Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 7:13:26335565231168041.
doi: 10.1177/26335565231168041. eCollection 2023 Jan-Dec.

Using qualitative study designs to understand treatment burden and capacity for self-care among patients with HIV/NCD multimorbidity in South Africa: A methods paper

Myrna van Pinxteren  1 , Nonzuzo Mbokazi  1 , Katherine Murphy  1 , Frances S Mair  2 , Carl May  3 , Naomi S Levitt  1
Affiliations

Using qualitative study designs to understand treatment burden and capacity for self-care among patients with HIV/NCD multimorbidity in South Africa: A methods paper

Myrna van Pinxteren et al. J Multimorb Comorb. .

Abstract

Background: Low- and middle-income countries (LMICs), including South Africa, are currently experiencing multiple epidemics: HIV and the rising burden of non-communicable diseases (NCDs), leading to different patterns of multimorbidity (the occurrence of two or more chronic conditions) than experienced in high income settings. These adversely affect health outcomes, increase patients' perceived burden of treatment, and impact the workload of self-management. This paper outlines the methods used in a qualitative study exploring burden of treatment among people living with HIV/NCD multimorbidity in South Africa.

Methods: We undertook a comparative qualitative study to examine the interaction between individuals' treatment burden (self-management workload) and their capacity to take on this workload, using the dual lenses of Burden of Treatment Theory (BoTT) and Cumulative Complexity Model (CuCoM) to aid conceptualisation of the data. We interviewed 30 people with multimorbidity and 16 carers in rural Eastern Cape and urban Cape Town between February-April 2021. Data was analysed through framework analysis.

Findings: This paper discusses the methodological procedures considered when conducting qualitative research among people with multimorbidity in low-income settings in South Africa. We highlight the decisions made when developing the research design, recruiting participants, and selecting field-sites. We also explore data analysis processes and reflect on the positionality of the research project and researchers.

Conclusion: This paper illustrates the decision-making processes conducting this qualitative research and may be helpful in informing future research aiming to qualitatively investigate treatment burden among patients in LMICs.

Keywords: Qualitative research methods; low-middle income context; multimorbidity; treatment burden.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Gugulethu, urban field-site for the EXTRA project.
Figure 2.
Figure 2.
Bulungula, rural field-site for the EXTRA project.
Figure 3.
Figure 3.
Patient experiences of treatment burden analysis of themes.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Oni T, Youngblood E, Boulle A, et al.Patterns of HIV, TB, and non-communicable disease multi-morbidity in peri-urban South Africa-a cross sectional study. BMC infectious diseases 2015; 15: 1–8. - PMC - PubMed
    1. Levitt NS, Steyn K, Dave J, et al.Chronic noncommunicable diseases and HIV-AIDS on a collision course: relevance for health care delivery, particularly in low-resource settings—insights from South Africa. The American journal of clinical nutrition 2011; 94: 1690S–1696S. - PMC - PubMed
    1. Godongwana M, Billings NDW, Milovanovic M. The Comorbidity of HIV, Hypertension and Diabetes: A Qualitative Study Exploring the Challenges Faced by Healthcare Providers and Patients in Selected Urban and Rural Health Facilities where the ICDM Model is Implemented in South Africa. 2020. - PMC - PubMed
    1. Mayosi BM, Flisher AJ, Lalloo UG, et al.The burden of non-communicable diseases in South Africa. The lancet 2009; 374: 934–947. - PubMed
    1. George S, McGrath N, Oni T. The association between a detectable HIV viral load and non-communicable diseases comorbidity in HIV positive adults on antiretroviral therapy in Western Cape, South Africa. BMC infectious diseases 2019; 19: 348. DOI: 10.1186/s12879-019-3956-9 - DOI - PMC - PubMed

LinkOut - more resources