This research aims to provide an analytical description of the experience of counseling for African (Batswana) counselors and their counselees with specific reference to HIV/AIDS counseling with a view to improving this interaction. Based on the findings of this research, the importance of an HIV/AIDS counseling approach for Africans is emphasized.
INTRODUCTION
- BACKGROUND OF THE RESEARCH
- PROBLEM STATEMENT
- AIM, OBJECTIVES AND CENTRAL THEORETICAL ARGUMENT OF THE RESEARCH
- DEFINITION OF TERMINOLOGY A
- SIGNIFICANCE OF THE RESEARCH
This leads to the enormous burden of HIV/AIDS care in Africa on the nursing profession (Van Dyk, 2001b). Faced with this history of South Africa and its diverse cultures, knowledge of culture is one of the most important factors in HIV/AIDS counseling.
THE RESEARCH SETTING
INTRODUCTION
CURRENT ETHNOGRAPHY
South Africa is divided into nine provinces and the research took place in the North West province. In the North West province there is a Provincial Council on AIDS (PCA), which is divided into four health districts, which are in turn subdivided into eighteen Local AIDS Councils (LAC).
TRADITIONAL ETHNOGRAPHY
Although the chief is the head of the tribe, he does not have autocratic decision-making power. If there is a new law or policy in the tribe, the chief will consult with the men in council.
CONCLUSION
Through work and migration, the Batswana people have moved to different areas and therefore the culture is constantly influenced by other African or Western cultures. The above description is of a typical Tswana culture, but as no culture lives in isolation, so it can take many forms at this stage.
RESEARCH DESIGN AND METHOD
- Research design
- Research method
In this research, counseling and HIV/AIDS counseling were examined from homogeneous and heterogeneous comparison groups to identify similarities or contrast differences from which the analytical description emerged (Glaser & Strauss, 1967). This constant comparison method of analysis in grounded theory used in this research allows the researcher to validate, contrast and extend the categories found.
SAMPLING
The applicability of the categories identified during the analysis could also be tested to establish a clear comparative analysis (Glaser & Strauss, 1967). They state that the scope of the developed theory and the external validity can be carefully controlled by such choices.
DATA COLLECTION
- Individual in-depth unstructured interview
- Focus group interviews
- Participative observation
- Role of the researcher during data collection
After the opening, the leader allows the members of the meeting to discuss and debate the issue. For the purpose of the research the researcher contacted the chief, discussed the research problem with him and then negotiated a lekgotla with the chief.
DATA ANALYSIS
An analytical distance was maintained throughout data collection and comparison by bracketing preconceived ideas and allowing the data to guide the emergence of theory. The third level, which was theory refinement, was developed by shortening, collapsing and connecting the categories and themes to be stated in a theory.
RIGOUR OF THE RESEARCH
Consistency or reliability of the research was ensured by the clear description of the research process. The researcher also provided a clear description of the research process to strengthen rigor and support the chain of evidence in the results of this research.
ETHICAL RESPONSIBILITIES OF THE RESEARCHER
Compliance with the principles of scientific research as well as the assurance of rigor in the research has been respected. Other measures were put in place to avoid bias, for example clear description of the research process as well as the findings.
BRACKETING OF THE RESEARCHER
Personal, cultural, and professional belief systems, for example, the "researcher bracket" and "researcher role clarification" that may cause research biases were identified and exposed in this research. However, some members of my family continued to consult traditional or spiritual healers.
CONCLUSION
The first counseling contact I experienced outside of the family setting was with a traditional healer or sometimes a spiritual healer. As a professional nurse, counselor and educator I worked in a relatively rural community in the North West Province and was again exposed to traditional and spiritual healers.
REALISATION OF DATA-COLLECTION AND -ANALYSIS
INTRODUCTION
WESTERN HIV/AIDS COUNSELLING
- Introduction
- Who counsels?
- What does the counsellor do?
- To whom (counselee)
- In what situation/condition
- How was the HIV/AIDS counselling experienced by the counselee and counsellor and what was the outcome of
So we want to make one hundred percent sure whether these people want to test or just the sister said so." I don't know her name. It was one of the people who worked there, but she didn't say much about me after that.. and then she told me I'm negative." Most of us eat things that are not necessary.. spices or any meat think you just fry it.";.
34;I would like to add is that I wish you would be counseled, you know, they do it on an individual..because in a group like you don't take it too much into consideration.";.
AFRICAN (TRADITIONAL) COUNSELLING
- Introduction
- Who counsels?
- What does the counsellor do?
- To whom (the counselee)
- In what situation/condition?
- How was the HIV/AIDS counselling experienced by the
- The counselee and the counsellor's ideal situation in HIV/AIDS counselling
According to the traditional healers, it was also important for the interaction to welcome the guided. The traditional healer told the counselor that his blood was weak or dirty (this is how traditional healers 'diagnose' any blood disease like STIs and HIV). Another aspect in the interaction between the traditional healer and the guide is the handling of emotions.
This is in preparation for the counselor to find out the HIV status in the family. This gap was created between the counselor and the counselee because of the change in focus. As traditional healers said, the healer's healing is based on his/her belief system.
CONCLUSION
Level 1 findings were confirmed through level 1 discussions with nurse consultants who counsel Africans about HIV/AIDS and traditional healers and counselors who received Western and African (traditional) counselling. The techniques labeled emerged spontaneously as key categories (See Table 1). These techniques were also emphasized as important by the participants during the discussion at the first stage. The findings of the Western HIV/AIDS counseling were discussed with the nurse consultants, and the traditional (African) counseling with the traditional healers.
During the first level discussion I became aware of the intense need of the counselees to peacefully integrate these two health systems with an awareness of the comfort of the counselees to use the power of both systems, but also a frustration of the external conflict, some health professionals, which sometimes makes it impossible for counselees to just 'be'.
DESCRIPTION OF THE EMERGING COUNSELLING THEORY
INTRODUCTION
TIME ~
AN HIV/AIDS COUNSELLING APPROACH FOR AFRICANS
Phases
- Counselling before an HIV diagnosis
The first phase starts before the counselor made a decision to be tested and ends when the counselor has made a decision to be tested or not tested. The second phase starts when the mentee is informed of an HIV-positive result, and the third phase is after the mentee has received an HIV-positive result. This clearly focuses on the experience from the counselor's professional point of view and not from the counselor's needs.
During this period, the counselee may be completely unsuspecting and therefore shocked by the HIV-positive diagnosis, or the counselee may be expecting an HIV-positive diagnosis and therefore be anxious and uncomfortable.
KE PHELA BOPHELA BA KA' (I LIVE MY OWN LIFE
Informing of an HIV- positive result
In the traditional (African) health system, the traditional healer addresses the basic needs of the counselee during counselling, e.g. Definition: The counselor explains, listens and gives the counselee time to experience and work through his/her emotions. Listen for the landmarks in the story (discussed in chapter 4) and guide the counselee through this important landmark.
Definition: The ending ritual is letting go of that guide to continue with one's life, e.g.
Principles of the counselling approach for Africans
The goals of the three phases are focused on the counselor and he is allowed to move from one to the other in his/her own time. Another goal, therefore, is not to deny or minimize the counselee's suffering, but for the counselor to move in a committed manner with the counselee during these three phases. The essential goals of the three stages are in the first stage, the counselee decides to be tested for HIV or not, the second stage is to discover the counselee's HIV status as well as his/her truth, and the third stage is to accept responsible living with HIV/AIDS.
Harmony is not only important between counselor and counselee, but also between the two principles, time and purpose.
CONTRIBUTION OF THIS APPROACH
Unlike the narrative approach described by Monk et al (1997), the supervisor is not challenged or confronted during the telling of his/her story. The counselor also discovers his own truth and creates meaning in living with HIV/AIDS. The context of this approach is based on developing a culturally friendly relationship of trust and helping the counselor make an informed decision about whether to be tested or not.
Rogers (1984) suggests that the client must be motivated to discover his/her capabilities, while this approach emphasizes discovering the client's own truth in order to find meaning in life with HIV/AIDS.
EVALUATION OF THIS EMERGING THEORY
The techniques revolve around two principles, the timing and purpose of counseling Africans about HIV/AIDS. The usual phases of HIV/AIDS counseling are divided into pretest and posttest counseling (Kaplan, Sadock & Grebb, 1994). The research introduces social theory at the macro level because it describes an approach to counseling Africans about HIV/AIDS that describes the cultural system of the society.
This study advances the understanding of the HIV/AIDS counseling approach for Africans through interpretive explanations.
THE IMPLICATIONS OF THIS APPROACH
In this research education and training in counseling, with specific reference to HIV/AIDS counseling, Western counseling is transformed to promote justice for Africans. This challenge faces not only nursing education, but all stakeholders in the education and training of HIV/AIDS counselling. This emerging theory strives to create a less biased, culturally distinct approach to HIV/AIDS counseling for Africans.
Most nurses are already actively part of NGOs that support healthcare delivery in the HIV/AIDS arena.
LIMITATIONS OF THIS RESEARCH
CONCLUSION
If you go as (4) pregnant, they haven't even advised you properly. 2) They just did the test and then they told us that as a pregnant mother you need to be tested for the consequences of the child. They just told you in a group that you need to be tested because of your baby. You think about many things. And as far as counseling goes, I don't think this is good counseling.
Because if you are HIV positive, no matter what you have disclosed, then you have the role.
