No abstract available. / Dissertation (LLM)--University of Pretoria, 2013. / gm2014 / Centre for Human Rights / unrestricted

PhD (Sociology) / Department of Sociology / The purpose of the study was to investigate the influence of traditional healing practices on anti-retroviral treatment adherence in Vhembe District. This qualitative study used an explorative design to envisage the aim. A cross-sectional snowball sample was used to draw a sample of 9 participants from the 4 municipalities of Vhembe District. The data collection methods were; in-depth interviews, focus group discussions and key informants’ interviews. The 3 data collection techniques ensured triangulation for more complete and well-validated outcomes of the study. The researcher used the Van Manen method to analyse data. Contrary to popular belief that THPs promote non-adherence among people living with HIV/AIDS (PLWHA), the study found out that the majority of Traditional Healing Practitioners (THPs) encourage and positively influence PLWHA to adhere to anti-retroviral treatment. Apart from a minority of participants who claimed to cure HIV/AIDS, the majority acknowledged and admitted that traditional healing practices do not cure HIV/AIDS but it only heals opportunistic infections. As a result, the majority of THPs influences PLWHA to adhere to anti-retroviral therapy (ART). However, the positive influence of THPs is challenged by individual and social-cultural factors that are beyond THPs’ control which influence treatment adherence such as; traditional and cultural beliefs, side effects of ARVs, nurses’ attitude, inconveniences, lack of transport, personal choices, lack of trust in ARVs and fear of loss of the Disability Grant. It is on this backdrop that study findings prompted devising of a model and a 5 phase support program for intervention. / NRF

Bakgrund: ALS är en progressiv, ovanlig och obotlig sjukdom. Vuxna personer drabbas främst. Livsstilsförändringar är oundvikliga och eftersom att upplevelsen att leva med denna sjukdom kan variera, är det angeläget att olika upplevelser lyfts i denna studie för att sjukvården kring dessa personer ska kunna vara så personcentrerad som möjligt.   Syfte: Syftet var att beskriva personers upplevelser av att leva med ALS.  Metod: En litteraturöversikt som bygger på sju kvalitativa och tre kvantitativa vetenskapliga artiklar från CINAHL Complete, Academic Search Complete och PsycINFO, dessa var publicerade mellan åren 2010 – 2020.   Resultat: Fem stycken teman identifierades: Ångest; Missuppfattningar; Acceptans; Lidande; och Beröring. Det framkom att de upplevde ett multidimensionellt lidande som förvärras ju mer sjukdomsprogressionen fortlöper. Det framkom även att många personer hade ångest inför när de skulle avlida. I samband med sjukdomslidandet framkom det att många personer upplevde ångest.   Diskussion: I metoddiskussionen diskuterades användningen av vetenskapliga artiklar med samma författare samt hur samspelet mellan författarna varit. I resultatdiskussionen diskuterades två dominerande resultat, att samtliga deltagare upplevde ett multidimensionellt lidande i takt med att sjukdomsprogressionen fortlöpte samt ångest inför när de skulle avlida. / Background: ALS is a progressive, unusual and incurable disease. Adults are primarily affected. Lifestyle changes are inevitable and because the experience of living with this disease may vary, it is important that different experiences are highlighted in this study in order to allow the care of these people to be as person-centered as possible.  Aim: The aim was to describe experiences of people living with ALS.  Method: A literature review based on seven qualitative and three quantitative articles found on CINAHL Complete, Academic Search Complete and PsycINFO, that was published between the years 2010 – 2020.    Results: Five themes were identified: Anxiety; Misconceptions; Acceptance; Suffering; and Touch. It turned out that they experienced a multidimensional suffering that worsened as the disease progression progressed. It also emerged that many people had anxiety when they would die. In connection with the illness suffering, many people experienced anxiety.  Discussion: In the method discussion the use of articles with the same author was discussed and how the interaction between the authors has been. In the results discussion, two dominant outcomes were discussed, that all participants experienced a multidimensional suffering as disease progression progressed and anxiety faced when they were to die.

Bakgrund: Inflammatorisk tarmsjukdom (IBD) är ett samlingsnamn för de kroniska tarmsjukdomarna Crohns sjukdom (CD) och Ulcerös kolit (UK). Det gemensamma för de två sjukdomarna är att de löper i skov med försämringsperioder och långa besvärsfria perioder samt att de drabbar relativt unga personer. Det är viktigt att sjuksköterskan kan stödja dessa individer genom evidensbaserad och personcentrerad vård för att kunna ge en så god omvårdnad som möjligt.  Syfte: Beskriva individers upplevelse av att leva med inflammatorisk tarmsjukdom Metod: En litteraturöversikt valdes som metod. Artikelsökningen genomfördes i databaserna CINAHL Complete och PubMed. De begränsningar som gjordes i databassökningarna var vetenskapliga originalartiklar, skrivna på engelska, genomgått peer-review och publicerade mellan 2009-2019. Totalt inkluderades elva artiklar i resultatet, av dessa var tio artiklar kvalitativa och en var kvantitativ. Resultat: Resultatet visade att individerna upplevde att sjukdomen påverkade deras arbetsliv, sociala liv, känslor och identitet. Deras möte med hälso- och sjukvården påverkade personernas förtroende för vården samt deras vilja att söka vård framöver. Det visades även att personer med inflammatorisk tarmsjukdom genomgick en transitionsperiod efter deras diagnos. Hur personerna upplevde att leva med IBD påverkades av om de för tillfället befann sig i ett skov eller nyligen fått diagnosen. De personer som befann sig i ett skov eller nyligen fått diagnosen hade en övervägande negativ syn.  Diskussion: Resultatet diskuterades utifrån Katie Erikssons teori om lidande och hälsa. Författarna resonerade om individernas negativa påverkan kunde kopplas till stigman av sjukdomen. De diskuterade även angående den långsiktiga påverkan av frånvaron från arbetet och sociala sammanhang. Författarna fann i resultatet att individer med IBD upplevde sjukdomen olika i sin vardag beroende på hur länge de haft sjukdomen och vilken inställning de har gentemot sin IBD. Därmed bör vården anpassas efter de individuella behoven för att säkerställa att insatserna främjar hälsan. / Background: Inflammatory bowel disease (IBD) is a chronic illness that includes Crohn´s disease (CD) and ulcerative colitis (UK). Both diseases have in common that they have relapse and periods with improvement. The diseases effects relatively young people. It is important that the nurse can support these individuals through evidence based and person-centred care in order to provide the best possible care. Aim: Describe individuals experiences of living with inflammatory bowel disease  Method: A literature review was chosen as the method. The article search was carried out in the databases CINAHL complete and PubMed. The limitations made in the database searches were scientific original articles, written in English, peer-reviewed and published over the last ten years. A total of eleven articles was included in the result, of which ten were of qualitative design and one was quantitative design. Results: The results showed that the individuals experienced that the disease affected their working life, social life, feelings and identity. Their meeting with healthcare services affected their trust in the care and their willingness to seek care in the future. It was also shown that people with inflammatory bowel disease underwent a transition period after the diagnosis. How the individuals experienced living with IBD was affected by whether they were relapsing or in remission. People currently in a relapse had a more negative view of the disease.  Discussion: The result was discussed based on Katie Eriksson´s theory of suffering and health. The authors reasoned if the negative impact of the individuals could be linked to the stigma and shame of the disease. They also discussed the long-term impact of the absence from work and social activities. The authors found in the results that individuals with IBD experienced the disease differently in their daily lives depending on how long they had the disease and what attitude they had towards their IBD. The care should be adapted to the individual needs to ensure that the efforts promotes health.

Bakgrund: Cancer är en sjukdom som 61000 individer drabbas av i Sverige varje år. Antalet överlevande är större tack vare tidigare upptäckt av cancer. Att drabbas av cancer kan upplevas traumatisk varför flera efter friskförklarande upplever rädsla för canceråterfall. Syfte: Syftet med denna litteraturöversikt var att utforska upplevelser av att leva med rädsla för canceråterfall. Metod: En litteraturöversikt över nio vetenskapliga artiklar enligt Fribergs metod. Artiklarna till resultatet hämtades från Academic Search Complete, Cinahl Complete och Nursing & Allied Health Database. Resultat: Rädsla för canceråterfall kan ses som ett fenomen som orsakar lidande hos den drabbade, och påverkar fler områden i livet negativt, fysiska, psykologiska samt psykosociala. Litteraturöversikten presenteras i två teman. Det första temat är Utlösande fenomen som behandlar fenomen som ökar rädslans intensitet. Det andra temat är Hantering av rädslan för canceråterfall som behandlar hur det drabbade påverkas psykosocialt och hur de hanterar livet. Diskussion: Canceröverlevare befinner sig i en ny livssituation efter cancerbehandlingen är klar, detta kan innebära svårigheter att hantera livet efter cancersjukdom. Sjuksköterskan behöver vara uppmärksam på att dessa patienter inte enbart dyker upp i onkologisk kontext utan också i öppenvården. Litteraturöversiktens fynd har diskuterats utifrån Roys adaptionsmodell. / Background: Cancer is a disease that 61,000 individuals suffer in Sweden each year. The number of survivors is greater due to early cancer detection. Being affected by cancer can be perceived as traumatic, which is why several people whom survived cancer, experience fear of cancer recurrence. Aim: The aim of this literature review was to explore experiences of living with fear of cancer recurrence. Method: A literature review of nine scientific articles according to the Friberg method. The results articles were taken from Academic Search Complete, Cinahl Complete and Nursing & Allied Health Database. Results: Fear of cancer recurrence can be seen as a phenomenon that causes suffering in the affected person, and affects areas of life negatively, physically, psychological and psychosocially. The literature review is presented in two themes. The first theme is Triggering Phenomena which deals with phenomena that increase fear. The second theme is Managing the Fear of Cancer Recurrence, which addresses how the fear affect the affected psychosocially and how the affected deal with life. Discussion: Cancer survivors are in a new life situation after the cancer treatment is complete, this can mean difficulties in managing life after cancer. The nurse needs to be aware that these patients not only appear in the oncological context but also in outpatient care. The findings of the literature review have been discussed on the basis of Roy's adaptation model

Effectiveness of services for Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) depends on viable and efficient health systems, adherence to and utilization of services. Despite strategies to provide access to PMTCT of HIV services, utilization of these services remain low in Nigeria thereby increasing child morbidity and mortality from HIV-related causes. Adherence to comprehensive HIV/AIDS care, for both the mother and baby, remain a challenge for HIV positive women. Utilizing the Health Belief Model and Social Support Theory, this qualitative study explores factors influencing utilization and adherence to PMTCT services by mothers living with HIV/AIDS in Rivers State, Nigeria. Purposive sampling procedures were used to select 40 study participants including 20 HIV positive mothers and 20 health care workers as key informants. Findings indicate that high self-perceived susceptibility to HIV influences utilization and adherence to PMTCT services among mothers living with HIV and AIDS in Rivers State. Although utilization and adherence to PMTCT were reported very high among this population, there were however challenges and barriers to optimal utilization of PMTCT. These include unavailability of test kits, antiretroviral medication stock-outs, and inadequate human resources for health. High transport, PMTCT and antenatal care costs were identified as the major socio-economic barriers to PMTCT administration as well as the high financial burden of formula feeding for women that preferred exclusive formula feeding. In addition to increased numbers of health care workers trained in PMTCT service delivery, recommendations for a public health approach to service delivery and a streamlined primary care strategy are proposed. These include social and community activities to address HIV/AIDS stigma, improving awareness of PMTCT facts, addressing gender relations and encouraging male participation. Inter-ministerial collaborations and targeted partnerships are also recommended for expanding coverage and ensuring optimal utilization of PMTCT services.

Bakgrund: Amyotrofisk lateralskleros, även kallat ALS, är en obotlig sjukdom som orsakar att nervceller som styr skelettmuskulatur dör. Detta leder till muskelförtvining och senare förlamning. I Sverige insjuknar 220-250 personer årligen, de flesta är mellan 45-75 år. Vården har ett stort ansvar gällande symtomlindring, då inga botemedel hittats. På så sätt har sjuksköterskan ett stort omvårdnadsansvar kring patienter med ALS, för att underlätta vardagen och hjälpa patienten att bibehålla sin livskvalité. Syfte: Syftet med studien var att beskriva personers upplevelser av att leva med ALS. Metod: En beskrivande litteraturstudie som baseras på en studie med mixad metod, sex kvalitativa och sju kvantitativa vetenskapliga artiklar. Huvudresultat: Resultatet visade att upplevelsen av att leva med ALS var svår att hantera ur ett fysiskt och psykiskt perspektiv. Flera copingstrategier visade sig underlätta upplevelsen av att leva med sjukdomen. Stöd från närstående var viktigt trots att detta kunde upplevas som jobbigt då många personer kände sig som en börda gentemot sina närstående. Vården beskrevs som en viktig del i den sjukdomsdrabbades liv genom att hjälpa personen med information om sjukdomen och eventuella hjälpmedel. Den psykiska upplevelsen av ALS visade sig vara jobbig, vilket ofta hörde ihop med försämrad fysisk förmåga samt smärta. Slutsats: ALS är en obotlig sjukdom som medför en stor livsförändring och resultatet visade att de negativa upplevelserna av sjukdomen var dominerande. Genom kompetens inom området av vårdpersonal, kan upplevelsen av de svårigheter som kommer med sjukdomen underlättas genom gott stöd och symtomlindring. / Background: ALS, also called amyotrophic lateral sclerosis, is an incurable disease that affects the nerve cells which controls voluntary muscles. This leads to a loss of muscles and paralysis. About 220 to 250 people in Sweden get the disease every year, and it usually starts at the age 45 to the age 75. Healthcare has an important role to relieve the symptoms of ALS, as no cure is yet to be found. Nurses have a great responsibility to provide good care to help the patient maintain a good life quality and help to relieve the experience of living with ALS. Aim: The aim of this study was to describe how people experienced living with ALS. Method: A descriptive literature study based on one study with a mixed method, seven quantitative and six qualitative scientific studies. Results: The results showed that living with ALS was difficult to deal with in a physical and mental way. Several coping strategies showed to ease the experience of living with the disease. Support from relatives was important but many people felt like they were a burden towards their relatives. Healthcare was an important part of the experience of living with ALS, as healthcare could help the person with information about the disease and assistive devices. The psychological experience of living with ALS was difficult because of the physical impairment and the pain coming with the disease. Conclusion: ALS is an incurable disease that affects the daily life of those living with it and the results showed that the negative experiences were dominating. With knowledge about ALS, the healthcare professionals can relieve the symptoms and support the people living with it.

Magister Public Health - MPH / Sub Saharan Africa (SSA) single-handedly accounted for approximately two thirds (196 000) of the world maternal deaths. High maternal deaths have been attributed to high prevalence of HIV and low uptake of Antenatal Care (ANC). This made World Health Organization (WHO) to recommend integration of Prevention of Mother to Child Transmission of HIV (PMTCT) services into ANC to improve accessibility and utilization. According to Zambia Ministry of Health (MoH), every pregnant woman should have her ANC registration in the first trimester and achieve eight visits by delivery time. With the extra need of PMTCT services in the women living with HIV, early and regular ANC attendance is emphasized. However, in Zambia, there is limited information on ANC uptake and its associated factors among women living with HIV. / 2023

Bakgrund: Typ 1 diabetes mellitus (T1DM) bland ungdomar ökar i Europa och också i Sverige. Sjukdomen är kronisk och kräver livsstilsförändringar samt egenvård. Ungdomsåren kännetecknas av frigörelse från föräldrar och att hitta sin sociala tillhörighet. Att drabbas av kronisk sjukdom under denna del av livet kan antas vara särskilt omvälvande. Syfte: Syftet var att beskriva ungdomars upplevelser av att leva med T1DM. Metod: Studien var baserad på en litteraturöversikt med tio vetenskapliga artiklar som systematiskt söktes fram från databaserna Cinahl Complete och PubMed. Analysen genomfördes enligt fem steg där sista steget bestod av kategorisering och tematisering av artiklarnas resultat. Resultat: Genom analysen identifierades tre teman; Ett liv som ungdom med T1DM i isolering och utanförskap, mötet med sjukvårdspersonal, upplevelser av diagnostiseringen. Slutsats: Litteraturöversikten visar att ungdomarna hade svårigheter att hantera den förändrade livssituationen efter diagnosen. De beskriver känslor av utanförskap och isolering. Ungdomarnas kontakter med vården är överlag negativ då de inte blir respekterade som individer. Resultatet diskuteras med utgångspunkt från Dorotea Orems egenvårdsteori. / Background: Type 1 diabetes mellitus (T1DM) among young people is increasing in Europe and also in Sweden. The disease is chronic and requires lifestyle changes and selfcare. Adolescence is characterized by liberation from parents and finding one’s social affiliation. Suffering from a chronic illness during this part of life can assumed to be particularly transformative. Aim: The aim was to describe young people’s experiences of living with type 1 diabetes mellitus. Method: The study was based on a literature review with ten scientific articles systematically retrieved from the databases Cinahl Complete and PubMed. The analysis was carried out according to five steps, the last step consisted of categorizing and thematizationthe results from the included articles. Results: The analysis resulted in three themes: A life as a youth in isolation and exclusiondue to T1DM, encounters with healthcare professionals and Experiences of getting thediagnosis. Conclusion: This literature review highlights that young people had difficulty coping with the changed life situation after the diagnosis. They described feelings of exclusion and isolation. Their contacts with healthcare are generally perceived as negative as they experienced not being respected as individuals. The results are discussed in relation to Dorotea Orem’s self-care theory.

Philosophiae Doctor - PhD / Women living with HIV (WLHIV) desire to bear children. Safe conception (SC) education for informed decision-making to prevent peri-conception HIV infection is needed but not routinely available. Poor SC knowledge, attitude, skills in addition to the absence of a standardised training programme were challenges that limited delivery. This study therefore aimed at developing a training programme for healthcare workers to facilitate SC education among WLHIV. The study adopted the intervention research approach. Both qualitative and quantitative methods were employed.