Mpango Richard Stephen, Kinyanda Eugene, Rukundo Godfrey Zari, Osafo Joseph, Gadow Kenneth D
Mental Health Project, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
Department of Psychiatry, Mbarara University of Science and Technology, Uganda.
Afr Health Sci. 2018 Sep;18(3):488-495. doi: 10.4314/ahs.v18i3.4.
Attention-Deficit / Hyperactivity Disorder (ADHD) is one of the most prevalent behavioural disorder among children and adolescents with HIV infection (CA-HIV).
To explore the explanations used by adolescents with HIV/AIDS, caregivers and health workers to understand and explain ADHD in HIV/AIDS.
This was a qualitative sub-study nested within a larger research project whose focus was on mental health among HIV infected children and adolescents in Kampala and Masaka, Uganda (CHAKA study, 2014-2017). Participants were recruited from five study sites: two in Kampala and three in Masaka. We purposively sampled 10 ADHD adolescent-caregiver dyads equally divided between the Masaka and Kampala sites, age groups and gender. Semi-structured interviews were carried out within 12 months of baseline. Ten HIV health workers (two from each study site) participated. The ten health workers were assessed about their knowledge related to psychiatric disorders (especially ADHD in HIV/AIDS), services available for such clients and gaps in service provision for CA-HIV with behavioural / emotional disorders. Participants were recruited over one month. Taped interviews were transcribed and preliminary coding categories generated based on the research questions. Broad categories of related codes were then generated to derive a coding framework. Thematic analyses were conducted to elicit common themes emerging from the transcripts.
Explanations used by respondents to express their understanding related to ADHD among CA-HIV included; psychosocial stressors, biomedical manifestations, personal traits and supernaturalism, which affected health seeking behaviour.
In contexts similar to those in Uganda, treatment approaches for ADHD among HIV positive CA-HIV should consider the explanations provided by CA-HIV, caregivers to CA-HIV and HIV health workers.
注意力缺陷多动障碍（ADHD）是感染艾滋病毒的儿童和青少年（CA-HIV）中最常见的行为障碍之一。
探讨感染艾滋病毒/艾滋病的青少年、照顾者和卫生工作者用于理解和解释艾滋病毒/艾滋病患者中ADHD的原因。
这是一项定性子研究，嵌套在一个更大的研究项目中，该项目重点关注乌干达坎帕拉和马萨卡感染艾滋病毒的儿童和青少年的心理健康（CHAKA研究，2014 - 2017年）。参与者从五个研究地点招募：坎帕拉两个，马萨卡三个。我们有目的地抽取了10对ADHD青少年 - 照顾者二元组，在马萨卡和坎帕拉地点、年龄组和性别之间平均分配。在基线后的12个月内进行了半结构化访谈。10名艾滋病毒卫生工作者（每个研究地点两名）参与。对这10名卫生工作者进行了评估，了解他们与精神障碍（特别是艾滋病毒/艾滋病患者中的ADHD）相关的知识、为此类患者提供的服务以及为患有行为/情绪障碍的CA-HIV提供服务方面的差距。参与者在一个月内招募完成。对录音访谈进行转录，并根据研究问题生成初步编码类别。然后生成相关代码的广泛类别以得出编码框架。进行主题分析以找出转录本中出现的共同主题。
受访者用于表达他们对CA-HIV中ADHD理解的解释包括：心理社会压力源、生物医学表现、个人特质和超自然主义，这些因素影响了寻求医疗行为。
在与乌干达类似的背景下，艾滋病毒阳性的CA-HIV中ADHD的治疗方法应考虑CA-HIV、CA-HIV的照顾者以及艾滋病毒卫生工作者提供的解释。
