Omvattende behoeftegesentreerde tuisversorging vir pasiënte met VIGS in die Potchefstroom-distrik / Elsabé Bornman
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In South Africa, with the highest HIV population in the world, more than 5 million people live with HIV and AIDS, and it is predicted that deaths because of AlDS will rise sharply up to 2010 (Evian, 2003:20; UNAIDS, 2003:19). Because of this, great numbers of patients in the final stages of AlDS need support and homecare in areas with little resources. In this context of limited resources it became necessary for communities and health care services to investigate alternatives for cost-effective and sustainable methods to care for patients with AIDS. Patients are often discharged home to die because the hospital staff can do nothing but palliative care and they feel that resources and space can be better utilised on patients with a greater chance of recovery (Jackson, 2002:232). The government and non-governmental organisations established a number of homecare services to care for patients with AlDS at home. The Potchefstroom-district is no exception; the question however arises whether the care needs of these patients are addressed. The objective of this research was to identify the physical, psychological, spiritual and social needs of patients with AlDS for home care and the perceptions of caregivers of what these needs are. The ultimate objective was to formulate recommendations from the results for need-centred homecare for patients with AlDS in the Potchefstroom-district. A two-phased design was used to reach this objective. These two phases took place simultaneously. During phase one, caregivers operated as fieldworkers and completed questionnaires on behalf of the patients on their needs for homecare. During phase two the perceptions of caregivers of patients with AIDS's needs for homecare were determined using the nominal group technique. The director of health of the local authority gave consent for this research. The population of phase one consisted of available patients with AlDS in the Potchefstroom-district of the Northwest Province that compiled to the prerequisites of the research. The population of phase two consisted of a group of caregivers from another area that did not take part in phase one. After they gave consent a total of 24 patients with AlDS and 31 caregivers took part in the research. Data analysis in the case of the questionnaires was done by frequency distribution and for the nominal groups during the group sessions. On the grounds of the results the conclusion was made that patients with AlDS experience a great deal of hopelessness and that their needs are mostly on the first level of basic needs, according to the Maslow needs hierarchy. Higher levels of needs like self-concept needs and self-actualisation came to the attention in the need for spiritual support especially from their own church community. Social and financial needs were also identified. The caregivers stressed the need for equipment when caring for these patients, as there is nothing available for basic homecare. Caregivers identified needs that were not mentioned by the patients and vice versa. For patients an important need was pain relieve which the caregivers did not mention. It appears from this research that the need for the involvement of the multidisciplinary team is not being addressed. Based on the results of this research guidelines were formulated for registered nurses, that train and supervise the caregivers, to ensure that these patients receive the comprehensive care they deserve.
- ETD@PUK