The experiences and needs of HIV/AIDS counsellors at a South African hospital

Abstract

To increase the availability of HIV/AIDS counselling in South Africa, nurses have been trained to serve as counsellors within hospital services. The aim of the study was to document the experiences and needs of nurse HIV/AIDS counsellors at a small South African hospital (with 279 beds and 10 medical doctors on the staff). The design was a qualitative, multiple-case study. The sample consisted of four nurse counsellors and the co-ordinator of HIV/AIDS services at the hospital. Three semi-structured interviews with the counsellors were used as the basis for case narratives of their experiences. These narratives were in turn subjected to content analysis to determine the range and nature of the concerns identified by the counsellors. The counsellors found their HIV/AIDS counselling work to be emotionally demanding and identified several significant problems. These were related to confidentiality, stigmatisation, motional responses to informing clients of their HIV-positive status, cultural and contextual factors and situational stressors related to the organisation of the work environment. They did not feel sufficiently supported by their work infrastructure. It is recommended that in setting up counselling services of this sort, managers need to be aware of the need for ongoing support in the form of facilitated groups, professional supervision, managerial attention to problems in the working environment, and regular in-service training.

Keywords:counselling, training, workplace stressors, management

Journal of Psychology in Africa 2005, 15(1):1-10