Objective: A neglected issue in literature on nutrition and HIV/AIDS is how other health
professionals view their role in that arm. The purpose of this study was to understand
professional nurses' perception regarding their ability to render effective nutritional care
to people living with HIV/AIDS (PLWHA).
Design: A qualitative approach was used. Twenty-three, in-depth, semi-structured
interviews were conducted with nurses (mean age 38) working in eight (five rural and
three urban) Wellness clinics within public hospitals providing antiretroviral therapy
(ART) in North West Province, South Africa. Brief structured demographic
questionnaires were also administered. All interviews and focus group discussions were
recorded for transcription and open-coding. NVivo was used for open coding, whilst
descriptive statistics were done using SPSS for windows (version 14, SPSS Inc., Chicago.
IL). A research team of professionals and researchers collaboratively analysed data for
emerging themes.
Results: All the hospitals that participated had at most three nurses, having at least one
professional nurse working in the Wellness clinic for PLWHA. More than half of the
participants interviewed were diploma holders, eight (35%) were degree holders and
three (13%) had certificates in nursing. Five main themes (previously guided by the
interview questions) emerged during the analysis of data and these portrayed participants'
perceptions regarding their ability to render effective nutritional care to PLWHA. The
themes were 1) challenges faced by nurses dealing with PLWHA on a daily basis, 2) concerns of PLWHA, 3) nurses’ perception on the importance of nutrition in HIV/AIDS care, 4) nurses’ perceived ability to deal with nutritional issues in HIV/AIDS, 5) the role of traditional healers, traditional medicine in HIV/AIDS. Thirty five percent of
participants mentioned poor socio-economic status of PLWHA as a barrier to the
participants to talk about good nutrition to people that are food insecure. Furthermore,
13% of participants indicated that they are constantly facing the dilemma of PLWHA
mixing traditional medicines and ART. Participants perceived the following skills to be
important in the area of nutrition and HIV/AIDS: communication, listening and
knowledge. Although knowledge could be debated as it is not a skill per se, the participants believed that on needs to acquire nutrition knowledge first and then improve on the communication and listening skills with more exposure and training. Ten (41%) of
the participants interviewed rated themselves as average, 11 (48%) participants as good
whilst only 4%, representing one participant, felt they were very good at giving out
nutrition education. Sixty one percent of participants said they would require more
knowledge, whilst 39% said they would need to acquire communication and listening
skills for them to be able to render effective nutritional cart to PLWHA. In this study,
participants perceived nutritional care to PLWHA as their responsibility and that lack of
knowledge was influencing their inability to offer this service effectively. All the
participants indicated a need for collaboration with nutrition professionals, ill-service
training us well as exposure to clear communication channels for nutrition and HIV/AIDS
information. Participants were concerned with the lack of policy implementation
regarding nutrition and policy documents. Of the 23 participants interviewed, only two
(9%) confirmed having seen and rend the South African Guidelines on Nutritional Care
for People Living with TB, HIV/AIDS and other Chronic Debilitating Conditions.
Conclusion: All participants interviewed believed that nutrition knowledge in the area of
HIV/AIDS can be improved if poor people who are infected and affected by HIV/AIDS
are food secure. Concerning practice, it is recommended that nutrition and HIV/AIDS as
a topic be introduced in both undergraduate mid postgraduate training for nurses. The
lack of policy implementation, level of qualification and years spent in the nursing
profession may have influenced participants' perception regarding their ability, as well as
confidence, to render nutritional care to PLWHA. Possible interventions to improve
policy implementation could be the development of user-friendly information, education
and communication materials for health institutions as these may serve as constant
reminders to health care service providers. It was found that participants' perceptions
regarding their ability to render effective nutritional care to PLWHA was affected by a
complex number of factors which emerged as themes that need to be addressed.
Participants' experience suggests that more research and inquiries are needed into
traditional medicines and traditional healing, as the issue of ARVs and traditional
medicine is becoming a public health dilemma, riot only to the nurses, but to every
stakeholder involved in the field of HIV/AIDS. Furthermore, a need exists for nurse-specific
outreach, collaboratively done by nutrition professionals and other stakeholders.
This work thus provides a foundation for further exploring ways to improve the ability of
other health care workers such as nurses in the nutritional care of PLWHA which will
ultimately improve the quality of life of PLWHA. / Thesis (M.Sc. (Nutrition))--North-West University, Potchefstroom Campus, 2007
| Identifer | oai:union.ndltd.org:NWUBOLOKA1/oai:dspace.nwu.ac.za:10394/1707 |
| Date | January 2006 |
| Creators | Chasauka, Daisy |
| Publisher | North-West University |
| Source Sets | North-West University |
| Detected Language | English |
| Type | Thesis |
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