Experiences of patients living with HIV and AIDS on antiretroviral therapy in Accra, Ghana

Background: The human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) pandemic has greatly affected Africa, particularly Ghana. The pandemic remains a public health concern, particularly in terms of accessing essential medication and improving quality of life for people living with the disease. Objectives: This study aimed to explore and describe the experiences of persons diagnosed and living with HIV who are on antiretroviral therapy. Method: A qualitative, exploratory, descriptive, and contextual design was used. The research population included persons diagnosed with HIV who were receiving antiretroviral therapy at three public hospitals in Ghana. Data saturation was achieved after conducting 15 semi-structured interviews. Creswell’s six steps of data analysis were used to analyse the data, which resulted in the emergence of one main theme and six sub-themes. Results: The main theme identified by the researchers highlighted the participants’ diverse experiences of being diagnosed and living with HIV. It was found that the study participants expressed shock, disbelief, surprise, and fear of death after being diagnosed with HIV. The participants also experienced stigmatisation, discrimination, and rejection. Conclusion: There is a need for further research on the extent of discrimination and stigmatisation and the effect on optimal adherence to antiretroviral therapy. Continuous public education on HIV is required to limit the extent of discrimination and stigmatisation. Contribution: The study has highlighted the various emotions related to stigma and discrimination expressed by persons living with HIV (PLHIV). The findings will guide policy on eliminating discrimination and stigmatisation for people living with HIV

A model for higher education campus health services

This study was undertaken in order to develop a holistic healthcare model that would assist registered nurses who are employed at a higher education campus’ health service to render a healthcare service relevant to the healthcare needs of the campus healthcare consumers. A theory-generative, qualitative, explorative,descriptive and contextual research design for theory generation was used to develop a holistic healthcare model for a higher education campus’ health service. It became evident throughout the study that the participants experienced a need for a more comprehensive healthcare service on campus. The main concepts of holistic healthcare were identified from the information obtained from the in-depth, focus group interviews that were conducted with the participants. The process of theoretical model generation was conducted according to the steps of theory generation as proposed by Walker and Avant (1995:39), namely that of concept analysis,the placing of concepts in relationships, a description of the model and guidelines to operationalise the model. This model provides a structured holistic healthcare frame of reference for registered nurses employed in a campus health service at a Higher Education Institution (HEI) and could be used to assist all campus healthcare consumers to become balanced whole persons who are able to realise their dreams and maintain consistency with regard to optimal health and capacity. Opsomming Hierdie studie is onderneem om teneinde ‘n holistiese gesondheidsorgmodel te ontwikkel wat geregistreerde verpleegkundiges, werksaam by ‘n hoër onderwys kampusgesondheidsorgdiens,kan help om ‘n gesondheidsorgdiens te kan lewer wat relevant is tot die gesondheidsbehoeftes vandie kampusgesondheidsorg verbruikers. ‘n Teorie-generende, kwalitatiewe,eksplorerende, beskrywende en kontekstuele navorsingsontwerp vir teorie genering is gebruik om ‘n holistiese gesondheidsorgmodel vir hoër onderwys kampusgesondheidsorgdienste te ontwikkel. Tydens die studie het dit duidelik geword dat die deelnemers ‘n behoefte het daaraan om ‘n meer omvattende gesondheidsorgdiens op kampus te ervaar. Die hoof konsepte van holistiese gesondheidsorg was geïdentifiseer vanuit die data wat verkry was deur die in-diepte fokusgroep onderhoude wat met die deelnemers gevoer is. Die proses van model-generering is uitgevoer volgens die stappe soos voorgestel deur Walker en Avant(1995:30) naamlik dit van konsep-analise, die plasing van konsepte in verhoudings, die beskrywing van die model en die riglyne om die model operatief te maak. Die model maak voorsiening vir ‘n gestruktureerde holistiese gesondheidsorgraamwerk wat as verwysing kan dien vir geregistreerde verpleegkundiges werksaam by ‘n kampus gesondheidsorgdiens by ‘n Hoër Onderwys Instansie(HOI) en kan gebruik word om alle kampus gesondheidsorgverbruikers te help om gebalanseerde, heel persone te word wat in staat is om hul drome te vervul en konsekwentheid met betrekking tot optimale gesondheid en kapasiteit te handhaaf

Provision of antiretroviral therapy for children in Nelson Mandela Bay: Health care professionals’ challenges

Background: The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children. Aim: To explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics. Setting: The study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa. Methodology: The researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell’s data analysis spiral. We used Lincoln and Guba’s model to ensure trustworthiness. Ethical standards were applied. Results: Health care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level. Conclusion: Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level