Exploring the self-management needs of adolescents living with HIV in the Nelson Mandela Bay area of the Eastern Cape

Adams, Adian Leone (2019-04)

Thesis (MNur)--Stellenbosch University, 2019.

Thesis

ENGLISH SUMMARY : Background: An increased number of human immunodeficiency virus (HIV) infected children are progressing to adolescence and beyond because of effective antiretroviral therapy (ART). Adolescents receiving ART tend to have poorer treatment outcomes compared to adults. HIV is now classified as a chronic illness and adolescents need the support of the whole family to self-manage (handle, direct and control) their chronic illness. When individuals and their families acquire self-management skills, they become responsible for the management of their chronic conditions, are able to control the illness and acquire healthy behaviours. Little is known about self-management amongst adolescents who live with HIV (ALHIV) and no self-management support programmes exist in the context of the Eastern Cape, South Africa. Aim and objectives: This study aimed to explore the self-management needs of ALHIV in the Nelson Mandela Bay area of the Eastern Cape in order to make recommendations that can be used to develop a programme to support adolescents’ HIV self-management. Specific objectives were to explore adolescents’ beliefs, knowledge and understanding of their illness; describe their self-regulation skills and abilities and identify the resources adolescents utilise to facilitate them to manage their illness. Methods: A qualitative descriptive design was applied. Thirteen adolescents between the ages of 14 and 19 years attending the West End and Booysen Park clinics were purposely selected. The data were collected through individual interviews. Data analysis was done by using the six steps described by Creswell. Trustworthiness was enforced by adhering to the principles of credibility, confirmability, transferability and dependability. Results: The research findings demonstrated that ALHIV, have limited knowledge and understanding about HIV and safe sex. Some ALHIV lack self-regulation skills and abilities such as taking their treatment, coping mechanisms, effective communication and disclosure of their HIV status to people outside the family. HIV services were not adolescent-friendly, with no dedicated services for adolescents and long queues. Support from family and friends plays a key role in the lives of the adolescents living with HIV. Self-management programmes should include strategies to improve HIV and sexual health knowledge and self-regulation skills, particularly through using technology. Adolescent-friendly healthcare services and the involvement of parents and peers may be important to improve self-management support for ALHIV. Conclusion: As an adolescent grow older, the responsibility of their care is transferred to them and they become more independent. The study revealed that ALHIV have several self-management needs; a programme that will support adolescents and their caregivers to acquire self-management skills may lead to better treatment and health outcomes.

AFRIKAANSE OPSOMMING : Agtergrond: As gevolg van effektiewe antiretrovirale terapie, is daar is ʼn toename in kinders met Menslike Immuungebrek virus (MIV), wat na adolessensie en verder vorder. Adolessente wat antiretrovirale terapie ontvang, is geneig om swakker behandelingsuitkomste in vergelyking met volwassenes te hê. MIV word nou geklassifiseer as ʼn kroniese siekte en adolessente benodig die ondersteuning van die hele gesin om hul chroniese siekte te bestuur (hanteer, reguleer en beheer). Wanneer individue en hul gesinne selfbestuursvaardighede verkry, word hulle verantwoordelik vir die bestuur van hul chroniese toestande, hulle kan die siekte beheer en gesonde gedrag verwerf. Min is bekend oor selfbestuur onder adolessente wat met MIV leef (AMIVL) en geen selfbestuur ondersteunings programme bestaan in die konteks van die Oos-Kaap, Suid Afrika, nie. Doelwit en doelstellings: Hierdie studie het ten doel gehad om die selfbestuursbehoeftes van AMIVL in die Nelson Mandelabaai-gebied van die Oos-Kaap te ondersoek ten einde aanbevelings te maak wat gebruik kan word om 'n program te ontwikkel om adolessente se MIV-selfbestuur te ondersteun. Spesifieke doelwitte was om adolessente se oortuigings, kennis en begrip van hul siekte te ondersoek; hul selfregulerende vaardighede en vermoëns te beskryf en die hulpbronne wat adolessente gebruik om hulle te fasiliteer om hul siekte te bestuur, te identifiseer. Metode: 'n Kwalitatiewe beskrywende ontwerp was toegepas. Dertien adolessente tussen die ouderdomme van 14 en 19 jaar wat die Westend en Booysenpark klinieke bywoon, is doelbewus gekies. Die data is versamel deur individuele onderhoude. Data analise is gedoen deur gebruik te maak van die ses stappe beskryf deur Creswell. Betroubaarheid was afgedwing deur aan die beginsels van geloofwaardigheid, bevestigbaarheid, oordraagbaarheid en bestendigheid, te voldoen. Resultate: Die navorsingsbevindings het getoon dat AMIVL beperkte kennis en begrip oor MIV en veilige seks het. Sommige AMIVL het nie selfreguleringsvaardighede en vermoëns soos om hul behandeling te neem, hanteringsmeganismes, effektiewe kommunikasie en openbaarmaking van hul MIV-status aan mense buite die familie, gehad nie. MIV-dienste was nie adolessent-vriendelik nie, sonder toegewyde dienste vir adolessente en met lang rye. Ondersteuning van familie en vriende speel 'n sleutelrol in die lewens van die adolessente wat met MIV leef. Selfbestuursprogramme moet strategieë om MIV en seksuele gesondheidskennis en selfreguleringsvaardighede te verbeter insluit, veral deur gebruik te maak van tegnologie. Adolessentvriendelike gesondheidsorgdienste en die betrokkenheid van ouers en eweknieë kan belangrik wees om ondersteuning vir selfbestuur vir AMIVL, te verbeter. Slotsom: Soos 'n adolessent ouer word, word die verantwoordelikheid van hul sorg oorgedra aan hulle en word hulle meer onafhanklik. Die studie het getoon dat AMIVL verskeie selfbestuursbehoeftes het en dat daar 'n behoefte is aan 'n program wat adolessente en hul versorgers sal ondersteun om selfbestuursvaardighede te bekom wat tot beter behandelings- en gesondheidsuitkomste kan lei.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/106000
This item appears in the following collections: