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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Patient and nurse perspectives on loss to follow-up in HIV care

Modipane, Mahlatse Bridgette 16 May 2020 (has links)
PhD (Psychology) / Department of Psychology / Background: South Africa has world’s highest prevalence of HIV-positive people with approximately 7.06 million HIV-positive people with 110 000 HIV- related deaths reported by Statistics South Africa in 2017. South Africa has expanded access to anti-retroviral therapy services, from urban centers to resource-constrained rural communities. The rate of loss, however, to follow-up for patients on anti-retroviral treatment continues to increase. Aim of the Study: The aim of this study was to determine patient and nurse perspectives on loss to follow up among HIV-positive patients in Sekhukhune District of Limpopo Province, South Africa. The findings of the study guided the development of a proposed strategy to decrease loss to follow up among HIV-positive patients. Method: A qualitative research design was used with non-probability purposive sampling and with probability systematic sampling. The sample of patients comprised 30 HIV-positive people classified as lost to follow-up from clinics with high prevalence rates of lost to follow-up patients. Eight nurses, four from clinics with high rates and four from clinics with low lost to follow-up rates comprised the sample of nurses. Semi-structured interviews were conducted using the study research questions as a guide. Eight interviews were conducted with nurse clinic managers and 30 with the patients. Content analysis was used to analyze the data. Results: The key themes that emerged from the study included patients’ and nurses` perspectives on factors contributing to loss to follow up among HIV- positive patients; and Patients’ and nurses’ perspectives on strategies that would address barriers to loss to follow up among HIV- positive patients. Sub-themes on patients’ and nurses’ perspectives on factors contributing to loss to follow up among HIV- positive patients included: Lack of understanding of anti-retroviral treatment; fearful to disclose HIV status; lack of confidentiality; negative side effects; use of traditional medicine; self-transfer from one clinic to another. Patients’ and nurses’ elicited the strategies that would assist patients to remain in care and to take antiretroviral treatment consistently. The strategies included: providing patients with health education; working as a team; implementing social support group programme; providing nurses with in-service education on ethics and ethos. Informed by various intervention models in HIV care: Information Motivational Behavioural model; Health Belief Model; Social Action Theory and Social Cognitive Theory; I proposed a strategy that may reduce the rate of non-adherence and loss to follow up among patients with HIV in Limpopo Province. / HWSETA

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