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在南非资源有限的社区中养育感染 HIV 的儿童:HIV 阳性母亲的情感脆弱性和对未来的希望。

Parenting the child with HIV in limited resource communities in South Africa: mothers with HIV's emotional vulnerability and hope for the future.

机构信息

Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa.

出版信息

Womens Health (Lond). 2021 Jan-Dec;17:17455065211058565. doi: 10.1177/17455065211058565.

Abstract

INTRODUCTION

A diagnosis of HIV does not affect the well-being of mothers alone but also affects how they care for their children. The aim of this study was to explore how mothers who were diagnosed with HIV when pregnant or when their children became ill experience raising children living with HIV. The purpose was to understand how a diagnosis of HIV impacts mothering their children at different points on the mothering journey.

METHODS

Using descriptive phenomenological enquiry, interviews were conducted with 28 mothers recruited via purposeful sampling from clinics in health district in South Africa. The interviews were audiotaped, transcribed verbatim, and analysed following the thematic approach.

RESULTS

The mothers found mothering a child living with HIV stressful and associated with constant thoughts of death. The burden of mothering was increased for mothers who had to confront emotions of self-blame and guilt for unintentionally infecting the child. They used secrecy to protect their children from the social consequences of a diagnosis of HIV. The thought of living with HIV weighed on them every day and they expressed their experience of intense feelings of chronic worry, anxiety, and sadness. The findings identified high levels of stress, with the mothers expressing emotions suggestive of depression. With time, they accepted living with HIV and embraced motherhood, and became better mothers.

CONCLUSION

The negative coping strategies used to deal with the child's HIV diagnosis and high levels of stress and anxiety identified in the study underscore the need to address the psychosocial needs of mothers living with HIV. There is need to provide psychosocial support and continuous counselling for these mothers post diagnosis and upon a positive HIV diagnosis of the child to women enrolled in the prevention of mother to child transmission of HIV programme.

摘要

简介

艾滋病的诊断不仅影响到母亲自身的幸福感,还影响到她们照顾孩子的方式。本研究旨在探讨那些在怀孕期间或孩子生病时被诊断出感染艾滋病的母亲如何抚养感染艾滋病的孩子。目的是了解艾滋病的诊断如何在母亲育儿旅程的不同阶段影响她们对孩子的养育。

方法

采用描述性现象学研究方法,通过目的性抽样,从南非一个卫生区的诊所招募了 28 名母亲进行访谈。访谈进行了录音,逐字转录,并采用主题分析方法进行分析。

结果

母亲们发现养育一个感染艾滋病毒的孩子压力很大,而且经常会想到死亡。对于那些不得不面对因无意感染孩子而自责和内疚情绪的母亲来说,育儿的负担更重了。她们用隐瞒来保护孩子免受艾滋病诊断带来的社会后果。每天都要面对感染艾滋病的现实,她们表达了自己强烈的担忧、焦虑和悲伤的感受。研究结果发现了高水平的压力,母亲们表达了抑郁情绪的情感。随着时间的推移,她们接受了感染艾滋病的现实,并拥抱了母性,成为了更好的母亲。

结论

研究中发现,母亲们为了应对孩子的艾滋病诊断而采用了消极的应对策略,而且还存在高水平的压力和焦虑,这突显了需要满足感染艾滋病的母亲的心理社会需求。需要为这些母亲提供心理社会支持和持续咨询,包括在预防艾滋病母婴传播项目中为被诊断为艾滋病阳性的妇女提供咨询。

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