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      “Mi Dragón Dormido”, herramienta terapéutica y psicoeducativa para la revelación del diagnóstico de VIH/SIDA a niños y prevención del estigma social Translated title: “Mi Dragón Dormido” (“My Sleeping Dragon”), therapeutic and psychoeducational tool for the HIV/AIDS diagnosis disclosure to children and prevention of social stigma

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          Abstract

          Resumen Introducción: La Organización Mundial de la Salud y la Académica Americana de Pediatría sugieren revelar el diagnóstico de VIH a niños. Sin embargo, esto no es una práctica consolidada en Colombia; a menudo esto ocurre porque los cuidadores no tienen una metodología adecuada para llevar a cabo este proceso. Objetivo: Se presenta la evaluación de la eficacia de la historia “Mi Dragón Dormido” para el proceso de educación y revelación del diagnóstico de VIH/SIDA a niños. Método: Mediante muestreo no probabilístico intencional; se administraron entrevistas semiestructuradas a 40 niños, seropositivos (n = 20) y seronegativos (n = 20) para VIH/SIDA. Se trató de un estudio cualitativo y diseño sistemático. Se realizó análisis cualitativo mediante el software NVivo 10 con codificación tipo Nodos de Árbol. Resultados: Los datos cualitativos aportaron aproximaciones necesarias para mejorar el contenido y el diseño de la herramienta e indicaron que refleja la realidad de los niños y permite identificar temores y preguntas frecuentes frente a la condición crónica de salud del VIH. Conclusiones: Estos resultados aportan información importante a considerar en el proceso de revelación del diagnóstico y su manejo por parte del personal de salud.

          Translated abstract

          Abstract Background: The World Health Organization and the American Academy of Pediatrics suggest disclose the HIV diagnosis to children. However, the disclosure of HIV/AIDS diagnosis to children and adolescents, it is not a consolidated practice in Colombia, often this occurs because caregivers do not have an adequate methodology to carry out this process. Aim: We present the efficiency components validation of “Mi dragon Dormido” history in the educational process and revelation ofAIDS diagnosis to boys and girls. Method: By means of purposive non-probability sampling, semi-structured interviews were conducted with 40 children, with an equal number of children who were seropositive (n = 20) and seronegative (n = 20) for HIV/ AIDS. A qualitative study with the approach of grounded theory and systematic design was conducted. We conducted the qualitative study through the NVivo software, with the codification type being Tree Nodes. Results: The qualitative data provided necessary approximations to improve the content and design of the tool and showed that it reflects the reality of children and allows them to identify frequent fears and questions regarding to chronic health condition of HIV. Conclusions: These results provide important information to be considered in the process of diagnosis revelation and its management by health personnel.

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          The perceived impact of disclosure of pediatric HIV status on pediatric antiretroviral therapy adherence, child well-being, and social relationships in a resource-limited setting.

          In resource-limited settings, beliefs about disclosing a child's HIV status and the subsequent impacts of disclosure have not been well studied. We sought to describe how parents and guardians of HIV-infected children view the impact of disclosing a child's HIV status, particularly for children's antiretroviral therapy (ART) adherence. A qualitative study was conducted using involving focus groups and interviews with parents and guardians of HIV-infected children receiving ART in western Kenya. Interviews covered multiple aspects of the experience of having children take medicines. Transcribed interview dialogues were coded for analysis. Data were collected from 120 parents and guardians caring for children 0–14 years (mean 6.8 years, standard deviation [SD] 6.4); 118 of 120 had not told the children they had HIV. Children's caregivers (parents and guardians) described their views on disclosure to children and to others, including how this information-sharing impacted pediatric ART adherence, children's well-being, and their social relationships. Caregivers believed that disclosure might have benefits such as improved ART adherence, especially for older children, and better engagement of a helping social network. They also feared, however, that disclosure might have both negative psychological effects for children and negative social effects for their families, including discrimination. In western Kenya, caregivers' views on the risks and benefits to disclosing children's HIV status emerged a key theme related to a family's experience with HIV medications, even for families who had not disclosed the child's status. Assessing caregivers' views of disclosure is important to understanding and monitoring pediatric ART.
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            Metodología de la Investigación

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              Patterns of disclosure of HIV status to infected children in a Sub-Saharan African setting.

              Adult caregivers provide children living with HIV with varying amounts and types of information about their health status that may affect their coping and health care behaviors. We aimed to describe patterns of information sharing with children and thoughts around disclosure among caregivers in the Democratic Republic of the Congo. A total of 259 primary caregivers of children aged 5 to 17 years in an HIV pediatric care and treatment program were screened; 8 adult caregivers (3%) had informed their child of the child's HIV status. We conducted structured interviews with 201 caregivers whose children had not yet been told their HIV status. Nearly 50% of caregivers had provided no information to their child about their health; 15% had given partial information without mentioning HIV, and 33% provided information that deflected attention from HIV, whether deliberately so or otherwise. Almost all caregivers said that the child should be told their status some day, and three-fourths reported having ever thought about what might lead them to tell. However, nearly one-third of caregivers saw no benefits to informing the child of her/his HIV status. A majority of caregivers felt that they themselves were the best to eventually disclose to the child but some wanted support from health care providers. HIV-infected children are given limited information about their health. Health care providers may serve as important sources of support to caregivers as they decide when and how to talk candidly with their children about their health.
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                Author and article information

                Journal
                rci
                Revista chilena de infectología
                Rev. chil. infectol.
                Sociedad Chilena de Infectología (Santiago, , Chile )
                0716-1018
                August 2021
                : 38
                : 4
                : 540-547
                Affiliations
                [2] Barranquilla Atlántico orgnameUniversidad del Norte orgdiv1Departamento de psicología Colombia
                [1] Barranquilla Atlántico orgnameUniversidad Simón Bolívar orgdiv1Facultad de Ciencias Jurídicas y Sociales Colombia
                [3] Barranquilla Atlántico orgnameUniversidad Simón Bolívar orgdiv1Facultad de Ciencias Jurídicas y Sociales Colombia
                Article
                S0716-10182021000400540 S0716-1018(21)03800400540
                823f9c04-15cb-4256-8797-6c640fc0f8e1

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 06 July 2021
                : 28 April 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 8
                Product

                SciELO Chile

                Categories
                ARTICULOS ORIGINALES

                HIV,psicoeducaciæn,revelación de diagnóstico,niños,diagnóstico,VIH,psychoeducation,disclosure,children,diagnosis

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