Knowledge, attitudes and practices of caregivers about oral lesions in HIV positive patients in NGOs / CBOs in Region, Johannesburg, Gauteng
Date
2009-10-19T09:21:33Z
Authors
Malele-Kolisa, Yolanda
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Journal ISSN
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Abstract
Title: Knowledge, Attitudes and Practices of caregivers about oral lesions in HIV positive patients in
NGOs /CBOs in Region 8, Johannesburg, Gauteng.
Background: The HIV pandemic continues to be a major public health problem in South Africa
where 11% of people were infected with HIV in 2005(HSRC, 2005).The care and support of these
patients as they eventually become ill will necessitate the increase in use of community-based/homebased/
hospice institutions. The City of Johannesburg (CoJ), one of the metropolitan municipalities
(local government) in Gauteng Province-SA, has been planning the development and implementation
of programmes related to the prevention, care and support for people infected and affected by
HIV/AIDS. Care and support has been limited to 18 NGOs/ CBOs. Four of these institutions provide
palliative care and are staffed by 64 caregivers. Studies done throughout the world indicate that oral
lesions associated with HIV occur in over half of HIV/AIDS patients. These oral lesions seriously
impair the oral-health-related-quality of life in affected individuals and necessitate the need to provide
services to alleviate them and improve patient comfort. The caregivers in the NGOs/CBOs are
therefore pivotal in offering care and support in the management of HIV including the management of
oral lesions. In order for the caregivers in the NGOs/CBOs to be able to manage the disease in its
entirety; they need optimal knowledge of the infection/illness including the oral manifestations
associated with the ailment.
Objectives: (1.) To determine the knowledge of the caregivers in the NGOs/CBOs providing
palliative care in Region 8, CoJ, Gauteng regarding common oral manifestations associated with HIV.
of the caregivers in the NGOs/CBOs . (2.) To assess the attitudes of the caregivers in the NGOs/CBOs
providing palliative care in Region 8, CoJ, Gauteng on common oral manifestations associated with
HIV. (3.) To determine the practices of the caregivers in the NGOs/CBOs in Region 8, CoJ, Gauteng,
pertaining to the common oral manifestations associated with HIV. (4.) To determine the sociodemographic
profile of the caregivers providing palliative care in the NGOs/CBOs in Region 8, CoJ,
Gauteng.
Methods: A descriptive cross-sectional study was conducted where all caregivers providing care and
support in the four NGOs/CBOs were invited to participate in the study. Data was collected by a
customised questionnaire to obtain information on demographics, knowledge, attitudes and practices
on providing for HIV positive patients.
Results: The results were grouped according to training in oral health care (TOHC) and no training
(NTOHC). The mean age was 43.5 years for TOHC and 30.8 years NTOHC and was statistically
significant (p<0.005). There were statistical significant differences in the gender proportions in
within groups in the both groups, employment status, work experience as a caregiver and training in
general home-based care (p<0.05). Most (72.2%) of those NTOHC had little experience (<1 year) of
care giving compared to 41.1% (p=0.03) and 33.3% were providing care without training in homebased
care (HBC) compared to 100% (p=0.00). The caregivers trained in oral health care had
knowledge levels shown by higher knowledge levels on four of seven variables compared to those
who were not trained in oral health care (p< 0.05, Table 3.3 p.21). The majority of caregivers
NTOHC reported that caring for the mouth of HIV positive patients is an ‘unpleasant difficult task
and poses an infection risk to the caregivers’ while these concerns were expressed by the minority of
caregivers TOHC (p<0.05). Practices performed by caregivers NTOHC were appropriate for dry
mouth, difficulty in swallowing but was inappropriate for bleeding gums and bad breath while those
caregivers TOHC provided appropriate advice/practices for oral thrush, bad breath, bleeding
gums, dry mouth with statistical difference.
Conclusion: The caregivers TOHC had fairly better knowledge, attitudes and practices regarding oral
lesions in HIV compared to those NTOHC. There was strong likelihood of knowledge variables and
training in oral health care.
Recommendations: Bearing in mind the limitations of KAP surveys and the cross sectional nature of
the study, it is recommended that training in oral health care and refresher courses for those trained
must be incorporated into the programme of all caregivers working in palliative institutions because it
will provide specialised knowledge about oral health and oral lesions in HIV improve their
knowledge, attitudes and practices and thus provide a better service to their patients.
Description
M.Dent.(Community Dentistry), Faculty of Health Sciences, University of the Witwatersrand, 2009
Keywords
caregivers, oral lesion, HIV positive patients