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MA/PhD Theses Abstracts of Current Students & Alumni |
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Shively, Nora (MA). The caregiver’s perspective on appointment keeping in an outpatient, pediatric HIV clinic, (Angrosino), 2002.
The issue of compliance (also referred to as adherence) has long been a closely scrutinized and highly debated issue within and among the medical, public health and anthropological communities. Adherence is defined most often as "the degree to which behavior coincides with medical or health advice" (Catz et at. 1999:362). The lllV/AIDS epidemic has recently been addressed with the introduction of antiretroviral combination drug therapies (i.e. "drug cocktails"), a situation that has heightened the concern regarding patient compliance. Research and analysis in the area of compliance has typically focussed on the practice of medication-taking. Many studies have been completed to examine patients' adherence to prescribed drug regimens and to suggest recommendations for improving or enhancing the patients' ability to better follow physicians' instructions and approved treatment guidelines. Medicine, public health, and anthropology have often taken very different approaches in the examination process due to diverse and often antithetical perspectives on the role and value of compliance in health care and health-seeking behaviors. This thesis attempts to analyze a different, and heretofore less thoroughly examined component of compliance within the HIV/ AIDS arena: appointment-keeping practices. The research was conducted at the University of South Florida (USF) College of Medicine Department of Pediatrics and Children's Medical Services (CMS) Infectious Disease Clinic in Tampa, Florida. Four one-on-one, semi-structured, in-depth interviews and twenty-two surveys were conducted with parents, caregivers, and guardians from this clinic. The final analysis yielded a clear description of the beliefs and attitudes about appointment-keeping practices of a small sample of the caregiver population. It highlights the supports that enable and the barriers that inhibit caregivers from keeping their children's medical appointments. Based on this research, it appears that the vast majority of the caregivers, surveyed and interviewed, have a clear understanding of the importance of attending appointments and the role it plays in keeping on top of the progression of he disease. There also seems to be a very strong indication that almost all caregivers believe that keeping their children's appointments is necessary and contributes to the health of their children. The lack of understanding, therefore, appears to exist between the physician/medical staff and the caregiver on what is the best way to address the care and treatment of the disease.
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