This paper adds to the current debate on why it is important for nurse researchers to clearly understand phenomenology as a philosophy and research method before embarking on a study. The paper guides novice researchers on key methodological decisions they need to make when using descriptive or interpretive phenomenological research approaches.

Nurses play key roles in educating patients about ART adherence and side effects, but they should also educate patients about CD4 and viral-load test results and about the dangers of using traditional medicines and alcohol with ART. Shorter waiting times at clinics could make ART patients' lives more manageable.

Ebola hemorrhagic fever, caused by the highly virulent RNA virus of the filoviridae family, has become one of the world's most feared pathogens. The virus induces acute fever and death, often associated with hemorrhagic symptoms in up to 90% of infected patients. The known sub-types of the virus are Zaire, Sudan, Taï Forest, Bundibugyo and Reston Ebola viruses. In the past, outbreaks were limited to the East and Central African tropical belt with the exception of Ebola Reston outbreaks that occurred in animal facilities in the Philippines, USA and Italy. The on-going outbreak in West Africa that is causing numerous deaths and severe socio-economic challenges has resulted in widespread anxiety globally. This panic may be attributed to the intense media interest, the rapid spread of the virus to other countries like United States and Spain, and moreover, to the absence of an approved treatment or vaccine. Informed by this widespread fear and anxiety, we analyzed the commonly used strategies to manage and control Ebola outbreaks and proposed new approaches that could improve epidemic management and control during future outbreaks. We based our recommendations on epidemic management practices employed during recent outbreaks in East, Central and West Africa, and synthesis of peer-reviewed publications as well as published "field" information from individuals and organizations recently involved in the management of Ebola epidemics. The current epidemic management approaches are largely "reactive", with containment efforts aimed at halting spread of existing outbreaks. We recommend that for better outcomes, in addition to "reactive" interventions, "pre-emptive" strategies also need to be instituted. We conclude that emphasizing both "reactive" and "pre-emptive" strategies is more likely to lead to better epidemic preparedness and response at individual, community, institutional, and government levels, resulting in timely containment of future Ebola outbreaks.

A needs assessment done among HIV-positive (HIV+ve) people in Botswana in 2000 indicated that these people required social support. Based on these results, a buddy system for and by HIV+ve women was instituted in Botswana during 2002. This study examined the impact of the buddy system on the self-care behaviours of 116 HIV+ve women volunteers who used the services of COCEPWA (Coping Centre for People with Aids) during 2002. The convenience sample comprised 39 buddies who completed the buddy training programme, 39 patients assigned to the 39 buddies and 38 controls who lived in areas where the buddy programme did not operate. The results indicate that HIV+ve patients who had buddies showed improved self-care behaviours from April 2002 until November 2002 compared to the controls. These self-care behaviours encompassed informing a number of other people about their HIV+ve status, compliance with tuberculosis treatment, CD4 quantification and adherence to antiretroviral therapy. Although the differences were not always statistically significant, the patients showed greater improvements than the controls in all self-care behaviours. Thus the buddy system might have assisted and empowered the patients to achieve higher levels of self-care behaviours than the controls. <b>Opsomming</b> ’n Behoeftebepaling wat in 2000 van MIV-positiewe (MIV+we) persone in Botswana gedoen is, het getoon dat hierdie mense sosiale ondersteuning nodig gehad het. Gebaseer op hierdie bevindinge is ’n “buddy”-stelsel vir en deur MIV+we vroue gedurende 2002 in die land ingestel. Hierdie studie het die impak van die “buddy”-stelsel op die selfsorggedrag van 116 MIV+we vroulike vrywilligers ondersoek wat die dienste van COCEPWA (Coping Centre for People with AIDS) gedurende 2002 benut het. Die gerieflikheidsteekproef het uit 39 “buddies” bestaan wat die “buddy”-opleidingsprogram voltooi het, 39 pasiënte wat aan die 39 “buddies” toegewys is en 38 kontrolepatiënte wat in areas gewoon het waar die “buddy”-program nog nie in werking gestel is nie. Die bevindinge dui aan dat MIV+we pasiënte wat “buddies” gehad het verbeterde selfsorggedrag van April 2002 tot November 2002 getoon het, in vergelyking met die kontrolegroep. Selfsorggedrag is aangedui deur die aantal ander persone wat ingelig is omtrent die individu se MIV+we status, die nakoming van tuberkulosebehandeling, CD4-bepalings en die nakoming van antiretrovirale behandeling. Alhoewel die verskille nie altyd statisties beduidend was nie, het die pasiënte groter verbeteringe getoon in vergelyking met die kontrolegroep in alle aspekte van selfsorggedrag. Dus is dit moontlik dat die “buddy”-stelsel die pasiënte ondersteun en bemagtig het, wat hulle in staat gestel het om ’n groter mate van selfsorggedrag te bereik as die kontrolegroep

Living under the constant threat of Ebola is experienced as distressing in the physical, social, and psychological realms. In the future, prompt treatment and nursing care are recommended to minimize deaths and to reduce the widespread terror, anxiety, ostracism, and stigmatization that affected individuals and families face. Furthermore, it is recommended that the resilience of survivors and caregivers be increased to facilitate their better coping with the rampant antisocial overtones that they are likely to experience because of their association with Ebola.

HRQoL assessments can identify and address patients' needs, and it is important that guidelines be developed that will yield improved care to ART patients in Botswana.

Background: Malawi provides cervical cancer screening services free of charge at some public health facilities. Few women make use of these cancer screening services in Malawi and many women continue to be diagnosed with cervical cancer only during the late inoperable stages of the condition. Objectives: The purpose of this study was to discover whether the perceived susceptibility to cervical cancer, amongst Malawian women aged 42 and older, influenced their intentions to utilise the available free cervical cancer screening services.Method: A quantitative, cross-sectional descriptive study design was adopted. Structured interviews were conducted with 381 women who visited 3 health centres in the Blantyre District of Malawi.Results: A statistically-significant association existed between women’s intentions to be screened for cervical cancer and their knowledge about cervical cancer (X² = 8.9; df = 1; p = 0.003) and with having heard about HPV infection (X² = 4.2; df = 1; p = 0.041) at the 5% significance level. Cervical cancer screening services are provided free of charge in government health institutions in Malawi. Nevertheless, low perceived susceptibility to cervical cancer amongst women, aged 42 and older, might contribute to limited utilisation of cervical screening services, explaining why 80% of cervical cancer patients in Malawi were diagnosed during the late inoperable stages.Conclusion: Malawian women lacked awareness regarding their susceptibility to cervical cancer and required information about the available cervical cancer screening services. Malawi’s women, aged 42 and older, must be informed about the advantages of cervical cancer screening and about the importance of effective treatment if an early diagnosis has been made. Women aged 42 and older rarely attend antenatal, post-natal, well baby or family-planning clinics, where health education about cervical cancer screening is often provided. Consequently, these women aged 42 and older should be informed about cervical screening tests when they utilise any health services.Vroue se vermeende vatbaarheid en benutting van servikale kanker dienste in Malawi Agtergrond: Malawi verskaf gratis servikale kanker siftings dienste by sommige openbare gesondheids instansies. Min vrouens maak gebruik van die kanker siftings dienste in Malawi en baie vrouens word steeds gediagnoseer met servikale kanker tydens die laat onopereerbare fases van die toestand.Doelwitte: Die doel van die studie was was om te bepaal of Malawiese vrouens wat 42 en ouer is se waargenome vatbaarheid vir servikale kanker hulle beïnvleod om beskikbare gratis servikale siftingsdienste te gebruik. ’n Kwantitatiwe, deursnee beskrywende navorsingsontwerp was gekies.Metode: Gestruktureerde onderhoude is met 381 vrouens gevoer wat drie gesondheidsdiensentrums in die Blantyre Distrik van Malawi besoek het.Resultate: ’n Statistiese beduidende verhouding het bestaan tussen vrouens se voornemens om vir servikale kanker getoets te word en hulle kennis oor servikale kanker (X² = 8.9; df = 1; p = 0.003) en dat hulle al gehoor het van MPV infeksies (X² = 4.2; df = 1; p = 0.041) op die 5% vlak van beduidenis. Servikale kanker siftingsdienste is gratis beskikbaar in openbare gesondheidsdiensinrigtings in Malawi. Desnieteenstaande was daar ’n lae waargenome risiko van servikale kanker onder vrouens wat 42 jaar oud en ouer was en dit het bygedra tot die beperkte benutting van siftingsdienste, wat verduidelik waarom 80% van servikale kankergevalle in Malawi gedurende die laat onopereerbare fases gediagnoseer is.Gevolgtrekkings: Malawiese vrouens was onbewus van hulle vatbaarheid vir servikale kanker en het inligting benodig oor servikale kanker siftingsdienste. Malawi se vrouens wat 42 jaar oud en ouer is, moet ingelig word aangaande die voordele van servikale sifting en die belangrikheid van effektiewe behandeling indien ’n vroë diagnose gemaak is. Vrouens van 42 of ouer benut selde voorgeboorte, nageboorte gesonde baba, of gesinsbeplanningsklinieke waar voorliging aangaande servickale kanker verskaf word. Gevolglik behoort die vrouens ingelig te word oor servikale siftingstoetse wanneer hulle enige gesondheidsdienste benut.

BackgroundAntiretroviral therapy (ART) improves patients’ health-related quality of life (HRQoL). Defaulting from ART has detrimental consequences, including the development of viral resistance, treatment failure and increased risks of disease progression. Little is known about the quality of life of ART defaulters and reasons for discontinuing their ART.ObjectivesThis study sought to measure the HRQoL of ART patients in Botswana who were on ART for up to 5 years but had discontinued treatment for at least 3 months, and to identify factors associated with ART defaulting.MethodWe conducted a cross-sectional study with 104 eligible respondents in four ART clinics in south eastern Botswana. We assessed respondents’ HRQoL using the World Health Organization Quality of Life Questionnaire for HIV short form. Clinical information was obtained from respondents’ medical records. Data were analysed using SAS version 9.2.ResultsReasons for discontinuing ART were inaccessible clinics (22.4%), feeling better (21.4%), running out of pills (11.2%), depression (8.2%), lack of care and/or support (8.2%), failure to understand instructions (7.7%), medications’ side effects (6.1%) and alcohol abuse (3.1%). In multivariate analyses, respondents aged 36–45 years had a 0.03 lower independence HRQoL score compared to those aged 35 and younger (β = -0.03; 95% confidence interval: -1.72, -1.66). Despite defaulting from their ART, respondents’ calculated HRQoL scores were moderate.ConclusionThis study highlights the need to enhance ART adherence in order to improve the HRQoL of people living with HIV and/or AIDS.