L.B. Khoza

The psychological experience of HIV and AIDS by newly diagnosed infected patients at Hospital A of Vhembe district, Limpopo province.

South Africa has one of the fastest growing rates of new HIV infection in the world. It is estimated that 5.7 million people in South Africa were infected with HIV. A combination of poverty, illiteracy, migrant labour, commercial sex workers and disruption of family and communal life has increased the individual’s risk of infection. The purpose of this study was to explore and describe the psychological experiences of HIV/AIDS by infected persons in Hospital A in the Vhembe district of Limpopo Province. The research design was qualitative, exploratory and descriptive, using the phenomenological approach. The target group for this study were males and females who visited the institution seeking health care, whose blood samples were found to be HIV positive, between the ages of 18 and 49 years at Hospital A in the Vhembe district of Limpopo Province. A convenience sampling method was used. Data was collected through in-depth unstructured one-to-one interview. Three phases suggested by Miles and Huberman were used which are: data display; in data reduction and lastly during data interpretation. Measures to ensure trustworthiness and ethical issues were ensured. The effects of HIV/AIDS on the infected persons were identified and the following theme and sub-theme: Psychological experiences, factors contributory to psychological imbalance and observations. Living with HIV/AIDS poses tremendous psychological and physical challenges to those who are infected. The experience of HIV-related symptoms is a significant part of that challenge. The physical and psychological symptoms are profoundly disruptive and impact on almost every aspect of daily life.

Experiences of family members caring for tuberculosis patients at home at Vhembe district of the Limpopo Province.

Tuberculosis (TB) is a potentially serious infectious disease which enters the body by inhalation and usually affects the lungs. TB is ranked amongst the leading infectious diseases worldwide, and in South Africa (SA) it has become an epidemic, because of its high prevalence. There are multiple factors that were found to attribute to the existence and spread of this disease. The purpose of this study was to explore and describe experiences of family members caring for TB patients at home, in the Vhembe District of the Limpopo Province. The study was qualitative, explorative, descriptive, phenomenological and contextual in nature. The population group selected for the study all comprised of family members caring for tuberculosis patients at home in Tshifulanani village. A purposive sampling method was applied in the study. Data were collected through semi-structured interviews guided by three questions. Techs eight steps of data analysis were followed. Measures to ensure trustworthiness and ethical issues were observed. The results of the study revealed that family members experienced difficulties when they care for TB patients at home. These difficulties included providing food, attending to hygiene needs, the lack of equipment, financial constraints as well as physical and psychological exhaustion. Recommendations were made concerning the provision food, attending to hygiene needs, assisting in the administration of medication, nursing practice and policy making.

Needs assessment for adapting TB directly observed treatment intervention programme in Limpopo Province, South Africa: A community-based participatory research approach

Background Limpopo Province is one of the hardest hit by tuberculosis and human immune virus infections in the country. The province has been implementing a directly observed treatment strategy since 1996. However, the cure rate was 64% in 2015 and remains far from the set target by the World Health Organization of 85%. Poor health-care seeking and adherence behaviours were identified as major risk behaviours. Aim To apply a Community-Based Participatory Research (CBPR) approach in identifying barriers and facilitators to health-care seeking and adherence to treatment, and to determine strategies and messages in order to inform the design of an adapted intervention programme. Setting This study was conducted in three districts in the Limpopo Province, Capricorn, Mopani and Sekhukhune districts. Methods The community participatory research approach was applied. Purposive sampling was used to sample participants. Focus group discussions were used to collect data. Participatory analysis was used comparing findings within and across all the participants. Results A total of 161 participated in the study. Participants included coordinators, professional nurses, supporters and patients. Major modifiable behavioural-related barriers were lack of knowledge about tuberculosis, misinformation and misperceptions cultural beliefs, stigma and refusal of treatment support. Environment-related barriers were attitudes of health workers, lack of support by family and community, lack of food and use of alcohol and drugs. Strategies and messages included persuasive and motivational messages to promote healthy behaviour. Conclusion Joint programmatic collaboration between the community and academic researchers is really needed for interventions to address the needs of the community.

The intimate partner violence experiences of sexual assault, a risk factor on the transmission of HIV infection among women in the Vhembe District of Limpopo Province, South Africa.

Violence against women is present in every country and it cut across boundaries of culture, class, education, income, ethnicity and age. Research has shown that there are links between HIV and AIDS, gender inequity and gender based violence that prevents women from influencing the circumstances of sex, resulting in unsafe sex practice and contracting of sexually transmitted infections including HIV and AIDS. The overall objective of the study was to increase understanding of Intimate Partner Violence experiences of sexual assault, its risk factor on the transmission of HIV infection among women admitted in Trauma Unit A of a particular hospital in the Vhembe District. This raises the questions “What is the women’s experience of sexual assault? Is sexual assault a risk factor to the transmission of HIV infection among women?” The research design was qualitative, exploratory descriptive and contextual in nature. In this study the target population consisted of all women who made use of a trauma unit A ata particular hospital in the LimpopoProvince. Six participants were selected by means of purposive sampling. In-depth individual interviews were conducted, using a voice recorder. The principles outlined by Lincoln and Guba were followed to ensure the trustworthiness of the study. Data analysis was guided by Tesch’s principles of qualitative data analysis. The findings of the study reflected that women experienced Intimate Partner Violence sexual assault in their lives and that sexual assault is a risk factor to the transmission of HIV infection among women. The study therefore, suggests a need for screening and prevention programmes that aims to reduce Intimate Partner Violence and HIV infection

Factors associated with patient and health care system delay in diagnosis and treatment for TB in sub-Saharan African countries with high burdens of TB and HIV: Patient and system delay in diagnosis and treatment for TB in sub-Saharan Africa

Objective To identify factors causing delayed diagnosis and treatment for tuberculosis in high tuberculosis (TB)/HIV burden African countries.

Knowledge, attitudes and practices regarding cervical cancer prevention at Thulamela Municipality of Vhembe District in Limpopo Province

Background Cervical cancer is a widespread and often fatal disease that affected 1 million women globally in 2005. Not only is it the second most common cancer in women but it was also the second leading cause of cancer deaths, accounting for over 250 000 in 2006. Purpose The purpose of the study was to assess the knowledge, attitudes and practices regarding cervical cancer prevention among rural women in Vhembe District in Limpopo Province. Methodology A quantitative descriptive approach was adopted. The quantitative design enabled the discovery of more information by means of direct questioning of a sample of women aged 30 years and older. A convenience sampling was used to select the respondents. Data were analysed using the Statistical Package for Social Sciences. Measures to ensure ethical issues were adhered to. Results The findings revealed that women lacked knowledge about cervical cancer and preventive methods, and displayed positive attitudes to the use of services if made available as health workers did not adequately inform them about the availability of the services. Conclusion The awareness of cervical cancer among women in Vhembe District is limited. There is a need to educate and promote awareness of cervical cancer among women to reduce the burden of morbidity and mortality.

Self-perceived Challenges of Lay Counselors Implementing Voluntary Counseling and Testing in Mopani District, Limpopo Province and South Africa

Abstract The demand for counselling and testing for Human Immune Virus (HIV) services is increasing in South Africa. The purpose of the paper was to identify the challenges faced by lay counsellors in implementing VCT in the health facilities of Mopani District Limpopo Province, South Africa. Qualitative research design was used to collect the data. The population consisted of 60 lay counsellors in the Greater-Tzaneen, Greater Letaba and Ba-Phalaborwa municipalities. Data was collected through semi-structured interview guide for focus group discussions. Data was analysed qualitatively through the open coding. The results revealed that lay counsellors experienced challenges when implementing the VCT programme, clients denying their HIV positive status and lack of counselling skills. Counselling aspects such as explaining the counselling process, the issue of pre-testing and post-testing, the importance of consent forms and how tests are conducted, are important processes that counsellors should effectively use for successful counselling sessions.

Views of professional nurses regarding low tuberculosis cure rate in Greater Giyani Municipality, Limpopo Province

BACKGROUND Management of patients suffering from tuberculosis (TB) after discharge from hospital plays a critical role in the cure rate of TB. Despite interventions developed by the World Health Organization (WHO) to improve the cure rate, TB remains a worldwide health problem. OBJECTIVE The purpose of the study was to explore and describe the views of professional nurses regarding the low TB cure rate in primary healthcare facilities of Greater Giyani Municipality in Limpopo Province, South Africa, with the aim of determining strategies that can be used to improve this low rate. METHOD This study was qualitative, exploratory, descriptive and contextual in nature. The population consisted of professional nurses working in primary healthcare facilities within Greater Giyani Municipality, which has a TB cure rate below the national target of 85%. Data gathering was through individual face-to-face interviews using an interview guide. Open-coding was used to analyse the data in this study. RESULTS The theme that emerged from data was ‘factors contributing to low TB cure rate’. This theme was supported by the following sub-themes: poor referral system, lack of knowledge about TB and its treatment, stigma attached to TB, and cultural and religious beliefs. The professional nurses suggested counselling of TB patients upon diagnosis, advice about patients’ responsibilities and the involvement of family members. CONCLUSION The involvement of community stakeholders in TB prevention, health promotion and education activities devoted to disease spread and cure is vital so that the stigma attached to TB can be eliminated. TB education and awareness programmes should be included in the curriculum of primary schools.

Perceived Roles of Fathers in the Promotion, Support and Protection of Breastfeeding

Fathers of young infants have a crucial role to play in the promotion, support and protection of breastfeeding as women often face many challenges during the post-partum period. The World Health Organization recommends paying particular attention to participation by the male partners in child and maternal health as they also have responsibilities and roles to play in nurturing their young ones and supporting their families. The focus of this research was to explore and to describe the perceived roles of fathers in the support, protection and promotion of breastfeeding. This study adopted a qualitative method using an explorative and descriptive design, and the sample included twelve fathers of infants aged less than six months at Schoonoord Village, Sekhukhune District, Limpopo province, South Africa. Using in-depth individual unstructured interviews, data were collected until data saturation was attained and analysed using Tesch’s open-coding method. The findings show that fathers perceive breastfeeding to be the optimum feeding choice for the baby and beneficial to the mother. Provision of emotional and financial support to the women, protection of the mother and the baby, motivation and assistance in seeking healthcare emerged as the key roles of fathers during the breastfeeding period. This study recommends that fathers be involved in breastfeeding counselling and that healthcare providers create an environment that is conducive to the participation of fathers in the topic of infant feeding.

Challenges Affecting the Implementation of the Integrated Approach to Mental Healthcare at PHC Clinics

Abstract The implementation of the integrated approach could pose a challenge to nurses. The purpose of the study was to explore and describe the perceptions of the professional nurses on the challenges affecting the implementation of the integrated approach with specific reference to the care of mentally ill patients. A qualitative, exploratory and descriptive design was used. The population comprised of PHC nurses working in the Mutale subdistrict PHC facilities of Vhembe District. Probability systematic random sampling and purposive sampling were used to obtain a sample of six PHC clinics and 45 PHC nurses, respectively. Ethical principles were adhered. Focus groups and individual interviews were used. Data was analyzed using Tesch’s open coding method. Findings revealed poor management of resources and difficulties in managing psychotic patients to be affecting the implementation of the integrated approach. The study suggests staff development programs. Furthermore, nurses need skills to handle aggressive mentally ill patients.