Challenges faced by traditional healers when treating people living with HIV and AIDS: the case of Intsika Municipality, Eastern Cape province
- Authors: Zimba, Zibonele France
- Date: 2014
- Subjects: People with HIV and AIDS disease -- Healers -- South Africa , Traditional medicine -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Treatment -- South Africa
- Language: English
- Type: Thesis , Masters , M SW
- Identifier: vital:11768 , http://hdl.handle.net/10353/d1015357 , People with HIV and AIDS disease -- Healers -- South Africa , Traditional medicine -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Treatment -- South Africa
- Description: The aim of the study was to examine the procedures followed by traditional healers treating people living with HIV and AIDS in the Instika Municipality and the challenges faced by them in this endeavour. Using the qualitative research method, in-depth interviews and focus group discussions were conducted with twenty traditional healers. Among the significant findings of this study were the hardships encountered by traditional healers in terms of finance, the transport needed to collect medicinal plants, the shortage of medicinal plants, the lack of co-operation from the formal health care sector and the discrimination and abuse suffered at the hands of members of the community, with Christians and members of the SAPS being among the chief antagonists. It is also acknowledged in this study that traditional healers have been trained by the Department of Health concerning issues of hygiene and that traditional healers have knowledge of the symptoms of HIV and AIDS. It can therefore be concluded that traditional healers have a significant role to play in preventing the spread of HIV and AIDS if they employ preventative measures such as the use of protective gloves and limiting the use of a blade to one patient only. However, traditional healers are not supplied with safety kits or condoms to distribute to patients who consult them for treatment of STIs.
- Full Text:
- Date Issued: 2014
- Authors: Zimba, Zibonele France
- Date: 2014
- Subjects: People with HIV and AIDS disease -- Healers -- South Africa , Traditional medicine -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Treatment -- South Africa
- Language: English
- Type: Thesis , Masters , M SW
- Identifier: vital:11768 , http://hdl.handle.net/10353/d1015357 , People with HIV and AIDS disease -- Healers -- South Africa , Traditional medicine -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Treatment -- South Africa
- Description: The aim of the study was to examine the procedures followed by traditional healers treating people living with HIV and AIDS in the Instika Municipality and the challenges faced by them in this endeavour. Using the qualitative research method, in-depth interviews and focus group discussions were conducted with twenty traditional healers. Among the significant findings of this study were the hardships encountered by traditional healers in terms of finance, the transport needed to collect medicinal plants, the shortage of medicinal plants, the lack of co-operation from the formal health care sector and the discrimination and abuse suffered at the hands of members of the community, with Christians and members of the SAPS being among the chief antagonists. It is also acknowledged in this study that traditional healers have been trained by the Department of Health concerning issues of hygiene and that traditional healers have knowledge of the symptoms of HIV and AIDS. It can therefore be concluded that traditional healers have a significant role to play in preventing the spread of HIV and AIDS if they employ preventative measures such as the use of protective gloves and limiting the use of a blade to one patient only. However, traditional healers are not supplied with safety kits or condoms to distribute to patients who consult them for treatment of STIs.
- Full Text:
- Date Issued: 2014
Illustrated medicines information for HIV/AIDS patients: influence on adherence,self-efficacy and health outcomes
- Authors: Barford, Kirsty-Lee
- Date: 2012
- Subjects: AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Patients -- South Africa , HIV-positive persons -- South Africa , AIDS (Disease) -- Study and teaching -- South Africa , Antiretroviral agents -- South Africa , Communication in medicine -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3863 , http://hdl.handle.net/10962/d1015678
- Description: South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
- Full Text:
- Date Issued: 2012
- Authors: Barford, Kirsty-Lee
- Date: 2012
- Subjects: AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa , AIDS (Disease) -- Patients -- South Africa , HIV-positive persons -- South Africa , AIDS (Disease) -- Study and teaching -- South Africa , Antiretroviral agents -- South Africa , Communication in medicine -- South Africa , Communication in public health -- South Africa
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:3863 , http://hdl.handle.net/10962/d1015678
- Description: South Africa has an estimated 920 000 patients on antiretrovirals (ARVs), the largest number of patients in any country. ARV therapy demands adherence levels in excess of 95% to avoid development of drug resistance, but adherence to ARV therapy is estimated to be only between 50% and 70%. Poor medication adherence is acknowledged as a major public health problem, reducing the effectiveness of therapy and promoting resistance to ARVs. More than two thirds of the South African population have marginal reading skills and this significantly influences a patient’s ability to read and understand health-related information. Patient education materials tailored for the South African population could be a useful aid in facilitating communication with patients and perhaps impact positively on their medicine-taking behaviour. This behaviour is influenced by patient knowledge, beliefs, attitudes and expectations and includes self-management, self-efficacy and adherence. Self-efficacy, which refers to patient confidence in the ability to self-manage medicine taking, is a key factor influencing adherence. This study aimed to develop illustrated patient information leaflets (PILs) and medicine labels for all first-line ARV regimens used in the public health sector in South Africa and, using a randomised control study design, to investigate the impact of these illustrated information materials on knowledge, medication-taking behaviours and health outcomes in HIV/AIDS patients taking ARVs. To achieve this aim, the objectives were to assess HIV/AIDS and ARV-related knowledge, as well as self-efficacy and adherence to ARV therapy; to assess the influence of demographic variables on knowledge, adherence and self-efficacy; to assess the influence of the information materials on knowledge, self-efficacy and adherence and to assess the association of knowledge with health outcomes. Medicine labels and PILs, both English and isiXhosa, were developed for ARV regimens 1a, 1b, 1c and 1d. The 8-item Morisky Medication Adherence Scale (MMAS-8) and HIV Treatment Adherence Self Efficacy Scale (HIV-ASES) instruments for measuring respectively adherence and self-efficacy, were modified to optimize clarity, simplicity and cultural acceptability and were translated into isiXhosa using a multi-stage translation-back translation. The questions and the rating scales, for both the MMAS and HIV-ASES, underwent preliminary qualitative evaluation in focus group discussions. Patients were recruited from local Grahamstown clinics. A pilot study to evaluate applicability of the instruments was conducted in 16 isiXhosa AIDS patients on ARVs and the results from this study informed further modifications to the instruments. One hundred and seventeen patients were recruited for the randomised control trial and were randomly allocated to either control group (who received standard care) or experimental group (who received standard care as well as pictogram medicine labels and the illustrated PIL). Interviews were conducted at baseline and at one, three and six months. Data were analysed statistically using the t-test, chi-squared test and ANOVA (Analysis of Variance) at a 5% level of significance. Correlations were determined using Pearson and Spearman rho correlations. Approval was obtained from Rhodes University Ethical Standards Committee, Settlers Hospital Ethics Committee and the Eastern Cape Department of Health. The results of this research showed that illustrated PILs and medicine labels enhanced understanding of HIV/AIDS and ARV information, resulting in a mean overall knowledge score in the experimental group of 96%, which was significantly higher than the 75% measured in the control group. Variable knowledge scores were measured in three areas: baseline knowledge of general HIV/AIDS-related information was good at 87%, whereas knowledge scores relating to ARV-related information (60%) and side-effects (52%) were lower. These scores improved significantly in the experimental group over the 4 interviews during the 6 month trial duration, whereas in the control group, they fluctuated only slightly around the original baseline score. There was no significant influence of gender on knowledge score, whereas health literacy, education level and age tested (at one and three months) had a significant influence on knowledge. Self-efficacy and adherence results were high, indicating that the patients have confidence in their ability to adhere to the ARV therapy and to practice optimal self-care. Age, gender and education, in most cases, significantly influenced self-efficacy, but were found to have no effect on adherence. The CD4 count improved over the trial duration which may have been influenced by a number of factors, including better knowledge of ARVs and improved adherence. No significant parametric correlation was found between knowledge score and change in CD4 count, however, Spearman's rho showed significance (rs=0.498; p=0.022). Both patients and healthcare providers were highly enthusiastic about the illustrated labels and PILs, and indicated their desire for such materials to be routinely available to public sector HIV/AIDS patients. The isiXhosa version of the PIL was preferred by all the patients. These simple, easy-to-read leaflets and illustrated medication labels were shown to increase understanding and knowledge of ARVs and HIV/AIDS in low-literate patients, and their availability in the first-language of the patients was central to making them a highly useful information source.
- Full Text:
- Date Issued: 2012
The experiences of people living with HIV-AIDS with regard to the comprehensive antiretroviral therapy management received from registered nurses at selected public primary heathcare clinics in Nelson Mandela Bay
- Authors: Jackson, Dawne Shirley
- Date: 2009
- Subjects: Antiretroviral agents -- South Africa , Stigma (Social psychology) , Nurses -- South Africa -- Attitudes , HIV-positive persons -- Counseling of -- South Africa , AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10032 , http://hdl.handle.net/10948/1253 , Antiretroviral agents -- South Africa , Stigma (Social psychology) , Nurses -- South Africa -- Attitudes , HIV-positive persons -- Counseling of -- South Africa , AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa
- Description: Currently South Africa has the highest number of persons living with HIV-AIDS (PLWAs) in the world. Focus-group discussions conducted by Moon (2005:3) in the Eastern Cape indicated that people may not want to get tested for HIV or to access antiretroviral therapy (ART) for fear of disclosure of their HIV-positive status and of stigmatization. These findings prompted the researcher to conduct a study in this field. The objectives of this study are to explore and describe the experiences of PLWAs with regard to the comprehensive ART management received from registered nurses at selected public primary healthcare clinics in Nelson Mandela Bay; and to develop guidelines for registered nurses that could facilitate them in rendering appropriate comprehensive ART management. The research study is based on a qualitative, explorative, descriptive, phenomenological and contextual research design. The research population comprised of HIV-positive patients who received treatment at the selected public primary healthcare clinics. Criterion-based, purposive sampling was used to select participants for the interviews. Ten in-depth unstructured interviews were conducted. Data was then transcribed and coded. One central theme identified the fact that PLWAs experienced both positive and negative experiences at the clinics. The main findings of this research included evidence of various forms of stigma experienced by the PLWAs; distrust of the lay health counselors; but also that PLWAs were generally well-treated and satisfied with the service they had received. Broad guidelines for registered nurses was formulated that could facilitate them in rendering appropriate comprehensive ART management. The study concludes with recommendations made with regards to the areas of nursing practice, education and research. Throughout the study the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2002:354).
- Full Text:
- Date Issued: 2009
- Authors: Jackson, Dawne Shirley
- Date: 2009
- Subjects: Antiretroviral agents -- South Africa , Stigma (Social psychology) , Nurses -- South Africa -- Attitudes , HIV-positive persons -- Counseling of -- South Africa , AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa
- Language: English
- Type: Thesis , Masters , MCur
- Identifier: vital:10032 , http://hdl.handle.net/10948/1253 , Antiretroviral agents -- South Africa , Stigma (Social psychology) , Nurses -- South Africa -- Attitudes , HIV-positive persons -- Counseling of -- South Africa , AIDS (Disease) -- Treatment -- South Africa , HIV infections -- Treatment -- South Africa
- Description: Currently South Africa has the highest number of persons living with HIV-AIDS (PLWAs) in the world. Focus-group discussions conducted by Moon (2005:3) in the Eastern Cape indicated that people may not want to get tested for HIV or to access antiretroviral therapy (ART) for fear of disclosure of their HIV-positive status and of stigmatization. These findings prompted the researcher to conduct a study in this field. The objectives of this study are to explore and describe the experiences of PLWAs with regard to the comprehensive ART management received from registered nurses at selected public primary healthcare clinics in Nelson Mandela Bay; and to develop guidelines for registered nurses that could facilitate them in rendering appropriate comprehensive ART management. The research study is based on a qualitative, explorative, descriptive, phenomenological and contextual research design. The research population comprised of HIV-positive patients who received treatment at the selected public primary healthcare clinics. Criterion-based, purposive sampling was used to select participants for the interviews. Ten in-depth unstructured interviews were conducted. Data was then transcribed and coded. One central theme identified the fact that PLWAs experienced both positive and negative experiences at the clinics. The main findings of this research included evidence of various forms of stigma experienced by the PLWAs; distrust of the lay health counselors; but also that PLWAs were generally well-treated and satisfied with the service they had received. Broad guidelines for registered nurses was formulated that could facilitate them in rendering appropriate comprehensive ART management. The study concludes with recommendations made with regards to the areas of nursing practice, education and research. Throughout the study the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2002:354).
- Full Text:
- Date Issued: 2009
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