Kisim help bilong olgeta manmeri long PNG long sikAIDS : a mixed methods study
Creators: name: Clark, Geoffrey
Publisher: name: Monash University
Year: 2017
Subjects: Uncategorized

description: In May, 2005, the Papua New Guinea (PNG) National Department of Health (NDoH) determined that the Integrated Management of Adult and Adolescent Illness (IMAI) Chronic HIV Care training program, modified for the PNG context, would serve as the basis for the development of teams for the Rapid Scale-Up of HIV/AIDS Care and Treatment. The IMAI Chronic HIV Care training program was developed as a joint effort carried out in a working partnership involving WHO, Geneva, the WHO Regional Office for Africa (AFRO), as well as many international collaborating institutions. Trials and implementation of the program have occurred predominantly on the African continent and to date there has been no research undertaken to examine the effectiveness of the IMAI program as a learning modality for preparing registered nurses to provide comprehensive HIV care. The purpose of this hermeneutic informed interpretive research study is to explore and describe how registered nurses in Papua New Guinea make sense of their learning and implementation of the IMAI training program in providing Comprehensive Care and treatment to people living with HIV/AIDS. The study is a mixed methods study. The rationale for this approach was to better understand the research problem by converging both broad numerical trends from quantitative research and the detail of qualitative research with the intent of producing a richer and more complete picture of the investigated phenomenon. Data collection included a quantitative survey, semi-structured interviews and a focus group. These data informed the development of descriptive accounts that allowed for the subsequent identification of common and divergent themes reflective of factors that influenced nurses learning and implementation of IMAI training. The findings from the quantitative survey revealed that all respondents had a positive impression of the IMAI program and expressed the view that the IMAI program had a positive effect on various aspects of patient care and their learning and experience. Overall, the survey identified that registered nurses who participated in the IMAI Chronic HIV Care training program perceived the program to be beneficial for improving the way HIV care is provided. Three major themes were identified from the qualitative analysis, and under these major themes data was arranged as sub-themes. The three major themes identified were Overcoming Personal Anxiety, Actioning Learning and Identifying Challenges. The qualitative analysis revealed that overwhelmingly, the fear of anxiety of HIV was significant for all participants of the semi-structured interviews. Nurses in the focus group felt that the overt expression of fear given by the interview participants more accurately reflected the reality for the majority of nurses in Papua New Guinea. Most nurses also identified that their participation in the IMAI program contributed to their personal change process and helped them to identify and understand their fear of HIV. Expert patient trainers (EPTs) were a highly valued component of the flexible IMAI training methodology and were seen by nurses as being important both for learning and for assisting them to overcome their personal anxiety created by the fear of HIV. The findings also identified that the key challenge faced by nurses in attempting to implement their learning was that of system issues including a lack of medical supplies, including antiretroviral drugs (ART), lack of staff and an absence of continuing professional education. These issues require enhanced commitment from the NDoH if nurses are to be effective in implementing their learning to provide HIV care and treatment. It is also important that NDoH give support to enable the establishment and implementation of continuing education for nurses providing HIV care and treatment and that the development of processes to ensure the ongoing maintenance of quality in HIV care and treatment training be implemented as a matter of priority. Finally this study has provided an in-depth understanding of the experiences of how registered nurses in Papua New Guinea make sense of their learning and implementation of the IMAI training program in providing comprehensive HIV care and treatment to people living with HIV/AIDS. The current multitude of factors fueling the HIV/AIDS epidemic in Papua New Guinea are explored as is the current status of HIV/AIDS in New Guinea, and the multitude of cultural patterns, social, and political factors influencing the spread of HIV within the country. This exploration also undertakes a comprehensive discussion of cultural issues related to gender inequality including a rich description of changing cultural patterns and values in Papua New Guinea. [Appendix J not included in PDF]