Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Faculty of Health Sciences, Gauteng Province, University of Pretoria, Prinshof Campus, Pretoria, South Africa.
BMC Health Serv Res. 2022 May 9;22(1):624. doi: 10.1186/s12913-022-07978-4.
Despite significant achievements made towards HIV testing, linkage to antiretroviral therapy treatment and viral load suppression, the Sub-Saharan region of Africa continues to be reported to have the highest prevalence of HIV/AIDS, with over 26 million people living with the disease. In light of the added burden on already overwhelmed health systems due to the Covid-19 pandemic, maintaining the reliability and accuracy of point-of-care diagnostics (POC) results is crucial to ensure the sustainability of quality service delivery. The integration of technology-based interventions into nurse education curricula is growing, to help prepare students for the current practice environment which requires access to large amounts of information. The aim of this study was to determine the effect of a Mobile Learning (mLearning) Curriculum on improving the quality of HIV rapid testing services in rural clinics of KwaZulu-Natal (KZN), South Africa.
To achieve the aim of this study, pre-test and post-test audits were conducted in a quasi-experimental design. Eleven clinics of KZN, with the highest availability and usage of POC diagnostics were selected from a cross-sectional study survey to constitute the sample of this study. The World Health Organization On-site Monitoring Checklist-Assessment of Quality System was adapted and used as an audit tool to evaluate four key quality components. The effect of the mLearning curriculum on HIV testing quality improvement was determined through statistically comparing pre-audit and post-audit results. The independent samples t-test and the Levene's test were employed to evaluate the equality of measured variables for the two groups. The relationships between variables were estimated using the Pearson pair wise correlation coefficient (p) and correlations were reported as significant at p < 0.05.
A total of 11 clinics was audited at the pretest and 7 clinics were audited post-piloting of the mLearning curriculum. The estimated level of compliance of the participating clinics to quality HIV rapid testing guidelines ranged between poor and moderate quality. The mLearning curriculum was shown to have no statistically significant effect on the quality of POC diagnostic services provided in rural clinics of KZN.
The mLearning curriculum was shown to have no statistically significant effect on the quality of HIV rapid testing services provided in participating clinics; however, multiple barriers to the full adoption of the piloted curriculum were identified. The provision of reliable technology devices and improved internet connection were recommended to enhance the adoption of technology-based interventions necessary to improve access to relevant learning material and updated information.
尽管在艾滋病毒检测、与抗逆转录病毒治疗治疗和病毒载量抑制方面取得了重大进展，但撒哈拉以南非洲地区继续报告艾滋病毒/艾滋病发病率最高，超过 2600 万人患有这种疾病。鉴于大流行给已经不堪重负的卫生系统带来的额外负担，确保即时护理诊断（POC）结果的可靠性和准确性对于确保优质服务的可持续性至关重要。将基于技术的干预措施纳入护士教育课程的做法正在增加，以帮助学生为当前的实践环境做好准备，当前的实践环境需要他们能够访问大量信息。本研究旨在确定移动学习（mLearning）课程对提高南非夸祖鲁-纳塔尔省（KZN）农村诊所的艾滋病毒快速检测服务质量的影响。
为了实现本研究的目的，采用准实验设计进行了预测试和后测试审计。从横断面研究调查中选择了 KZN 可用性和使用率最高的 11 个诊所，构成本研究的样本。适应了世界卫生组织现场监测清单-质量体系评估，并将其用作审计工具，以评估四个关键质量组成部分。通过统计比较预审计和后审计结果，确定 mLearning 课程对艾滋病毒检测质量改进的影响。采用独立样本 t 检验和莱文检验评估两组测量变量的平等性。使用 Pearson 成对相关系数（p）估计变量之间的关系，并报告相关性在 p<0.05 时有统计学意义。
共有 11 家诊所进行了预测试审计，7 家诊所进行了 mLearning 课程试点后的审计。参与诊所对艾滋病毒快速检测指南的合规程度估计为从质量差到中等。结果表明，mLearning 课程对 KZN 农村诊所提供的即时护理诊断服务质量没有统计学上的显著影响。
结果表明，mLearning 课程对参与诊所提供的艾滋病毒快速检测服务质量没有统计学上的显著影响；然而，确定了完全采用试点课程的多个障碍。建议提供可靠的技术设备和改善互联网连接，以增强对必要的基于技术的干预措施的采用，从而改善获取相关学习材料和最新信息的机会。
