Marseille 2007
| Abstract #409 - Readiness in HIV treatment adherence. The ALLIANCE project: an exploratory study | ||||
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Session: 24.5: Adherence (Parallel) on Monday @ 16.30-18.30 in HC Chaired by Ana Josefina Guell, Rahul Battcharya Authors: Presenting Author: Mrs Hlne Sylvain - Universit du Qubec Rimouski, Canada |
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| Additional Authors: Mr Philippe Delmas, | ||||
| Aim: Adherence to treatment is recognized as true way to a successful HIV combination therapy. This is of prime importance since the recognized standard of assiduity is very high, that is to say 95% of medication taken, and that non-observance is likely to develop an irrevocable resistance to medication. Currently, one even recognizes that the beginning of the treatment should be delayed as long as the person is not ready to adhere to it. Optimal adherence thus implies a readiness to begin the treatment on the patients behalf. Health professionals are therefore challenged because they have to develop approaches of evaluation and intervention of adherence to the treatment. A better comprehension of the of "readiness phenomenon" could become an asset in optimizing the quality of the interventions. Current researches relating to adherence with medication mostly explored the quantitative aspects of the problem, factors of influence, for instance. However, few researches have focused on understanding the decision-making process to become compliant (Enriquez, Lackey, O'Connor, & McKinsey, 2004). The aim of this study is to describe and understand the decision-making process to adhere completely to the HIV treatment, from patient and professional points of view. | ||||
| Method / Issue: Twenty-six in-depth interviews, within a qualitative phenomenological design, generated data from three groups made up of patients observing the treatment (PO), patients beginning the treatment (PB) and health professionals implied with HIV patients (HP). Participants were recruited in two hospitals in Paris by the way of an intentional sampling to maximise the perspectives on the process of readiness and adherence. A synthesis of each interview were used as starting point for data analysis in order to get a global idea of significance. Afterwards coding and categorization of the transcribed interviews were supported by the qualitative analysis NVivo software. The analyzed data were subjected to the evaluation of the partners throughout the analytic process. | ||||
| Results / Comments: Findings. Four major themes interrelated with a core variable represents the common themes emerging from all participants perspectives. Willing to take control of ones health and treatment is a matter of confidence towards ones self, towards the relatives, towards the treatment and towards the health professional team. Moreover self-confidence is influenced by health status within the illness and the way one lives with HIV. All those themes are not fixed forever, they represent a moving picture across time and life events. | ||||
| Discussion: Results of this study fall under a definition of the adherence which goes beyond "conforming" to the medical regulation but should acknowledge that the patient plays an active role in the choice to adhere. Those findings are supported by an empowerment theory of adherence which means active participation and taking control of ones life. The implications of this research will be also approached in this presentation. | ||||
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