Objectives Low adherence to antiretroviral (ARV) therapy in pregnant women with human immunodeficiency virus (HIV) increases the risk of virus transmission from mother to newborn. Increasing mothers’ knowledge and motivation to access treatment has been identified as a critical factor in prevention. Therefore, this research aimed to explore barriers and enablers in accessing HIV care and treatment services.
Methods This research was the first phase of a mixed-method analysis conducted in Kupang, a remote city in East Nusa Tenggara Province, Indonesia. Samples were taken by purposive sampling of 17 people interviewed, consisting of 6 mothers with HIV, 5 peer facilitators, and 6 health workers. Data were collected through semi-structured interviews, focus group discussions, observations, and document review. Inductive thematic analysis was also performed. The existing data were grouped into several themes, then relationships and linkages were drawn from each group of informants.
Results Barriers to accessing care and treatment were lack of knowledge about the benefits of ARV; stigma from within and the surrounding environment; difficulty in accessing services due to distance, time, and cost; completeness of administration; drugs’ side effects; and the quality of health workers and HIV services.
Conclusions There was a need for a structured and integrated model of peer support to improve ARV uptake and treatment in pregnant women with HIV. This research identified needs including mini-counseling sessions designed to address psychosocial barriers as an integrated approach to support antenatal care that can effectively assist HIV-positive pregnant women in improving treatment adherence.
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Objectives To develop and investigate the effectiveness of an integrative counseling intervention for enhancing social intelligence and reducing bullying behaviors among lower secondary school students in Bangkok, Thailand.
Methods An interventional mixed-method design was employed in 2 phases. Phase 1 involved the development of a qualitative method-based integrative counseling program from key informants using the eclecticism technique. In phase 2, a randomized controlled trial with a wait-list control was conducted and qualitative research was performed with students who demonstrated bullying behaviors. Demographic data, Social Intelligence Scale (SIS) scores, and Bullying-Behavior Scale (BBS) scores were collected at baseline. Changes in SIS scores and qualitative findings obtained from in-depth interviews were examined after counseling ended, and BBS scores were collected again 1 month later.
Results The developed social intelligence counseling program included eight 1-hour weekly sessions consisting of 3 components: (1) social awareness, (2) social information processing, and (3) social skills. After receiving this intervention, scores for the SIS overall (p<0.001) and all of its components (p<0.05) were significantly enhanced in the experimental group compared to the control group. Moreover, the mean BBS scores in the experimental group significantly decreased 1 month after counseling (p=0.001). With regard to the qualitative research results, the experimental students demonstrated improvements in all components of social intelligence.
Conclusions The results indicated that a preventive counseling program may enhance social intelligence, decrease bullying behaviors among lower secondary school students, and prevent further incidents of school violence. However, further studies in various population subgroups should also be performed.
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OBJECTIVES Due to the economic crisis and globalization, many workers have been suffering from severe occupational stress due to job insecurity and struggles related to downsizing and restructuring. This study aims to assess the stress levels among workers involved in fierce labor disputes and massive layoffs and to evaluate their specific needs and satisfaction with counseling services set up to help workers cope with severely stressful situations? METHODS: The authors provided crisis intervention to workers in traumatic situations to compare the differential level of stress responses and needs among the workers remaining employed in a large auto factory, those laid off by it, and those laid off by other companies in the same region (Pyeongtaek, Gyeonggi Province). We measured stress levels using the worker's stress response inventory (WSRI) and heart rate variability (HRV), and assessed workers' satisfaction with the counseling services. RESULTS: 502 workers participated in the program. Fifty-seven percent of them consulted with occupational problems. The mean WSRI score of the workers remaining employed in the automobile factory was higher than that of the unemployed (employed: 39.8+/-19.9, unemployed: 29.3+/-18.8). Ninety-five percent of workers responded that they were satisfied or very satisfied with the counseling services. CONCLUSIONS: This study suggests the urgent need for the establishment of a national crisis intervention program dedicated to supporting workers in severely stressful situations.
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