A qualitative study aimed at describing interpreting the changing symbolic meanings of HIV/AIDS which encountering HIV-positive patients introduces into the personal professional identities of selected health care professionals

摘要

This study aimed at describing and interpreting the changing symbolic meanings of the Acquired Immunodefiency Syndrome (AIDS) which encountering a Human Immunodefiency Virus (HIV)-positive patient introduced into the personal and professional identities of six health care professionals in a subregion of the Eastern Cape. With the exponential increase of HIV/AIDS in South Africa, medicalpractitioners have become increasingly exposed to HIV infected patients. This study has considered the psychological structures developed by practitioners in an attempt to control and understand their situation in the context of HIV/AIDS.In order to describe these psychological structures the existential phenomenological approaches of L. Binswanger (in Needleman, 1963), A. Giorgi (1975) and F.J.Wertz (1985) were employed. Through these procedures, the structure of the experience of encountering an HIV infected patient waselucidated. This comprised the first goal of this study. The second goal focused on interpreting these descriptions by way of the symbolic meanings and definitions implicit in the structure of this experience. For this latter purposethe approach of symbo1ic interactionism was used, in particu1ar the understandings outlined by H. Blumer (1969). This theory was seen as appropriate in that the encounter between the practitioner and patient was primarily locatedin interpersonal parameters. The findings were discussed in terms of the two dominant metaphorical frameworks used by the subjects to comprehend the disease - namely the perspectives of society and the biomedical model. These twoframeworks were critically evaluated in the context of HIV/AIDS, the needs of HIV infected individuals as well as the needs of the general practitioner. The process of the encounter was found to be very significant for practitioners in terms of their conceptualisations of HIV/AIDS. Old understandings were reinterpreted within the interpersonal context and replaced with more appropriatesymbolic metaphors upon which to base practise. This study has revealed these new understandings were limited and constrained with regard to understanding and treating HIV/AIDS in that the subjects were still influenced by the metaphors of the biomedical model. These constraints were examined in the light of both personal and professional meanings and identities. This study concluded by makingsuggestions for modification of the medical practitioner's role in the context of HIV/AIDS.