Discussion of findings of Phase one of the study for development of guidelines for assessment

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THEORETICAL ASSUMPTIONS

In keeping with a phenomenological investigation, the researcher approached the field without any preconceived framework. The literature control was conducted after the description of the essence of the experiences of abuse among women living with HIV and AIDS and the constituents that substantiate the essence.

METHODOLOGY OF THE RESEARCH

Qualitative research was used in this study. In this qualitative inquiry, the researcher used the phenomenological research approach for phase 1 of the study, in order to allow the participants to communicate their experiences of abuse to provide a comprehensive description of the women’s experiences (Polit & Beck 2008: 227). WLWHA were interviewed to describe their experiences of abuse. The interviews were audiotaped with the permission of the participants, transcribed verbatim and analysed using the process described in Dahlberg et al. (2008: 236), in combination with the method of Collaizi 1978 (cited in Streubert Speziale & Rinaldi Carpenter 2007: 83). The researcher used bridling to ensure that preconceived ideas were kept in check throughout the research process.
The following section describes the research setting, population and sample, data collection, data analysis and ethical considerations of the study in detail.

Country background

Malawi is a country situated in the south eastern part of Africa and lies between 13 57.5’ and 33 42’. It is within the sub-Saharan region. It has a population of about 13 million people of which 51% are women (National Statistics Office 2008: 2). It shares its borders with the United Republic of Tanzania to the north and north east, the People’s Republic of Mozambique to the east, south and southwest and the Republic of Zambia to the west and northwest. The country is divided into three regions namely north, central and south and it has a total of 28 districts. The districts are further subdivided into traditional authorities, each covering several villages. A village constitutes the smallest administrative unit in the country (NSO 2011: 1).
The study was conducted in both rural and urban settings in the Lilongwe district in Malawi, in order to obtain experiences of participants from different locations.
Lilongwe is the capital city of Malawi where many programmes for people living with HIV and AIDS have been implemented by both government and nongovernmental organizations. These programmes include HIV testing and counselling (HCT), treatment and support, including home-based care and support groups.
Like in many other African countries, women in Malawi bear the burden of HIV and AIDS more than their male counterparts. The reason for this largely remains the gender inequalities between men and women (Ministry of Women and Child Development [Malawi] 2005: 4). Women in Malawi have little access to productive resources such as income, assets and education. The lack of resources places them in an economically dependent situation, which influences their decision-making ability, to the effect that they may engage in risky behaviours such as transactional and unprotected sex (Kathewera-Banda et al. 2005: 649). Thus, for women, inequality in income is a major driving force behind the HIV infection (Feldacker, Ennet & Speizer 2011: 723). Consequently, unequal power relations lead to abuse of the women’s human rights, through which violence is perpetuated and the risk of HIV transmission is increased.
Malawian society, to a large extent, condones gender norms that are permissive of multiple and concurrent partners for men (Ministry of Women and Child Development [Malawi]: 2005: 4). These norms are rooted in a culture of gender inequality that results in exploitation of women by tolerating and perpetuating gender-based violence (Ministry of Women and Child Development [Malawi]: 2005: 4). Low education of girls is the effect of gender barriers that impact negatively on the women, such as early marriages and pregnancy. The Malawi Demographic and Health Survey (MDHS) indicates that low education is a risk factor for gender-based violence, so is ever having been married, considering that the most common perpetrators of violence reported by women, are their partners (NSO 2011: 240).

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Chapter 1 Orientation to the study
1.1 Introduction
1.2 Background
1.3 Research problem
1.4 Research question
1.5 Purpose of the study
1.6 Objectives of the study
1.7 Significance of the study
1.8 Assumptions
1.9 Clarification of concepts
1.10 Research methodology
1.11 Organisation of the study chapters
1.12 Summary
Chapter 2 Paradigmatic and methodological grounding of phase 1 of the research study
2.1 Introduction
2.2 Meta theoretical assumptions
2.3 Qualitative research
2.4 Phenomenology: A sub-discipline of philosophy applied to research
2.5 Phenomenology: Research methodological assumptions
2.6 Theoretical assumptions
2.7 Methodology of the research
2.8 Summary
Chapter 3 Presentation of findings for Phase one of the study
3.1 Introduction
3.2 Description of the essence of the phenomenon and its constituents; the new whole: violating experiences
3.3 Summary
Chapter 4 Discussion of findings of Phase one of the study for development of guidelines for assessment
4.1 Introduction
4.2 Violating experiences: the essence of abuse experienced by women living with HIV and AIDS
4.3 Humiliation
4.4 Hopelessness
4.5 Blame
4.6 Harm
4.7 Abandonment
4.8 Summary
Chapter 5 Phase two of the study: development and refinement of guidelines for the assessment of abuse of women living with HIV and AIDS
5.1 Introduction
5.2 Development of the draft guidelines for assessment of abuse of WLWHA
5.3 The draft guidelines for the assessment of abuse of WLWHA
5.4 Process of refinement of the draft guidelines for assessment of abuse of WLWHA
5.5 The Delphi method
5.6 The draft guidelines for assessment of abuse of women living with HIV and AIDS and input from the experts
5.7 Validation, reviewing and updating the guidelines for assessment
5.8 Summary
Chapter 6 Guidelines, recommendations, implications, limitation and conclusion
6.1 Introduction
6.2 Summary of the study
6.3 The guidelines for assessment of abuse of women living with HIV and AIDS in Malawi
6.4 Recommendations
6.5 Implications for nursing
6.6 Limitation of the study
6.7 Conclusion
List of references

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