Nghi§n CLTU Gia dinh vk Gidi
S^ 6 - 2012
Tiep can dien da dan tgc tioc trong nghien ciili HIV/AIDS:
Chia se cua nghien ciiu vien tre tham gia dU an STAR
Vu Diirc Viet
Trung ISm Nghifin CIAJ vi Dflo tao HIV/AIDS, Oai hpc Y Ha N6i
Le Minh Giang
B6 mOn Dich Ift hoc. Dai hpc Y Ha \ii
Tom tilt: PhUdng phdp nhan hoc dUOc sU dung c6 hieu qua d nhieu nu6c tren the gidi trong nghien cffu v4 nhitng hdnh vi nguy cd lay nhiem HIV nhu tinh dye khong an todn vA sU dung ma iiiy Bdi viet nay tim hieu, phan tich mot so khai niem lien quan don cdc liep cfin ilu'ii da dfin toe hoc trong nghien cLfu ve sifc khoe n6i chung vd HIWAIDS n6i rieng. Nghien ciiu da chi ra rfing cfic phUOng phAp n6y khong chi g6p ph^n bo sung nhflng hidu biet, nliunt; kien thflc khoa hoc ve HIV, mh n6 con giiip cho viec xay di^ng nhflng kO ho^ch can thi^p c6 hi^u qua cao vk phu hpp ve m$t van h6a, Tuy nhien chua c6 nhi^u nghien cflu sfl dung tiep can dien da dan t^c hoc trong nghien cflu HIV t^i Vi?t Nam. Chia se cua nhflng nghien cflu vien tham gia du an ""Tiep cSn kho.I hoc xa hoi trang nghien cflu HIV/AIDS" gop phan l&m ro hOn vi- thuc te irien khai phUdng phap tiep can nay trong nghien cflu ve nhflng chia de nh&y cam vk d nhflng nh6m d l ton thuong. Tfl nhflng phlin tich, cfic tac gia khuyen nghi ap dung sau rpng hdn nfla nhflng phUOng phap di^n da dan tpc hpc trong nghien cflu va can thiep lien quan den sflc khoe, dSc biet i^ trong phong chong HIV/AIDS 6 Viet Nam.
TU khoa: Tiep can dien da d&n tpc hoc; PhUOng phap nhan hoc Nghien cflu HIV/AIDS, Du an STAR. ' '
Vu DCtc Viet va Le Minh G i a n g 65
1. Dat van de Muc tieu ciia bdi viel
Tren the' gidi, viSc siJr dung cdc phucfng phap dinh tinh theo li^p can nhan hoc, dac biet 1^ di^n da dan tOc hoc trong nghiSn cthi v^ HIV duoc chiing minh \k c6 hiSu qua vk ngky ckng ph6 bifi'n. Tuy nhifin d Vifit Nam vific tri^n khai phucmg phdp nky trong nghifin cthi ve HIV c6n chua dugc nhan dugc su quan lam cita cac nhk nghifin cuu. Do vSy b^i vifit nay nham muc tifiu tim hi^u xem di^n da dan t6c hgc \k gi, cdc phucfng phap tifi'p cSn diln da dan iGc hoc thudng dugc dl cap cung nhu nhiJng d6ng gdp ciaa nghifin cihi nhan hgc trong phong chO'ng HIV/AIDS va vific ap dung cac phirong phdp nky tai Vifii Nam. Chung t6i cung tifi'n hanh phong va'n sau mfit s(5 nghifin cflu vifin tre tham gia du dn "Tie'p can khoa hgc xa h6i trong nghifin cflu HIV/AIDS" (tfin lifi'ng Anh vifit tat la STAR) nhdm tim hi^u nhirng ihdch thii'c va co hgi cita vific thuc hifin tifip cdn di^n da dan t6c hgc trong nghifin cflu v6 nhflng va'n de lifin quan de'n .sflc khoe dac bifit la HIV.
Dien dd ddn tgc hgc Id gi? Cdc phucmg phdp nghien curu dien dd ddn tdc hqc
Khoa hoc xa h6i la m6l khai nifim chung dp dung cho nghien cflu ve xa hoi va mQ'i quan hfi ciia con ngudi. Nhan hgc cting voi xa hgi hoc, kinh tfi' hoc, khoa hgc ve chi'nh iri, tdm 1^^ hgc, lich su va dia ly la cac nganh khoa hgc xa hgi chi'nh. Nhdn hgc (lifi'ng Anh la anthropology) dugc hi^u theo nghia r6ng la nghifin cuu ve nhan loai, v6 loai ngudi, gom co hai nhanh chi'nh la nhdn hgc hinh the va nhdn hgc xa hgi hay edch ggi khde la nhdn hoc vdn hoa. Nhan hgc hinh ih^ quan tdm tdi vific hinh thanh va thay ddi clia loai ngudi va dua tren sinh hoc tifi'n hoa, ddn so hgc, va khao c6 hgc.
Trong khi do nhung nha nhdn hgc xa h6i ihudng tham gia xdy dung mo la chi tifi't vdn hoa cua mdt xa hdi (ethnography), dd la nhiing bao cao dugc viet sau nhiing khoang thdi gian quan sdt tham dtr (participant observa- tion) dai (Jary and Jary. 1995). Quan sat tham du la mdt each tifip cdn chinh va quan trgng trong cdc phuong phap di^n da ddn igc hgc (ethno- graphic methods). Nhieu tac gia cho rdng di^n da ddn Idc hgc la mdt nhanh chi'nh cua nhdn hgc vdn hda. Dfi' giam su ldp lai, bai viet nay se sir dung thudt ngu nhan hoc lhay cho di^n da ddn tdc hgc, nhdn hgc van hda hay nhdn hgc xa hdi. Diln da ddn tgc hgc (ethnographic) khac vdi ihudl ngii ddn tdc hgc (ethnology) thudng cd nghia la nghifin cflu vl cdc dan tdc thifi'u sd. Phdn Idn nghifin cflu ddn tgc hgc b Vifit Nam dua tren hgc thuye't lifi'n hda cua Morgan va quan tdm nhilu dfi'n sir md la vl nhihig dac di^m van hda cr cac quan the ngudi sdng d viJng cao va den su phdn loai cac ddn
64 Nghien cflu Gia dinh vi Gidi. Quy^n 22, so 6, tr 64-76 tdc ihi^u ,sd (Salemink, 1995; Luong, 2006).
Nghifin cflu iheo tifi'p can nhan hgc sijr dung mdt sd phuong phap chi'nh nhu quan .sal tham dt; va phdng vd'n sdu, phdng v^n lich sfl ddi sd'ng. Quan sdt tham du Id phucmg phap thu thdp ihdng tin md irong dd ngirdi nghifin cflu vifin lifi'p can vfln hod nghifin cflu bdng edch tham gia sinh hoat. sdng ciing vdi dd'i tugng d^ md ta vd If giai cdc su vdl hifin iflcmg lir edch nhin cua ngudi irong cudc. Quan sal iham du Id n^n lang cua cac hoai ddng nghifin cflu khac nhu ghi chfip thia dia. trd chuyfin khdng chi'nh thiJc, thuc hifin cdc cudc phdng van. thu thdp dii lifiu, ldp danh muc, vk cdc hoai ddng nghifin cflu kh;ic Nd khdng don gian chi Id vdn dtf tham gia vk quan sdi.
Theo Bernard (2011), quan sat tham du la mdi qud trinh gdm cd nhitfu giai doan. Khi mdi lifi'p xiic vdi mdt nfin vdn hda mdi nhitfu nha nhdn hgc cam iha'y rd't hung thu vii ki'ch ddng, tuy nhifin sau dd mdi hai ludn da sd ho rcri vdo irang ihai chdn nan vii sd'c do dp luc phai hodn ihdnh cdng vific va su lhay ddi vl mdi trudng .sd'ng, ihudng dugc goi la sde vdn hda. Sau giai doan ndy nhimg nha nhdn hgc tdp irung thu thdp s6 lifiu v^ cd cam gidc phai hifin ra nhirng bi mdi ctia noi md hg nghifin cflu. Khoang sau ba d^n bdn thdng d ihflc dia la quang thdi gian ma nghifin cflu vitn ihuc dia nghi ngoi, dfi" sau dd lai tifi'p luc tdp uung vdo cdng vific cho den khi cam iha'y kifit sflc. Hg nghi ngoi Id'y lai sflc rdi lai hdng say lam \ific cho d^n khi cam tha'y nhiing ihdng lin Iheo dudi khdng cdn ihu vi nira ihi dd td liic hg rdi khdi dja ban.
Trong qud irinh quan sal iham dir, phong vdn sdu bdn ctfu Irflc hodc khdng ca'u true cung dugc sir dung. Cdc cudc thao ludn khdng cd'u true dugc su dung itc- khuyfi'n khi'ch li'nh phan xa cua ngudi iham gla nghifin cflu, dc cho hg cd ihdi gian suy nghi. biiy td -y kifi'n trdi ngugc nhau. nhiing hodi nghi, ndi sg hai cung nhu hy vgng cua hg. Nghifin cflu vifin cd ih^
dung mdt ban phdc ihao nhflng dicm cdn hdi hay hudrng dSn phdng vd'n.
nhung thudng ihi hg dc cho ngudi dugc phong vdn tifip luc edu iruyfin cua minh dii ddi khi nd di ra ngoai chii d l dang dugc ndi idi. Dilu ndy Id bdi VI nhflng nha nhdn hgc thudng cd gdng dfi* lim hifi'u quan di^m rifing cua nhung ngudi dugc phdng vdn. dfi* cd dugc quan difim cua mdt ngudi trong cudc. edi khdng ihd dugc thuc hifin bang edch dai ra mdt loat nhims edu hdi cho hg. Phdng vdn Uch sit ddi sd'ng Id mdt dang dac bifit cua phone vdn sau. trong dd nghifin cflu vifin se tifi'n hanh phdng vdn ngudi da ddng ^ tham gia nghifin cflu nhilu Idn. Muc dich cua phdng vdn lich sir ddi sd'ns la nham tim hilu sdu hctn vl nhiing khi'a canh ddi sd'ng cua dd'i tucme c6 lifin quan dfi'n ndi dung dugc nghifin cflu. Vific phdng vHn nhilu Ian cii giup cho thdng tin dugc ddy dii vd chi ti^l md ddi khi bi bd qua nfi'u h"
Vu Dflc Viet va Le Minh G i a n g 67 phong vdn mdt Idn. Ddng thdi nd cung tao dilu kifin dl ngudi dugc phdng van cd co hdi hdi tudng lai nhflng su vific quan trgng trong cudc sd'ng cua hg va b6 xung, dmh chinh lai nhihig thdng lin da cung cd'p trudc do.
Trong qua trinh di ihuc dia, nhflng nhd nhdn hgc thudng ghi chep lai td't ca nhflng thdng tin hg ihu dugc Irong ngdy irong nhihig cudn nhat k^^ thuc dia. Nhat ky cung cd thi do ngfldi tham gia nghifin cflu vifi't tii trudc hodc dugc dl nghi dd'i tugng vifi'i theo yfiu edu vdi cdc dat hdng cu th^ ctia nghifin cflu. Cac nhd nghien cult se phdn tich dtt lieu dua trfin nhai ky nay, va thudng thi hg kfi't hgp vdi phan tfch cdc dtt lifiu tfl phdng vd'n sdu. Ngoai ra mdt sd phuong phdp nhdn hgc khac cung dugc dp dung la thao ludn nhdm tifiu dilm, phuong phap dd'i iflgng nghifin cflu tu ehup anh (photo voice)... Cac phuong phdp ndy ed ihl dugc su dung dl bd sung thdng tin cho cac phucfng phap chi'nh kfi trfin.
Dong gdp cda nghien cffu nhdn hoc trong phdng chdng HIV/AIDS Nghifin eiiu tren thfi' gidi vl HIV da chi ra rdng hanh vi tinh due khdng an toan vd sfl dung ma tiiy dugc chflng minh la nhijtig yfi'u td chfnh trong Idy Uuyin HIV trong nhung nhdm cd nguy cao. Tuy nhifin cdc hanh vi nay thudng cd dac dilm vd y nghTa khde nhau trong nhung bd'i canh vdn hda xa hdi khde nhau. Vi du, hanh vi nguy co lien quan dfi'n su dung ma tuy CO the cd su khac bifit vl loai ma tuy sfl dung, nhdm sfl dung vd y nghia ctia hanh vi nguy co dd'i vdi ngudi su dung ma tuy. Hanh vi su dung ma tuy d mdt ca nhdn vdn cd thi khac nhau d cac dia dilm, vdi cac ca nhdn tham gia khac nhau, trong cdc hoan canh xa hdi khac nhau, vd d cac giai doan khac nhau trong cudc sd'ng (Clatts vd Sotheran, 2000). Do dd vific tifi'p cdn tim hifi'u "lie'ng ndi" eiia ngudi trong cudc, ma d ddy la nhung ngudi su dung ma luy, la ndi dung dugc quan Idm tfl Idu trong cac nghifin cuu nhdn hgc lien quan de'n ngfldi sfl dung ma tuy (Clatts, Davis, va Atillasoy, 1995).
Su Idy Ian bfinh HIV lam tdng nhu edu cdn thifi't ed dugc thdng lin chfnh xac, sau sde, nhflng thdng tin lifin quan dfi'n chuyfin linh cam rifing tu ciia cac qudn thi ^n va khd tiep cdn cho cae nha nghifin cflu. tap trung vdo cdc loai hanh vi khdng dfi dang tifi'p cdn thdng qua cdc cudc khao sdt, cac thifi't ke nghifin cflu ban thirc nghifim hodc thuc nghifim, ddc biei la trong qud trinh thdm dd ban ddu nhflng hanh vi nay. Thdng tin vl hanh vi nguy ca HIV dugc cho la quan trgng thudng bao gdm cac vd'n de ma ngudi ta khdng earn thd'y ihoai mdi trao ddi vdi ngfldi la. chdng han nhfl mdi quan hfi tinh cam va nhflng hdnh vi dugc cho la khdng ihl chdp nhdn duge vfi mat van hda (Trotter, 1995). Tuy nhien ddy lai la nhflng cai cd thi phan
68 NghiSn curu Gia dinh vk GI6i. QuyS'n 22, so 6, tr. 64-76
anh c^c g\i tri, hilnh dOng, ni^m tin, va nhftig cliu^n mirc ciia van lioa phu nhiing ci\ mil IchOng quen thuOc vAi nhttng nguM chi tham gia Iroiig van h6a chi'nh (Hong et al., 2005). Cilch ti4p can nhan hoc cung co th« giup l<ham pha nhiing g6c canh Sn ciia thirc li xa M. ilac biet trong cSc b«i canh duoc dac trung bM ky thi, phan biet dfii xir va cit tuyet qu4 miJc (Parker and Elirhardl, 2001). Day la nhiing 1^ do dJn tdi viec cic nha khoa hoc su dung nhiing phuong phap nhan hoc trong nghien ciiu vd HIV.
Trong cu6c chie'n phdng chd'ng HIV 6 nhiing nucSc nghSo va nhiing nutSc dang phat trilSn, su tham gia va dong g6p cua cac t6 chile qu6c l(\h rat dang ki. Tuy nhien. viec ap dung nguyen ban nhiing chuong trinh can thiep phSn IcSn la tir cac nudc Chau Au vk Bac M7 vio nhiing nudc nSy dSi khi chua thuc sir hiSu qua. Nguyen nhan ciia viec nay m6t phdn 14 do cac chuong trinh can thiep chira cd su phii hop ve mat van hda (Hong et al., 2005). Thuc le da chi ra rang ket qua ciia cic nghien ciiu sir dung hoac ket hpp sir dung phucmg phap nhan hoc da gdp phin lim nin tang cho viec xay dung nhiing chuong trinh phong chdng HIV hieu qua (Claris. Davis.
va Atillasoy, 1995). Trong nghien cilu vi nghien ma luy v i nguy CO liy nhiim HIV, nhan hpc da nang tSm khai niem ve nguy co Irong vd'n tir vung nhan hpc. VI du nghien cim nhan hpc da giup lam ro hanh vi nguy co thuc - chil khdng phai triru tupng - ciia ngudi liem chich ma liiy. dc cao vai trd quan trpng ciia sir san cd bom kim tiem hon la viec sir dung chung bom kim tiem Irong nguy co lien quan de'n bom kim tiem, vii giup cho su phat tne'n cua cac chie'n lupc can thiep nhu vice sir dung mang ludi xa hdi va cac giao due vien ddng dang trong \ iec tie'p can nhiing quSn the khd lie'p can (Grund, Kaplan, and Adriaans, 1991).
2. Nghien cOu nhan hoc ve HIV/AIDS a Viet Nam
Nghien eilu nhan hpe lai Viet Nam da va dang phdt trien manh me trong hon hai mupi nam qua. PhSn Idn eac nghien ciiu nhan hpc g^n day lap trung lim hie'u su lhay dOi kinh le va van hda xa hdi ciing nhu su bi^u hien ciia nd (Luong, 2006). Mdi sd chu de dupe nghien cilu nhidu nha't la gidi va gia dinh (vi du Oosterhoff el al., 2010); nghi le: dien ngdn va ly tudng (Roben, 2005); va su lhay ddi vi kinh t6'(Phinney, 2009). Nhidu ly Ihuye'l dupe dp dung gdp phSn ly giai cic v&n di nfiu tren nhu chu nghTa chile nang ca'u triic, sinh thai van hda, chii nghia ca'u true, chii nghia hau ca'u true cua Foucault, chii nghia Mac va ehu nghia Mac mdi, va chii nghia hau hien dai (Luong, 2006).
Trong nghien ciiu vi HIV/AIDS, nhidu nha nghien cilu xa hdi va nhan
Vu Diic Viet va Le IVIinh G i a n g 69 hoc tdp trung nghifin cflu v^ nhflng ddc di^m vdn hda, hdnh vi va djch tfi cua hdnh vi linh due. Mdt sd nghifin cflu nhd'n manh tdm quan trgng ciia qua trinh Ddi Mdi Idi vific dinh hinh dich HIV. Nhung chi'nh sach kinh lfi' xa hdi cua Ddi Mdi cd th^ lao cho nam gidi co hdi lifi'p can vdi tinh due ngoai hdn nhdn (Phinney. 2009). Mdt bdi vifi't gdn ddy su dung mdt sd phucfng phap tifi'p can nhdn hgc trong dd cd phan tich tdi lifiu va quan sal tham du da tim hifi'u md'i lifin quan rang budc gifla HIV vdi nhung hanh vi dugc coi la tfi nan xa hdi trong nhiing ndm 1990 Id cd bac, sfl dung rugu, ma tuy va mai ddm (Monloya, 2012). Dua trfin {•f thuyfi't ve chii nghia lu do mdi, tac gia da phdn tich nhflng chi'nh sach. lap trudng cua chfnh phii ciing nhu nhihig trd ngai. nhu edu cua vifin chflc PEPFAR (Kfi'hoach cflu trg khdn cd'p cCia Tdng thd'ng Hoa Ky v^ phdng, chd'ng HIV/AIDS), nhflng i6 chflc phi chfnh phu qude tfi' cung nhu trong nudc, vd nhflng can bd Idm c6ng tdc xa hdi trong cdng cudc phong chdng HIV d Vifit Nam.
Oosterhoff vd cdng sir thu thdp du lifiu dinh tinh qua phdng van sdu va quan sal Iham du lim hi^u quy dao cudc sd'ng cua phu nu gda cd HIV duong tinh vamdc AIDS (Oosterhoff el al, 2010). Mdt sd phu nfl nay tifi'p tue sdng d nha chdng vdi con irai minh, mdt sd sd'ng ddc thdn, sd khac ud ve sdng vdi gia dinh ciia minh. Nghien cflu chi ra rdng phdn Idn phu nu trd v^ vdi gia dinh cd dugc mdi quan he tinh cam mdi Ihdng qua nhung nhdm h5 trg cho ngudi nhifim HIV. Trong khi dd Nguyfin Thu Anh va cdng su su dung phuong phdp phdng van sdu va quan sat tham du tim hieu vai trd cua nhdn vifin y lfi' trong vific hd trg nhung phu nfl mang thai nhifim HIV CO mong mud'n gifl thai lai thanh phd Ha Long va thi Iran Cam Pha, Quang Ninh (Nguyen Thu Anh et al., 2009). Kfi't qua nghien cflu da chi ra rdng nhCmg phu nfl nay hdi long vdi nhimg djch vu hg nhdn dugc tfl chuong trinh phdng chd'ng Idy iruyen ifl me sang con va ndi rdng nhdn vifin y te khfing chi cung cap cho hg chdm sde y te' ma cdn ca sfl hd trg v^ tinh th£n va xa hdi. Bai bao kfi't ludn rdng hfi thd'ng y tfi' la mdt ehd dua sd'ng cdn cho phu nu mang thai cd HIV. Mdt nghifin cflu khac ciing sfl dung phdng vd'n ban edu iriic va quan sat khdng edu true kfi't luan rdng chat lugng cua dich TO phdng chdng Idy truyen HIV tfl me sang con co ih^ dugc cai thien ihflng qua vific ndng cao cdc ky ndng, trong dd cd ky ndng truydn thdng, cua nhdn vifin y lfi', hd trg hg idt hon cung nhu ndng cao ddng luc cCia hg (Nguyen Thi Thuy Hanh et ai.. 2009). Nghifin cflu cung chi ra rdng su phat trien mdt chifi'n luge cd tinh ihuc tfi' Id cdn thiet cho vific ciing cd va dieu chinh hfi thd'ng chuyen giii nhdm ddp flng nhu cau cua bfinh nhan.
Nhu vdy vific si> dung phuong phap nhdn hgc da cd nhflng ddng gdp budc ddu irong nghifin cflu vi HIV/AIDS lai Viet Nam. Mdt sd nghien cflu
70 Nghifin clJru Gia dinli vh Gidi. QuyS'n 22, s6' 6, tr. 64-76
phdn tfch bd'i canh kinh ifi'xa hdi vd nhflng chi'nh sdch g^n ddy cd lac ddng dfin cdng tdc phdng chdng HIV. Mdt sd nghifin cflu khde ldp trung vdo nghifin cflu phdng chd'ng Idy truydn HIV ifl me sang con. phu nfl sd'ng chung vdi HIV. Tuy nhifin chua co nhidu nghifin cflu. bdi vitfl phdn lich d gde dd ca Ih^ nhflng nhdm nguy co cao nhu ngudi sir dung ma tfly. phu nfl bdn ddm, nam ddng tmh, vd nam ban ddm. Trong khi il(') nghifin cu\i can thifip cd sii dung phucmg phdp nhdn hgc cung cdn rdi ft. Ngodi ra chiing tdi cung chira ihd'y rd vific ap dung cdc ly thuyfi't xa hdi trong phdn ii'ch bdi canh lifin quan dfi'n nhflng ndi dung dugc nghifin cuu.
3. Lien he tir phan tich cua cac nghien ciiU vien tham gia diJ an STAR Theo O'Reilly thi edch td't nhd't dfi' hgc vi thuc hdnh di^n da ddn tdc hgc la hgc hdi tfl chfnh nhung nha nhdn hgc (O'Reilly, 2005), vd dugc su giiip dd ciJa didu phdi vifin dfl an 'Tifi'p cdn khoa hgc xa hdi trong nghifin cflu HIV/AIDS" (vifi't tat la STAR), chiing l6i lifin hdnh phdng vd'n sdu mdi sd nghifin cihi vicn da iham gia du an nhdm tim hifiu r5 hon vfi vice dao lao va dp dung each lifi'p cdn nhdn hgc trong nghifin cflu \fi sue khoe cdng ddng ndi chung vd HIV ndi rifing. Nhflng nghifin cflu vifin ndy Id nhflng ngfldi cd ndn tang kfi'n thflc chuyfin mdn khde nhau nhu y te cdng cdng, xa hdi hgc va ehua bifi't nhidu vd cung chua cd kinh nghifim vd phucmg phdp khoa hgc xa hdi trong nghifin cti\i sflc khde trfldc khi iham gia du an. Hg da dugc ddo lao ba khda hge: ly ihuyfi't va phuong phdp; phdn lich sd lifiu;
vifi't va trtnh bay bai bdo. Hg cung da dugc cdc giang vifin, nghifin cflu vifin cd kinh nghifim hudng ddn thuc dja vd vifi't bdo cdo. Ddc bifii la nhiing nghifin cflu vifin nay cung da dfloc true tifi'p tham gia mdt s6 nghifin cflu thue dia trong dd cd nghifin cuu vd nhflng nhdm cd nguy co cao nhu ngudi su dung ma tu^. nam gidi quan hfi linh due vdi nam gitS.
Mdt nhdn xcl ban ddu la phucmg phdp tifi'p cdn xa hdi va nhdn hgc u-ong nghifin cflu vd sflc khde \dii cdn mdi me dd'i vdi nhflng nghifin cuu vifin nay. Td't ca nhflng ngudi dugc phdng vdn ndi rdng trfldc khi iham gia du an STAR hg chi bifi'l ra't ft vd edch lifi'p can xa hdi ndi chung cung nhu phuong phap nhan hgc ndi rifing trong nghifin cuxi vd sflc khde. Chi ed mdt ngfldi dugc phdng vdn ndi rdng da tham gia nghifin cuxi dinh tinh sfl dung phucfng phdp phdng vd'n lich su ddi .sd'ng. nhutig ngfldi cdn lai chua limg ed kinh nghifim nghifin cflu vd nhdn hgc. Hidu bifi'l ciia hg vd nhdn hgc la gi va vai trd cua nghifin cflu nay cdn rd'l chua rd rang. Hg "chi Id md dodn"
la nd cd lifin quan dfi'n phuong phdp dinh tinh. phdng vdn sdu.
Nhung nghifin cflu vifin nay da khdi ddu vific Iham gia trong llnh vuc
Vu Diic Viet va Le M i n h G i a n g 71 nhan hgc trong nghifin cflu vc y tfi' edn mdi me thdng qua iham gia mdt khoa hgc ve phuong phdp lifi'p cdn khoa hgc xa hdi trong nghifin cflu vd HIV/AIDS. Do khda hgc phSn Idn do chuyfin gia nudc ngodi giang day bang tifi'ng Anh trong khi lai lifiu tham khao tifi'ng Vifit vd ITnh vuc nay chua CO nhidu. vific hgc tdp ctia hg gdp nhidu khd khdn. Sau khda hgc. mde du nhidu ngudi thu nhdn Id chua thue sir hi^u hci, da sd hgc vifin da ro hon
\'e cac phflong phap tifi'p cdn \'c nhdn hgc. Td'l ca nhflng ngudi dugc phdng vdn ddu ndi rdng klida hgc da tao cho hg mdt edi nhin rdng hcfn klii tim hieu, phdn lich mdt vd'n dd sflc khde. Bd'i canh ciia mdi vd'n dd sflc khde duoc nhdn manh nhieu hon. nghia Id lim hidu xem "cai vd'n dd sflc khde ddy no difin ra d cdng ddng nhu thfi' ndo va ihfl hai niia la tai sao ngucri ta lai cd nhiing hanh ddng nhu the''. Hem nfla. ngudi nghifin cflu vien eung cdn phai
"dat minh trong cai bd'i canh cua cai con ngfldi md minh mud'n nghien cflu"
de' tim hifi'u xem vdy thi nhung cai yfi'u td vd mat cd'u true, nhiing cai yfi'u td vd mat xa hdi da anh hudng dfi'n ho nhu thfi' nao, va khdng chi la nhiing cai anh hudng dfi'n hg ma cdn la nhung cai ma hg phan flng lai, cai tfnh chu thfi'. cua hg nhu thfi' ndo. Quan trgng hon ca, khda hgc da truyen cam hung, sit dam mfi cho mdi sd hgc vifin va la lidn de cho hg trong vlec theo dudi each tifip edn khoa hgc xa hdi trong nghifin ciru vd sflc khde.
Mfit ddc didm rd'l quan trgng ciia khda dao tao dd la cac hge vien da dugc tham gia thuc hanh ap dung nhirng phuong phap khoa hgc xa hdi.
Mfit sd phucfng phdp nhfl quan sat tham dfl, phdng vd'n Ijch su ddi sd'ng, phdn tfch tai lifiu... da dugc dp dung. Dd'i vdi cdc nghifin cflu vien su dung quan sdt tham du, ihi khd khdn ddu tifin la vific tie'p cdn ddi tugng nghifin cflu, ddc bifit khi cac dd'i tugng nay la nhiing nhdm qudn the ^n, nhflng nhdm dfi bi tdn ihflong nhfl ngfldi sii dung ma tiiy, nam ban ddm... Dd lam dugc dieu nay, cac nghifin cflu vifin cho rang vific hge hdi. tham khao kinh nghifim cua nhung ngfldi da iflng lam nghifin cflu nhdn hge da tflng tie'p xuc, lam viec vdi nhung nhdm dd'i tugng dd la rd't quan trgng. Ngoai ra ngudi nghifin cuu vifin cung can phai cd ky ndng giao tie'p xa hdi lot.
Ngudi dugc phdng vdn ndi khi Idng nghe, quan sat se thd'y dugc nhung
"cau chuyfin xung quanh nd difin ra nhu thfi' nao... thfi' rdi minh hdi lai..
bdt nhiing cai didm hg dang ndi, hg dang rd'l phan khich". Mdt ngudi dugc phong vd'n khac cung cho rdng nghifin cflu vien "phai [cd] ky ndng giao tifip. hodc la cai each ggi md. cai each lam thfi' nao dd ndi chuyen hodc de' lao Idng tin dd'i vdi nhflng ngudi ma Idn dau lifin minh gap ma minh mudn ndi chuyfin".
Vd'n dd ngdn ngu sir dung khi ndi chuyfin, giao tie'p vdi ddi tugng nghifin cuu cung dugc cac nghifin cflu vien ddnh gia cao. Ngudi dugc
72 Nghlftn cflu Gla dinh vk G\6\. Quyen 22, so 6, tr. 64-76
phdng vd'n eho rdng mdt .sd dd'i tugng nghifin cflu cd ngdn ngO nfing. cac tfl Idng khi ndi chuyfin vdi nhau. hg khdng dOng ngdn ngu thdng thudng.
Vd nfi'u nhu nghifin cflu vifin ma thudc dugc cai ngdn ngfl cua hg, hifiu dugc phdn n^o ndi dung md ddi lugng dang ndi ihi cang dd hda nhdp dugc vdo cai mdi trudng ciia hg, Vific hifi'u cdc ngdn ngfl ndy khdng chi cd ^ nghia trong vific lao thudn Igi cho giao liCp. ma cdn cd f nghTa nghifin cflu.
Nd giup cho vific phdn lich dfl lifiu dflgc Ihudn Igi hem. chfnh xdc hon. Mdi nghifin cflu vifin chia sc:
"Minh cOng n6i nhflng tfl ddy ra thi ho c5m ihdy vui vui, hp lai ti^p chuyfin vdi minh. hfii minh thd ndy thd l<ia, thd thi ddy Id nhflng edch r^l Id hay dd md minh b^t dau cSu chuyfin vdi ngudi sfl dyng ma tuy"
Ghi chdp Ihuc dia Id mdi phdn quan trgng irong nghifin cflu nhdn hgc.
tuy nhifin cd rdi nhidu vdn dd lifin quan d^n nd da duoc dd cdp d^n. Trudc tifin vific vici nhdi k^ md't khd nhidu thdi gian. mdi Idn di ihuc dia v6 hg thudng md't khoang bdn ndm lifi'ng dfi vifi't lai nhung ihOng tin ihu dugc trong ngdy. Nghifin euu vifin thudng phai vi^i nhdt ky ngay sau khi d thuc dia vd nhu vdy thi nhflng su kifin mdi sdng ddng, khdng bi bo s6l. hodc Id sang hdm sau thi lai cd nhflng cau chuyfin mdi vd cdc edu chuyfin cd thd bi Idn vdi nhau. Nhflng ngudi dugc phdng vHn cung cho rdng khdng nfin ghi chep bang gidy but hoac ghi chdp nhidu ngay tai thuc dia dd tranh su chii y cua dd'i tugng Iham gia nghifin cflu cung nhu tranh vific dfi Id ihdng tin nfi'u sd nhat ky bi mat. Ddi khi vific viet nhdi ky rdi I^ le nhai, nhdt Id khi ma nhung su kifin quan sdi dugc khdng cd lifin trifin gi. Tuy nhifin hg cung cho rdng \'iec ghi lai nhdi k\ thuc sir Id cd y nghTa. mdt ban chia se:
"Cudi Cling khi dd hodn thdnh xong rdi thi mdi ngutlri cd mdt cdi tap [nhdt kyj cd phai vdl tram trang Gid ra doc thi mdi thay dugc edi gid tri cua nd. luc day nd giup cho minh hdi tucmg iai (flng bi/dc chdn cua minh d dudi day[dja bdn nghifin cflu], ngdy ndo nhu thd ndo. suy nghi cua minh ra sao,"
Khda hgc ST/\R cung bao gdm vice thuc hanh phdn ti'ch dii lifiu va vifi't bdo cdo. Cac nghifin cflu vifin ndi nhidu dfi'n \iec dp dung cdc khung ly thuyfi't Irong nghien cuu. dd Id ca sd dd nghifin cflu vifin cd thfi ma hda cdc du lifiu da thu thdp dugc. Khung 1^' thuyfi't lifin quan dfi'n vific ddi vd'n dd trung tdm ndi dung nghifin cflu, tim hidu xem nhung yfi'u td xung quanh anh hudng dfi'n nd cung nhu li'nh chii Ihd cua dd'i tugng nghifin cflu. Vific phdn lich Id mdt qud trinh quy nap vd Idp di Idp lai nhidu Idn. Mdt nghifin cflu vifin chia se:
"Ddy id edi qua trinh ma cfl phSi sfla di sfla lai y, rat la lifin tue. Anh X sfla bdi cho em khQng bidt ddn bao nhifiu lan em cOng khdng nhd nfla, nhung ma em ch?
Vu Ddc Vifit va Le M i n h G i a n g 7 3
nhd ia hdi day sO^ di sCra lai, sfla dl sfla lai thOi",
NhQng nghifin cflu vifin dugc phdng vdn ddu rdi coi trgng nhung vd'n dd lien quan dfi'n dao dfle nghifin cflu trong khi thuc hdnh phucfng phdp nhdn hgc, Hg nhdn manh dfi'n vific cung cd'p thdng lin vd nghifin cflu cho dd'i tugng nghifin cflu. trong dd tfnh bao mdt vd an todn cua thdng lin. Nhiing nhan xet cua hg ciing IflOng ddng vdi danh gia ciia Trotter (Trotter. 1995) rang vific dao lao thfch hgp vd nhung boat ddng nghifin cflu thd hifin su hidu bidt vd vdn hda Id quan u-gng dd'i vdi sir thdnh cdng ciia each tiep can nhdn hgc. Nhflng ngudi dugc phdng vd'n cung dd cdp dfi'n mdt sd vd'n dd lifin quan dfi'n khfa canh dao dfle md hg gdp phai. Vi du nhu sau mdt thdi gian lam vific vdi nhiing ngudi sir dung ma tfly dd thi hg thudng hay hdi vay lidn, bdi vi hg "thudng xuyfin d trong linh trang thifi'u tidn, thifi'u cai nay thifi'u edi kia". Nhidu khi d thuc dia ngudi nghifin cflu vifin "nhin nhung hodn canh dang thflong 1dm vd khdng ihd nao ma khdng giiip dugc", do vdy nghifin cflu vifin nfin ddt vd'n dd la nfin giup hg nhfl the' nao, vi hg cd thd sur dung sd tidn dd vao vific mua ma tfly, hay la vd'n dd vific hoan tra sd lidn dd cd thd anh hfldng tdi md'i quan hfi gifla nghifin cflu vifin vdi hg.
Mfit sd nghifin cflu vifin trfldc khi tham gia khda ddo tao cung bdn khodn ve gia tri vd vai trd ciia nghifin cflu nhdn hgc ve sflc khde d khfa canh la ed mdu cua nhiing nghifin cflu dinh luong "Ihi phai de'n hdng nghin ngtrdi thi tai sao d ddy chi cd mdt vai ngfldi ihdi ma ciing cd the lam thanh mpt cai nghifin cflu". Tuy nhifin ddy ehi la nhung suy nghT ban dau. Sau khi ngfldi nghifin cflu vifin cung sd'ng, cung trai nghiem nhung hoat ddng v^ dd'i tugng nghifin cflu trong mdt thdi gian rdt ddi, hg nhdn ra rang cai difin ra d thflc dia. cai difin ra d thuc tfi' ddi khi khdng phai la cai ma nghifin cflu vien cfl dp ddt suy nghT ciia minh (nhfl trong nghifin cflu djnh lugng), gidng nhau d mgi hodn canh mgi mdi u-udng. Thuc tfi' hdnh vi cua con ngudi chiu anh hudng nhidu bdi hoan canh mdi irudng xung quanh nhu yeu Id vd mdt cd'u true, vd mat xa hdi lich sfl. Va rdi khi chiu tdc ddng cua nhflng ye'u ld dd, con ngudi se phan khang lai nhu thd" nao hay cai ifnh chu thd, niem lin cua hg dugc thd hifin ra sao. Nhu vdy ngudi nghifin cflu vifin mdi hidu duge cai ban chdt, cai bd'i canh hanh vi cua hg de cd the dua ra nhflng khuyfi'n nghi, can ihifip phu hgp.
Vugt qua nhiing bd ngd ban ddu vd each tifi'p cdn cdn mdi me vd nhflng khd khan trong qua trinh dao lao cung nhu thuc hanh nhflng kifi'n thflc da duoc ldp hu^n, tdt ca hgc vien iham du khda ddo lao ^ A R ddu cho rang ho da tnrdng thanh Ifin rd't nhidu. Su nhin nhdn vd phdn tfch mdt v^n dd sflc
74 Nghidn cflu Gia dInh vk Gidi Quyd'n 22, so 6, tr. 64-76
khde da bao qudl vd rdng hdn. Mdi ban chia sd:
"Dfii l<hi minh khdng nhdn ra. nhung md ban b6 em lai nhdn ra Id em tatdng thdnh hon, kd cd trong edi edch md minh ndi chuyfin, kd c^ edi edch md minh nhin mfit vdn dd, minh phdn tfch nd thd ndo",
Nhifiu ngudi trong s6 hg da cd nhung bdi bdo ddng lap chf 6 Vifii Nam vd qud'c lfi', Kifi'n thflc vd kinh nghifim tham gia du dn da gdp phdn giup hai trong sd nhflng ngudi dudc phdng vd'n danh dugc nhflng sutfl hgc bdng qudc tfi'. cai ind sc giup hg lifi'p luc theo dudi va phdt tridn htm nfla nidm il;irii mfi cua minh vdi nghifin ciiu v;i ap dung cac phuong phap nhdn hgc trong nghifin ciiu vd sue khde. Mni nghifin cflu vifin hifin dang du hgc tai nudc ngodi chia sc:
"Hdm md em phdng vdn |xin hpc bjngj, nhflng ngudi phdng vSn ho hdi rdt ky vd nghifin cunj ndy Ban thdn hp cung cdm th^y rSl hdo hflng vdt nghifin cflu ndy bdi nhflng phudng phdp md minh sfl dung trong nghifin cflu. vd kd ca nhflng kdt qud ma minh dat dflpc, Hp gdt gii lifin luc thi em thdy d^y Id nhflng didm rSt Id tfl hdo vd em nghT, cho ddn bdy gid thi nhdn hpc van Id c i i yfiu thich cua em".
Nhu vdy khda dao lao STAR da thuc su giup cho vific dua edch tiS'p cdn khoa hgc xa hdi. ddc bifii Id didn da ddn tdc hgc. vao vific nghifin cuu nhflng vd'n dd lifin quan dfi'n HIV/AIDS lai Vifii Nam. Ddng thdi nd cung da gdp phdn kfch thich nidm dam mfi vd lao co hdi phdt trifin cho nhflng nghifin cflu vifin tre tham gia kiu\i hgc nay.
4. Ket luan
Bai vifi't nay da lam rd hon mdt sd khdi nifim lifin quan dfi'n cdc tifi'p cdn khoa hgc xa hdi trong nghifin cflu vfi sflc khde ndi chung \a HIV/AIDS ndi rifing cflng nhu ndi dung ciia nhiing phuong phdp nhdn hgc van hda nhu quan sdt iham du va phdng vd'n lich sir ddi sdng. Cdch lifi'p cdn nhdn hgc cung cd'p mdt qud trinh ndng ddng, linh hoat. va ldp di lap lai u-ong danh gid su phat iridn cua cdc can thifip. Nd khdng chi gdp phdn bd sung nhiing hifiu bifi't, nhflng kifi'n thflc khoa hgc vd HIV, ma nd cdn giflp cho vific xdy dung nhflng kfi' hoach can thifip cd hifiu qua cao cung nhu phu hgp vd mdt van hda. Cdc phuong phap ndy ndm bat va nfiu bdt tdm quan trgng ciia nhidu yfi'u Id' lifin quan de'n cd'u iriic, kinh leva chi'nli tri nhung yfi'u td duoc cho la ngdy cang quan trgng trong vific dinh hinh phuong hudng ciia dai dich HIV/AIDS loan edu. Hifin nay cdc phuong phdp ddn idc hgc duoc ti'ch hgp ngay cang nhidu vdi cac phuong phdp nghifin cuu khac trong cdc du an nghifin cflu phflc lap, giup cho vific tham chifi'u ihdng tin tfl cdc neud dfl lifiu khac nhau. Chia se ciia nhflng nghifin cuu vifin tham gia du A
Vfl Dijfc Viet va Le Minh Giang 75
"Tifip Cdn khoa hgc xa hdi trong nghifin cflu HIV/AIDS" ihuc su Id nhiing vf du minh hga sinh ddng, gdp phdn 1dm rd hon vd vific dp dung phuong phap ndy trong nhihig nghifin cflu thirc dja gSn ddy d nhiing chii dd dugc coi la nhay cam va nhung nhdm dfi tdn thuong d Vifit Nam. Qua tim hidu nghifin cflu vd nhdn hgc trong nghifin ciiu HIV tai Vifit Nam, ihd'y rdng nhihig nhd nghifin cflu chua quan tdm nhidu tdi vific dp dung cdc phucmg phap nhdn hgc trong nghifin cflu ve HIV. Tfl thuc ic irfin chiing tdi khuyen nghi ap dung sdu rdng hon nfla nhung phucfng phap nhdn hgc trong nghifin cihi vd can thifip Ufin quan dfi'n sflc khde ndi ehung eung nhu trong phdng chdng HIV/AIDS."
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