How clinicians experience a simulated antiretroviral therapy adherence exercise: A qualitative study
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS
Abstract
BACKGROUND: With the shift of paediatric antiretroviral therapy (ART) from tertiary to primary
health care, there has been a need to train clinicians working in primary health care facilities to
support adherence to treatment. An adherence simulation exercise was included in a course on
paediatric human immunodeficiency virus (HIV) and tuberculosis (TB) to stimulate health
care providers’ awareness and generate empathy of complex paediatric adherence practices.
AIM: The aim of this study was to describe the experience of clinicians completing the
simulation exercise and to assess whether enhancing their empathy with patients and treatment
supporters would improve their perceived clinical and counselling skills.
SETTING: The study was conducted at the Faculty of Medicine and Health Sciences, Stellenbosch
University, and a guesthouse in Cape Town.
Methods: The adherence module used blended learning methodology consisting of face-to-face
contact sessions and distance learning. A qualitative thematic approach was used to understand
the participant experiences through focus-group discussions and semi-structured interviews.
RESULTS: Three thematic clusters emerged, namely, experiences of the simulated exercise,
patient–provider relationships and adherence strategies. Their experiences were both
positive and challenging, especially when a ‘caregiver and/or treatment supporter’ scenario
encouraged participants to reflect on their own relationships with their patients. Clinicians
had also considered how empathy fits into their scope of responsibilities. Text messaging and
adherence counselling strategies were identified.
CONCLUSION: Simulated learning activities have the potential to create awareness of relationships
between clinicians and their patients and generate ideas and discussion that could lead to
improvements in clinical practice, and adherence promotion strategies.
Description
Keywords
Antiretroviral therapy (ART), Human immunodeficiency virus (HIV), Tuberculosis (TB), Paediatric adherence practices
Citation
Engelbrecht, J.G. et al. (2018). How clinicians experience a simulated antiretroviral therapy adherence exercise: A qualitative study. African Journal of Primary Health Care & Family Medicine, 10(1): a1836.