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Levels of resilience and delivery of HIV care in response to urban violence and crime.

Abstract：

AIMS:To understand the impact of urban violence and crime on HIV care delivery. BACKGROUND:Urban violence and crime can put pressure on the healthcare system and on nursing staff. Whilst there is research about the impact this has at the individual level, there is less research that places this in the context of the overall social eco-system. DESIGN:A qualitative design using inductive thematic analysis. METHODS:Between July 2016 - February 2017, we conducted in-depth interviews with 10 nurses working in two neighbourhoods with high levels of violence in Cape Town, South Africa. RESULTS:The effects of crime and violence were evident at multiple levels resulting in participants feeling "safe and unsafe" in a context where people view crime as endemic. Resilience emerged as a key concept in the findings. Resilience was apparent at individual, community, and organizational levels and enabled continued delivery of HIV care. CONCLUSION:The findings demonstrate the potential role of resilience in the social eco-health system required to sustain delivery of HIV care in the midst of urban violence and gangsterism. IMPACT:This study examined the impact of and response to urban violence on HIV care delivery. The findings indicate that resilience manifests at all levels of the social eco-system. Understanding the mechanisms employed to cope with endemic violence helps to address these challenges in the study setting, but also has a much wider application to other areas with endemic urban violence and crime. :目的: 了解城市暴力和犯罪对艾滋病毒护理服务的影响。背景: 城市暴力和犯罪会给医疗保健制度和护理人员带来压力。虽然有关于这在个人层面上的影响研究,但很少有研究将这放在整个社会生态系统的背景下。设计: 使用归纳型主题性分析的定性设计。方法: 2016年7月至2017年2月期间,我们对在南非开普敦两个暴力高发区工作的10名护士进行了深度访谈。结果: 犯罪和暴力的影响在多个层面都很明显,导致参与者在人们视犯罪为地方病的背景下感到“安全和不安全”。复原力成为调查结果中的一个关键概念。复原力在个人、社区和组织层面是显而易见的,并且能够持续提供艾滋病毒护理。结论: 调查结果表明,在城市暴力和强盗主义的情况下,复原力在维持艾滋病毒护理服务所需的社会生态卫生系统中具有潜在作用。影响: 本研究调查了城市暴力对艾滋病毒保健服务的影响和应对措施。研究结果表明,复原力体现于社会生态系统的各个层面。了解应对地方性暴力所采用的机制不仅有助于在研究背景下应对这些挑战,而且可更广泛地将其应用于其他地方性城市暴力和犯罪地区。.

journal_name

J Adv Nurs

journal_title

Journal of advanced nursing

authors

Cooper D,Green G,Tembo D,Christie S

doi

10.1111/jan.14022

subject

Has Abstract

pub_date

2019-08-01 00:00:00

pages

1723-1731

issue

eissn

0309-2402

issn

1365-2648

journal_volume

pub_type

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Levels of resilience and delivery of HIV care in response to urban violence and crime.