The researcher has observed an increase in young people visiting a comprehensive primary health care clinic in Cape Town after being traumatized by the death of a family member. In this study, young people were persons of the above age who lost a family member to HIV/AIDS.
INTRODUCTION
BACKGROUND
INCREASE IN HIV/AIDS
East and Southern Africa remain the regions most affected by the HIV epidemic in Africa, and accounted for 20.7 million people living with HIV in 2019 (UNAIDS, 2020: 6). Less than a third of children living with HIV/AIDS in the region were on treatment, the lowest coverage rate for this age group in the world (Avert, 2019).
HIV AND RELATED FACTORS
EFFECTS OF HIV ON THE YOUTH AND FAMILY ENVIRONMENT
LITERATURE
THEORETICAL DEPARTURE OF THE STUDY
In this study it is assumed that the three strategies are part of self-management. Cognitive (constructive thinking) behavioral therapy in the context of self-management may be needed as an intervention to train attention and working memory to improve the ability to exploit episodic memories and problem solve.
PROBLEM STATEMENT
PURPOSE OF THE STUDY
OBJECTIVES
POPULATION AND SAMPLING
SAMPLING
INCLUSION CRITERIA
Young people visiting a Comprehensive Primary Health Care clinic in Cape Town after losing a family member to HIV/AIDS.
EXCLUSION CRITERIA
DESIGN
10 interests (Willis, Sullivan-Bolyai, Knafl & Cohen, 2016), adolescents coping with self-care after losing a family member to HIV/AIDS. The descriptive design included the description of specific phenomena such as youth self-management in the research area of loss of a family member (Dudovskiy, 2019).
METHOD
DATA GATHERING
In this study, a specific outpatient unit was the context in which data were collected on the lived experiences of the participants. The unit manager was informed about the purpose of the study and the advantages of providing advice to young people managing themselves due to the loss of a family member to HIV/AIDS.
TRUSTWORTHINESS
ATLAS.ti Version 9 Windows is a computer program mainly, but not exclusively, used in qualitative research or qualitative data analysis. According to Muller and Bester, guidelines have been developed from the data analysis based on the four themes discussed in Chapter 2.
ETHICS
After the process of the interviews and the benefits were explained, all participants signed a written informed consent form (Appendix B). The principles of withdrawal, informed consent, beneficence, privacy, autonomy, justice and confidentiality will be discussed in Chapter 2.
OUTLINE OF THE STUDY
Participants were asked to participate voluntarily and were informed of their rights and that they could withdraw from the study at any time if they felt uncomfortable participating (Appendix A). This chapter discusses the implications of this study for further research and the limitations of the study are outlined.
SUMMARY
METHODOLOGY
- INTRODUCTION
- RESEARCH DESIGN
- PHENOMENOLOGICAL Approach
- STUDY SETTING
- POPULATION AND SAMPLING
- SAMPLING
- INCLUSION CRITERIA
- EXCLUSION CRITERIA
- METHOD
- PREPARATION OF THE FIELD
- PILOT INTERVIEW
- DATA COLLECTION
- DATA ANALYSIS
- Development of guidelines
- TRUSTWORTHINESS
- ETHICS
- SUMMARY
15 Health Research Database (Ethics clearance number: WK and the Comprehensive Primary Health Care Clinic in Cape Town. The participants were made aware that a counselor working at the clinic was available during and after the interviews if participants needed to be questioned and hold a consultation.
FINDINGS
INTRODUCTION
DEMOGRAPHIC PROFILE OF PARTICIPANTS
FINDINGS
THEME 1: TIME RELATED CIRCUMSTANCES DEFINE BEHAVIOUR TO
- CATEGORY: CONSEQUENCES OF DEATH WHILE SIBLINGS STILL AT
- CATEGORY: SUDDENNESS OF DEATH TRIGGERS FEELING anxiousness
- CATEGORY: UNEXPECTED REALITY THAT FAMILY MEMBER WITHHELD
- CATEGORY: DEVELOPING UNUSUAL BEHAVIOUR DUE TO DETACHMENT
THEME 2: youths go through different stages after the unexpected loss of the
- CATEGORY: DENIAL AND GRIEF
- CATEGORY: GUILT AT BEING UNABLE TO DO MORE BEFORE THE FAMILY
- Category: Struggle of those left behind to realise there is a future
- Category: Financial needs
- Category: Family fights and not dealing with reality
- Category: Stigma in the community
THEME 4: SUPPORT MEASURES FOR THE NEXT OF KIN
- Category: Communicating and speaking out as part of emotional support
- Category: Financial assistance
- Category: Social worker availability
- Category: Realisation of stumbling blocks and new possibilities
- Category: Own role in providing hope for the future
- Category: Counselling
CONCLUSION
CONCLUSIONS, GUIDELINES, LIMITATIONS AND
INTRODUCTION
A second aim of this study was to develop guidelines for nurses to counsel young people about self-management after losing a family member to HIV/AIDS. Written guidelines are needed for nurses to support young people in a clinical setting who have lost a family member to HIV/AIDS. These guidelines will help young people cope with grief and anxiety and guide them through the steps to follow to access government support for basic needs.
CONCLUSIONS
The youth experienced guilt over not being able to be there for their loved ones and blamed themselves for their loved one's death. The youth developed inappropriate behavior because of their detachment from the reality of death. The young people were unable to understand what the future before them would mean, and as a result of the death, some experienced feeling unloved by the relatives left behind.
Young people turned to alcohol and drugs due to the stress of dealing with grief. Young people had a hard time coping with the loss of a loved one of whom they had fond memories. They experienced pain and sadness and reminisced about the moments they shared with the deceased.
Therefore, a plan must be developed to help the youth control their emotions, prevent family fights and bring peace to the family. The youth had to give hope for the future to their brothers and sisters, family and themselves. The youth in this study did not know how to manage themselves because of the emotional burden they carried around and the absence of group support sessions for dealing with their grief.
GUIDELINES
79 due to a lack of therapeutic sessions, which could provide emotional support and help them with their healing process. A social worker in their local clinic was needed to help them with counseling and social consequences after their loved one passed away. It was difficult for them to leave school and university to take care of their families.
They struggled to manage the situation and to step up and do what their peers weren't doing. At that time their peers were still going to school and going to university, while they had to go and work to support their siblings and family, most young people like their peers were enjoying life by going out with friends whenever they could. they wanted to, but they didn't. they do not have that privilege because they have taken on the role of breadwinners at home. Some of the participants had to go back to school to get formal education and a brighter future.
The death of a parent has the potential to have a long-term impact on one's mental health and can result in self-blame, substance abuse, emotional eating, and behavioral disengagement.
The youths need to practice self-management during unexpected situations
The nurse should be there and help the youth by listening and helping the youth understand their value in life even after the loss of loved ones. Young people should be given a booklet to read and become aware of the specific steps to take to forgive the deceased. A therapy session can include encouraging young people to share ways of coping with stress and negative thinking.
After the death of a family member, the young person should plan their daily activities to maintain their pace and focus. The nurse should allow children to talk about their fears and cry if necessary, as this is part of the grieving process. Adolescents should not isolate themselves when faced with the loss of a family member, but should be encouraged to continue with their daily activities.
The youth should learn to empathize with the grief of family members. The young people must share their understanding of what it is like to follow in the footsteps of the deceased breadwinner. The youth must have goals for the future and should continue to dream of a brighter future, regardless of the consequences of death.
Youths should be provided with emotional support both in the community
RECOMMENDATIONS FOR NURSING EDUCATION AND NURSING RESEARCH
- Recommendations for nursing research
This study provided findings and information on the lived experience of young people who lost a family member to HIV/AIDS in the Western Cape, Cape Town. The general experiences of young people after the death of their loved one were not positive. Therefore, based on the findings, the research has developed guidelines that nurses can use to counsel young people to manage themselves after losing a family member to HIV/AIDS.
Short courses on counseling should be offered to students as part of their curriculum (as required by the South African Nursing Council). It remains the responsibility of nurses to work on their development and equip themselves with new knowledge by reading articles on youth self-management, counseling and social work and their benefits for those who need it. Nurses should offer continuing education in the steps involved in bereavement to the general public accessing the clinic.
94 Some of the nursing universities and colleges have already implemented short courses on HIV/AIDS counseling as part of their curriculum. It is recommended that nursing students who are aspiring nurses receive a short course in grief counseling and conducting therapeutic sessions for those who are in grief, pain and confusion due to the death of a loved one. The researcher recommends that further qualitative research be carried out into the social impact of young people affected by deaths related to HIV/AIDS.
LIMITATIONS OF THE STUDY
There was a lack of men in the clinic, indicating that men who may be feeling the same pain, grief and confusion are not seeking the help they need.
CONCLUSION
Online], Available: https://www.avert.org/professionals/hiv-around-world/sub-sharan-africa/overview [2020, Sept. 16]. Online], Available: https://www.avert.org/professionals/hiv-around-world/sub-sharan-africa/overview [2019, April 25]. You just can't trust everyone”: The impact of sexual risk, partner type, and perceived partner trustworthiness on HIV status disclosure decisions among HIV-positive black gay and bisexual men.
Online], available: https://www.interaction-design.org/literature/book/the-encyclopedia-of-human-computer-interaction-2nd-ed/contextual- design [2019, 20 August]. Online], available: https://www.joincake.com/blog/how-to-deal-with-greedy-family- members-after-a-death/ [2020, 10 August]. Online], available: https://www.ebscohost.com/assets-sample-content/SWRC-Clients-Families-in-Grief-Skill-Sheet.pdf [2020, 31 July].
Let's talk about it': The moderating role of self-disclosure in complicated grief over time among suicide survivors. Online], available: https://www.coronainsights.com/2017/08/phenomenology-one-way-to-understand-the-lived-experience/ [2020, 3 October]. I started working because I was hungry': Implications of food insecurity for child well-being in rural Ethiopia.
Online], Available: https://www.franksonnenbergonline.com/blog/sacrifice-for-the-larger-good-and-for-your-own-good/ [2020, August 10]. Online], Available: https://www.sos-childrensvillages.org/news/partnership-for-man-living-with-HIV [2019, September 15].
