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.
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