Male HIV-Positive Patient’s Decision-Making Process and Adaptation of Living in Mid-Way Shelter

• Main Authors: Chia-Yin Hsieh, 謝佳吟
• Other Authors: Fu-Jin Shih
• Format: Others
• Language: zh-TW
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/vsx2y7

碩士 === 國立陽明大學 === 臨床暨社區護理研究所 === 97 === ABSTRACT Background In an epidemiological reportof UNAIDS (The Joint United Nations Programme on HIV/AIDS; UNAIDS) (2008), the age trend of HIV (Human Immunodeficiency Virus; HIV) infected patients (HIVIP) continued to decline. Young adults now have become the largest HIVIP. Many of them have senses of low self-esteem and neagative appraisals due to negative social stigma and lack of significant other’s (SO) support. Some of them, then, decide to stay away from their normal social interdepende network, and become howsless people or move to a mid-way shelter (MWS). Until now, little information is available about Taiwan’s male HIVIP’s (TMHIVIP) decision-making process of moving to a MWS, the related difficulties and adaptation dilemmas, as well as needed help. Method An explored qualitative research method was used in this study. A purposive sample was obtained from TMHIVIP living in a MWS in northern Taiwan. Data were collected through semi-structured face-to-face in-depth interviews, and then analyzed by qualitative content analysis. Aims This project attempted to explore: (a) the demographic characteristics of TMHIVIP living in a MWS; (b) TMHIVIP’s decision-making process of moving to a MWS; (c) the difficulties and needs involves in TMHIVIP’s decision-making process of moving to a MWS; (d) the adaptation dilemma for TMHIVIP’s preparation for re-enter to society; and (d) the needed help of TMHIVIP during decision-making process of moving to a MWS and re-ter to society. Results A total of 14 TMHIVIP participated in this study. They aged from 30 to 62 years old (mean ± SD = 44.6 ± 7). Their decision-making process of moving to a MWS involved four transitions: (a) under being assessed transition; (b) information gathering and MWS’ involvement in assessment transition; (c) admission and under caring transition; and (d) being referred to another health institute transition. During under being assessed transition, the factors contributing to decision-making were making sure the needs of living and health care. The related difficulties were lack of senses of respect and being cared; the related needs were being treaed fare as a human being. During information gathering and MWS’ involvement in assessment transition, the factors contributing to decision-making were medical refer system, informants’ taking initiative in searching for information, families’ decision-making, and MWS’s staff’s assessment report. The related difficulties were the opportunities of getting into a MWS. They reported needs of the MWS’ taking initiative in helping their admission, and managing their needs based on their individual conditions. During admission and under caring transition, the factors contributing to decision-making were supportive relationships appraisals of senses of belonging and free living style, as well as meeting self-expectations for living environment. The related difficulties were under-expected living environment, and lack of supportive relationships. Their needs were having supportive relationships, medical care, and a better living environment. Finally, during the being referred to another health institute transition, the factors contributing to decision-making were leaving MWS before due days, readiness of leaving MWS, and period of postpone leaving from MWS. The related difficulties were sense of uneasiness of leaving from MWS, and uncertainty about the next step. They called for need of more time for preparation. Most informants were afraid of the following difficulties after re-entry the society: (a) the physical and psychological trauma caused to disease; (b) being unable to meet social expectations; and (c) the stress of managing challenges in the beginning stage. Conclusions Four transitions wren found involved with TMHIVIP’s decision-making process of moving to a MWS and re-entry to society. About half of the informants reported having received related information in a passive way, and then taking an initiative in decision-making later. The major information providers were cited as health professionals. They reported better compliant to medication, better outcome of CD4 and disease control. Most of them were afraid of lacking competence required after re-try to society, and the negative impacts of social sigma of disease. Health professionals are suggested to continue to provide adequate and reliable information for them and their SO. Additionally, TMHIVIP’s confidence in re-try to society requires their self-empowerment, and the reliable social support from TMHIVIP’s SO, medical team, as well as public. With these help, the negative impacts of social stigma of disease will be gradually decreased and TMHIVIP’s positive participation in society will be more possibly ensured.