Determinants of adherence in patients on ART on the Copper Belt Province in Zambia

Chisa, Sume Percival (2010-03)

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2010.

Thesis

ENGLISH ABSTRACT: Chronic drug therapy has been fraught with many issues such as adherence, drug intolerance, long-term toxicity and resistance. In HIV/AIDS care, adherence is a major problem due to the fact that for success of the therapy, adherence must be in the region of ninety five percent. If this is not maintained the virus begins to mutate and resistant moieties appear, and this in turn leads to failure of the therapy. This high level of adherence is very difficult to maintain especially in patients who begin antiretroviral therapy (ART) for various reasons such as persuasion by health workers and family, and not due to their own conviction. They usually tend not to adhere to the therapy when symptoms resolve and they start feeling better. There are a number of factors that promote adherence and these are incorporated into HIV care for the programme to succeed. The research was intended to explore and describe factors causing patients to default ART on the Copper belt in Ndola at Ndola Central Hospital and to ultimately propose appropriate interventions to ensure improved return rates of patients on ART. Qualitative tools i.e. interviews and focus group discussions respectively were used, taking into account ethical considerations and data collected was then analyzed. Factors causing patients to default on ART were found to be poor social economic background, inadequate finance, unavailability of food, poor or little understanding of instructions, poor quality of counseling or low literacy levels, high pill burden, unpalatability of drugs and patient readiness to life time commitment to taking ARVS.

AFRIKAANSE OPSOMMING: Chroniese medisyneterapie is gepaard gaande met vele kwessies soos trou bly, weerstandsgebrek aan medisyne, langtermyn toksisiteit en weerstand. In MIV/Vigs sorg, is trou bly 'n groot probleem weens die feit dat vir sukses in terapie moet dit oor vyf-en-negentig persent wees. As dit nie gehandhaaf word nie sal die virus begin verander en weerstand weestandbiedende gedeeltes sal verskyn, en dit op sy beurt lei tot die mislukking van die terapie. Hierdie hoë vlak van trou bly is baie moeilik om te handhaaf veral in pasiente wie antiretrovirale terapie (ART) vir verskeie redes begin het soos oorreeding deur gesondheids werkers en familie, en nie deur hul eie oortuiging nie. Hulle neig gewoonlik om die terapie te laat vaar wanneer simptome verminder en hulle begin beter voel. Daar is verskeie faktore wat trou bly bevorder en wat ingelyf word in MIV sorg om die program te laat slaag. Die doel van hierdie navorsing was om die faktore te beskryf wat veroorsaak dat pasiente op die Copperbelt in Ndola by Ndola Sentrale Hospitaal hul ART verpligtinge nie nakom nie en om uiteindelik geskikte intervensies voor te stel om verbeterde terugkeer koerse van pasiente op ART te verseker. Kwalitatiewe insrumente, dit is, onderhoude en fokusgroupe is gebruik, met in agneming etiese kwessies, en data is daarna geanaliseer.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/4120
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