Riglyne vir die familie ter ondersteuning van die MIV-positiewe pasiënt
De Wet, Gedina Eureka
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In South Africa, which has the largest HIV infected population world-wide, more than 5 million individuals presently live with HIV and AIDS (Evian, 2002:20; LINAIDS, 2004:19). These HIV-infected patients in turn affect the family structure within which they find themselves in a specific community. According to Saleeby (1992:54) and Barnett and Blaikie (1992:34), several families in South Africa are affected by the challenges posed by AIDS. This research forms part of the group research project, Tswaragano, which deals with an investigation into the competencies, abilities and strengths of the family of the HIV-positive patient while supporting the patient at home (Wessels, 2003:54). Problems such as unemployment, poverty, crime and changed demands in the community where these families live and increased challenges place a tremendous amount of stress on the families (Saleeby, 1992:54; Barnett & Blaikie, 1992:34). A vicious circle of AIDS and poverty is clearly confirmed and it has been found that people who live with HIV and AIDS need more support than health care alone (Booysen et al,. 2004:817-826). It is evident from the literature that, although information regarding HIV and AIDS is conveyed during pre- and post-HIV and AIDS test counselling, the transmission of information is not necessarily successful (Parker et al., 1998:18). A question which hence arises is whether the HIV positive patient and his family who support him at home fully grasp the necessary information. Greeff and Du Plessis (2001:2) confirm that health workers in the North-West Province do not convey the information effectively. Several factors probably contribute to defective information transfer between the health worker and the patient. One factor is that if the environment within which information is conveyed is not comfortable and mutual respect and trust between the health worker and the HIV positive patient is limited, the interpretation of information on HIV and AIDS is impaired (Allender & Spratley, 2001:163). A further aspect that should be taken into consideration is that HIV and AIDS-related information can be understood and internalised by the HIV positive patient in different ways, since several interpretation possibilities exist for information that is conveyed (Parker et al., 1998:20). Health workers who convey the information to the patient does however not always determine whether the HIV positive patient understands and internalises the information correctly (Parker et al., 1998:21). The facts mentioned above not only limit the HIV positive patient's understanding but also eventually the understanding of the family who have to support the HIV positive patient at home, regarding HIV and AIDS. The family can be seen as a primary core support resource for the HIV positive patient (Uys, 1999:2), and limited understanding impairs support at home (Hartman, 1981:10). With this is meant that the family is the "social service agency in meeting the social, educational and health care needs" of its members. The aim of this research was to investigate and describe the understanding of the HIV positive patient and the family regarding HIV and AIDS-related information. Guidelines were formulated to promote the understanding of the family of the HIV positive patient regarding HIV and AIDS-related information with the view to empower the family of the HIV positive patient in order to be able to support the patient at home. The research design was quantitative and descriptive by nature. It entails a pilot study in the Kagiso district, Vryburg area (Bophirima) of the North-West Province. The actual research study was performed in the Primary Health Clinics in the Potchefstroom district of the southern area of the North-West Province. Purposive sampling was performed (Burns & Grove, 2001:376; Brink, 1996:141; Abramson & Abramson, 1999:70; Bainbridge, 1989:46). Selected health workers acted voluntarily as go-betweens to identify HIV positive patients and their families who are prepared to participate in the research and who answer to the criteria, and to assist in filling out the questionnaires. The questionnaires were analysed by means of the frequency method with the assistance of the Statistical Consultation Services of the North-West University, Potchefstroom Campus and reported on by means of tables and graphs (Brink, 1996:499; Burns & Grove, 1997:430). From the research it was found that, although information transfer regarding HIV and AIDS does take place, there still are many voids in respect of the understanding of this information and this pertains to HIV positive patient as well as the families. The researcher has come to the conclusion that the proposed guidelines in order to empower families of the HIV-positive patients to support these patients at home therefore is obvious and important. Furthermore, the researcher is of opinion that families midst the difficult circumstances will realise their own strengths if they could acquire the necessary knowledge and skills. Recommendations were made for nursing education, for the practice of the community nurse as well as for nursing research. Guidelines were formulated to empower the family of the HIV positive patient to be able to support the patient at home.
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