BackgroundInfection with human immunodeficiency virus (HIV) has changed from an acute to a chronic illness in the past decade, because of highly active antiretroviral therapy (ART). Malawi’s response to the HIV challenge included provision of ART for people living with HIV or AIDS (PLWHA), which significantly reduced HIV- and AIDS-related mortality. In addition, palliative care for PLWHA was introduced as a strategy that improves the success of ART.ObjectiveThe purpose of the study was to explore the needs of PLWHA concerning care received from primary caregivers and palliative care nurses in Malawi.MethodsA qualitative, explorative design was used and 18 participants were selected purposefully and interviewed individually using a semi-structured interview guide. Data were analysed using NVivo software package version 10.ResultsResults revealed that PLWHA needed physical care from the primary caregivers due to severity of illness, integration of healthcare services, and continuity of care and proper care from nurses. They also needed knowledge from nurses in several areas which affected decision-making and needed financial and nutritional support.ConclusionMore could be done in meeting needs of PLWHA to improve their health and survival and assist them to achieve a better quality of life.
The literature shows that there are important differences between women and men in the underlying mechanisms of transmission of HIV infection and AIDS, as well as in the social and economic consequences of HIV/AIDS. These stem from sexual behaviour and socially constructed ‘gender’ differences between women and men in roles and responsibilities. Despite the fact that numerous gender-related sociocultural factors influence HIV/AIDS protective behaviours, little gender specificity is included in HIV prevention among the elderly. In order to close this gap, this study explored gender-related perceptions of risk of HIV infection among elderly men and women of Ga-Rankuwa in Gauteng Province, South Africa. This qualitative study used purposive sampling to conduct three focus group interviews with 22 women and 10 men who were above 60 years of age. Findings revealed that both genders blame each other for the spreading of HIV/AIDS. Male participants displayed the tendency to have multiple partners, whereas females accepted that males are promiscuous. Mixed perceptions about disclosure of HIV status were found. Condom use was a challenge, as men did not know how to introduce it with their wives, and some female participants indicated that men are resistant to using condoms. The elderly men also believed that women will have sex in exchange for money. It is concluded that there is a need for substantial behaviour change among both elderly males and females, which should address gender power relations. More in-depth and extensive research in this area is recommended.
Emphasis on African-based clinical studies which directly relate to patient care and culture can advance evidence-based practice in nursing with particular reference to African settings.
Background: Death is one of life's few certainties and a universal experience for all individuals. When death occurs there is usually an impact on the family and friends of the deceased, the magnitude of which often depends on whether death was expected or unexpected. The grieving experiences of the elderly are rarely discussed. The purpose of this study was to describe experiences of grief and reactions to the death of family members amongst the elderly. Methods: A qualitative phenomenological approach was used to obtain data from elderly women in Ga-Rankuwa, Gauteng, to gain insight into the experiences of grief in this age group. Purposive sampling was used to conduct in-depth interviews with 10 elderly women whose family members had died. The data were analysed using a thematic approach. Results: The findings show that the elderly were exposed to multiple deaths of family members. The participants helplessly experienced with sorrow the death of family members, had experienced death anxiety, and relinquished control to God in terms of deaths. Conclusions: The response to death of the elderly affirms that it cannot be assumed that multiple death experiences establish their readiness or ability to handle these experiences and to grieve successfully. It can be concluded that the grieving process of the elderly is not different from any other age group and that they will also require the type of support and assistance considered for younger persons in times of grieving.
The literature pertaining to the elderly shows that HIV infection among this population is on the increase, suggesting that the elderly population engages in activities risky for HIV infection. Reports on such behaviour include frequent sexual relations with much younger people and having multiple partners. A study was carried out in Ga-Rankuwa, a black township in Gauteng Province, South Africa to explore and describe the understanding of these elderly people regarding their risks of HIV infection and AIDS. Using a qualitative, exploratory design, three focus-group interviews were conducted with 32 women aged over 50 years. Findings revealed that older persons have knowledge about transmission of HIV infection and AIDS. However, a few had misconceptions as to how HIV infection is transmitted, as they believed that poor nutrition and sharing facilities play a role. Knowledge of mechanisms of protecting themselves against infection, such as use of a condom during coitus and wearing gloves when caring for infected family members, was also evident. The elderly indicated that they would prefer an older person, who they could identify with, to educate them more about HIV infection and AIDS. Although majority of participants had knowledge of how HIV is transmitted, and issues that put them at risk of transmission, a few the older persons had misconceptions about how HIV is transmitted due to lack of knowledge, as they believed that poor nutrition and sharing facilities can transmit infection. The lack of knowledge underscores the importance of addressing sexual risk with older people. It was very clear that more needs to be done in terms of education campaigns to dispel the myths of HIV infection and to empower the elderly.
BackgroundThe clinical learning environment is a complex social entity that influences student learning outcomes in the clinical setting. Students can experience the clinical learning environment as being both facilitative and obstructive to their learning. The clinical environment may be a source of stress, creating feelings of fear and anxiety which in turn affect the students' responses to learning. Equally, the environment can enhance learning if experienced positively.ObjectivesThis study described pupil enrolled nurses' experiences of facilitative and obstructive factors in military and public health clinical learning settings.MethodUsing a qualitative, contextual, exploratory descriptive design, three focus group interviews were conducted until data saturation was reached amongst pupil enrolled nurses in a military School of Nursing.ResultsData analysed provided evidence that acceptance by clinical staff and affordance of self-directed learning facilitated learning. Students felt safe to practise when they were supported by the clinical staff. They felt a sense of belonging when the staff showed an interest in and welcomed them. Learning was obstructed when students were met with condescending comments. Wearing of a military uniform in the public hospital and horizontal violence obstructed learning in the clinical learning environment.ConclusionStudents cannot have effective clinical preparation if the environment is not conducive to and supportive of clinical learning, The study shows that military nursing students experience unique challenges as they are trained in two professions that are hierarchical in nature. The students experienced both facilitating and obstructing factors to their learning during their clinical practice. Clinical staff should be made aware of factors which can impact on students’ learning. Policies need to be developed for supporting students in the clinical learning environment.
Background: Death is one of life’s few certainties and a universal experience for all individuals. When death occurs there is usually an impact on the family and friends of the deceased, the magnitude of which often depends on whether death was expected or unexpected. The grieving experiences of the elderly are rarely discussed. The purpose of this study was to describe experiences of grief and reactions to the death of family members amongst the elderly.Methods: A qualitative phenomenological approach was used to obtain data from elderly women in Ga-Rankuwa, Gauteng, to gain insight into the experiences of grief in this age group. Purposive sampling was used to conduct in-depth interviews with 10 elderly women whose family members had died. The data were analysed using a thematic approach.Results: The findings show that the elderly were exposed to multiple deaths of family members. The participants helplessly experienced with sorrow the death of family members, had experienced death anxiety, and relinquished control to God in terms of deaths.Conclusions: The response to death of the elderly affirms that it cannot be assumed that multiple death experiences establish their readiness or ability to handle these experiences and to grieve successfully. It can be concluded that the grieving process of the elderly is not different from any other age group and that they will also require the type of support and assistance considered for younger persons in times of grieving.
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