The lived experiences of rural-based grandparents raising HIV/AIDS-orphaned grandchildren in the Kingdom of Swaziland: a proposed self-care health education programme
Sithole, Sifiso I.
MetadataShow full item record
Since the late 1990s, the Swazi adult population has been dying from HIV/AIDS related illnesses and leaving behind children who end up being looked after by older adults, in particular grandparents in rural areas. Empirical evidence abounds with findings that indicate that older adulthood is predominantly characterized by declining health. Owing to the HIV/AIDS epidemic that has killed many Swazi adults, most grandparents, especially those in rural areas have become primary caregivers of HIV/AIDS-orphaned minors. This research investigated 14 rural-based grandparents whose ages ranged from 60 through 88 years and looked after, on a full time basis, grandchildren orphaned through HIV/AIDS in the lowveld of the Kingdom of Swaziland. Primarily, the study sought to explore and describe the lived experiences of rural-based grandparents raising grandchildren orphaned through HIV/AID. Secondly and based on the findings, the ultimate purpose of the study was to formulate a strategy to address the findings thereof. The study was guided by the four phases of the nursing process, namely assessment, planning, implementing and evaluation. While phase one focused on exploring and describing the day-to-day personal realities of these rural-based grandparents raising grandchildren orphaned through HIV/AIDS, phase two described the development of the conceptual framework that was used to guide the development of the health education programme. Phase three focused on the structure and process of the actual programme. Phase four evaluated the developed programme. Phase one: This phase was the phenomenological part of the study and had a design that was qualitative, exploratory, descriptive and contextual. As the study was naturalistic, the data were collected at the homesteads of the participants through audio taped face-to-face unstructured in-depth interviews that were guided by the following two open-ended-questions, ‘‘Ngiccela ungichazele kabanti kutsi engabe kunjani kunakekela batukulu bako labashiywa batali babo?“ [“What/How is it like to care for your grandchildren whose parents died through HIV/AIDS?“] and “Ukhona njani kumelana netidzingo tonkhe telabatukulu bako?“ [“How do you manage to look after your grandchildren whose parents dies through HIV/AIDS?“] An exploratory interview preceded the main data collection for the purpose of ensuring that the two questions were clear enough for the participants to understand and describe their day-to-day encouters with such children. Other sources of data were: field notes, health records and to a lesser extent, photographs that were taken of objects and relevant scenary but not the participants. The researcher adhered to the prescribed research standards. Data analysis started soon after completion of each interview. The data were analyzed through the method of Tesch (1990:93). Six major categories were identified: NO SUPPORT, COMPROMISED HEALTH, RESOURCE AND BASIC NEEDS CONSTRAINTS, FEELING OVERWHELMED, CONCERNS ABOUT THE FUTURE OF THE GRANDCHILDREN and SACRIFICING. The majority of the afore-mentioned identified categories needed interventions that were collaborative between various stakeholders. However, the category COMPROMISED HEALTH was found to be an area that nursing could do something about. Consequently, a health education programme to empower with self-care rural-based grandparents raising GOTHA in the lowveld was the strategy that was chosen. With the completion of data analysis phase one had been completed. Phase two: This phase marked the post research stage and focused on the development of the conceptual framework that guided the development of the proposed health education programme to empower with self-care rural-based grandparents raising grandchildren orphaned through HIV/AIDS in the lowveld. Its structure and process were described. Phase three: Phase three was divided into two interrelated parts, namely phases 3(a) and 3(b). While phase three(a) described the structure of the proposed health education programme, phase three(b) focused on describing the process apsect of its implementing. The implementers of the proposed health education programme were identified as community health nurses. Phase four: Phase four formed the final phase of the development of this research and sought to evaluate the programme. Selected stakeholders were requested for their input on the developed health education programme. Also discussed in this phase were the study contributions, limitations and implications, especially to government and community health nursing practice, education, management and research. Recommendations were suggested.