title: Using an innovative mixed method methodology to investigate the appropriateness of a quantitative instrument in an African context: Antiretroviral treatment and quality of life.
abstract: The relationship between quality of life (QoL) and antiretroviral treatment (ART) has mainly been studied using quantitative scales often not appropriate for use in other contexts and without taking peoples' lived experiences into consideration. Sub-Saharan Africa has the highest incidence of HIV and AIDS yet there is paucity in research done on QoL. This research report is intended to give an account of the use of a mixed method convergent parallel design as a novice approach to evaluate an instrument's context specificity, appropriateness and usefulness in another context for which it was designed. Data were collected through a qualitative exploration of the experiences of QoL of people living with HIV or AIDS (PLHA) in Africa since being on ART, as well as the quantitative measurements obtained from the HIV/AIDS-targeted quality of life (HAT-QoL) instrument. This study was conducted in three African countries. Permission and ethical approval to conduct the study were obtained. Purposive voluntary sampling was used to recruit PLHA through mediators working in community-based HIV/AIDS organisations and health clinics. Interviews were analysed through open coding and the quantitative data through descriptive statistics and the Cronbach's alpha coefficient. A much wider range and richness of experiences were expressed than measured by the HAT-QoL instrument. Although an effective instrument for use in the USA, it was found not to be sensitive, appropriate and useful in an African context in its present form. The recommendations focus on adapting the instrument using the data from the in-depth interviews or to develop a context-sensitive instrument that could measure QoL of PLHA in Africa.
authors.affiliation: a African Unit for Transdisciplinary Health Research , North-West University Potchefstroom Campus , South Africa.
authors.forename: Minrie
authors.initials: M
authors.lastname: Greeff
authors.forename: Lignet M
authors.initials: LM
authors.lastname: Chepuka
authors.forename: Winnie
authors.initials: W
authors.lastname: Chilemba
authors.forename: Angela F
authors.initials: AF
authors.lastname: Chimwaza
authors.forename: Lucy I
authors.initials: LI
authors.lastname: Kululanga
authors.forename: Mabedi
authors.initials: M
authors.lastname: Kgositau
authors.forename: Eva
authors.initials: E
authors.lastname: Manyedi
authors.forename: Sheila
authors.initials: S
authors.lastname: Shaibu
authors.forename: Susan C D
authors.initials: SC
authors.lastname: Wright
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001902:Botswana; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D008295:Malawi; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012107:Research Design / Q000592:standards*; D012959:Socioeconomic Factors; D013019:South Africa; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D019380:Anti-HIV Agents
keywords: Africa; HIV and AIDS; antiretroviral treatment; mixed methods; nursing; quality of life