I appreciate their openness and willingness to take risks, making themselves vulnerable in the hope that the performance and outcomes of the research would be useful in improving the practice of CHBC. However, many informal caregivers indicate that the demands placed on them do not end with the death of the patient.
INTRODUCTION
- OVERVIEW OF THE CURRENT SITUATION
- THE CONTEXT OF THE STUDY AREA The Province of KwaZulu-Natal
- RATIONALE FOR THE STUDY
- PURPOSE OF THE STUDY
- OBJECTIVES OF THE STUDY
- THEORETICAL FRAMEWORK Feminist critiques on community care
- ASSUMPTIONS UNDERLYING THE STUDY
- LIMITATIONS OF THE STUDY
- ORGANIZATION OF THE THESIS
The study area was chosen because of the rich history of the area as explained in the discussion below. According to Kumal (2005), the problems related to housing in the area should be analyzed within this background of the study area.
LITERATURE REVIEW
INTRODUCTION
The context discussion highlights the different models of care and a place for situated learning in CHBC, while the CHBC content delves into the issues of training, teaching, learning, and knowledge acquisition in CHBC. The following concepts and their uses should be understood in the context of this study: adult education, curriculum analysis, community-based home care, a caregiver, and a volunteer.
DEFINITION OF CONCEPTS Adult education
15 In the context of this study, the term adult teacher' is used to refer to 'CHBC volunteer carers'. It must be stated that the concept of volunteering is not clearly defined in the government's health policy.
THEORETICAL FRAMEWORK Paulo Freire on critical consciousness
The following discussion examines feminist perspectives under three broad categories considered relevant for the purposes of this study: the personal is political, feminists' views on the production of knowledge, and women as collective agents of structural change. Part of the reason I chose the feminist framework for this study is that feminists' views on knowledge production are concerned with individual women developing their own voices (Hurtado, 1996).
AN OVERVIEW OF THE DEBATE IN COMMUNITY CARE Institutional care versus community care
In his analysis, Harber (1998) acknowledges that the idea of community care is related to but distinct from community development. As I reflected on the emerging issues, I noticed that state community care policies often represented this limited sense of community in a way that assumed it was women's responsibility to provide unpaid care in the community.
THE CONTENT OF A CHBC TRAINING PROGRAMME Documentary review of four CHBC training manuals
Comparisons between the training content of different CHBC organizations show that the content focuses on professional training, ie on practical nursing care. There is no follow-up strategy to monitor the impact of the training at the community level.
THE CONTEXT OF CARE
This is the most fundamental part of this research, as it gives me the opportunity later in chapter 5 to critically analyze the training content as outlined above and find out if it fits the needs of the voluntary carers. In this context, Boud (2001) would argue a need for educational programs to take into account a large variety of differences that exist in the context of the learners.
CONCLUSION
Miller's analysis is illustrated in a case study conducted by UNAIDS (2000), which focused on six HIV/AIDS-focused organizations in Uganda and seven providers in South Africa. The report demonstrates that many large CHBC organizations focus on training and supervising volunteers (UNAIDS, 2000), i.e. sending their nurses with specialist knowledge in the field of palliative care to the field with volunteers.
However, the emphasis is placed on the fact that when they are in the field with the volunteers they are not allowed to give practical care themselves - their job is to supervise the volunteer.
- INTRODUCTION
- RESEARCH DESIGN
- QUANTITATIVE VERSUS QUALITATIVE RESEARCH
- SAMPLING
- METHODS OF DATA COLLECTION
- FINDINGS AND DATA ANALYSIS
- ETHICAL CONSIDERATIONS Informed consent
- LIMITATIONS OF THE STUDY
- CONCLUSION
To find out what the CHBC education entails by exploring the content of the curriculum;. Given the nature of the research design, data analysis began by identifying themes and relationships. In order to arrange interviews with the local caregivers, the starting point was to obtain permission from the management of the CHBC training organization.
I then spent quality time with the respondents as a group to highlight the purpose and objectives of the study.
PRESENTATION OF FINDINGS
INTRODUCTION
PROFILES OF WOMEN VOLUNTEERS INTERVIEWED 30
He comes from a family of nine children, four of whom moved out of the house. Phumzile has been trained in both community home care and HIV and AIDS counseling. Nonjabulo became the head of the house as she is the eldest in the family.
Her cousin died of AIDS in 1999, so Nokuthula was motivated to get involved in volunteer work.
34;..for example, we take food packages to our patients' homes once a month, whereas I wish I could take home a package for my family." 34;..people don't take antirheumatic drugs on an empty stomach. .because we were recently exposed to work at the clinic, we were shocked by what we witnessed there 34;..because I am the only person the patient trusts, not even her relatives and friends know about her HIV status - I am the only person , which the patient revealed to her...".
Further questioning revealed that Nokuthula strongly believed that quality care for people living with HIV could ultimately only be provided if carers received adequate care and support as, in her view, “..carers were not given much support and care".
BACKGROUND TO THE CHBC TRAINING
QUALIFICATIONS OF THE CHBC TRAINERS"
46 When I conducted the final interviews in July 2005, I learned that Bongiwe had left the CHBC training organization to work for another employer. He is the only man involved in CHBC training volunteer carers in the organization under investigation. 34; Very little is provided during CHBC training regarding the needs of carers.
According to Nomonde, she was contacted by the training organization CHBC, which needed volunteers to facilitate CHBC trainings in Zulu.
FORMAT OF THE TRAINING
COURSE CONTENT AND FACILITATION PROCESS
The course content of the observed CHBC training organization covered the following sessions. The participants were encouraged to adopt a similar approach by including the names of the NGOs to whom they volunteer their services. The facilitator encouraged them to choose a scribe and someone to report back on behalf of the group.
Regarding the quality of respect for others, the trainer emphasized the need for caregivers to be aware and sensitive to the rights of the patients.
DAY TWO
In the first role play, the mother challenges the volunteer caregiver and demands to know who informed her about her sick daughter. This unexpected response created a difficult situation for the volunteer caregiver who came to provide home care. Consequently, the volunteer caregiver had to leave the house as he had not had the opportunity to meet the patient who was in the bedroom.
In the second scenario, although the volunteer caregiver was allowed to meet with the sick daughter, the scene presented challenges of a different nature.
DAY THREE
After lunch, the afternoon session started with a topic on nursing symptoms, followed by issues on HIV and AIDS, record keeping and the session ended with an evaluation of the day's work. Before concluding the day's program, the trainer outlined key elements of a patient's well-kept record. The participants were shown how to remove the patient's clothes, with minimal discomfort and pain.
The day ended with all participants giving an oral evaluation of how they had either benefited or not from the day's schedule.
DAY FOUR
Participants were asked to consider some of the ways they could use to prevent bedsores, which included helping them to turn over to avoid lying on one side for long hours, providing pillows and cushions to protect their joints, or carrying the patient out the house. After the tea break, the trainer asked the participants to think about what they thought were examples of change that loss and change had brought about in people's lives. When thinking about different emotions as a result of such changes, participants outlined emotions such as anger, fear, regret, self-blame, sadness, grief, and loneliness.
By immediately correcting the mistakes of the participants and reinforcing the correct procedures, the trainer successfully and effectively helped the participants to learn the tasks faster.
DAY FIVE
CAREGIVERS' PERCEPTIONS OF THE CHBC TRAINING CONTENT
It was revealed that some of them enjoyed certain sessions of the training better than others. 3 out of the 10 volunteer caregivers reflected on the role plays and how they enjoyed acting out the scenes in the learning environment, which Buyi noted: "We used to laugh our lungs out. 34;There was no attempt during the training to learn from my own experiences.
34;..being a part of the training made me slowly realize that the concept of home based care is not a new idea but something I have been doing all my life.
GAPS BETWEEN PRACTICE AND TRAINING Skills and knowledge of caregivers
Findings revealed that only 5 of the 10 volunteer caregivers interviewed possessed CHBC and counseling skills (see Table A). To sympathize and be nothing more than a helpful neighbor.. to easily give in and discourage. However, volunteer caregivers who have been trained in counseling acknowledged the role and impact of the training in their lives.
I feel I need this information because some of the people in the house I visit want to know."
CONCLUSION
34;In cases where family members are not available to learn skills from us, we feel compelled to perform the duties of a caregiver, especially providing basic health care. But what would our role be if family members fulfilled all the roles and responsibilities of a caregiver?".
ANALYSIS O F FINDINGS
- INTRODUCTION
- UNDERLYING PRINCIPLES IN CHBC
- THE POOR TENDING TO THE POOR
- CHBC TRAINING CURRICULUM
- CHALLENGES FACING CHBC TRAINING PROGRAMMES
- WORKING TOWARDS A COLLECTIVE SOCIAL ACTION AGENDA
- CONCLUSION
In the findings of the study, the profiles of the women interviewed revealed that it is mostly women who provide community home-based care. The research findings identified sources of stress in volunteer caregivers who participated in the study. The study indicated that some of the CHBC trainers are unable to adequately deal with the challenges involved in training volunteer caregivers for people living with AIDS.
This was shown in women's profiles where the needs of carers were highlighted.
CONCLUSIONS AND RECOMMENDATIONS
- INTRODUCTION
- MAJOR FINDINGS AND RECOMMENDATIONS
- DISSEMINATION OF FINDINGS AND RECOMMENDATIONS
- A NEED FOR FURTHER RESEARCH
- CONCLUSION
However, along with these findings, the study also argued for a need for genuine development to take place in the training of volunteer carers. These observations demonstrate to service providers and other key CHBC role players the need to design programs that are simultaneously responsive to the needs of PLWHA while responding to the needs and well-being of volunteer caregivers. The study found that in the CHBC training organization under study, volunteer caregivers receive an extremely short course in CHBC and are then expected to provide a free service in their community.
The study highlighted some of the key challenges associated with volunteer carers who have no counseling skills.
INTERVIEW GUIDE FOR VOLUNTARY CAREGIVERS
Describe your typical day as a caregiver – what types of chores you do/. Research into routine and scope of tasks). What skills and knowledge do you need to do the job? Refer to descriptions of daily routines – what have you learned that has helped you cope with
What did the facilitators do to help you build on your experience.
