sense of coherence. Among these the following could be counted: (a) spirituality, (b) insight into interpersonal situations, (c) utilisation of social support systems, and (d) multi-disciplinary cooperation. It would therefore seem that informal caregivers do possess general resistance resources which enable them to persevere with their tasks as caregivers in spite of the stressors they encounter on a daily basis. One of the recommendations that can be posed after having carried out this study and after having analysed the results, is the compilation as well as the evaluation and implementation, of a psycho-education training programme for informal caregivers, with special emphasis on such general resistance resources. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2006.

The aim of this research was to determine the way in which informal caregivers of HIV/AIDS patients experience their task as caregivers as well as to identify factors, or general resistance resources, which exercise an influence on their psychological well-being, and more specifically on their sense of coherence. The stressors encountered by informal caregivers of HIVIAIDS patients have previously been investigated thoroughly in a number of studies. The tasks of informal caregivers very often encompass much more than what would be, for example, included in the nursing context and therefore exceed the limits applying to the formal sector. Stressors to which caregivers are exposed include physical, financial and emotional aspects. It has been proved that this state of affairs has a negative impact on their physical health conditions as well as their psychological well-being. Caregivers do, however, at times report a certain extent of growth experienced by them which can be related to the care giving situation. The salutogenic perspective allows for a study of the origin of health and has, for the purposes of this study, been applied to obtain an alternative description of the caregivers' experiences. According to this perspective health does not merely mean the absence of disease, but also refers to health being influenced by an individual's management of stressful events. When an individual, even if confronted with stressful circumstances, has adequate general resistance resources at his/her disposal, a strong sense of coherence can develop and this will have a positive influence on his/her psychological well-being. In the South African context little if any literature can be found on the salutogenic factors that may affect informal caregivers of HIV/AIDS patients. The investigation of this study was based on an availability sample consisting of 8 informal caregivers of HIVIAIDS patients. A one shot cross sectional design with triangulation of data assessment techniques was used. The researcher obtained data with regard to the caregivers' sense of coherence by means of the Sense of Coherence Scale (SOC) (Antonovsky, 1987). Semistructured interviews were conducted with all the caregivers involved and a qualitative analysis followed. The results revealed that informal caregivers' sense of coherence was much lower than- that of a group of nurses (formal caregivers) as described by Cilliers (2003). One of the reasons for this significant difference could be the lack of a structured setting or environment in which caregivers still have to perform their duties and responsibilities. According to the results a variety of factors exercising a negative impact on informal caregivers' sense of coherence could be identified. These included (a) stress, (b) exposure to unfamiliar situations, and (c) a lack of counselling skills. Within the framework of the salutogenic perspective there were, however, different factors also known as general resistance resources, that exercised a positive impact on the caregivers' sense of coherence. Among these the following could be counted: (a) spirituality, (b) insight into interpersonal situations, (c) utilisation of social support systems, and (d) multi-disciplinary cooperation. It would therefore seem that informal caregivers do possess general resistance resources which enable them to persevere with their tasks as caregivers in spite of the stressors they encounter on a daily basis. One of the recommendations that can be posed after having carried out this study and after having analysed the results, is the compilation as well as the evaluation and implementation, of a psycho-education training programme for informal caregivers, with special emphasis on such general resistance resources. / Thesis (M.A. (Psychology))--North-West University, Potchefstroom Campus, 2006.

M.Sc.(Nursing), Faculty of Health Sciences, University of the Witwatersrand, 2009 / The purpose of this research was to investigate job satisfaction and the impact of HIV and AIDS on nurses in a public hospital in Gauteng. The problems that generated this study included absenteeism, low morale and negativity of nurses working with patients in the presence of the HIV/AIDS crisis. A quantitative research method was used. The sample size comprised 248 nurses from all categories. The Measure of Job Satisfaction was the framework used which covers issues such as remuneration, security, growth, social and supervisory aspects. The framework for the HIV/AIDS section of the research was the Government policy on HIV/AIDS. Results showed job satisfaction was adversely affected by staff shortages, workload, frustrations with management, remuneration, lack of developmental opportunities and equipment. Analysis of the open-ended responses showed ambivalence amongst nurses towards nursing HIV/AIDS patients. Some expressed sadness and fear while others found their caring role fulfilled. The study indicated that facilitating development of staff, improving management skills, providing staff and equipment will all impact positively on job satisfaction. In addition, a deliberate effort needs to be made to plan debriefing/counselling services for nurses as well as ongoing HIV training.

Thesis (M.A. (Clinical psychology )) --University of Limpopo, 2009 / This study is aimed at exploring the influence of shame and stigma on the psychological functioning of HIV/AIDS and cancer patients. Four hypotheses were stated and they are: 1. There will be a difference on the scores of shame and stigma and psychological functioning between HIV/AIDS and cancer patients. 2. Patients who experience shame and stigma are more likely to experience psychological dysfunction than those who do not. 3. Females will experience more shame and stigma, and then consequently report more psychological dysfunctions than males. 4. There will be a difference on the scores of shame and stigma and psychological functioning between age groups. Method: This study used a quantitative research design. A convenient sample of 100 HIV and cancer patients from different race, ethnicities, genders and age groups participated in this study. Statistical tests used to measure the results included means and ANOVAs. Results: Results revealed that HIV patients do experience more enacted stigma and anxiety than cancer patients. Enacted stigma and perceived community stigma were associated with anxiety, and depression. Females experienced more enacted stigma than males whiles males and internal felt stigma than females. There were age differences in the experience of somatic symptoms and internal felt stigma. Conclusion: Recommendation included that shame and stigma be addressed through stress management and the community counselling model.

O conhecimento sobre a epidemia de AIDS e a organização dos serviços de saúde de atendimento aos pacientes HIV/AIDS no estado é indispensável para a realização de atividades de planejamento de ações que possam oferecer uma melhor assistência a esses pacientes. O estudo realizou um diagnóstico da assistência odontológica ao usuário HIV/AIDS prestado através das Equipes do Serviço Ambulatorial Especializado - SAE, tendo como foco a percepção do usuário e a do Cirurgião Dentista (CD) na qualidade dessa assistência.Trata-se de um estudo qualitativo que no primeiro momento descreve o fluxo de atendimento do SAE; o serviço de referência e contra referência e, no segundo momento aplicação de dois questionários, um voltado para o usuário e outro para o CD; o questionário destinado ao usuário foi aplicado pelos coordenadores dos SAES. Os dados foram agrupados em categorias que se relacionam entre si, buscando avaliar: opiniões, atitudes, preferências e comportamento do usuário e CD em relação ao serviço prestado e o oferecido,e a descrição de citações diretas do usuário e CD sobre suas vivências. Participaram da pesquisa 174 usuários pertencentes aos SAES de Porto Velho, Vilhena, Cacoal e Ji-Paraná, todos pacientes HIV/AIDS em registro ativo, ambos os sexos, adultos, e 13 CD. A maioria dos usuários mostrou satisfação com o atendimento realizado pelos CD de seus municípios, percebe-se a falta de conhecimento dos CD no atendimento a pacientes HIV/AIDS. O preconceito, o medo e a discriminação são fatores comuns entre pacientes e CD. Através das informações obtidas podemos destacar os seguintes pontos: É primordial a participação integral do CD nas equipes do SAE; Estabelecer novas estratégias de Capacitação para os CD; A Pactuação de medicamento no âmbito do SUS deve incluir lista de medicamento utilizados pelos CD no atendimento a pacientes HIV/AIDS; Ampliar o conhecimento da infecção HIV, incluindo atualização para os pacientes sobre saúde bucal e biossegurança. / The knowledge about the AIDS epidemy and the organization of health services for HIV/AIDS patients in the state is essencial to carry out planning activities of actions that might offer a better assistance for those patients.The study carried out a diagnosis of odontological assistance to HIV/AIDS user provided by the teams of Specialized Outpatient Service, focusing the users and dentists perception of the quality of such assistance.This is a qualitative study that in the first moment describes the flow of the attendance at the Specialized Outpatient Service; the reference and counter reference service and, in a second moment, the aplication of two questionaries, one to the users and other to the dentists; the questinaries to users were applied by the coordinators of the Specialized Outpatient Service. Data were gathered into categories that mix to each other, in order to evaluate: opinions, attitudes, preferences and behavior of users and dentists in relation to the service provided and offered and the quotations of users and dentistis about their experiences;174 users of Specialized Outpatient Services from Porto Velho, Vilhena, Cacoal and Ji-Paraná took part into this research, all them were HIV/AIDS patients in active registration, of both sexes, adults, and 13 dentists. Most of the users demonstrated satisfaction about the attendance carried out by dentists in their municipalities. We could notice the lack of knowledge by the dentists about the attendance to HIV/AIDS patients. Prejudice, fear and discrimination are common factors between patients and dentists.From the informations collected we are able to point out the following aspects as essencial: The paticipation of dentists in teams of Specialized Outpatient Services; Defining new strategies for training the dentists; The agreement about medicines into the Unique Health System must include the list of medicines used by dentists on the attendance of HIV/AIDS; Extending the knowledge about the HIV infection, including getting up to date for patients about oral heath and biosafety.

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.

International aid organizations and wealthy nations have contributed billions to combat the spread and treatment of HIV/AIDS in sub-Saharan Africa; however, these programs have been critiqued for not addressing the socioeconomic and cultural context of the epidemic, instead relying upon generalized approaches. The prevalence rate in Zanzibar, Tanzania is low in the general population, but high among vulnerable segments of Zanzibari society, resulting in interventions focusing on particular groups (e.g. sex workers, drug users, and men who have sex with men). Through interviews with government agencies, non-profit organizations, medical professionals, vulnerable populations, and HIV/AIDS patients, this paper examines how local realities inform and challenge HIV/AIDS programming in Zanzibar.

Thesis (MPH.) -- University of Limpopo, 2015 / The 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.

The purpose of the study was to describe the support services available for nurses who care for patients with human immunodeficiency virus / acquired immune-deficiency syndrome (HIV/AIDS) in Pretoria urban pubic hospitals. Problems faced by nurses in HIV/AIDS care support preferences were also investigated. The study was conducted between March and April 2003, using a descriptive design. Respondents comprised eighty-seven (87) nurses who were conveniently selected from five (5) hospitals. Results reveal that support available is inadequate in both quality and coverage of nurses. Other significant findings are inadequate job preparation, shortage of nurses and that nurses prefer to receive support from both within and outside the hospital. It has been recommended that management should work with nurses to design support interventions that match the identified problems/needs. Nurses need to take an active role in caring for themselves and more in-service training opportunities need to be created for nurses. / Health Studies / MA (Health Studies)