Abstract
Human Immunodeficiency virus (HIV) infection presents both medical and social effects on infected individuals and their families. Literature has indicated that the HIV-related mortality rate has significantly declined in age groups such as the paediatric and adult population, but such effect has not been observed among adolescents. HIV management in the adolescent age group is posing significant challenges. To enable sustainable models of care, it is important to understand what it is like for female adolescents to live with HIV and what can facilitate their management of HIV infection and promote their quality of life. The purpose of this study was to gain an understanding of the experiences of female adolescents living with HIV and their grandmothers and to develop a conceptual framework and nursing strategies to be used as a framework of reference to facilitate the self-management of HIV by female adolescents living with HIV and their grandmothers who care for them in Eswatini. A qualitative, exploratory, descriptive, and contextual research design was used. The study was conducted in three phases. Phase one utilised a multiple case study approach to explore and describe the experiences of female adolescents living with HIV and their grandmothers who cared for them in rural Manzini region. The purposive sample consisted of female adolescents aged 18 to 21 years who were living with HIV and their grandmothers who cared for them. Data was collected through individual in-depth interviews. Data analysis was conducted thematically using Giorgi’s method. Trustworthiness was ensured by following Guba’s (1985) model of trustworthiness for qualitative research. The criteria for trustworthiness that was applied in this study were truth value, applicability, consistency, and neutrality. Ethical considerations were observed to ensure the protection of participants. The following four themes were identified from the data: (1) experienced the quest to survive, (2) experienced support system, (3) experienced psychological effects; and (4) experienced extended duty of caregiving role by grandmother. Categories for each theme were identified. vii Phase two of the study involved the development of a conceptual framework for the facilitation of self-management of HIV by female adolescents living with HIV based on the findings of the field study. The conceptual framework is based on a facilitation relationship between the community health nurse, the female adolescent and the grandmother. The phases of the facilitation procedure are relationship phase, working phase and the termination phase Phase three of the study focused on developing and describing the strategies for the facilitation of self-management of HIV by female adolescents living with HIV and their grandmothers who care for them. Three strategies were developed based on the conceptual framework. Strategy 1 is facilitating the building of trusting relationships between the community health nurse, female adolescent living with HIV and the grandmother. Strategy 2 is facilitating the working phase and strategy 3 is facilitating the termination phase. Each of the strategies has objectives and action plans.
D.Cur. (Nursing)