Assessing Self Care Practices of People Living with AIDS Attending
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C S & lini ID ca A l f R o e l s Okoronkwo et al., J AIDS Clin Res 2015, 6:12 a e Journal of n a r r DOI: 10.4172/2155-6113.1000528 c u h o J ISSN: 2155-6113 AIDS & Clinical Research Research Article Open Access Assessing Self Care Practices of People Living with AIDS attending antiretroviral clinic Kafanchan, Kaduna State, Nigeria Ijeoma Okoronkwo1*, Salamatu Ishaku1,2, Anthonia Chinweuba1, Paulina Akpan-Idiok1,3, Chika Ihudiebube1 and Chika Odira1,4 1Department of Nursing Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria 2Kaduna State College of Nursing, Kafanchan, Nigeria 3Department of Nursing Sciences, University of Calabar, Calabar, Nigeria 4Department of Nursing Sciences, Nnamdi Azikiwe University, Nnewi, Nigeria Abstract Background: The shift from acute to chronic illness of HIV/AIDS requires a self-management model in which patients assume an active and informed role in healthcare decision. Promoting self-care management for people living with AIDS includes addressing complex issues such as keeping to treatment regimen, dietary pattern, physical exercise and seeking for social support. This study provides baseline information about the self-care practices of people living with AIDS attending antiretroviral clinic of General Hospital Kafanchan, Kaduna State, Nigeria. Methods: A cross-sectional study was conducted at the antiretroviral clinic of General Hospital Kafanchan, Kaduna between August and September, 2014. A sample size of 412 People living with AIDS was selected using systematic sampling technique. A structured pre-tested questionnaire was used to collect data using four research assistants from the antiretroviral clinic who were trained on the purpose of the study, contents of the instrument and how to administer the instrument on clinic days while maintaining objectivity and confidentiality. Data were analyzed descriptively using frequencies, percentages, means and standard deviation. All analyses were performed using SPSS version 20.0 at 95% confidence interval. Results: Respondents described their dietary pattern as good. Majority (88%) kept to their clinic appointment and did not miss taking their drugs as prescribed. Respondents felt more at home seeking support from family members, health workers and significant others. Most of the respondents embarked on exercises such as walking, running and doing physical work. Conclusion: Self-care management practice is critical for people living with AIDS. There is need for continuous counseling and closer monitoring of people living with AIDS by health care providers to enable them sustain their self- care management. It is also suggested that physical exercise be included in their health education to promote health and wellbeing. Keywords: Self-care practices; People living with AIDS; Kaduna; more generalized epidemics that are sustained primarily by multiple Nigeria sexual partners than others. Youth and young adults are vulnerable to HIV, with young women at higher risk than young men due to their Introduction young age at marriage and higher risk for sexual abuse than their male HIV/AIDS is one of the major public-health problems worldwide. counterparts [5]. With the success of antiretroviral therapy (ART) in improving the In 2010 HIV/AIDS prevalence rate in Nigeria was about 4%, Kaduna quality of life of people living with AIDS (PLWA) and reducing State had 5.1% on the average and some areas in southern Kaduna have morbidity and mortality, HIV has become a chronic manageable doubled it. In the same year, Kafanchan had a prevalence of 11.4% disease [1]. Like all other chronic diseases, it requires lifetime changes followed by Kwoi all areas in southern Kaduna with 8.7% which was in physical health, psychological functioning, social relations, and far above the national average. The high prevalence may be attributed adoption of disease-specific regimen based on choice and decision to poor attitude of infected persons to receiving antiretroviral drugs making. The shift from acute to chronic illness requires a self- in addition to lack of access. Although UNAIDS [6] noted that only a management model in which patients assume an active and informed relatively few treatment-eligible people in the sub region are currently role in healthcare decision-making to change behaviours and optimize health and wellbeing [2]. There are many risk factors that contribute to the spread of HIV, including prostitution, high-risk practices among itinerant workers, high prevalence of sexually transmitted infections *Corresponding author: Ijeoma Okoronkwo, Department of Nursing Sciences (STIs), clandestine high-risk heterosexual and homosexual practices, Faculty of Health Sciences, University of Nigeria, Enugu Campus, Enugu, Nigeria, international trafficking of women, and irregular blood screening [3]. Tel: +234-8063581297; E-mail: [email protected] These individuals have significant roles to play in avoiding the risk Received October 10, 2015; Accepted December 02, 2015; Published December behaviors. An estimated 36.9 million people are living with HIV around 08, 2015 the world [3]. Citation: Okoronkwo I, Ishaku S, Chinweuba A, Akpan-Idiok P, Ihudiebube C, et al. (2015) Assessing Self Care Practices of People Living with AIDS attending The U.S. Department of State [4] observed that epidemic is antiretroviral clinic Kafanchan, Kaduna State, Nigeria. J AIDS Clin Res 6: 528. more concentrated and driven by high-risk behaviors. According doi:10.4172/2155-6113.1000528 to United Nations AIDS (UNAIDS) statistics, Nigeria accounts for Copyright: © 2015 Okoronkwo I, et al. This is an open-access article distributed about 10% of people living with HIV/AIDS (PLWHA) worldwide under the terms of the Creative Commons Attribution License, which permits [6]. The HIV epidemic varies widely by region [4]. Some States have unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. J AIDS Clin Res ISSN: 2155-6113 JAR an open access journal Volume 6 • Issue 12 • 1000528 Citation: Okoronkwo I, Ishaku S, Chinweuba A, Akpan-Idiok P, Ihudiebube C, et al. (2015) Assessing Self Care Practices of People Living with AIDS attending antiretroviral clinic Kafanchan, Kaduna State, Nigeria. J AIDS Clin Res 6: 528. doi:10.4172/2155-6113.1000528 Page 2 of 6 receiving ART due to lack of access, it was not certain whether those Data collection who have access follow the treatment regimen as required. The instrument used for data collection was developed by the From anecdotal reports and researchers’ observations, despite researchers based on extensive literature search on self-care practices the education given to clients who attend antiretroviral (ARV) clinic, of PLWA. The questionnaire was divided into 5 sections. Section A was some still engage in risky behaviours such as unprotected sex, drinking on socio-demographic data, section B on dietary pattern, section C on alcohol, smoking cigarette, use herbal medication. Some even take self-care management on treatment regimen. Section D dealt on social their drugs with alcohol. Centre for Disease Control and Prevention support services sought for and utilized by PLWA while section E was [7] notes that such risky behaviors lead to complications. This may on their physical exercises. A total of 23 items were generated for the imply that many people infected with HIV are not taking proper care study. A consultant physician in HIV Unit and two senior lecturers in of themselves. Department of Nursing Sciences of University of Nigeria, Nsukka were requested to vet the instrument and critically assess the relevance of Promoting self-care management for PLWA includes addressing content and clarity of statements so as to establish the content validity. complex issues such as social stigma and medication adherence. These specialists made various suggestions which were used to modify Disclosure of one’s disease status to others and coping with social the questions before administration. rejection are experiences that add stressors to the burden of living with an incurable infectious disease [8]. Souza [9] observed that HIV/ To establish reliability of the instrument, it was pilot-tested on AIDS is now a condition people live with in their lifetime as a result of 42 PLWA in ARV clinic of another hospital in Enugu, and the scores improvements in ART, and suggests that person’s mental and emotional subjected to reliability test using Cronbach’s alpha. The reliability adjustments to the illness as defined by the type of social support coefficient of 0.81 showed that the instrument was very reliable. Self- available to him can be understood. care practices as used in this study refer to the dietary pattern, self- care management practice on treatment regimen, seeking and utilizing Social support has a major effect on the progression of illness. social support and physical exercise of PLWA. Sufficient social support and positive interpersonal relations positively affect one’s physical and mental health related outcome [10]. Social Data quality control and collection relationships can be a form of social capital; people greatly benefit and succeed from the interaction and support they offer and receive from A one-day-training was conducted for four Registered Nurses one another. The influential nature of social support is evident in that working as permanent staff in the ARV clinic of the hospital who were individuals with more social ties generally experience better physical used as research assistants.