Caregivers' Barriers to Disclosing the HIV Diagnosis to Infected Children on Antiretroviral Therapy in a Resource-Limited District in South Africa: A Grounded Theory Study.
Caregivers' Barriers to Disclosing the HIV Diagnosis to Infected Children on Antiretroviral Therapy in a Resource-Limited District in South Africa: A Grounded Theory Study.
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DOI：
10.1155/2012/402403
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发表时间：
2012
影响因子：
1.7
通讯作者：
Mokwena K
中科院分区：
文献类型：
--
作者：
Madiba S;Mokwena K
我们采用了一种扎根理论的方法来探索接受抗逆转录病毒治疗（ART）的儿童的护理人员样本如何向其感染的儿童披露艾滋病毒。本文探讨了照顾者对感染儿童披露艾滋病毒的障碍。接受抗逆转录病毒治疗的6-13岁儿童的照料者参加了四次焦点小组访谈。三个主要的主题出现了，照顾者是否愿意告诉，合适的时间告诉，以及披露的背景。披露被推迟，因为护理人员必须首先处理影响其披露准备程度的个人恐惧；披露也被推迟了，因为护理人员不知道如何判断。护理人员缺乏披露的技能，因为他们没有受过培训，不知道如何告诉孩子自己的诊断结果，不知道如何与孩子谈论艾滋病毒，也不知道如何处理对披露做出负面反应的孩子。照顾者担心孩子可能会把诊断告诉别人，从而受到歧视和社会排斥，孩子们会生活在对死亡和临终的恐惧中。保健提供者在向受感染儿童披露艾滋病毒信息方面可发挥关键作用，因为照顾者表示希望接受培训并做好披露艾滋病毒信息的准备。
We used a grounded theory approach to explore how a sample of caregivers of children on antiretroviral treatment (ART) experience HIV disclosure to their infected children. This paper explores caregivers' barriers to disclosing HIV to infected children. Caregivers of children aged 6–13 years who were receiving ART participated in four focus-group interviews. Three main themes, caregiver readiness to tell, right time to tell, and the context of disclosure, emerged. Disclosure was delayed because caregivers had to first deal with personal fears which influenced their readiness to disclose; disclosure was also delayed because caregivers did not know how to tell. Caregivers lacked disclosure skills because they had not been trained on how to tell their children about their diagnosis, on how to talk to their children about HIV, and on how to deal with a child who reacts negatively to the disclosure. Caregivers feared that the child might tell others about the diagnosis and would be discriminated and socially rejected and that children would live in fear of death and dying. Health care providers have a critical role to play in HIV disclosure to infected children, considering the caregivers' expressed desire to be trained and prepared for the disclosure.