Attitudes and perceptions of doctors and clinical nurse practitioners regarding the HIV patient
Thesis (MFamMed)--Stellenbosch University, 2010.
ENGLISH SUMMARY : Seven point seven percent of the population in the Boland Overberg Region is HIV positive.23 Attitudes of Health Care Workers (HCWs) impact on the quality of care given to HIV positive patients. This study explores the attitudes and perceptions of doctors and clinical nurse practitioners towards the healthy HIV patient. Thirteen in-depth interviews, including doctors and Clinical Nurse Practitioners (CNPs), from a variety of departments and levels of experience were done over six months using the Q-sort instrument6 as the basis for these interviews. Interviews were transcribed and themes identified using the cut and paste method. Twelve themes were identified namely; Anti retro viral drugs (ARVs), complexity, perceived ability, prognosis, prejudice, perceived risk of infection, anger, children, distancing, patient relationships, making a difference and obligation. ARVs, while improving the health and prognosis of patients, also cause complications in patients. HIV patients were perceived to be more complex than others due to an increased incidence of infections, complications and uncommon presentations. Several respondents felt capable of managing HIV patients and knew where to refer while others perceived themselves to have a lack of knowledge. Most respondents viewed HIV as a chronic (manageable but not curable) disease. A shortening of life expectancy of ten years were expected. Prejudice regarding patients was due to heterosexual behaviour. Men were viewed much more negatively while women and children were seen as innocent. A fear of being stigmatised if the HCW became positive was shown. All respondents showed a change in behaviour due to perceived risk of infection, either by being more cautious or taking precautions. Anger was expressed regarding defaulters and failure to prevent infection. Children were viewed with sadness and anger towards the mother. Some respondents felt a need to emotionally distance themselves from patients while others built a relationship with patients. Several respondents felt they were making a difference in the lives of HIV patients. Two thirds of the respondents’ attitudes were generally positive.
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