10 research outputs found
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Food meanings in HIV and AIDS caregiving trajectories: ritual, optimism and anguish among caregivers in Lesotho
The article describes the caregiving responsibility to provide food for chronically ill family members and the meanings attached to food and eating when ill created stress for family caregivers. The results come from a qualitative phenomenological study using in-depth interviews with 21 family caregivers of chronically ill HIV and AIDS patients in one district in Lesotho. Analysis of the interview data showed that the caregivers attached profound meanings to food and feeding care recipients. Their perceptions about food as part of family life and caring, the role of food and eating in curbing disease progression, the link between food and medical efficacy and the link between food and life led to ritualised behaviour around food, and moments of optimism and anguish in caregiving. Patients' behaviour in relation to food was in most instances inconsistent with the caregivers' goals, thus leading this aspect of caregiving to induce stress. Services intended to support home-based caregivers and patients could contribute to the reduction of stress associated with food through suitably tailored food assistance and professional support to caregivers to enhance their competences and understanding of the dynamics of food intake as AIDS progressed.
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Child maltreatment relational diagnosis using ICD codes: considerations for low- and middle-income settings
This chapter examines the extent of use of ICD-10 codes in health systems in general, and its use for diagnosing CM in LMICs in particular. Institutional arrangements, policy requirements, and practices of health professionals in relation to recognizing, documenting, and reporting CM as a public health issue, as well as some of the impeding factors to effective ICD use will be discussed.
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HIV/AIDS caregiving without ARVs in Lesotho: food, medicine, body and emotions
The book chronicles poignant experiences of family members who provided care for HIV and AIDS patients before antiretroviral drugs were available in the public health sector in Lesotho. Central to the caregivers' experiences is the patients' bodies that need attention, resist care and project suffering. The issues of confidentiality, the 'minimum package of care', de-medicalisation of HIV/AIDS care and rationing are discussed to illustrate their significance in the studied care contexts. Policy and practice that are consistent with the ethic of care and ubuntu are needed in the provision of humane interventions. It is concluded that improved communication between care-recipients, health care providers and family caregivers about HIV diagnosis and prognosis as well as improved access to appropriate medical care are consistent with the ethic of care and ubuntu and these could influence caregiving experiences positively.
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The phenomenology of bodily care: caregivers' experiences with AIDS patients before antiretroviral therapies in Lesotho
This study provides an account of caregivers' experiences with the bodily care of AIDS patients before antiretroviral therapies were available in the public health sector in Lesotho. It describes the mechanisms through which the body may become a stressor in caregiving. The phenomenological method, guided by the notion of epoche, was used to understand caregiving experiences from the perspective of family caregivers. Data on caregivers' physical activities and what they saw and thought were collected through in-depth interviews with 21 caregivers (mostly females); the caregivers were identified with the help of HIV/AIDS counsellors at two hospitals where AIDS patients received medical treatment. The thematic analysis shows that a patient's body was central in caregiving experiences. Social interaction in caregiving was mediated through seeing and touching the bodies of the patients. The different aspects of caregiving and the close interaction with the body of an ill family member - especially seeing major changes in the patient's physical appearance, their declined capacity to perform the activities of daily living, and discovering the symptoms of their illness - contributed to the caregivers' experiences of sympathy and pain. The social meanings and boundaries that tended to persist regarding touching and accessing others' bodies and bodily matter also contributed to the caregivers' stress.
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Confidentiality or continuity?: family caregivers' experiences with care for HIV/AIDS patients in home-based care in Lesotho
In the context of poor access to antiretroviral therapies in sub-Saharan Africa, the minimum treatment package intended to treat
opportunistic infections common with HIV infection is inadequate but appealing, since it presumes universal coverage of medical
care for patients living with HIV and AIDS. The overall objective of this study was to analyse the challenges which family caregivers
encountered in home-based care when they tried to access medical treatment for home-based AIDS patients in the context of
confidentiality and limited medical care. A qualitative study using in-depth interviews with a sample of 21 family caregivers - 16
females and 5 males aged between 23 and 85 years was conducted with the assistance of health personnel in two hospitals in Lesotho. Using the concept of continuity of care, this article discusses the experiences of family caregivers about home care, including their experiences of adherence to confidentiality by health care professionals and non-disclosure of AIDS as the context of illness, the circumstances under which the caregivers initiated caregiving and sought medical care, and how these factors could be stressors in caregiving. There was continuity of care where the caregivers obtained hospital support. However, when confidentiality was adhered to the caregivers were frustrated by lack of information, disrupted treatment, exclusion of their perspectives in medical care, failure to secure hospitalisation, ambiguous goals and non-responsiveness, so that continuity of care was jeopardised. Thus it can be concluded that professional-assisted disclosure benefited the patients because it facilitated continuity of care through the caregivers.
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The South African National Health and Nutrition Examination Survey, 2012: SANHANES-1: the health and nutritional status of the nation
South Africa is undergoing a process of epidemiological transition from infectious to non-communicable diseases (NCDs). While the burden of infectious diseases such as HIV and TB remains high, there are now other emerging epidemics of NCDs. NCDs,
mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes represent a leading threat to human health and development. According to World Health Organization (WHO) statistics, these four diseases are the world's biggest killers, causing an estimated 35 million deaths each year 60% of all deaths globally with 80% in low- and middle-income countries (WHO, 2008). These diseases are preventable. Up to 80% of heart disease, stroke, and type 2 diabetes and over a third of cancers could be prevented by eliminating shared risk factors, mainly tobacco use, unhealthy diet, physical inactivity and the harmful use of alcohol. Unless addressed with urgency, the mortality and disease burden from these health problems will continue to increase in our country. There is therefore a great need for a better understanding of both the prevalence of NCDs and the associated risk factors among South Africans and a need to translate such information into effective health policies, health programmes and services. It is timely that the HSRC and its various partners including the Medical Research Council (MRC) and several South African universities have been able to come together and undertake this fundamental survey, the first South African National Health and Nutrition Examination Survey (SANHANES-1). Indeed, this survey report could not have come at a better time as we now begin the enormous task to implement the National Health Insurance (NHI) system. It is also important to note that one of the Ten Point Plan actions for the Department of Health is the introduction of this type of survey that will assess the health and nutritional status of adults and children in South Africa. The Government's Strategic Priority: 'Improve the health profile of all South Africans' requires a dedicated survey such as SANHANES-1 that addresses the National Department of Health's (NDoH) priority health indicators. The uniqueness of SANHANES-1 is its ability to integrate findings from personal interviews with standardised physical examinations, diagnostic procedures, and a variety of laboratory tests. The results provide information on a broad range of health topics and associated risk factors that were beyond the scope of previous Demographic and Health Surveys (DHS). SANHANES-1 data will provide critical information for establishing national standards for weight, height, and blood pressure.