Abstract
D.Cur. (Psychiatric Nursing)
Malawi has a population of 9 million people with AIDS the leading cause of death in the
age group of 20 • 40. The HIV prevalence rate, estimated at 23% in urban areas and 8%
in rural areas, is one of the highest in the world (AIDSEC, 1994: I). Evaluation of
counselling practices showed poor results with counsellors feeling ineffective and
inadequate. Patients are mostly tested on medical indication but testing is increasingly
refused by patients who do not see the benefit of knowing their HIV status. The
counselling practice as it is known in the Western world is a foreign concept for patients
living in rural Malawi. The high stigma of AIDS complicates support of the patients. The
goal of this research study is to describe a model of counselling that would meet the
needs of an AIDS patient in a rural community in Malawi. A qualitative research design that is explorative, descriptive and contextually specific to rural Malawi was used for the study. In order to describe a counselling model it was important to understand the illness experience of HIV reactive patients. The patients are seen in group context congruent with the African culture and therefore the experience of the primary care giver of AIDS patients is also examined. The experience of counsellors of AIDS patients is explored as the other major factor in the phenomenon examined. In the first phase of the study in-depth phenomenological interviews were conducted with identified groups. Focus interviews were conducted with a hundred AIDS patients to identify the needs and resources of the patients and to compile a demographic profile. Focus group discussions were conducted with counsellors for more complete comprehension. Data analysis and a literature control were undertaken. In the second phase of the study theory generation was used in order to develop a counselling model for AIDS patients and guidelines for implementing the model were generated. Based on the results of the analysis the major concept enable was identified as the essence of a model for counselling AIDS patients in rural Malawi.