Provision of antiretroviral therapy for children in Nelson Mandela Bay: health care professionals' challenges

Background: The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children.Aim: To explore the experiences of health care professionals regarding the provision of ART for children at PHC clinics.Setting: The study was conducted in six PHC clinics in Nelson Mandela Bay Health District, Eastern Cape, South Africa. Methodology: The researchers used a qualitative, explorative, descriptive and contextual research design with in-depth interviews. We used non-probability purposive sampling. Data collected were thematically analysed using Creswell's data analysis spiral. We used Lincoln and Guba's model to ensure trustworthiness. Ethical standards were applied.Results: Health care professionals experienced numerous challenges, such as lack of resources, need for training, mentoring and debriefing, all related to providing decentralised ART for HIV-positive children at the PHC level.Conclusion: Capacitation of the health care system, integration of services, competent management and visionary leadership to invoke a collaborative interdisciplinary team approach is required to ensure that HIV is treated as a chronic disease at the PHC clinic level

Experiences of Registered Nurses with Regard to Accessing Health Information at the Point-of-Care via Mobile Computing Devices

Background: The volume of health information necessary to provide competent health care today has become overwhelming. Mobile computing devices are fast becoming an essential clinical tool for accessing health information at the point-of-care of patients.Objectives: This study explored and described how registered nurses experienced accessing information at the point-of-care via mobile computing devices (MCDs).Method: A qualitative; exploratory; descriptive and contextual design was used. Ten in-depth interviews were conducted with purposively sampled registered nurses employed by a state hospital in the Nelson Mandela Bay Municipality (NMBM). Interviews were recorded; transcribed verbatim and analysed using Tesch's data analysis technique. Ethical principles were adhered to throughout the study. Guba's model of trustworthiness was used to confirm integrity of the study. Results: Four themes emerged which revealed that the registered nurses benefited from the training they received by enabling them to develop; and improve; their computer literacy levels. Emphasis was placed on the benefits that the accessed information had for educational purposes for patients and the public; for colleagues and students. Furthermore the ability to access information at the point-of-care was considered by registered nurses as valuable to improve patient care because of the wide range of accurate and readily accessible information available via the mobile computing device. Conclusion: The registered nurses in this study felt that being able to access information at the point-of-care increased their confidence and facilitated the provision of quality care because it assisted them in being accurate and sure of what they were doing

The Experiences of AIDS Orphans Living in a Township

An overwhelming challenge to health-care professionals today; is the rendering of care services to AIDS orphans. This article is based on a study that explored and described the lived experiences of AIDS orphans in a township in order to understand their 'life world' as AIDS orphans. A further purpose was to provide information to primary health-care nurses (PHCNs); related professionals and partners involved in the care of these children; so that they could plan a care response to meet the orphans' unique needs. A qualitative research design that used an explorative; descriptive; contextual and phenomenological strategy of inquiry was employed. Data were collected by means of in-depth interviews from a purposively selected sample; and were analysed according to the steps of qualitative data analysis proposed by Tesch (Creswell 1994). Guba's model was used to ensure the trustworthiness of the qualitative data. Two main themes and their sub-themes were identified. The first theme was that children experience devastating changes in their life circumstances when they become AIDS orphans. The second theme highlighted how the participants rediscovered hope to persevere. Recommendations directed at nursing practice; education and research; were made based upon the findings