Nurse-patient Relationships: Implications for Retention in the PMTCT of HIV Programme

Abstract

Abstract Background Relationships established between nurses and midwives, and their patients have far-reaching implications; the most significant being its impact on the health-related outcome of patients. These relationships are especially relevant in the Prevention of Mother-to-Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) programme as women, diagnosed with HIV navigate the emotional and psychological effects of their diagnosis while carrying pregnancies. This study aimed to explore the relationships between nurses, midwives and mothers diagnosed with HIV and its impact on retention in the PMTCT Programme. Methods An Appreciative Inquiry approach that employed qualitative research methods was conducted among twenty-four participants made up of 12 HIV positive mothers, and eight midwives and four community health nurses engaged in the PMTCT programme. Individual generative interviews were conducted among the mothers while paired interviews were conducted among the health professionals. Thematic analysis guided by Colaizzi’s approach was conducted. Results Three main themes emerged; Establishing Rapport, Journeying Together and Celebrating the Spoils. Nurse-patient relationships evolved as the women progressed along the PMTCT cascade. Establishing trust, setting mutuals goals, sharing emotional experiences and personal stories, and building clients’ self-worth positively impacted commitment to the nurse-patient relationship and retention in the programme. Termination of care was unsuccessful in some relationships as professional boundaries were blurred. Conclusions The nurse-patient relationship in the PMTCT programme evolved as the relationship progressed along the PMTCT cascade. Strengthening of the nurse-patient relationships was underscored by building trust through maintenance of confidentiality, setting mutuals goals, shared emotional experiences and personal stories, and building clients self-worth. Therefore, there is a need to ensure that professional boundaries are set and maintained to reduce the occurrence of overdependence of the clients and burnout of the nurses.