Knowledge, Attitudes and Perceptions of Nurses Regarding the Adherence Counselling of Persons with HIV-TB Coinfection

A Descriptive Survey

Abstract

Introduction People living with HIV (PLHIV) co-infected with tuberculosis (TB) account for one in three HIV-related deaths. Retention in care and adherence to medication remain key behaviours that people co-infected with HIV and TB must adopt to achieve better health outcomes. TB/HIV adherence-counselling services provided by nurses are designed to enhance these behaviours, but this remains inadequate as patients still default their treatment plans by not attending follow up appointments and not adhering to their programme. Aim To assess the Knowledge, Attitudes and Perceptions (KAP) of nurses towards adherence to counselling of people living with HIV co-infected with TB in a health sub district of the Cape metropole, South Africa. Method A descriptive-sectional design was used on all-inclusive population of nurses. The instrument used was an adapted five- point Likert scale questionnaire with original reliability: knowledge (α=.70), perception (α=.77), and attitude (α=.77) in each domains Data was analysed using SPSS version 26. Data presentation was in simple percentages, means and standard deviations. The two-way ANOVA was used in determining the effect of level of qualification and training on nurses’ knowledge, attitudes, and perceptions regarding counselling of PLHIV co-infected with TB. Results Most of the respondents 72 (87.8%) were females. The mean and standard deviation years of working experience with HIV/HAST protocol was 6.8 ± 4.63 and number of years working as a nurse was 11.33±7.21. With reference to knowledge of nurses on adherence counselling of these patients, most of the respondents agreed “TB is considered as a very serious disease and health problem, can infect anyone should be explained to the patient during counselling. Regarding perceptions of nurses on adherence counselling PLHIV co-infected with TB, most of nurses 3.89, 56 (69.2%) agreed “Poverty stricken patients just need treatment, as they cannot do anything to improve their health hence counselling not necessary”. Regarding attitudes of nurses to adherence counselling, most respondents agreed “Speak clearly and use language that HIV/TB patients will understand counselling” (mean 4.34, 70 (85.4%). There was no significant difference on effect of level of qualification and training on nurse’s adherence counselling PLHIV co-infected with TB (p>.05). Conclusion There is a need for capacity building training in adherence counselling to improve nurses’ skills in counselling and management of patients with TB/HIV. Appropriate training of nurses of all categories and orientation and re-orientation of the patients to enhance support and adherence.