Дисертації з теми "HIV-positive persons Dental care"
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1
Behardien, Nashreen. "Oral mucosal and facial manifestations of HIV/AIDS in children (Cape Peninsula, South Africa)." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&.
Анотація:
Currently, HIV/AIDS is one of the greatest threats to child survival in South Africa. It is estimated that approximately 6000 newborn babies become infected with the HIV virus monthly i.e. approximately 200 babies per day. During a 24 month period (October 1999 &ndashOctober 2001), a descriptive prevalence study of the oro-facial manifestations affecting HIV-positive children was conducted in the Cape Peninsula, South Africa. The study population consisted of 268 vertically infected HIV-positive children. The study was motivated by the lack of data regarding oral mucosal lesions in children with vertically acquired HIV-infection.
The study design was descriptive, and the population included consecutive, vertically infected HIV-positive patients sourced from out-patient clinics, hospital wards and special child-care facilities. The children were examined once consent was obtained from caregivers. The findings were documented using data capturing sheets. The data was captured on the Microsoft Excel program and analysed using the Epi 2000 program. The results indicated that a large proportion of HIV-infected children presented with orofacial manifestations at some stage during the course of HIV-infection. Oro-facial manifestations were observed in 70.1% of the study population. The prevalence of the most commonly observed manifestations were: oral candidiasis, 38.8%
parotid gland enlargement, 10.8%
oral ulceration, 5.6%
molluscum contagiosum, 7.8%
periodontal conditions, 3.4%
and herpes simplex infection, 0.7%.It can be concluded that in this sample of HIV-infected children, the prevalence of orofacial manifestations is higher than, and comparable with the findings of similar studies conducted in other regions of the world.
2
Albougy, Hany Ahed. "A systematic review of the management of oral candidiasis associated with HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2002. http://hdl.handle.net/10019.1/52713.
Анотація:
On t.p.: Degree MSc Dental Science (Community Dentistry)Thesis (MSc)--Stellenbosch University, 2002.
ENGLISH ABSTRACT: The purpose of this review was to investigate the management of oral candidiasis in HIV/AIDS patients and to evaluate the different guidelines that are available for its management. To achieve this aim, three objectives were identified: (i) to identify and report on the different interventions used to manage oral candidiasis, in patients with HIV/AIDS, (ii) to determine the efficacy of these interventions, and (iii) to provide guidelines for management. A thorough systematic search of the literature was carried out and all relevant papers were graded into three levels of evidence (A, B, and C) and scored for quality according to set criteria. A number of topical and systemic antifungal medications are used to treat oral candidiasis in HIV-positive patients. These include the poleyne antibiotics, nystatin and amphotericin B. Milder episodes of oral candidiasis respond to topical therapy with nystatin, clotrimazole troches or oral ketoconazole. Fluconazole has been extensively evaluated as a treatment for candidiasis. With HIV-infection, a cure rate of 82% has been achieved with a daily oral dose of 50 mg. Fluconazole was found to be a better choice of treatment for relapsing oropharyngeal candidiasis, resulting in either better cure rates or better prevention of relapse. Intravenous amphotericin B has been found to be effective therapy in azole refractory candidiasis where it was shown to be safe and well tolerated. Topical therapies were found to be effective treatment for uncomplicated oropharyngeal candidiasis, however patients relapsed more quickly than those treated with oral systemic antifungal therapy. Overall, nystatin appears less effective than clotrimazole and the azoles in the treatment of oropharyngeal candidiasis. With regard to the resolution of clinical symptoms, clotrimazole was found to be just as effective as the azoles, except when patient compliance was poor. Fluconazole-treated patients were more likely to remain disease-free during the fluconazole follow-up period than with those treated with other interventions. Relatively few studies were qualified to address the provision of guidelines for the management of oral candidiasis in primary health care settings. Most of the studies found were of moderate and low quality level of evidence. These studies included the assessment of different guidelines for identification, treatment and dental needs. They stressed that patients with HN need dentists who will act as primary health care providers, together with other providers to ensure adequate overall care. Given the level of interest and importance of candidiasis associated with treatment of HN -positive patients, it is surprising to find that little high quality research has been undertaken. As such, it is hoped that this review would provide researchers, oral health care workers and other health care providers with an overview of the management of oral candidiasis associated with HN/AIDS.
AFRIKAANSE OPSOMMING: Die doelstelling van die oorsig was om ondersoek in te stel na die hantering van orale kandidiase in HIV/AIDS pasiënte asook om die verskillende beskikbare riglyne vir die behandeling daarvan te evalueer. Ter verwesenliking van hierdie doelstelling is drie doelwitte geïdentifiseer: (i) om die intervensies wat gebruik word in die hantering van orale kandidiase behandeling te identifiseer, (ii) om die effektiwiteit van hierdie intervensies te identifiseer en (iii) om op grond hiervan riglyne vir die hantering voor te stel. 'n Sistematiese literatuursoektog is uitgevoer en alle relevante artikels is in drie groepe geklassifiseer (A, B en C) op grond van die data kwaliteit. 'n Verskeidenheid topikale en sistemiese antifungale middels word gebruik om orale kandidiase in HIV-positiewe pasiënte te behandel. 'n Sukseskoers van 82% is met die gebruik van 'n daaglikse dosis van 50 mg medikament gerapporteer. Fluconazole was die beter keuse van middel vir die behandeling van terugkerende orofaringeale kandidiase. Topikale behandeling was effektief in die behandeling van ongekompliseerde orofaringeale kandidiase, hoewel die kans op terugkeer van die toestand groter was as met die sistemiese middels. Pasiënte wat met flukonasool behandel is, het 'n groter kans gehad om siektevry te bly vergeleke met pasiënte op die ander intervensies. Meeste van die studies was van middelmatige tot lae kwaliteit en gevolglik was dit moeilik om behandelingsriglyne te stel. Wat egter wel duidelik is, is dat HIV pasiënte primêre mondsorg benodig wat saam met ander versorging omvattende sorg sal verseker.
3
Seng, Vuthy Santhat Sermsri. "Influences of stigmatization and discrimination on care for people living with hiv/aids (plwha) : a study of home based care services in Phnom Penh, Cambodia /." Abstract, 2007. http://mulinet3.li.mahidol.ac.th/thesis/2550/cd400/4838029.pdf.
4
Setwaba, M. B. "Stress and dysfunction in families caring for members physically deteriorating due to HIV/Aids in Limpopo Province : resilience as a moderating factor." Thesis, University of Limpopo, 2015. http://hdl.handle.net/10386/1207.
Анотація:
Thesis (Ph.D. (Psychology)) -- University of Limpopo, 2015The study aims at assessing the stress and dysfunction among families affected by the sudden reality of experiencing physically deteriorating family members due to HIV/AIDS progression, and to identify resilience factors that moderate the impact. Three-hundred and sixteen families were conveniently selected to participate in this study. The experimental group of the HIV/AIDS affected families (n=122), with two control groups of families caring for family members ailing because of a non- HIV/AIDS physical ailment (n=132) and the families not involved in the caring of any family member (n=62). Family resilience and stress questionnaires were used to collect the data. Family resilience questionnaires included Family Hardiness Index (FHI), Social Support Index (SSI), Relative and Friend Support (RFS), F-COPES, Family Time and Routine Index (FTRI), Family Problem Solving Communication (FPSC) Family Attachment and Changeability Index 8 (FACI 8). The family caregiver stress was measured by the Relative Stress Scale. Univariate and multivariate regression analysis were used to determine the moderating effect of the family qualities on the stress levels, and specific qualities unique in the families that bounce back. Stress was found to be high in the HIV/AIDS affected families when compared with the control families. Furthermore, the demographic information indicated that more stress was experienced in the HIV/AIDS affected families with a younger sick member and in poor economic conditions as well as when the sick person was a breadwinner. This indicated that stress elevation in the HIV/AIDS affected families was a function of economic conditions in the families and that caregivers may have experienced stress due to lack of proper resources and the stress of having sympathy for a young sick person who was expected to have a long life ahead of him or her. Social support (SSI), relative and friend support (RFS), and spending time together and engaging in similar routine collectively (FTRI) were found to moderate stress in HIV/AIDS affected families. Further research is needed to highlight the dynamics and the relationship with stress elevation around the new trend of HIV/AIDS infection of the younger age group as well as the economic burden or the impact of lack of resources in caring for the infected. More in-depth research must also be done with an emphasis on the dynamics between stigmatisation, stress moderation and resilience of families using more diverse families engaging in various caregiving situations of sick family members within various ecological and socio economic conditions.
5
Williams, Margaret. "A chronic care coordination model for HIV-positive children requiring antiretroviral therapy." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1020346.
Анотація:
The human immunodeficiency virus / acquired immune deficiency syndrome pandemic (HIV/AIDS) continues to increase in prevalence worldwide, particularly in South Africa. There is a concurrent and distinct increase in the prevalence of HIV/AIDS and HIV-related diseases in the paediatric population in South Africa, particularly those using public sector health services, with a corresponding increase in morbidity and mortality rates (Abdool Karim & Abdool Karim, 2010:363), which impacts greatly on paediatric healthcare services. Adding to this, the provision of paediatric antiretroviral care has numerous stumbling blocks, not least of which is lack of decentralisation of facilities to provide treatment. There is the additional shortage of staff, which includes staff that are comfortable dealing with children, lack of training programmes on the provision of antiretroviral therapy to children, and minimal on-site mentorship of staff regarding HIV/AIDS disease in children. This lack of capacity in the healthcare system means that not all of those who require treatment will be able to access it, and this is particularly pertinent to paediatric patients (Meyers et al., 2007:198). Therefore the purpose of this research was to develop a nursing model that would assist healthcare professionals, in particular professional nurses, to optimise the comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy at PHC clinics. To achieve the purpose of this study, a theory-generating design based on a qualitative, explorative, descriptive and contextual approach was implemented by the researcher to gain an understanding of how the healthcare professionals and parents/caregivers of HIV-positive children experienced the comprehensive treatment, care and support provided at primary healthcare clinics. The information obtained was used to develop a chronic care coordination model for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy. The study design comprised the following four steps: Step One of the research design focused on the identification, classification and definition of the major concepts of the study. This involved describing and selecting the research population and the sampling process prior to conducting the field work which comprised in-depth interviews with two groups of participants, namely healthcare professionals and parents/caregivers who accompany their HIV-positive children to PHC clinics in order to receive antiretroviral therapy. Step Two of the research design focused on the development of relationship statements in order to bring clarity and direction to the understanding of the phenomenon of interest. Step Three of the design concentrated on the development and description of the chronic care coordination model for optimising comprehensive treatment, care and support for HIV-positive children who require antiretroviral therapy in order to ensure a well-managed child on ART. A visual representation of the structure of the model for chronic care coordination was given and described as well as a detailed description of the process of the model. Step Four was the last step of the research design and its focus was the development of guidelines for the operationalisation of the model for chronic care coordination for the optimisation of comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at PHC clinics. Guidelines and operational implications for each of the five sequential steps of the model were developed. The evaluation criteria of Chinn & Kramer (2008:237‒248) were used to evaluate the model. It is therefore concluded that the researcher succeeded in achieving the purpose for this study because a chronic care coordination model that is understandable, clear, simple, applicable and significant to nursing practice has been developed for use by healthcare professionals, particularly professional nurses, in order to optimise the comprehensive treatment, care and support for HIV-positive children requiring antiretroviral therapy at primary healthcare clinics.
6
Keleekai, Nowai L. "Associations between engagement in the patient-provider relationship and quality of life and adherence among persons living with HIV/AIDS." Connect to this title online, 2004. http://hdl.handle.net/1811/178.
Анотація:
Thesis (Ph. D.)--Ohio State University, 2004.Title from first page of PDF file. Document formatted into pages; contains 27 p. Includes bibliographical references (p. 21-24). Available online via Ohio State University's Knowledge Bank.
7
Breet, Elsie-Marie. "The relationship between intimate partner violence, HIV-related stigma, social support, and mental health among people living with HIV." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71951.
Анотація:
Thesis (MSc)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Global estimates show that sub-Saharan Africa has the largest portion of HIV cases with South Africa having more people living with HIV than any other country in the world. Moreover, studies have shown a high incidence of intimate partner violence (IPV) among people living with HIV. IPV has been shown to be associated with mental health problems. Considerable empirical studies have demonstrated that HIV is a highly stigmatized disease. In addition, HIV-related stigma has also been shown to be a risk factor for mental health problems among persons living with HIV. However, no empirical studies have examined the combined effect of IPV and HIV-related stigma on mental health. This thesis builds on the existing body of research by examining to what extent the linear combination of IPV (timing and frequency) and HIV related stigma explained variation in symptoms of common mental health disorders in both men and women living with HIV. In addition, theoretical and empirical studies have suggested that social support may serve as a protective factor in the relationship between IPV, HIV-related stigma, and mental health. Yet, despite the increasing attention, no known studies have focused on the mediating or moderating role of social support in the relationship between IPV or HIV-related stigma, and mental health. This thesis examined the extent to which social support played a mediating or moderating role in these relationships. The study used a cross-sectional research design to study a convenience sample of 210 people living with HIV in three peri-urban areas in the Western Cape, South Africa. Participants completed a battery of self-report questionnaires that assessed IPV (timing and frequency), HIV-related stigma, social support, and symptoms of common mental health. The results from the hierarchical multiple regression analysis demonstrated that the linear combination of psychological aggression frequency and HIV related stigma explained a significant portion of the variance in symptoms of depression. Likewise, both physical assault timing and psychological aggression timing combined with HIV-related stigma explained a significant portion of variance in symptoms of depression. Psychological aggression timing combined with HIV-related stigma significantly explained variance in symptoms of posttraumatic stress disorder (PTSD). The results from the product-term regression analyses indicated that social support played a mediating role in the relationship between HIV-related stigma and symptoms of PTSD, but not depression. Social support did not moderate the relationship between HIV-related stigma and symptoms of common mental health disorders. In conclusion, the combination of IPV (physical assault and psychological aggression) and HIV-related stigma explained a significant portion of the variance in symptoms of common mental health disorders. Future research is needed for a better understanding of these relationships. A longitudinal experimental design is recommended in order to explore the direction of these relationships and to examine the context in which the IPV, HIV-related stigma, and social support is experienced.
AFRIKAANSE OPSOMMING: Wêreldwye beramings toon dat sub-Sahara Afrika die grootste gedeelte van HIV gevalle te wêreld het, terwyl Suid-Afrika meer mense het wat met MIV leef as enige ander land in die wêreld. Verder het studies getoon dat daar 'n hoë voorkoms van intiemepaargeweld (IPV) is onder mense wat met MIV leef. Daar is al getoon dat IPV verband hou met geestelike probleme. Aansienlike empiriese studies het getoon dat MIV 'n hoogs gestigmatiseer siekte is. Daarbenewens, is daar getoon dat MIV-verwante stigma 'n risiko faktor is vir geestelike probleme onder persone wat leef met MIV. Daar is egter geen empiriese studies wat die gekombineerde effek van IPV en MIV-verwante stigma op geestesgesondheid ondersoek nie. Hierdie tesis bou voort op die bestaande navorsing deur te ondersoek tot watter mate die lineêre kombinasie van IPV (tydsberekening en frekwensie) en MIV-verwante stigma variasie in die simptome van algemene geestesgesondheid afwykings verduidelik in beide mans en vroue wat met MIV leef. Daarbenewens, het teoretiese en empiriese studies voorgestel dat sosiale ondersteuning kan dien as 'n beskermende faktor in die verhouding tussen IPV, MIV-verwante stigma, en geestesgesondheid. Tog, ten spyte van die toenemende aandag, het daar al geen studies gefokus op die bemiddelende of modererende rol van sosiale ondersteuning in die verhouding tussen IPV of MIV-verwante stigma, en geestesgesondheid. Hierdie tesis ondersoek die mate waarin sosiale ondersteuning 'n bemiddelende of modererende rol speel in hierdie verhoudings. Die studie het 'n deursnee-navorsing ontwerp gebruik om 'n gerieflikheidsteekproef van 210 mense wat met MIV leef in drie peri-stedelike gebiede in die Wes-Kaap, Suid-Afrika te bestudeer. Deelnemers het 'n battery van self-verslag vraelyste voltooi wat IPV (tydsberekening en frekwensie), MIV-verwante stigma, sosiale ondersteuning, en simptome van algemene geestesgesondheid geassesseer het. Die resultate van die hiërargiese meervoudige regressie-analise het getoon dat die lineêre kombinasie van sielkundige aggressie frekwensie en MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Net so, het beide fisiese aanranding tydsberekening en sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma 'n beduidende deel van die variansie in simptome van depressie verduidelik. Sielkundige aggressie tydsberekening gekombineer met MIV-verwante stigma het „n beduidende variansie in simptome van post-traumatiese stresversteuring (PTSV) verduidelik. Die resultate van die produk-term regressie-analises het aangedui dat sosiale ondersteuning 'n bemiddelende rol speel in die verhouding tussen MIV-verwante stigma en simptome van PTSV, maar nie depressie nie. Sosiale ondersteuning het nie die verhouding tussen MIV-verwante stigma en simptome van algemene geestesgesondheid versteurings modereer nie. Ten slotte, die kombinasie van IPV (fisiese aanranding en sielkundige aggressie) en MIV-verwante stigma het 'n beduidende deel van die variansie in simptome van algemene geestesgesondheid versteurings verduidelik. Toekomstige navorsing is nodig vir 'n beter begrip van hierdie verhoudings. 'n Longitudinale eksperimentele ontwerp word aanbeveel om die rigting van hierdie verhoudings te verken en die konteks waarin die IPV, MIV-verwante stigma en sosiale ondersteuning ervaar is te ondersoek.
8
Chow, Maria Yui Kwan. "Client needs and satisfaction in an HIV facility." University of Sydney, 2008. http://hdl.handle.net/2123/4022.
Анотація:
Master of Philosophy (Medicine)Health care evaluation serves the purpose of monitoring the quality of health care provided by Health Care Providers (HCP), so that health care services can be provided most effectively and efficiently. Patient satisfaction studies are widely used to assess the quality of outpatient care. A client satisfaction study was conducted at an HIV health care facility in Sydney, Australia during 2007-2008. There were three objectives: 1.) To validate a questionnaire for future determination of client satisfaction in HIV health care facilities. 2.) To identify the levels of satisfaction of clients, and investigate any dissatisfaction and unmet needs towards HIV health care. 3.) To provide recommendations for improving client satisfaction levels in HIV health care. This research used a mixed method approach and consisted of two phases. The first phase was a quantitative survey conducted with 166 clients (both HIV positive and negative) at Albion Street Centre (ASC) using a newly-devised questionnaire. Clients were asked to answer demographic questions, rate their levels of satisfaction with each aspect and each HCP category, and provide suggestions for improvement. Quantitative statistical analysis was conducted to obtain a general view of client satisfaction levels. Dissatisfaction and unmet needs of clients were then investigated in-depth in the second phase of the research through qualitative face-to-face semi-structured interviews. Twenty-two clients (both HIV positive and negative) at ASC were interviewed individually and asked about their attitudes, perceptions, and experiences towards their HCP and the HIV health care services received. Thematic analysis was used to categorise and interpret the qualitative data. More than 90% of the clients were satisfied with most of the aspects covered in the survey, with a mean overall satisfaction score of 84 out of 100. Clients were most iii satisfied with the “technical quality” and “interpersonal manner” of the HCP, and were least satisfied with “waiting time” and “availability of HCP”. The HCP category with which the clients has the highest level of satisfaction was “nurses” (86%), followed by “psychologists” (84%), then “doctors” (83%). Clients who were HIV negative, had a full time job, visited ASC less frequently, or did not possess any type of Health Care Card were more satisfied with the services overall. No common dissatisfaction or unmet needs towards HIV health care service were identified. “Technical quality of HCP” and “the relationship with HCP” were the two most important determinants of client satisfaction, which outweighed the inconvenience contributed by the poor availability of HCP and the location of ASC. The maintenance of “confidentiality/privacy” was shown to be fundamental in HIV health care facilities. The multi-disciplinary nature of ASC increased the degree of convenience and satisfaction level among clients. Suggestions for improvement in client satisfaction levels include increasing the attractiveness of the physical environment and the variety of educational reading materials in the waiting area; introducing beverages, and encouraging clients to be involved in their treatment decisions. Health care administrative staff in particular are reminded not to neglect the importance of the availability of HCP, accessibility, and physical environment when establishing a new HIV health care facility. The mixed method approach (quantitative survey and qualitative interviews) proved beneficial. It increased the validity of the findings by assessing client satisfaction levels using more than one method. This enabled clarification of ambiguities noted in the initial survey through probes used in the interviews, and also allowed investigation of the determinants of client satisfaction through understanding their experiences in HIV health care. Future client satisfaction studies would benefit from using this approach.
9
Hutchinson, Angela Blair. "A health technology assessment of HIV counseling and testing technologies." Diss., Georgia Institute of Technology, 2004. http://hdl.handle.net/1853/8077.
10
DiDona, Toni Marie. "An evaluation of depression, self-efficacy, satisfaction with life and perceived access to medical care across stages of HIV infection." FIU Digital Commons, 1994. http://digitalcommons.fiu.edu/etd/2815.
Анотація:
This survey was designed to identify the incidence and scope of depression, satisfaction with life, self-efficacy and perceived access to medical care for those who are infected with the HIV virus. It also determined whether or not factors such as sexual orientation, ethnicity and socioeconomic status are intervening variables with respect to mental health issues.
Subjects were recruited through a purposive sample from South Florida. A total of 871 surveys were used in the analysis. The overall response rate was nearly 90%.
The incidence of depression was found to be higher than 75% across all stages of HIV infection. Furthermore, the incidence of depression increased as HIV disease progressed. Satisfaction with life and for the most part, self efficacy were found to decrease slightly as HIV disease progressed. Significant variance in depression, life satisfaction and self efficacy were found across stages of HIV infection. No significant differences between groups that were HIV infected, were found for depression, life satisfaction and self efficacy.
The severity of depression was found to vary significantly with self efficacy, life satisfaction and access to medical care but not with socioeconomic status. Life satisfaction was found to vary significantly with socioeconomic status, depression and self efficacy but not with access to medical care, Self-efficacy was found to vary significantly with socioeconomic status, depression and life satisfaction but not with access to medical care.
Gender and ethnicity were not found to be significant precedent variables in depression for HIV infected individuals. Sexual orientation was found to be a significant precedent variable for depression, life satisfaction and self efficacy.
11
Jacobs, Nandipha. "Catastrophic and impoverishing health care expenditure in households affected by HIV/AIDS." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_4413_1254307304.
Анотація:
The aim of this study was to capture the intensity and incidence of catastrophic health care expenditures in order to describe the degree to which catastrophic health care payments occur among households. Simultaneously, the study set out to assess the extent to which people are made poor or poorer by health spending, i.e. the impoverishing effects of healthcare spending.
12
Chaava, Thebisa Hamukoma. "Skills, training and support for carers in HIV/AIDS community home-based care: a case study of carers in Chikankata, Zambia." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
Анотація:
The high prevalence of HIV/AIDS in Zambia has led to the development of innovative ways of coping with sickness related to this infection. HIV/AIDS home-based care is one such innovation designed in Chikankata Hospital in 1987. Home-based care depends on the availability of family members and community volunteers in the provision of care and support for People Living with HIV/AIDS (PLWHA).This minithesis is based on a qualitative descriptive case study exploring perspectives regarding skills, supervision and support mechanisms for carers in the Chikankata HIV/AIDS Community-Home Based Care (CHBC) program. The study utilized documented research, focus group discussions with carers and structured interviews with local CHBC supervisors, national experts in CHBC, and PLWHA and their families, to collect data from 32 study participants.
The findings were that CHBC was being delivered by community volunteers with limited involvement from the local health services
that carers were highly motivated, personally and collectively mobilizing resources to meet the needs of CHBC clientele
that local arrangements for training, skills and support of carers were not aligned to national guidelines regarding process, content and duration of programmes
and that carers acquired skills in CHBC through formal and informal training processes and were facing challenges related to inadequate skills, poor infrastructure and extreme poverty in households caring for PLWHA.
Based on the findings the local arrangements for coordination of CHBC need to be strengthened and linked to formal processes for technical support, financial resources and materials for delivery of CHBC in line with existing guidelines on CHBC. The picture of the real situation of the carers that emerges from this qualitative study might inform the supervising organizations and policymakers on the gaps in the training and support of this crucial cadre in the provision of quality care for People Living with HIV/AIDS (PLWHA) at community level.
13
Dutkowsky, Sandra Olivia. "Writing(s) on the ambiguity of care." Diss., Online access via UMI:, 2008.
14
Sibuyi, Steven. "The impact of the home-based care programme in Skukuza Camp of the Kruger National Park on employees and people of adjacent villages." Thesis, University of Limpopo (Turfloop Campus), 2011. http://hdl.handle.net/10386/615.
15
Tame-Gwaxula, Sindiswa Ruby, and Lange Naydene De. "High school teachers' experiences of dealing with learners made vulnerable by HIV and AIDS." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/2959.
Анотація:
The HIV and AIDS pandemic have become not only a health concern but educational and social concern as well. According to Beyers and Hay (2011, p. 99) many school-going children are not only affected by HIV but a large number of adolescents are also either HIV positive or have AIDS. Other researchers argue that education should act as a vaccine against new HIV infections (Kendall and O’Gara, 2007, p. 6). This argument comes with the expectation that all teachers are willing and ready to work with learners made vulnerable by HIV and AIDS; without considering the lived realities of the teachers in relation to HIV and AIDS. While many teachers make a difference in the lives of affected and infected learners through the way in which they deal with the learners concerned, some may not take up the challenge to assist the learners, while others might unknowingly and unintentionally do harm. This study, therefore, aimed at exploring high school teachers’ experiences of working with learners made vulnerable by HIV and AIDS in order to generate guidelines to assist teachers to effectively deal with vulnerable learners in their classrooms.
16
Hollinger, Laura Suvajee Good. "Maintenance of hope among Thai HIV/AIDS patients in a Buddhist temple-based care center /." Abstract, 2000. http://mulinet3.li.mahidol.ac.th/thesis/2543/43E-Laura-H.pdf.
17
Ko, Shuk-chun, and 高淑珍. "Exploration of Hong Kong nurses' perceptions and experiences towards HIV/AIDS caring." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B45012076.
18
Symes, Camilla Anne. "An exploration of the experiences of the leaders of mentored community-based organisations in the Eastern Cape." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/615.
Анотація:
The potential of community-based organisations (CBOs) to provide lasting solutions in the field of Human Immune Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) has long been recognised. As interest in the role of CBOs has increased, so have attempts to build their capacity and increase their stability and sustainability. Capacity-building initiatives which aim to strengthen CBOs as if they were identical to formal, more established organisations have often proved ineffective, and even at times destructive, because they have ignored the very differences that make CBOs potentially the most effective agents of development change at community level. This study is a qualitative exploration of a new mentoring-based approach to CBO capacity-building, which is currently being used extensively with CBOs in the Eastern Cape of South Africa. The research is inductive, beginning with an exploratory, descriptive and contextual study of the personal experiences and perceptions of CBO leadership team members from four sample CBOs which have graduated from the Barnabas Trust mentoring programme. Data was collected using a combination of face-to-face unstructured interviews and focus group discussion, with the objective of exploring the subjects’ experiences and their perceptions of the impact of the Barnabas Trust mentoring programme on the sustainability of their organisations. The insights and findings arising from the research process are then applied as the basis for a series of recommendations for the adaptation of the Barnabas trust mentoring approach and materials. The findings of this study appear to show that the mentoring-based approach has been an effective strategy for capacity-building towards sustainability for the CBOs in the sample, bringing positive change at the individual, organisational and community levels.
19
Mashele, Steven Charles. "Psychosocial care of people living with HIV : the case of Tzaneen, South Africa." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/19978.
Анотація:
Thesis (MCur)--Stellenbosch University, 2012.ENGLISH ABSTRACT: The overall objective of this study was to ascertain whether lay counsellors offer psychosocial counselling to clients at antiretroviral therapy clinics. The study was conducted at two clinics in the Greater Tzaneen municipality, Limpopo province, South Africa. The sample of 14 consisted of seven female lay counsellors and seven HIV positive clients, three females and four males, at Xihlovo and Nyeleti antiretroviral clinics. They were interviewed using 11-item and 12-item interview guides, respectively. Interviews were conducted in the local languages. Qualitative data were collected for the study. The data were audiotaped, translated, transcribed and then categorised into a thematic framework. HIV positive participants were found to be suffering from psychosocial consequences of living with HIV, such as shock, denial, anger and blame, fear of death, fear of disclosure, and intimate-partner violence. However, lay counsellors did not offer effective counselling that could relieve the psychosocial consequences. They instead used religion to console clients, discouraged clients from expressing their feelings, and minimised their clients’ concerns. It is recommended that lay counsellors be taught basic counselling theories as part of their training so that they are better able to screen their clients for psychosocial problems and provide basic counselling.
AFRIKAANSE OPSOMMING: Die algehele doelwit van dié studie is om te bepaal of leke-beraders psigo-sosiale berading aan kliënte by die die anti-retrovale terapie klinieke bied. Kwalitatiewe data is vir dié studie versamel. Die studie is by twee klinieke in die groter Tzaneenmunisipaliteit in Limpopo provinsie in Suid‐Afrika gedoen. Die eksperimentele groep van 14 het bestaan uit sewe vroulike leke-beraders en sewe MIV-positiewe kliënte: drie vrouens en vier mans, by Xihlovo en Nyeleti anti-retrovale klinieke. Daar was onderskeidelike onderhoude met hulle gevoer en die 11-item en 12-item onderhoudriglyne is toegepas. Onderhoude is in inheemse tale gevoer. Die data was opgeneem, vertaal, getranskribeer en in 'n tematiese raamwerk vasgevang. Daar is gevind dat die MIV-positiewe persone negatiewe psigo-sosiale gevolge ervaar: skok, ontkenning, woede, blaam, vrees vir die dood, vrees dat hul status openbaar sal word, asook geweld binne hul verhoudings. Leke-beraders het egter nie doeltreffende berading gegee om bogenoemde psigo-sosiale gevolge te verlig nie. Hulle het eerder godsdiens gebruik in 'n poging om hul kliënte te vertroos, nie die kliënte aangemoedig om hul gevoelens uit te druk nie en hul gevoelens en kommer afgemaak. Daar word aanbeveel dat leke-beraders basiese beradingsteorie as deel van hul opleiding ontvang sodat hulle psigo-sosiale probleme in hul kliente kan uitken en beter basiese berading kan verskaf.
20
Zulu, Nompumelelo Patience. "The effect of an informal caregiver's programme on the care of patients infected with HIV/AIDS." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/5382.
Анотація:
Thesis (MCur (Interdisciplinary Health Sciences. Nursing Science))--University of Stellenbosch, 2010.ENGLISH ABSTRACT: Background & rationale: South Africa is faced with the major challenge of HIV/AIDS. Every South African has a vital role to play in managing this public health problem. One of the best ways of managing it is by informing and educating the communities about HIV/AIDS, as the communities lack knowledge about it. Problem statement: Due to the increase in the number of patients infected with HIV/AIDS, an informal caregiver’s programme was introduced to ensure that patients are better cared for at home, in a familiar environment and by their family members. Purpose and objectives: The purpose of the study was to evaluate the effect of an informal caregiver’s programme on the care of patients with HIV/AIDS. The objectives included evaluating the effect of care, physically, socially, spiritually, emotionally, information and educational support given. Methodology: A phenomenological research design was applied to evaluate the effects of an informal caregiver’s programme implemented for the care of patients infected with HIV/AIDS at Mfuleni Township in the Cape Metropolitan area. Population and sampling: The population of this study were HIV/AIDS infected patients who were participating in the informal caregiver’s programme. Ten of these patients, who gave consent, participated in the study. Reliability, validity & pilot study: The trustworthiness of this study was assured with the use of Lincoln and Guba criteria of credibility, transferability, dependability and conformability. A pre-test study was also completed. Ethical considerations: Ethical approval was obtained from the Stellenbosch University and the required consent from the individual participants. Data collection, analysis and results: Data was collected through an interview using an interview schedule based on the objectives. Data was analysed and the findings show that the care given to patients infected by HIV/AIDS at home through an informal caregiver’s programme has a positive outcome. Recommendations and conclusion: On the spot training of participants and their family members is recommended. The community health workers form a very strong support base for the participants.
AFRIKAANSE OPSOMMING: Agtergrond en rasionaal: Suid-Afrika kom te staan voor ’n reuse uitdaging t.o.v. HIV/VIGS. Elke Suid-Afrikaner het ’n belangrike rol te speel in die beheer van hierdie openbare gesondheidsprobleem. Een van die beste maniere om dit te beheer, is om gemeenskappe in te lig en op te voed aangaande MIV/VIGS, aangesien daar ’n gebrek aan kennis hieromtrent is. Probleemstelling: Weens die toename in die aantal pasiënte wat deur MIV/VIGS geaffekteer word, is ’n informele versorgingsprogram daarop ingestel om te verseker dat pasiënte beter tuis versorg word in ’n bekende omgewing en deur hul familielede. Doel en doelwitte: Die doel van hierdie studie was om die effek van ’n informele versorgingsprogram in die versorging van pasiënte met MIV/VIGS te evalueer. Die doelwitte is uiteengesit om die effek van die versorging wat gegee is, te evalueer met verwysing na die fisiese, sosiale, geestelike, emosionele, inligting en opvoedingsondersteuning te evalueer. Metodologie: ’n Fenomenologiese navorsingsontwerp is toegepas om die effekte te evalueer van ’n informele versorgingsprogram wat geïmplementeer is vir die versorging van pasiënte wat deur MIV/VIGS geaffekteer is in die Mfuleni woonbuurt in die Kaapse Metropolitaanse area te evalueer. Bevolking en steekproef: Die bevolking van hierdie studie is MIV/VIGS geaffekteerde pasiënte wat deelgeneem het aan die informele versorger se program. Tien van hierdie pasiënte wat toestemming verleen het, het deelgeneem aan hierdie studie. Betroubaarhied, geldigheid en loodsondersoek: Die betroubaarheid van hierdie studie is verseker deur die gebruik van Lincoln en Guba se kriteria van geloofwaardigheid, oordraagbaarheid, afhanklikheid en ooreenstemmigheid. ’n Aanvoortoets is ook voltooi. Etiese oorwegings: Etiese goedkeuring is van die Stellenbosch Universiteit en die vereiste toestemming van die individuele deelnemers verkry. Dataversameling, analise en uitslae: Data is ingesamel deur gebruik te maak van ’n onderhoudskedule wat gebaseer is op die doewitte. Data is geanaliseer en die bevindinge het bewys dat versorging wat by die huis deur ’n informele versorgingsprogram aan pasiënte gegee word wat met MIV/VIGS geaffekteer is, ’n positiewe uitkoms het. Aanbevelings en gevolgtrekkings: Op-die-plekopleiding van HIV geïnfekteerde pasiente en hul familielede word aanbeveel. Die gemeenskap se gesondheidswerkers bied ’n sterk ondersteuningsbasis aan die deelnemers.
21
Johnson, Laura K. (Laura Kimberly). "HIV and Duty to Protect: a Survey of Licensed Professional Counselors and Physicians." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc278463/.
Анотація:
This study was designed to investigate what course of action therapists and physicians report they would take in reconciling their conflicting duties to maintain confidentiality and protect third parties from harm in HIV-related situations. The physicians surveyed were licensed to practice medicine in Texas and board certified in Internal Medicine. The therapists surveyed were licensed professional counselors in Texas and members of one of three selected divisions within the Texas Counseling Association. A survey instrument developed by the researcher was mailed to 200 subjects randomly selected from each group.
22
Taruvinga, Kudakwashe. "Establishing a new home based care programme for the community of Swakopmund." Thesis, Stellenbosch : University of Stellenbosch, 2010. http://hdl.handle.net/10019.1/8539.
Анотація:
Thesis (MBA)--University of Stellenbosch, 2010.Since the first case was discovered in Africa in the late 80s, the HIV/AIDS epidemic has gradually increased at alarming proportions worldwide especially in sub-Saharan Africa which prompted the United Nations' World Health Organisation to declare it a global pandemic. This research undertakes to highlight the current composition of care given for HIV and Aids, and the strengths and weaknesses of such programmes. The aim of this is to establish a better home based care programme in Swakopmund, Namibia, for improving the quality of care as well as living conditions for the infected and affected. For this initiative to be of the highest quality there is need to pay special attention to various regional and national HIV/AIDS programmes and policies. As the HIV/AIDS epidemic continues to spread, organisations and communities are now considering engaging more programmatic approaches as sub-Saharan countries are looking for scaled-up responses and national strategies for home based care. Policy-makers and senior administrators must be involved in developing and monitoring home based care programmes, and the people who manage and run the programmes must share information and feedback with senior administrators. In this sense, policy and action are interrelated as each partner learns from and guides the other. The researcher saw the need to involve community members and home based care-givers in a participatory process to research this topic and engage them in a process on how to improve the programmes that already exist. 52 Pages.
23
Williams, Margaret. "The experiences of caregivers in formal institutions caring for terminal AIDS patients." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/644.
Анотація:
One of the greatest challenges facing sub-Saharan Africa, which incorporates South Africa, is the AIDS pandemic. The devastation wrought by this disease is unsurpassed in recent times. The health and social development structures, already overburdened, are totally overwhelmed by the needs of povertystricken households and communities affected by AIDS. Caregivers attempting to support those affected and infected are also facing unique challenges and demands, particularly relating to dealing with the large numbers of deaths due to this disease. Experiences for these caregivers are likely to be varied, ranging on a continuum from positive to negative, for instance, the recovery of patients versus the death of patients. The objectives of this study are to explore and describe the lived experiences of caregivers working with AIDS patients, particularly patients who die from this disease whilst resident in a formal institution. The research is based on a qualitative, explorative, descriptive and contextual research design. The study is grounded in a phenomenological approach to inquiry. Caregivers working fulltime in a formal institution caring for patients who are dying from AIDS were interviewed in an in-depth, unstructured manner in order to gather spontaneous, rich descriptions of their experiences. Through this study the researcher wants their voices to be heard, the potential richness of their reflections acknowledged and the generated data to be applied to the benefit of the field of HIV/AIDS – both for staff and patients. Thirteen in-depth, unstructured interviews provided saturated data, which was then transcribed and coded to yield the central and sub-themes that were identified in this study. One central theme identified the fact that in their daily duties (at their place of work), caregivers experience various challenges as a result of having to deal with the death and dying of their patients suffering from AIDS. These caregivers face the death of their patients daily, from a disease that causes untold suffering to the patient, family members and to the caregivers themselves, who wish they could prevent the anguish, the pain and the inability of the medical profession to do more than they are at present towards curing this disease. ii By describing the lived experiences of these caregivers by means of the research interviews, the researcher gained a clear picture of the AIDS environment. The information shared by the participants formed the foundation of the broad guidelines that were formulated. These are intended to provide support for the caregivers centering around the equipping of mentors of the caregivers, to enable them to support the caregivers in their daily task of caring for patients dying from AIDS. These caregivers, thus supported, will then be in a position to provide optimal care for these dying patients. These broad guidelines are intended to provide support by focusing firstly on the physical environment in which these caregivers work; secondly in providing education for the caregivers to enable them to fulfill their duties, and thirdly to provide adequate counselling to ensure that they do not succumb to caregiver fatigue/burnout, a constant threat in this type of environment. The study concludes with recommendations regarding the areas of nursing practice, education and research.
24
Kulu, Joyce Aliendar Nomvuyo. "Social workers perspectives on social support needed by people living with HIV/AIDS." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86481.
Анотація:
Thesis (M Social Work)--Stellenbosch University, 2014.ENGLISH ABSTRACT: The South African government has laws and policies that forbid discrimination against individuals. These policies protect people from being discriminated against in the workplace due to sickness, race and many other factors. Discrimination against people living with HIV/AIDS has caused many people who suffer from this disease not to come forward with their illness because they fear being discriminated against and stigmatised; some even lose their jobs because they are infected with HIV. People infected with HIV are discriminated against not only in the workplace but also in their communities and families. This implies that people living with HIV/AIDS need support from all levels of society in order to live positive lives, which may lead infected people to live longer. This study explored HIV/AIDS as terminal illness and the stressors experienced by people infected with the virus. This was done by examining the support available to people living with HIV/AIDS, as well as identifying the support needed by these people. By adopting an ecological approach to the study, the need for support could be investigated on multiple levels. A combination of a quantitative and qualitative research design was used in the study. Data were gathered by means of a semi-structured interview schedule that was administered during individual interviews with service providers. This allowed for data that were both measurable as well as rich in description to be collected. The questions in the semi-structured questionnaire were based on the information retrieved from the literature review. The findings from the empirical investigation revealed that people living with HIV/AIDS receive limited support from their families, the South African government and society at large. The findings further indicated that informal sources of support such as family, friends and partners are relatively supportive of people living with HIV/AIDS. However, the relationships between people living with HIV/AIDS and their families and partners are often strained, especially when a person first discovers his or her status as HIV positive. Furthermore, people living with HIV/AIDS are stigmatised on multiple levels because of their status. There is stigmatisation from family, friends, in the workplace and in the community. The most important recommendations resulting from the study are that services such as counselling are needed for people living with HIV/AIDS together with their families. This is of particular significance to the South African government, especially the health sector, which needs to improve the health care system. In addition, recommendations emphasise the importance of promoting education and awareness, which could have great value for people living with HIV/AIDS, their families and communities. Knowledge about HIV/AIDS would empower people at all levels to support those who live with the disease and would also be of great value in helping those living with the disease to contribute something of value towards their health condition.
AFRIKAANSE OPSOMMING: Die Suid-Afrikaanse regering beskik oor wette en beleide wat diskriminasie teen individue verbied. Hierdie wette en beleide beskerm mense teen diskriminasie in die werkplek, diskriminasie op grond van siekte, gestremdheid, ras en vele ander redes. Diskriminasie teen mense wat met MIV/vigs leef, laat baie van hulle hul MIV/vigs-status geheim hou omdat hulle diskriminasie en stigmatisasie vrees. Sommige verloor selfs hulle werk wanneer dit rugbaar word dat hulle aan MIV/vigs ly. Diegene met MIV/vigs ervaar egter nie net in die werkplek diskriminasie nie, maar ook in hul gemeenskappe en families. Dít impliseer dat mense met MIV/vigs op alle vlakke ondersteuning nodig het om ’n positiewe lewe te lei en daarmee hul lewensverwagting so ver moontlik te verleng. Hierdie studie het die stresfaktore van terminale MIV/vigs-lyers ondersoek. Daar is voorts ondersoek ingestel na die ondersteuning wat mense met MIV/vigs ontvang, sowel as die ondersteuning wat hulle nodig het. MIV/vigs-lyers se ondersteuningsbehoeftes op etlike vlakke is deur middel van ’n ekologiese navorsingsbenadering bepaal. ’n Kombinasie van ’n kwantitatiewe en kwalitatiewe navorsingsmetodologie is vir die studie gebruik. Data is met behulp van ’n semigestruktureerde vraelys ingesamel, wat gedurende individuele onderhoude met diensverskaffers afgeneem is. Sodoende kon meetbare sowel as hoogs beskrywende data ingesamel word. Die vrae in die semigestruktureerde vraelys was gegrond op die inligting uit die literatuuroorsig. Die bevindinge van die empiriese ondersoek toon dat mense wat met MIV/vigs leef beperkte ondersteuning van hul familie, die Suid-Afrikaanse regering en die groter samelewing ontvang. Die bevindinge dui voorts daarop dat informele ondersteuningsbronne, soos familie, vriende en lewensmaats, betreklik ondersteunend is teenoor diegene met MIV/vigs. Tog is die verhouding tussen MIV/vigs-lyers en hul families en lewensmaats ook dikwels onder druk, veral net nadat die persoon ontdek dat hy/sy MIV-positief is. Daarbenewens word mense met MIV/vigs op verskeie vlakke gestigmatiseer – deur hul familie, vriende, in die werkplek en die gemeenskap. Die belangrikste aanbeveling uit die studie handel oor die behoefte aan dienste soos berading vir mense wat met die virus leef, sowel as vir hul familie. Die aanbeveling behoort veral van belang te wees vir die Suid-Afrikaanse regering, en in die besonder die gesondheidsektor, wat hierdie behoefte in gedagte moet hou om die gesondheidsorgstelsel te verbeter. Ander aanbevelings beklemtoon die belang van meer opvoeding en bewusmaking, aangesien dit uiters waardevol kan wees vir mense met MIV/vigs, hul familie en gemeenskappe. Kennis oor MIV/vigs sal mense op alle vlakke bemagtig om diegene met die virus te ondersteun, terwyl dit MIV/vigs-lyers self ook sal help om hul eie gesondheidstoestand beter te bestuur.
25
Read, Gary Frank Hoyland. "A qualitative study aimed at describing & interpreting the changing symbolic meanings of HIV/AIDS which encountering HIV-positive patients introduces into the personal & professional identities of selected health care professionals." Thesis, Rhodes University, 1993. http://hdl.handle.net/10962/d1002550.
Анотація:
This study aimed at describing and interpreting the changing symbolic meanings of the Acquired Immunodefiency Syndrome (AIDS) which encountering a Human Immunodefiency Virus (HIV)-positive patient introduced into the personal and professional identities of six health care professionals in a subregion of the Eastern Cape. With the exponential increase of HIV/AIDS in South Africa, medical practitioners have become increasingly exposed to HIV infected patients. This study has considered the psychological structures developed by practitioners in an attempt to control and understand their situation in the context of HIV/AIDS. In order to describe these psychological structures the existential phenomenological approaches of L. Binswanger (in Needleman, 1963), A. Giorgi (1975) and F.J.Wertz (1985) were employed. Through these procedures, the structure of the experience of encountering an HIV infected patient was elucidated. This comprised the first goal of this study. The second goal focused on interpreting these descriptions by way of the symbolic meanings and definitions implicit in the structure of this experience. For this latter purpose the approach of symbo1ic interactionism was used, in particu1ar the understandings outlined by H. Blumer (1969). This theory was seen as appropriate in that the encounter between the practitioner and patient was primarily located in interpersonal parameters. The findings were discussed in terms of the two dominant metaphorical frameworks used by the subjects to comprehend the disease - namely the perspectives of society and the biomedical model. These two frameworks were critically evaluated in the context of HIV/AIDS, the needs of HIV infected individuals as well as the needs of the general practitioner. The process of the encounter was found to be very significant for practitioners in terms of their conceptualisations of HIV/AIDS. Old understandings were reinterpreted within the interpersonal context and replaced with more appropriate symbolic metaphors upon which to base practise. This study has revealed these new understandings were limited and constrained with regard to understanding and treating HIV/AIDS in that the subjects were still influenced by the metaphors of the biomedical model. These constraints were examined in the light of both personal and professional meanings and identities. This study concluded by making suggestions for modification of the medical practitioner's role in the context of HIV/AIDS.
26
Mandla, Veliswa Maureen. "Intercultural communication in three Eastern Cape HIV/AIDS clinics." Thesis, Rhodes University, 2009. http://eprints.ru.ac.za/1610/.
27
Mamaila, Tshifhiwa. "Community-based care for HIV/AIDS orphans." Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-01312006-092356.
28
Smit, Stefan. "A study of the differences in the relationship between HIV/AIDS prevalence and related costs in the mining and financial sectors in South Africa." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/1024.
Анотація:
Thesis (MBA (Business Management))--University of Stellenbosch, 2009.ENGLISH ABSTRACT: By understanding the costs of HIV/AIDS, businesses can understand the incentives for preventing and treating the disease better. This report primarily investigates whether there is a difference in the relationship between HIV/AIDS prevalence rates and related costs in different sectors in South Africa. With an HIV prevalence ratio of approximately 10:1 for the mining and financial sectors, it is difficult to motivate that more research should be done on the impact of HIV/AIDS on the financial sector. However, if the study indicates a higher cost ratio between the two sectors it could increase the priority of the epidemic in the financial sector, giving rise to a bigger incentive to fight the epidemic. The estimated HIV/AIDS-related cost of an infected manager is R120 000 compared to the cost of R4 600 for an infected unskilled employee. From this analysis it is estimated that the HIV prevalence ratio between highly skilled and semi- and unskilled labour is 1:2.5, while the HIV cost ratio between the different skill levels is 1:0.2. This clearly indicates that there could be a significant difference between the HIV prevalence ratio and the HIV cost ratio for different levels of skills. From the Absa and AngloGold average salary information reviewed, the assumption was made that the Absa employees are more skilled than the AngloGold employees. With the knowledge of this difference in skill levels between the two companies in the different sectors, and the information above regarding the difference in HIV/AIDS-related costs for different skill levels, it is possible that the HIV/AIDS-related costs in the financial sector could be in line with the costs in the mining sector. Using HIV prevalence as an indication of the impact of the disease on the financial sector, a high-level cost estimate could be R150.9 million, compared to R3 985 million if the difference in the relationship between HIV/AIDS prevalence and related costs are taken into account. These materially different estimates could cause companies in the financial sector to make incorrect decisions regarding HIV/AIDS budgets for HIV/AIDS prevention and treatment, as incorrect indicators of the impact of the epidemic on the profit of the organisation are used.
AFRIKAANSE OPSOMMING: Deur die koste van MIV/vigs te verstaan, kan besighede die dryfvere vir die voorkoming en behandeling van MIV/vigs beter verstaan. Die verslag ondersoek hoofsaaklik of daar ’n verskil is in die verhouding tussen die voorkomsyfer en verwante koste van MIV/vigs in verskillende sektore in Suid Afrika. Met die MIV-voorkomsverhouding van ongeveer 10:1 vir die mynwese en finansiële sektore, is dit moeilik om verdere navorsing oor die impak van MIV op die finansiële sektor te regverdig. Indien hierdie studie egter ’n hoër kosteverhouding tussen die twee sektore aantoon, kan dit die prioriteit van die epidemie in die finansiële sektor verhoog, wat sal lei tot dryfvere om die epidemie te beveg. Die beraamde MIV/vigs-verwante koste van ’n besmette bestuurder is R120 000, vergelykend met die koste van R4 600 vir ’n besmette ongeskoolde werknemer. Uit ontledings kan beraam word dat die MIV-voorkomsyfer tussen hoogs geskoolde en half- en ongeskoolde werknemers 1:2.5 is, terwyl die MIV-kosteverhouding tussen die verskillende vlakke 1:0.2 is. Die inligting toon dat daar beduidende verskille tussen die MIV-voorkomsverhouding en die MIV-kosteverhouding vir verskillende vlakke van geskooldheid kan wees. Volgens Absa en AngloGold se inligting oor gemiddelde salarisse is die aanname gemaak dat Absa-werknemers meer geskoold is as AngloGold-werknemers. Met die kennis van hierdie verskil in vaardigheidsvlakke tussen die twee maatskappye in die onderskeie sektore en die inligting hierbo rakende die verskil tussen MIV/vigs-koste vir verskillende vaardigheidsvlakke, is dit moontlik dat die MIV/vigs-verwante koste in die finansiële sektor in ooreenstemming met dié in die mynwesesektor kan wees. As MIV-voorkoms as ’n aanwyser van die impak van die koste op die finansiële sektor gebruik word, kan ’n hoëvlak-kosteberaming R150.9 miljoen wees, vergelykend met R3 985 miljoen, as die verskil in die verhouding tussen MIV/vigs-voorkoms en verwante koste in berekening gebring word. Die wesenlik verskillende beramings veroorsaak dat maatskappye in die finansiële sektor foutiewe besluite rakende MIV/vigs-begrotings vir MIV/vigs-voorkoming en -behandeling maak, aangesien foutiewe aanwysers van die impak van die epidemie op die wins van die organisasie gebruik word.
29
Ferreira, Clive J. "Churches as providers of HIV/AIDS care : a normative and empirical study." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71797.
Анотація:
Thesis (PhD)--Stellenbosch University, 2012.ENGLISH ABSTRACT: There is, as yet, no cure for HIV/AIDS, a disease that has affected South African society profoundly. While antiretrovirals (ARVs) are now available and have stemmed the tide of AIDS deaths, medicines alone cannot be seen as a long-term solution. Treatment costs, finite resources, limited health-care capacity, morbidity and the unpleasant side-effects of ARVs, make treatment an untenable solution. The Christian church in South Africa continues to retain a powerful position; it has a significant affiliation; it is present in most geographic areas and inspires trust and confidence. Furthermore, in my view, the church, by its very nature and calling, is mandated not only to demonstrate and provide care, but also to inspire care-giving. In the light of HIV/AIDS, what does care mean? Can it only mean rendering care that is welfarist in nature? Or does the church have the mandate to look beyond immediate suffering, to examine and address those issues that lie at the core of suffering? Research has demonstrated that issues such as poverty, injustice, stigma, discrimination, gender inequality and patriarchy fuel the pandemic. Ultimately, it is the “othering” of people; the failure not to recognise God in another person and our common humanity, that lie at the heart of the problem. These then, I suggest, are the very reasons why the church must address these areas. But that is not all: if HIV/AIDS care is to be rendered in a developmental way, then there must be a thorough understanding of the disease: how is the virus transmitted, how can it be prevented and treated? It is also important to understand that there is not a single global epidemic but many local epidemics; the determinants and risk-factors of these need to be recognised, as must the cultural, economic, political and social contexts that fuel the spread of the disease. The changing nature of society, the effects of globalisation, the evolving nature of care owing to biomedical advances and even the “privatisation” of sex all need to be comprehended. Furthermore, any meaningful rendering of care requires the churches to examine why they should be giving it and the values that underpin such care-giving. I make the case that the churches are required to do nothing less than drive social change in situations of suffering, injustice and abuse. An examination of the history of HIV/AIDS in South Africa illustrates that the churches have often failed to meet up to this calling. An empirical study was conducted as to how the churches render care at a more micro, grassroots level, using a framework propounded by David Korten, who suggests that authentic development must be people-centred, rather than growthcentred. Essentially, development must seek to increase personal and institutional capacities, guided by principles of justice, sustainability and inclusiveness. In these respects, I argue, it accords very strongly with the Christian message. Korten suggests that there are four orientations (or generations) of rendering help but it is only the fourth generation that is truly developmental. Through the use of case study methodology, I sought to examine the manner in which the churches render care, in a region of the Western Cape, outside Cape Town, known as the Helderberg Basin. The area is representative of many peri-urban areas in the Cape: it is predominantly Christian, with a mix of different denominations and racial and socio-economic groupings. It allowed for an assessment of care initiatives afforded by mainline, charismatic and African Independent Churches and in particular, sought to answer the question of whether churches engage with HIV/AIDS in a way that Korten would identify as developmental. From the research, it is clear that the church is hampered by its inability to talk of sex and sexuality; its knowledge of the issues surrounding HIV/AIDS is limited; it has not done a sufficient amount to conscientise its followers; the church has yet to learn to utilise its networks; it lacks technical know-how and is unwilling to engage in the political sphere. Social change is only possible if the church embraces a new vision of how to create a better world. Additionally, I recommend that the church looks to the emerging church movement to achieve radical transformation.
AFRIKAANSE OPSOMMING: MIV/VIGS is ‘n siekte wat Suid-Afrika onmeetbaar beїnvloed en waarvoor daar tot op hede geen genesing is nie. Antiretrovirale middels (ARVs) is weliswaar beskikbaar en het die gety van VIGS sterftes gestuit maar medisyne kan nie alleen as die langtermyn oplossing gesien word nie. Behandelingskoste, beperkte hulpbronne en vermoë om gesondheidsorg te lewer, morbiditeit en die negatiewe newe-effekte van ARVs bring mee dat slegs mediese behandeling ‘n onhoudbare oplossing is. Die Christelike kerk in Suid-Afrika behou steeds ‘n magsposisie; dit het ‘n beduidende lidmaatskap asook ‘n teenwoordigheid in meeste dele van die land en boesem vertroue en sekerheid in. Dié kerk is na my mening gemandateer deur haar besondere aard en roeping om nie alleen sorg te bewys en te voorsien nie maar ook om versorging aan te moedig. Maar wat beteken sorg, gegewe die aard van MIV/VIGS? Kan dit slegs die lewering van welsyngerigte sorg beteken? Of sou die kerk die mandaat hê om verder as onmiddellike lyding te kyk en ondersoekend die kwessies wat aan die wortel van lyding lê, aan te spreek? Navorsing het aangetoon dat kwessies soos armoede, onreg, stigma, diskriminasie, geslagsongelykheid en patriargie die epidemie aanvuur. Uiteindelik is dit die objektivering (“othering”) van mense - dit is die onvermoë om God nie in ‘n ander persoon en ons gemeenskaplike mensheid te herken nie - wat die hart van die probleem is. Ek betoog dat hierdie die redes is waarom die kerk hierdie kwessies moet aanspreek. Om ondersoek in te stel of en tot watter mate die kerk sorg verskaf in verband met MIV/VIGS het ek die raamwerk van David Korten gebruik. Dié raamwerk stel voor dat outentieke ontwikkeling mensgesentreerd eerder as groeigesentreed sal wees. Ontwikkeling moet essensieel streef na ‘n toename van persoonlike en institusionele vermoë, gerig deur beginsels van geregtigheid, volhoubaarheid en inklusiwiteit. Ek toon aan dat hierdie beginsels baie sterk ooreenkom met die Christelike boodskap. Korten stel vier hulplewerende oriëntasies (ook genoem generasies) voor maar dit is eintlik slegs die vierde generasie van hulp wat werklik ontwikkelingsgerig is. Maar dit is nie al nie. Indien MIV/VIGS versorging ontwikkelingsgerig gaan wees, moet dit gegrond wees op ‘n diepgaande verstaan en kennis van die siekte soos onder andere, hoe die virus versprei word en hoe die siekte voorkóm en behandel kan word? Dit is ook belangrik om te verstaan dat daar nie slegs ‘n enkele globale epidemie is nie maar verskeie lokale epidemies. Die veroorsakende en risiko faktore van hierdie epidemies moet daarom geїdentifiseer word en so ook die kulturele, ekonomiese, politieke en sosiale konteks wat die verspreiding van hierdie siekte aanhelp. Die veranderende aard van gemeenskappe, die effek van globalisering, die ontwikkelende aard van gesondheidsorg vanweë die vooruitgang in die mediese wetenskap en die “privatisering” van seks moet alles in ag geneem word. Betekenisvolle versorging vereis dat kerke ondersoek instel na waarom die versorging aangebied word en die waardes onderliggend daaraan. Ek stel die saak dat daar van kerke verwag word om sosiale verandering te stuur waar mense swaarkry, onregverdig behandel en misbruik word. ‘n Ondersoek na die geskiedenis van MIV/VIGS in Suid-Afrika illustreer dat kerke dikwels misluk het om aan hierdie roeping gehoor te gee. In opvolging van die bostaande argumente het ek navorsing uitgevoer oor hoe kerke sorg op ‘n mikro of voetsool-vlak aanbied. Hiervoor het ek die genoemde mensgesentreerde ontwikkelingsraamwerk van David Korten gebruik. ‘n Gevalstudie benadering is gevolg in die Helderbergkom wat geleë is in ‘n streek van Wes- Kaapland buite Kaapstad. Hierdie gebied is verteenwoordigend van baie buitestedelike gebiede van die Kaap: dit is oorwegend Christelik en sluit ‘n verskeidenheid van denominasies, rasse en sosio-ekonomiese groeperings in. Die gebied maak ‘n oorsig moontlik van die sorg-inisiatiewe van hoofstroom, charismatiese en Afrika onafhanklike Kerke, en in die besonder van ‘n identifikasie daarvan of kerke betrokke by MIV/VIGS dit doen op ‘n wyse wat Korten sou tipeer as ontwikkelingsgerig. Uit hierdie navorsing het dit duidelik geword dat die kerk gekniehalter word deur ‘n onvermoë om oor seks en seksualiteit te praat; die kerk se kennis beperk is wanneer dit kom by kwessies wat handel oor MIV/VIGS; dit nie genoeg doen om lidmate bewus te maak van VIGS kwessies nie; dit nog veel te leer het oor hoe om netwerke aan te wend; dit tegniese kennis kort en onwillig is om met sake van politieke belang om te gaan. Sosiale verandering is alleen moontlik indien die kerk ‘n nuwe visie voorhou oor hoe om ‘n beter wêreld te skep. Ek beveel ten slotte aan dat die kerk let op die ontluikende kerkbeweging om radikale transformasie te verwesenlik.
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Sobuce, Ndabazovuyo Wellington. "The experiences of volunteers involved in home-based care for people living with HIV/AIDS." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/608.
Анотація:
HIV/AIDS is a pandemic infecting and affecting millions of people worldwide. South Africa is also severely affected by this disease. Because hospitals cannot cope with patients admitted daily especially with the influx caused by HIV/AIDS patients, the government has introduced home-based care of people living with HIV/AIDS. Amongst those who practice home-based care are the volunteers. This study is aimed at exploring and describing the experiences of volunteers involved in home-based care of people living with HIV/AIDS in the Lusikisiki Magisterial district in the former Transkei area of the Province of the Eastern Cape. The researcher used a qualitative methodology with the aim of finding out what it is like to be a volunteer involved in home-based care in a rural area. The data was collected by means of semi-structured one-to-one interviews or guided interviews. A total sample of thirteen research participants was acquired through purposive as well as snowball sampling. The interviews were guided by a number of broad question themes. Data was analyzed using Tesch’s framework of data analysis as described in Creswell (1994). The researcher used Guba’s model as outlined in Krefting (1991) to ensure trustworthiness of the research findings. A literature control was undertaken to find out what other researchers and authors say about the issues raised by the study. There were five themes that came out of the data analysis process and these themes are: o The experiences of volunteers with home-based care. o Factors facilitating the work of volunteers. o Problems encountered by volunteers. o Possible solutions to problems encountered. o Views of volunteers regarding home-based care. These broad themes were further reduced into sub-themes and categories. Based on the discussion of themes, sub-themes, and categories, some research findings were presented. The discussion of the themes, sub-themes and categories was supported by verbatim quotations from the participants. On the basis of research findings, conclusions and recommendations were made.
31
Kieser-Muller, Christel. "Needle stick injury and the personal experience of health care workers." Diss., Pretoria : [s.n.], 2005. http://upetd.up.ac.za/thesis/available/etd-01302006-144425.
32
Mahasele, Phehello Anthony. "Monitoring and evaluation indicators of the HIV & AIDS programme in Grahamstown's public sector health care system." Thesis, Rhodes University, 2011. http://hdl.handle.net/10962/d1003248.
Анотація:
South Africa is one of the countries hardest hit with the Human Immunodeficiency Virus (HIV) and Acquired Immuno Deficiency Syndrome (AIDS) epidemic. In response to the epidemic, the South African government adopted the Comprehensive HIV & AIDS Care, Management and Treatment programme strategic plan (CCMT) in 2000 (1) and developed the Operational Plan for CCMT for antiretroviral therapy rollout in 2003 (2). In order to monitor the progress of the implementation of CCMT, the National Department of Health (NDOH) adopted the Monitoring and Evaluation (M & E) framework in 2004 (3). The aim of this study was to assess the HIV & AIDS programme in Grahamstown‘s public sector health care system by using the national M & E indicators of the HIV & AIDS programme. The national M & E framework was used as the data collection tool and available information was collected from various sources such as the District Health Office (DHO), Primary Health Care (PHC) office, accredited antiretroviral sites and the provincial pharmaceutical depot. Group interviews were conducted with key stakeholder health care professionals at the District Health Office, Primary Health Care office, Settlers Hospital and the provincial Department of Health personnel. A one-on-one interview was conducted with the Deputy Director of HIV & AIDS Directorate, monitoring and evaluation in the National Department of Health. Available indicators such as budget and expenditure including antiretroviral procurement; human resources; nutrition-related indicators; prevention care and treatment indicators were collected. A group interview was conducted to document current practices, or where there was a lack of documentation, for indicators such as traditional medicines and pharmacovigilance. Most of the national M & E indicators are not required to be collected or collated by the district because the reporting format designed by the provincial Department of Health is different. Facilities, districts and provinces in South Africa are at different levels of implementation of the antiretroviral programme and hence a common format of the M & E indicators is not used by all provinces. Uniform data collection is not achieved due to human resources‘ constraints and other challenges such as continued use of manual reporting systems by the clinics. Districts are expected to report according to the formats drawn up by the provincial Department of Health (DOH) and there is a lack of awareness regarding the national M & E document amongst the Grahamstown Health Care Professionals. There is a need for training on the use of the M & E national framework so that the HCPs at the primary and secondary levels of the health care system are proficient with the process of M & E, and can provide inputs as well as take ownership of the process. The establishment of an M & E unit in Grahamstown is essential so that data collection and submission of the HIV & AIDS programme in the public sector according to the National M & E framework is addressed. However, despite all constraints and challenges in the public sector health care system in Grahamstown, available human and financial resources are being used effectively to maintain the HIV & AIDS programme.
33
Sontyale, Ulungile Klaas. "Occupational stressors that influence professional health workers." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1098.
Анотація:
Background: Despite the prevalence of HIV/AIDS stabilizing and slightly decreasing in certain provinces, there are a number of People Living With HIV/AIDS (PLWHA) in South Africa. Many people seek help at primary health clinics and hospitals and receive chronic care at these facilities. Caring for these chronic patients and new patients entering the health system can be stressful to the health professionals who are involved. Many studies that have been conducted have focused on the clinical aspects of individual patients, while few studies have focused on the experiences and stressors of health professionals looking after PLWHA. To ensure quality of care for patients with HIV/AIDS, it is important to understand the experiences of health professionals looking after HIV/AIDS patients and how stressful experiences may influence their attitude towards these patients. Aim: The aim of this study is to report the factors health professionals perceive as occupational stressors caring for people living with HIV/AIDS in the public health sector of the Nelson Mandela Metropolitan Municipality. Research design and Methodology: A quantitative, descriptive and non-experimental research design was followed. A pilot study was conducted to determine the clarity of questions, effectiveness of the instructions, completeness of the response sets, the time required to complete the questionnaires and the success of the data collection. The primary method of data collection was self-administered questionnaires. The questionnaires were dispatched to 30 health professionals at the public health facilities in the Nelson Mandela Metropolitan Municipality. A descriptive statistical analysis was done using a Statistical Package. This revealed the following findings. Findings: The following are the findings that were perceived to be occupational stressors: organizational factors, job design factors, career and promotional factors, role-related factors and cultural factors. iv Conclusion and recommendations: There are occupational stressors that affect health care professionals working in an HIV/AIDS setting. The following are the recommendations to rectify or to improve the situation: • Improve the communication of goals and objectives; • Redesign the job; • Human-resources development ; • Improvement of salaries; • Career planning and mentoring; and • Sensitisation of employees to cultural differences.
34
Munthali, Spy Mbiriyawaka. "An institutional analysis of community and home based care and support for HIV/AIDS sufferers in rural households in Malawi." Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1002719.
Анотація:
Standard economic models often emphasize inputs, outputs and an examination of the structures in order to conduct an economic performance evaluation. This study applies the Institutional and Development Framework (IAD) in the broader context of New Institutional Economics (NIE) in order to examine the transaction costs of delivering Community and Home Based Care and Support (CHBC) to HIV/AIDS sufferers. For purposes of unveiling the empirical reality guiding decision making processes in the CHBC service delivery, comparative qualitative research techniques of normative variable and concept formation have been adopted to draw out the relative institutional influences from the HIV/AIDS national response partnerships. The study identifies the conflict between the predominantly standardized and more rigid formal management techniques adopted by key members of the national response and the informal cultural techniques familiar to the rural communities, and a lack of motivational incentives in the CHBC structures as the key factors against CHBC capacities to draw external funding for service delivery. CHBCs are also weakened by incoherent governance structures at the district level for facilitation of funding and information flow exacerbating the community vulnerability. Rationalization of the institutional arrangements and a clarification of roles from district to community levels, a shift of focus to facilitation of informal techniques and an integration of performance enhancing incentives are the critical policy insights envisaged to spur CHBCs to work better.
35
Tilton, Abigail C. "The health status of people living with HIV/AIDS and in treatment in the United States." Thesis, University of North Texas, 2006. https://digital.library.unt.edu/ark:/67531/metadc5339/.
Анотація:
Vulnerable populations comprise a growing number of people living with HIV/AIDS and are at increased risk for poorer health outcomes. The purpose of this research was to approximate the effect of the Ryan White CARE Act on the health status of people living with HIV/AIDS who were receiving medical care in the United States. The vulnerable populations model was utilized to identify appropriate variables for analysis as well as to provide a sequencing for the testing of models. Data analyzed in this study came from the 1996 Baseline Survey of the HIV Cost and Services Utilization Study (HCSUS), a cooperative study between RAND and the Agency for Health Care Policy and Research (now known as the Agency for Health Care Quality and Research). Three analyses sequences, using different dependent variables, to estimate health status were conducted. In the first analysis, health status was measured by CD-4 count and stage of illness. In the second analysis, only CD-4 counts were used for health status. In the final analysis, health status was estimated based on AIDS diagnosis. Each of the three analyses included the same independent variables: race, gender, education, sexual orientation, income, insurance status, region of the country, receipt of case management, perceived health, and level of antiviral therapy. The three analyses suggested similar results. Specifically, that African Americans and women had better health status as compared to whites and men, respectively. Additionally, insurance, case management, and antiviral therapy were associated with poorer health status. Factors such as education, income, and region of the country yielded inconsistent results between models. To better understand the effect of the Ryan White CARE Act on health outcomes for people living with HIV/AIDS, future research should consider inclusion of a variable that more directly measures the CARE Act, such as payer source for medical care.
36
Ward, Vivienne. "Networks, NGOs and public health : responses to HIV/AIDS in the Cape Winelands." Thesis, Stellenbosch : Stellenbosch University, 2007. http://hdl.handle.net/10019.1/19890.
Анотація:
Thesis (MPhil)--University of Stellenbosch, 2007.ENGLISH ABSTRACT: This reflexive study of responses to the HIV/AIDS pandemic was set in Stellenbosch, a town in the Cape Winelands that, with its diverse but disjointed population, in many ways is a microcosm of South African society. My question was what happens when the experience of HIV/AIDS, with its personal impacts and global connections, reaches a particular locality in South Africa. I worked on the assumption that the reach of the disease in this specific locality reflects the disconnectedness of people through historical, political, social and economic processes, and that responses to the disease attempt to repair ruptures through integrating people into caring systems of support. By tracking and interrogating responses at public health and service organisation levels as a participant observer, I noted recurrent references to the importance of engaging patients in the treatment process. My observations revealed a transformation in the dyadic relationship between doctor and patient, as well as an embracing reach of networked service organisations, both initiatives striving to render more effective services. In the process relationships developed between patients and service providers at health and social levels, and between providers themselves. Much of the impetus for these local developments was derived from global inputs as local players draw down packaged practices and funds from the global assemblage that Nguyen refers to as the “AIDS industry” (2005a). Thus, I suggest that HIV/AIDS becomes a catalyst for local innovation within globally standardised structures, such innovation being driven principally by building social relationships.
AFRIKAANSE OPSOMMING: Hierdie reflektiewe studie aangaande die response tot die MIV/VIGS pandemie is in Stellenbosch, ‘n dorp in die Kaapse Wynlande, gedoen. Stellenbosch se diverse, maar tog onsamehangende, populasie is in verskeie maniere ‘n mikrokosmos van die Suid- Afrikaanse samelewing. My vraag het gevra wat gebeur as die ondervinding van MIV/VIGS, wat persoonlike impakte en globale konneksies insluit, ‘n spesifieke lokaliteit in Suid-Afrika bereik. Ek het gewerk volgens die aanname dat die omvang van die siekte in dié spesifieke lokaliteit die uitskakeling van mense deur historiese, politieke, sosiale en ekonomiese prosesse reflekteer, en dat response tot die siekte poog om ontwrigtings te herstel deur die integrasie van mense in versorgende ondersteunings sisteme. Deur response, op publieke gesondheid en dienslewerings organisasie vlak, as deelnemende waarnemer op te volg en te ondersoek, het ek herhaaldelike verwysings gekry na die noodsaaklikheid om pasiente te betrek in die behandelings proses. My observasies het ’n transformasie in die wederkerige verhouding tussen dokters en pasiente ontbloot, sowel as ’n omvattende omvang van netwerke van dienslewerings organisasies. Beide inisiatiewe streef daarna om meer effektiewe dienste te lewer. In die proses ontwikkel verhoudings tussen pasiente en diensverskaffers op gesondheids and sosiale vlakke, asook tussen diensverskaffers. ’n Groot gedeelte van die dryfkrag agter hierdie plaaslike ontwikkelings spruit uit globale insette namate plaaslike spelers verpakte praktyke en fondse ontvang/trek van die globale groep, wat Nguyen na verwys as die ’VIGS industrie’ (2005a). Daarvoor, stel ek voor dat HIV/VIGS ’n katalisator vir plaaslike innovasie binne globaal gestandardiseerde strukture word, en dat inovasies van die aard hoofsaaklik deur die bou van sosiale verhoudings gedryf word.
37
Mokheseng, Mamolise. "The management of antiretroviral drug distribution in the Qwaqwa District." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1016077.
Анотація:
The supply of Antiretrovirals (ARVs) to HIV/AIDS patients in most of the provinces in South Africa is hindered by various factors such as ineffective and inefficient drug procurement, and drug distribution systems. In the QwaQwa district in the Free State Province, a major barrier to the consistent supply of Highly Active Antiretroviral Treatment was identified to be the lack of an effective and efficient ARV drug distribution system. This resulted in major drug supply shortages in the QwaQwa district. A continuous, uninterrupted supply of ARVs to HIV/AIDS patients is critical to avoid drug resistance and therapy failure. Failure of a patient to respond to treatment results in a deterioration of a patient's health, and ultimately leads to death. The purpose of the study was to determine whether the ARV drug distribution practices at the Manapo Hospital in the QwaQwa district were effective and efficient in the management of ARVs. The distribution practices reviewed were the ordering, transportation, the management of inventory and warehousing, and the distribution of treatment to HIV/AIDS patients. Quantitative exploratory, descriptive and contextual methods were used to determine the relationship between the ARV drug distribution practices and the effective management of the ARVs. The study comprised of a sample size of twenty-one participants. The sample size entailed the Manapo Hospital pharmacists and pharmacist assistants who have been or are currently involved in the distribution of ARVs in the QwaQwa district since the initiation of the ARV rollout programme in 2004. The study revealed that the practices performed in the management of ARVs in the QwaQwa district were neither effective nor efficient in the distribution of ARVs. The recommendations of the study were identified to further ensure the effective and efficient management of the ARV drug distribution system, which will ensure a consistent supply of treatment to HIV/AIDS patients. Guidelines were developed for better circulation, thus meeting the objectives of the research.
38
Mwingira, Betty. "Development and assessment of medicines information for antiretroviral therapy in Sub-Saharan Africa." Thesis, Rhodes University, 2005. http://hdl.handle.net/10962/d1003257.
39
Bambani, Nomfezeko. "The utility of Weingarten's witness positions in the understanding of compassion fatigue in people who care for their own family members with AIDS." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1004465.
Анотація:
This paper explores the utility of Weingarten's (2003) witness positions in the understanding of compassion fatigue in people who care for their own family members with AIDS. The research is embedded in Weingarten's theory of witnessing and narrative theory and practice. The literature review explores the shift from hospital-based care to community/home-based care which has led to family members assuming the role of caring for their family members with AIDS, an overview of the effects of caring for AIDS patients on caregivers and an overview of Weingarten's (2003) theory of witnessing with special emphasis on the witnessing positions and their consequences. Interviews, based on narrative theory and practice in which Weingarten's theory is rooted, gave access to the participants' experiences, which were then analysed and interpreted through a framework developed from the witnessing theory. This article demonstrates the utility of Weingarten's (2003) theory of witnessing to people who are caregivers to their own family members with AIDS. I argue that witness positions occupied by caregivers during witnessing determine whether the caregivers will experience compassion fatigue. The negative consequences related to compassion fatigue that will be reviewed could probably be prevented through active, intentional, compassionate witnessing.
40
Driscoll, Jeanine M. "Exploring white dental students' willingness to provide dental care to people with human immunodeficiency virus disease." 1996. http://catalog.hathitrust.org/api/volumes/oclc/47887936.html.
Анотація:
Thesis (Ph. D.)--University of Maryland at College Park, 1996.Thesis research directed by the Dept. of Counseling and Personnel Services. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.
41
Shiboski, Caroline Philippo. "Oral health and HIV infection." 1997. http://catalog.hathitrust.org/api/volumes/oclc/48238399.html.
42
Charbonneau, Anne. "Accessibilité aux services buccodentaires des personnes vivant avec le VIH-SIDA au Québec." 1998. http://catalog.hathitrust.org/api/volumes/oclc/48146368.html.
43
Fraser, Michelle (Michelle Lousie). "Systematics of the genus Candida; implications for understanding clinical presentation, mixed infection and antifungal treatment and the influence on strain maintenance and replacement during oral candidiasis in HIV-infected individuals." 2002. http://web4.library.adelaide.edu.au/theses/09PH/09phf8421.pdf.
Анотація:
"8th July 2002." Includes bibliographical references (leaves 276-308) Examines the systematics (taxonomy, phylogeny, and epiemiology) of the genus Candida using a combination of traditional and contemporary methodologies. Assesses these methods to determine their diagnostic potential to unequivocally identify and characterise species and strains of this medically and dentally important yeast genus.
44
Fraser, Michelle Louise. "Systematics of the genus Candida; implications for understanding clinical presentation, mixed infection and antifungal treatment and the influence on strain maintenance and replacement during oral candidiasis in HIV-infected individuals / by Michelle Fraser." 2002. http://hdl.handle.net/2440/21799.
Анотація:
"8th July 2002."Includes bibliographical references (leaves 276-308)
vi, 308, [57] leaves : charts ; 30 cm.
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Examines the systematics (taxonomy, phylogeny, and epiemiology) of the genus Candida using a combination of traditional and contemporary methodologies. Assesses these methods to determine their diagnostic potential to unequivocally identify and characterise species and strains of this medically and dentally important yeast genus.
Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 2002
45
Ntsuntswana, Vuyokazi. "HIV/AIDS and home-based care: experiences of patients and households." Thesis, 2008. http://hdl.handle.net/10210/676.
Анотація:
M.A.The challenge of HIV/AIDS is a global issue, instead of decreasing the number of people infected with the disease the number is increasing. Fortunately we have men and women who are volunteers to fight the increase of this pandemic. These heroes are the voluntary caregivers who are the mainstay of people with AIDS. However the fact that the caregivers suffer from loneliness and social isolation related to stigma and discrimination cannot be ignored. Voluntary caregivers can benefit form the opportunity to express basic emotions concerning, financial, emotional and physical issues and open line of communication should be in place. Providing an avenue foe emotional expression may enhance both physical and mental health to voluntary AIDS Caregivers. The qualitative study undertaken to explore the experiences of AIDS patients and their families regarding the home based care as service delivery. An explorative and qualitative design was used to determine the experiences of the AIDS caregivers, and aids patients concerning the support that they receive. AIDS patients and the families were selected from the organisations that are funded by the Department of Social Development in the Free State, Bloemfontein area. Pilot study was conducted prior to the commencement of the study comprising of ten participants in each group. Participants were requested to give information during the interviews. Data was collected and analysed and it was in followed by the literature control. The findings did not differ significantly in emotional and social aspects. The researcher drew conclusion and recommendations. Limitations were discussed.
Dr. Oliphant Ms. A. Vermeulen
M.A.
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Jaiswal, Jessica Lynn. "A qualitative study of urban people of color living with human immunodeficiency virus: challenges related to retention in care, antiretroviral therapy acceptance, and “conspiracy beliefs”." Thesis, 2017. https://doi.org/10.7916/D8GF106X.
Анотація:
Background: Despite advances in HIV medication, many people living with HIV (PLWH) do not link to care upon diagnosis, do not remain engaged if linked, and do not achieve viral suppression through consistent ART adherence. Not achieving viral suppression is associated with low CD4-cell counts, preventable hospitalizations, frequent emergency room usage, risk of developing a drug resistance, and excess morbidity and mortality. Despite extensive literature that explores barriers to care, these disparities remain, particularly among racial, ethnic and sexual minority groups. Mistrust of health care systems and/or providers is thought to provide a partial explanation for why racial and ethnic minority groups are less likely to access outpatient HIV care. One form of health-related mistrust, referred to as “conspiracy beliefs” in the literature and in popular culture, is particularly associated with racial and ethnic minority people. HIV-related “conspiracy beliefs” can include the ideas that the government created HIV to target specific minority groups, that antiretroviral medication is used to experiment on vulnerable groups, or that a cure is being withheld or delayed by pharmaceutical companies and/or the government. Although many studies have assessed the prevalence of such beliefs, little is known about the possible relationship between endorsing these ideas and engagement from HIV care/ART adherence among PLWH. Moreover, the extant literature has provided equivocal findings that point to the need for further research on the relationship between these beliefs and managing one’s HIV.
Methods: Over the course of one year, 27 semi-structured, in-depth interviews were conducted with low income PLWH of color living in the NYC area that are currently, or were recently, disengaged from outpatient HIV medical care. Additionally, a brief questionnaire was administered to obtain demographic and engagement/medication adherence data to describe the sample of participants.
Findings: This analysis revealed the variation, texture and diversity related to people’s beliefs about the origin and treatment of HIV. Beliefs about the pharmaceutical industry and the government highlighted both the racism and classism experienced by low income who belong to racial and ethnic minority groups. Notably, HIV care providers did not appear to be perceived as part of the government-pharmaceutical power complex. This suggests that while many people may endorse these types of ideas, endorsement does not necessarily directly impact engagement in care. However, endorsing positive beliefs about the efficacy of ART, and the belief that HIV can be a chronic disease if treated consistently, helped participants remain adherent or desire to re-commit to taking it consistently. Participants also appreciated, and desired, providers that engaged in patient-centered medicine.
Recommendations:
It may be that public health does not necessarily need to endeavor to dislodge origin or pharmaceutical/cure-related beliefs; rather, interventions can focus on building trust between health care providers and populations that have been experienced both historically and ongoing marginalization. Participants’ emphasis on wanting to manage their ART-related challenges with their providers suggests that HIV providers have an instrumental role in not only lowering viral loads and achieving viral suppression, but also helping their patients feel agentic and able to manage their HIV. Implementing patient-centered medicine will also engender trust, thereby helping patients internalize the belief that consistent engagement and ART adherence makes HIV a chronic, manageable illness.
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Moshidi, Maria Lebeko. "Care and support model for health care providers of HIV and AIDS patients in the public hospitals of Limpopo Province." Thesis, 2018. http://hdl.handle.net/10386/2402.
Анотація:
Thesis (Ph.D. (Nursing Science)) -- University of Limpopo, 2018Introduction: Health care workers have a pivotal role in the management of Human Immune Deficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) and their well-being is consequently crucial as it could impact negatively on the quality of caregiving. With the development of a care and support model, the needs of health care workers can be identified and catered for, and quality patient care will be rendered through well-cared and supported health care workers. Purpose: The purpose of this study was to develop a care and support model for health care providers of patients diagnosed with HIV and AIDS in the public hospitals of the Limpopo Province. A key step in the development of a model for care and support is to explore and describe the experiences of professional nurses regarding care and support they receive while providing care to HIV and AIDS patients in the public hospitals of Limpopo Province Methods: A qualitative, descriptive, exploratory and contextual design was the method used which guided the development of the model. The population of the study were the professional nurses in five public hospitals from each district of the Limpopo Province. These hospitals were selected because they all shared similar characteristics of having clinics where HIV and AIDS patients receive care. The sample was purposively selected. The sample size was 20 professional nurses which was determined by data saturation, meaning that four professional nurses who worked for 24 months or more per public hospital were selected. Data were collected through face-to-face interviews and an audiotape was used to record all unstructured interview sessions conducted. Analysis of data were done through using an open-coding method in accordance with Tech’s qualitative data methodology to develop a model. Results: The research findings revealed emotional and physical strain due to shortage of staff and heavy workload which was exacerbated by staff turnover and high absenteeism. Exhaustion, fatigue, development of work-related vi illnesses and increased level of stress were also challenges experienced which led to increased customer complaints and decreased quality of service provided to patients. Many professional nurses were not trained in the management of patients with HIV and AIDS, but were expected to execute their activities competently. There was also lack of counselling, debriefing sessions, recognition and rewarding systems for the health professionals who were taking care of those patients. Recommendations: This Care and Support Model provides strategies to be used by the managers in public hospitals of Limpopo Province to enhance care and support to health care providers of HIV and AIDS patients. The model should be implemented at various public hospitals throughout Limpopo Province and feedback provided so that it could be further developed and refined. Conclusion: The results indicated that health care providers of HIV and AIDS patients were deprived of the necessary care and support during provision of care to HIV and AIDS patients. A model for care and support as a strategy to assist the managers to offer care and support to health care providers of HIV and AIDS has been developed. The model is a contribution to the nursing management, the government and it serves as a guideline for improving the quality of patient care through well-cared and supported health care workers.
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Cho, Hwayoung. "Development and Usability Evaluation of an mHealth Application for Symptom Self-Management in Underserved Persons Living with HIV." Thesis, 2017. https://doi.org/10.7916/D8X06KJW.
Анотація:
Effective symptom management is essential to decrease symptom severity and improve health-related quality of life for persons living with HIV (PLWH). A mobile health (mHealth) application (app) has the potential to be an effective delivery mode of an existing paper-based symptom management manual with self-management strategies for underserved PLWH. The quality of the mHealth app requires a thorough understanding of the needs of the intended end-users and ensuring the app’s usability.
The purpose of this study was to translate paper-based health information into an mHealth app for symptom self-management in underserved PLWH, entitled mVIP (mobile Video Information Provider), and assess its usability. To achieve this goal, usability was evaluated rigorously throughout the development process of mVIP. Based on a stratified view of health information technology (IT) usability evaluation framework, usability evaluation was sequentially conducted with the following three levels: 1) user-task, 2) user-task-system, and 3) user-task-system-environment.
At level 1 (user-task), we applied a user-centered design method to guide the information architecture of mVIP. Using a reverse in-person card sorting technique, symptoms and self-management strategies from a paper-based HIV/AIDS symptom management manual were ranked. The rank order of the 13 symptoms and 151 self-management strategies determined the order of appearance to end-users of the mVIP app, with higher-ranked symptoms and strategies appearing first. Based on the findings, we developed a prototype of mVIP as following: 1) once users log in, they are guided by an avatar through a series of 13 symptom questions ascertaining the nature and severity of their symptoms, and 2) the avatar recommends three self-management strategies for each symptom reported. At level 2 (user-task-system), we conducted a usability evaluation of the mVIP prototype in a laboratory setting through end-user usability testing and heuristic evaluation. In end-user usability testing, we used an eye-tracking and retrospective think-aloud method to examine task performance by 20 PLWH. For the heuristic evaluation, five usability experts in informatics assessed the user interface. In the two usability evaluations conducted in a laboratory setting, we found strong user acceptance of the mVIP prototype while identifying a number of usability issues with this prototype. Based on the recommendations from the end-users and heuristic evaluators, we iteratively refined the app’s content, functionality, and interface. We then inserted videos of the finalized symptom self-management strategies into the refined mVIP prototype. At level 3 (user-task-system-environment), the usability of the refined mVIP prototype was evaluated in a real-world setting. Through 10 in-depth interviews and four focus groups conducted at the conclusion of a three-month randomized controlled trial, we explored in-depth understandings of users’ experiences, perceptions, and satisfaction of mVIP use. Findings from the study showed that first, mVIP is useful for HIV-related symptom self-management and has the potential for being used as a communication tool with healthcare providers; and second, mVIP is easy to use to monitor symptom experience over time. At the same time, participants suggested mVIP be more sensitively tailored based on years from initial diagnosis of HIV, an individuals’ age, and conditions. The overall user satisfaction with the mVIP prototype was high, which reflects strong user acceptance of mVIP.
Integral to the findings from the three-level usability evaluation, we assessed the quality of the mVIP prototype in use and found the prototype was highly accepted by PLWH with high user satisfaction. This study will add to the body of literature on translation of evidence-based health information into an mHealth app and its usability assessment, which highlights the importance of the use of mobile technology for PLWH, specifically racial and ethnic minorities and those from low-socioeconomic groups who have limited health literacy and low level of education.
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Sirwali, Ndwamato Robert. "Factors contributing to men's reluctance to seek HIV counselling and testing at primary health care facilities of Vhembe Health District, South Africa." Diss., 2015. http://hdl.handle.net/11602/308.
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Noroski, Lenora M. Markham Christine M. Parcel Guy S. Fu Yun-Xin. "The care to share HIV disclosure study - the attitudes toward and beliefs about HIV disclosure among perinatally-infected HIV-positive youth and their caregivers." 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1467578.