Counting, Coping, and Navigating the Flux: A Focused Ethnographic Study of HIV and Diabetes Self-Management

2021 ◽  
pp. 104973232110642
Author(s):  
Chelsi W Ohueri ◽  
Alexandra A. García ◽  
Julie A. Zuñiga
Keyword(s):  
Management Practices ◽  
Participant Observation ◽  
Ethnographic Study ◽  
Self Management ◽  
People Living With Hiv ◽  
Structured Interviews ◽  
Familial Support ◽  
Multiple Observations ◽  
Dual Diagnoses ◽  
Living With Hiv

Approximately 10–15% of people living with HIV are also diagnosed with diabetes. To manage their two chronic conditions, people must undertake certain activities and adopt behaviors. Due to overlapping symptoms, complex medication regimens, and heavy patient workloads, implementing these self-management practices can be difficult. In this focused ethnography, data were collected from semi-structured interviews and limited participant-observation with a selected subset of participants to gain insight into self-management challenges and facilitators. We conducted interviews and multiple observations with 22 participants with HIV+T2DM over the period of 9 months. Participants experienced numerous barriers to self-management in the areas of diet, medication adherence, and mental health. Social and familial support, as well as consistent access to care, were facilitators for optimal self-management. At the same time participants’ lives were in a unique flux shaped by the dual diagnoses, and therefore, required constant mental and physical adjustments, thus illustrating challenges of managing chronicity.

scholarly journals Experiences of People Living With HIV in Community Based Exercise: A Qualitative Longitudinal Study

2021 ◽  
Vol 20 ◽  
pp. 232595822199534
Author(s):  
Patricia Solomon ◽  
Soo Chan Carusone ◽  
Aileen M. Davis ◽  
Rachel Aubry ◽  
Kelly K. O’Brien
Keyword(s):  
Longitudinal Study ◽  
Self Management ◽  
People Living With Hiv ◽  
Health Providers ◽  
Structured Interviews ◽  
Community Based ◽  
Weekly Session ◽  
Living With Hiv ◽  
Over Time

This qualitative longitudinal study examined the experiences of people living with HIV who engaged in a structured community-based exercise (CBE) program under the supervision of a fitness coach. Twenty people living with HIV were invited to participate in 3 semi-structured interviews over time. Participants engaged in exercise 3 times per week for 6 months with one weekly session supervised by a coach. Interviews were audio-recorded, transcribed verbatim and underwent longitudinal thematic analyses. Eleven participants were included representing a total of 30 interviews. Participants valued their experiences with the CBE program, particularly the motivation provided by the coach. Concerns about the environment, stigma and episodic health challenges affected their overall experience. To foster independence and promote self-management, health providers should consider these findings when encouraging CBE with people living with HIV. It is important to understand their goals and offer a variety of exercise options to meet their needs.

scholarly journals The Lived Experiences of Stigmatization in the Process of HIV Status Disclosure among People Living with HIV in Taiwan

2021 ◽  
Vol 18 (10) ◽  
pp. 5089
Author(s):  
Chia-Hui Yu ◽  
Chu-Yu Huang ◽  
Nai-Ying Ko ◽  
Heng-Hsin Tung ◽  
Hui-Man Huang ◽  
...  
Keyword(s):  
Lived Experiences ◽  
Healthcare Professionals ◽  
Social Stigma ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Structured Interviews ◽  
Two Phases ◽  
Hiv Status Disclosure ◽  
Living With Hiv ◽  
Status Disclosure

People living with HIV (PLWH) face social stigma which makes disclosure of HIV status difficult. The purpose of this descriptive qualitative study was to understand the lived experiences of stigmatization in the process of disease disclosure among PLWH in Taiwan. Analysis of the semi-structured interviews from 19 PLWH in Taiwan revealed two phases and six themes. Phase one “experiences before disclosure” involved three themes: “Struggles under the pressure of concealing the HIV Status,” “Torn between fear of unemployment/isolation and desire to protect closed ones,” and “Being forced to disclose the HIV status.” Phase two “experiences after disclosure” included three themes: “Receiving special considerations and requirements from school or work,” “Receiving differential treatments in life and when seeking medical care,” and “Stress relief and restart.” Healthcare professionals need to assess stigmatization in PLWH and develop individualized approaches to assist with the disease disclosure process.

scholarly journals Self-management Interventions for Pain and Physical Symptoms Among People Living With HIV

2018 ◽  
Vol 79 (2) ◽  
pp. 206-225 ◽  
Author(s):  
Kennedy Nkhoma ◽  
Christine Norton ◽  
Caroline Sabin ◽  
Alan Winston ◽  
Jessica Merlin ◽  
...  
Keyword(s):  
Physical Symptoms ◽  
Self Management ◽  
People Living With Hiv ◽  
Management Interventions ◽  
Living With Hiv

scholarly journals COMPREHENSIVE MEDICATION MANAGEMENT SERVICES IN A BRAZILIAN SPECIALITY PHARMACY: A QUALITATIVE ASSESSMENT

2017 ◽  
Vol 9 (3) ◽  
pp. 227 ◽  
Author(s):  
Kirla Barbosa Detoni ◽  
Mariana Martins Gonzaga Do Nascimento ◽  
Isabela Viana Oliveira ◽  
Mateus Rodrigues Alves ◽  
Manoel Machuca GonzÁles ◽  
...  
Keyword(s):  
Participant Observation ◽  
Patient Flow ◽  
Medication Management ◽  
Implementation Process ◽  
Ethnographic Study ◽  
Qualitative Assessment ◽  
Healthcare Team ◽  
Structured Interviews ◽  
Eligibility Criteria ◽  
Manager Support

Objective: To understand and describe the implementation process of a comprehensive medication management (CMM) service in a public speciality pharmacy in Brazil.Methods: Ethnographic study conducted over 17 mo (September 2014 to February 2016) in a public speciality pharmacy. Semi-structured interviews were conducted with twelve participants. Notes on field journals, resulting from participant observation conducted by the two pharmacists directly responsible for the service implementation, were also used as a source of data.Results: Ten important conditions to improve the success of CMM service implementation were identified: manager support; evaluation of physical and material resources; evaluation of human resources practitioners’ characteristics and knowledge about the theoretical framework of CMM services; time dedicated to CMM services; redefining the work process; defining patient eligibility criteria to CMM service; defining patient flow to CMM service; communication with healthcare team; integration with the staff; and marketing the service internally.Conclusion: The results unveiled by this article can be used by pharmacists and managers as a tool to optimize the implementation of CMM services in different healthcare settings. These conditions do not consist the only aspects necessary to ensure the success of the service; however, they can contribute to optimize the implementation process of the practice

scholarly journals "The group facilitates everything": meanings patients with type 2 diabetes mellitus assigned to health education groups

2014 ◽  
Vol 22 (6) ◽  
pp. 980-987 ◽  
Author(s):  
Lucas Pereira de Melo ◽  
Edemilson Antunes de Campos
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Education ◽  
Healthcare Workers ◽  
Participant Observation ◽  
Ethnographic Study ◽  
Public Health Care ◽  
Structured Interviews

OBJECTIVE: to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups.METHOD: ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique.RESULTS: four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study.CONCLUSION: the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.

scholarly journals A Bridge to Portugal: Language and Identity in Bridgeport, CT

2020 ◽  
Vol 5 (2) ◽  
pp. 123-140
Author(s):  
Fabio Scetti
Keyword(s):  
Identity Construction ◽  
Language Contact ◽  
Language Use ◽  
Participant Observation ◽  
American English ◽  
Ethnographic Study ◽  
Language And Identity ◽  
Speech Community ◽  
Structured Interviews ◽  
The Status

Here I present the results of BridgePORT, an ethnographic study I carried out in 2018 within the Portuguese community of Bridgeport, CT (USA). I describe language use and representation among Portuguese speakers within the community, and I investigate the integration of these speakers into the dominant American English speech community. Through my fieldwork, I observe mixing practices in day-to-day interaction, while I also consider the evolution of the Portuguese language in light of language contact and speakers’ discourse as this relates to ideologies about the status of Portuguese within the community. My findings rely on questionnaires, participant observation of verbal interaction, and semi-structured interviews. My aim is to show how verbal practice shapes the process of identity construction and how ideas of linguistic “purity” mediate the maintenance of a link to Portugal and Portuguese identity.

scholarly journals TACTICS OF BORDER CROSSING MOVEMENT: EXPLORING THE MOBILITY OF BRAZILIANS THROUGH THE SCHENGEN AND UK AIRSPACE

2015 ◽  
Vol 3 (5) ◽  
pp. 216 ◽  
Author(s):  
Gustavo Dias
Keyword(s):  
Social Space ◽  
Participant Observation ◽  
Ethnographic Study ◽  
Border Crossing ◽  
Structured Interviews ◽  
Main Research ◽  
Social Actors ◽  
Research Orientation ◽  
Definition Of ◽  
Embodied Practice

This paper addresses the relations between migrants, mobility, tactics, negotiation, and the contemporary definition of borders in the aftermath of 9/11.The empirical focus of this paper is how Brazilians from Alto Paranaiba journey through airports located in the Schengen area and in the British territory to London. As a main research orientation, I use the notion of journey as approached by mobility studies, where actions and skills remain an important link between the wayfarer and the social space in which s/he moves through, the embodied practice to how we grasp the world. Migrants deal and struggle against border regime, but they are not powerless social actors. They rather produce creative resistance to reinvent their journey through the surveillance apparatus, which manage and delimit places with targets and threats. In this process, I explore the notion of border crossing movement as a tactical mobility developed by migrants to overcome the border control imposed by governments in airports. The article was drawn through fieldwork conducted initially in London, between 2009 and 2013, and afterwards in Alto Paranaiba, during 2013. The ethnographic study consisted in semi-structured interviews, participant observation through snowball technique, which enabled me to access a considerable number of participants in these two regions explored. The argument that I develop is that migrants as social actors are part important in the dialogue produced between border crossing and border reinforcement.

scholarly journals The Impact of Stigma and Discrimination on Adherence to Medication amongst People Living with HIV in Tiv Land, North Central Nigeria

2019 ◽  
pp. 1-9
Author(s):  
Godwin Aondohemba Timiun ◽  
Timothy J. Scrase
Keyword(s):  
People Living With Hiv ◽  
Structured Interviews ◽  
Hiv Patients ◽  
Stigma And Discrimination ◽  
Treatment Services ◽  
Adherence To Medication ◽  
Multi Stage ◽  
Living With Hiv ◽  
And Control ◽  
The Impact

In spite the identification of stigma as a factor impeding public utilisation of HIV counselling, testing, and treatment services in Nigeria, gaps still exist in knowledge on the impact of stigma, and discrimination on adherence to medication amongst people living with HIV (PLWH). This study adopted mixed methods to examine the impact of stigma and discrimination on adherence to medication amongst PLWH in Nigeria.  A sample of 1,621 respondents was collected using multi-stage and purposive sampling methods. Structured interviews using questionnaires and in-depth interviews (using a guide) were utilised for data collection. SPSS (version 21) was used for quantitative data analysis while the qualitative data was analysed thematically. There are 46.3% men and 53.7% women respondents. Generally, their income is low, 70.7% are earning less than N25, 000 (approximately $125 USD) per month. Some of the HIV patients are stigmatised. In reaction, they avoid public places, travel long distances away from their immediate community to collect drugs and to avoid been noticed around the centers. They sometimes miss taking drugs regularly as prescribed, suffer depression and die. Stigma and discrimination impede adherence to medication amongst PLHW in Nigeria. More efforts should be made to create awareness to reduce stigma and discrimination of HIV patients, while augmenting their income to meet up with the challenges of adherence to medication. The overall benefits would be enhanced mechanism of HIV prevention, treatment and control in the study area.

scholarly journals Effectiveness of a personalized health profile on specificity of self-management goals among people living with HIV in Canada: a protocol for a blinded pragmatic randomized controlled trial

2020 ◽  
Vol 4 ◽  
pp. 1
Author(s):  
Maryam Mozafarinia ◽  
Fateme Rajabiyazdi ◽  
Marie-Josée Brouillette ◽  
Lesley Fellows ◽  
Bärbel Knäuper ◽  
...  
Keyword(s):  
Health Outcome ◽  
Text Mining ◽  
Health Outcomes ◽  
Goal Setting ◽  
Rate Ratio ◽  
Self Management ◽  
People Living With Hiv ◽  
Brain Health ◽  
Personalized Health ◽  
Living With Hiv

Background: Goal setting is a crucial element in self-management of chronic diseases. Personalized outcome feedback is needed for goal setting, a requirement for behavior change. This study contributes to the understanding of the specificity of patient-formulated self-management goals by testing the effectiveness of a personalized health outcome profile. Objective: To estimate among people living with HIV, to what extent providing feedback on their health outcomes, compared to no feedback, will affect number and specificity of patient-formulated self-management goals. Methods: A personalized health outcome profile has been produced for individuals enrolled in a Canadian HIV Brain Health Now cohort study at cohort entry and at the last recorded visit. Participants will be randomized to receive or not “My Personal Brain Health Dashboard” prior to a goal setting exercise. Self-defined goals in free text will be collected through an online platform. Intervention and control groups will receive instructions on goal setting and tips to improve brain health. A total of 420 participants are needed to detect a rate ratio (number of specific words/numbers of person-goals, intervention:control) of 1.5. Text mining techniques will be used to quantify goal specificity based on word matches with a goal-setting lexicon. The expectation is that the intervention group will set more goals and have more words matching the developed lexical than the control group. The total number of words per person-goals will be calculated for each group and Poisson regression will be used to estimate the rate ratio and 95% confidence intervals and compare rate ratios between men and women using an interaction term. Conclusions: This study will contribute to growing evidence for the value of person-reported health outcomes in tailoring interventions, and will provide a thorough understanding of the quality of person-defined goals using text mining. Trial registration: Clinical Trials NCT04175795, registered on 25th November 2019.

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