Understanding Participation in a Hospital-Based HIV Support Group in Limpopo Province; South Africa

Background: Support groups are an appropriate way of delivering psychosocial support to people living with HIV/AIDS; especially in low-resource countries. The aim of the study was to understand why people with HIV attended psychosocial support groups. Methods: This was a qualitative study design using focus-group discussions in which support-group members volunteered to participate. Five focus groups were involved in the study. Results: The participants attended because they were referred by a health-care worker; wanted information; wanted emotional support; accompanied an ill relative or knew about the support group. Perceived benefits included receiving psychological support; accepting one's HIV status; reducing stigma and isolation; increasing hope; forging new friendships; helping others; obtaining HIV-related information; developing strategies to change behaviour; gaining access to medical care at the adjoining HIV clinic and receiving food donations. Negative aspects of attending the support group included the large size of the support group; long queues at the HIV clinic; concerns about confidentiality and negative staff attitudes towards the participants. Leaders were concerned about conflict; burn-out and impractical protocols. Access to disability grants was also a concern. Conclusions: Support groups can assist members to cope with the various challenges associated with living with HIV/ AIDS through offering structured emotional; informational; instrumental and material support. Support group sizes should be limited. A structured curriculum containing up-to-date information about ART should also be offered to support groups. Social workers should furthermore be involved to facilitate access to appropriate social grants. Finally; support group leaders should receive appropriate training and regular debriefing

How the families of the victims suicide through self-incineration function before and after the event a qualitative assessment

Background Durkheim defines suicide as all death resulting directly or indirectly from a positive or negative act of the victim himself or herself; which he or she knows will produce this result. Suicide is as old as human history itself. It is most frequently seen as a fatal sequel of psychiatric illnesses and it is thought that suicide only occurs in a state of insanity; and that it is by itself a special form of insanity. Health workers; especially family practitioners; are constantly confronted by family tragedies; which they have to deal with competently. It is therefore imperative that a health worker contextually understand a family tragedy; such as when a family member commits suicide through self-incineration. Between 1987 and 1998; Matsulu Township; Mpumalanga experienced a high incidence of suicide through self-incineration. Each victim either ingested or doused him or herself with inflammable liquid (usually kerosene) and set his or her body alight. This gruesome form of suicide; and the increased frequency of occurrence; horrified the families and reverberated through the township. This phenomenon drew the principal researcher's attention and resulted in this study. The principal researcher was the only family practitioner in the township during this period. It was hoped that the knowledge gained from this study would form the basis for interventions in similarly affected families in the future. The focus was on the surviving family members; in order to learn about the family dynamics before and after the events; and how the family dealt with the event. Although studies that focused on the role of doctors in suicide prevention found that there is little predictive power for the suicide candidates; which means that there were no identifiable factors directly associated with suicide outcome; information gleaned from the affected families could be used profitably in community campaigns and by support groups. Methods The aim of the study was to understand how the families of those who committed suicide through self-incineration functioned before and after the event. In-depth interviews were conducted with six focus groups selected urposively from 36 affected families. Interviews were conducted in Siswati; audiotaped; transcribed and translated into eng. Themes and sub-themes were identified. To enhance the trustworthiness of the information gathered; the data were triangulated. Results Themes identified were a shocking experience; no chance of survival; triggering factors; mystery; emotional and physical scars; and coping strategies. The perception of witchcraft being responsible for suicide featured prominently in the data analysed. Conclusions The functioning of the families affected by the suicide of a member through self-incineration was markedly reduced after the events. It is recommended that attention be given especially to the perception of witchcraft being responsible for suicide; and that grief support groups be established in the community to assist affected families cope better with the loss