Mafune Rhudzani V, Lebese Rachel T, Nemathaga Livhuwani H
Department of Advanced Nursing, School of Health, University of Venda.
Curationis. 2017 Aug 28;40(1):e1-e9. doi: 10.4102/curationis.v40i1.1541.
Children depend solely on caregivers who can be either parents or guardians for drug administration to enhance adherence to antiretroviral treatment (ART), which might pose any number of challenges.
The purpose of this study was to explore and describe the challenges faced by caregivers of children on ART at Mutale Municipality, Vhembe District, Limpopo Province.
The research design was qualitative, explorative, descriptive and contextual in nature. The population consisted of 16 caregivers who were 18 years of age and above, and mentally capable, irrespective of educational qualifications, caring for children aged between 0 and 15 years who were on ART between April 2013 and October 2014. Non-probability, purposive sampling was used to select the 16 caregivers. Required permission, approval and ethical clearance were obtained from the University of Venda Higher Degree Committee, Limpopo Provincial Health Department and relevant institutions. An in-depth, individual, unstructured interview method was used to collect data. One central question was asked: 'What are the challenges you experience when caring for a child on antiretroviral treatment?' Subsequent questions were based on the participants' responses to the central question. Qualitative data were analysed by means of Tesch's open-coding method.
The findings of this study revealed that participants, that is, caregivers of children on ART, experienced financial burdens because of transport costs needed to comply with follow-up dates and insufficient of money for food, clothing the child in need of care, pocket money for lunch boxes during school hours and time lost while waiting for consultations. Participants reported some level of stigmatisation against children on ART by family members, especially the husbands or in-laws of the secondary caregivers. Many primary and secondary caregivers seemed to have given up seeking support from government and community structures.
The conclusions drawn from this research are that caregivers hardly receive any support from family members or the community. Fear of disclosing the HIV-positive status of children resulted in the delay of financial support from the government, thus leading to serious financial burden on the caregivers.
儿童完全依赖照顾者(父母或监护人)来进行药物管理,以提高对抗逆转录病毒治疗(ART)的依从性,这可能带来诸多挑战。
本研究旨在探索和描述林波波省韦姆贝区穆塔莱市接受抗逆转录病毒治疗儿童的照顾者所面临的挑战。
本研究设计本质上是定性、探索性、描述性和情境性的。研究对象包括16名年龄在18岁及以上、心智健全、不论教育程度、在2013年4月至2014年10月期间照顾接受抗逆转录病毒治疗的0至15岁儿童的照顾者。采用非概率、目的抽样法选取这16名照顾者。已获得文达大学高等学位委员会、林波波省卫生部及相关机构的必要许可、批准和伦理许可。采用深入、个体、非结构化访谈方法收集数据。提出了一个核心问题:“在照顾接受抗逆转录病毒治疗的儿童时,你遇到了哪些挑战?”后续问题基于参与者对核心问题的回答。通过泰施的开放式编码方法对定性数据进行分析。
本研究结果显示,参与者,即接受抗逆转录病毒治疗儿童的照顾者,因遵守随访日期所需的交通费用以及用于购买食物、为需要照顾的孩子购置衣物、孩子上学期间购买午餐盒的零花钱以及等待咨询时所浪费的时间而面临经济负担。参与者报告称,家庭成员,尤其是二级照顾者的丈夫或姻亲,对接受抗逆转录病毒治疗的儿童存在一定程度的污名化。许多一级和二级照顾者似乎已放弃向政府和社区机构寻求支持。
本研究得出的结论是,照顾者几乎未从家庭成员或社区获得任何支持。由于担心披露儿童的艾滋病毒阳性状况,导致政府的经济支持延迟,从而给照顾者带来严重的经济负担。