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Integrating adherence to highly active antiretroviral therapy into children's daily lives: a qualitative study

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Show simple item record Hammami, N. en_US Nöstlinger, C. en_US Hoerée, T. en_US Lefèvre, P. en_US Jonckheer, T. en_US Kolsteren, P. en_US 2007-12-06T14:42:47Z 2007-12-06T14:42:47Z 2004 en_US
dc.identifier.issn 0031-4005 en_US
dc.identifier.other ITG-H1B en_US
dc.identifier.other ITG-C2A en_US
dc.identifier.other ITG-H3A en_US
dc.identifier.other ITG-H4A en_US
dc.identifier.other ITG-HLA en_US
dc.identifier.other HEALTH en_US
dc.identifier.other U-VOED en_US
dc.identifier.other CLINIC en_US
dc.identifier.other U-HIVCLI en_US
dc.identifier.other JIF en_US
dc.identifier.other FTA en_US
dc.identifier.other MULTI en_US
dc.identifier.other ABSTRACT en_US
dc.description.abstract OBJECTIVE: To acquire a deeper understanding of factors that influence adherence to highly active antiretroviral therapy (HAART) in a pediatric population. METHODS: We performed a qualitative study of adherence in children who receive HAART in a Belgian pediatric acquired immune deficiency syndrome referral center. Eleven primary caregivers were interviewed to assess their child's adherence and influencing factors. The interview guidelines were developed on the basis of an extensive literature review. Adherence to treatment was assessed using caregivers' self-report and laboratory results. Content analysis for common items was performed, and statements of adherent and less-adherent patients were compared. RESULTS: Three main factors influenced adherence. Adherent patients were found to internalize the medical information to a stronger extent than less-adherent patients. Adherent patients showed stronger motivation to stick to the medical regimen on the basis of personal cost-benefit analyses, ie, perceived benefits outweighed the costs or difficulties experienced. Adherent patients developed greater problem-solving capacities, ie, ways to deal with practical complications of medication intake. The interviews revealed a fourth, more dynamic component: knowledge, motivation, and capacities evolved in a progressive way, related to individual stages of coping with human immunodeficiency virus (HIV). CONCLUSIONS: The data suggest that coping with HIV and the process of establishing good adherence may be interrelated. Caregivers who accept the disease may be more likely to internalize the received information and thus develop a stronger motivation to fight for the child's life. Problem-solving skills sustain this adherence, and medication becomes a priority in the adherent caregivers' daily lives. On the contrary, less-adherent caregivers may be situated at less advanced stages of the coping process. Thus, tailor-made approaches adapted to the individual HIV-related coping strategies need to be developed to improve adherence in children and caregivers. en_US
dc.language English en_US
dc.publisher American Academy of Pediatrics en_US
dc.subject Viral diseases en_US
dc.subject HIV en_US
dc.subject AIDS en_US
dc.subject Children en_US
dc.subject Antiretrovirals en_US
dc.subject HAART en_US
dc.subject Compliance en_US
dc.subject Caregivers en_US
dc.subject Determinants en_US
dc.subject Belgium en_US
dc.subject Europe, West en_US
dc.title Integrating adherence to highly active antiretroviral therapy into children's daily lives: a qualitative study en_US
dc.type Article en_US
dc.citation.jtitle Pediatrics en_US
dc.citation.volume 114 en_US
dc.citation.pages 591-597 en_US Elk Grove Village en_US
dc.citation.jabbreviation Pediatrics en_US

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