Table 1.
Summary of objectives and structure of ACCA* intervention
| Session 1 | Session 2 e 3 | Session 4 | |
|---|---|---|---|
| Objectives | Contract; | Increase knowledge about treatment; | Deeper understanding of feasible and desired changes in context and personal conduct aiming at self-care and enhancement of patient-clinic quality of communication and care; |
| Identify situations ant context of daily life that are obstacles for treatment; | Understand and decodify real life scenes; | Identify resources to pursue and sustain chosen paths to face difficulties with ARV treatment; | |
| Organize priority issues and decide on themes to be part of next conversations; | Amplify daily scene to bigger programmatic and social context; | Close the process. | |
| Clarify most technical question about treatment. | Foster creative and active imagination about daily life | ||
| Foster new personal repertoires to face identified obstacles to treatment. | |||
| Themes | Mutual recognition of patient as experts on daily life and professionals-researchers as technical experts; | Questions about treatment; | Questions about treatment; |
| The overview of patients’ social and inter-subjective context; | Real episodes where treatment is not followed; | Reviewing paths, solutions and repertoires; | |
| Question about treatment. | Paths to face obstacle and “in scene” solutions. | Talking about how to face future obstacle and difficulties and sustain changes; | |
| Final clarification and orientation on the research process. | |||
| Methodology | Talking about the procedure, aim and contract; | Reviewing contract and questions; | Reviewing contract and questions; |
| Free conversation and careful listening about the person’s life | Looking at typical episodes of non-adherence | Taking and exploring scene from real episodes; | |
| Focus questions about treatment and on situations and episodes where following treatment is difficult; | The participant chosen their priority from list of problems; | Decoding the scenes, and through active imagination and role-playing reinvent them; | |
| Use of informative resources(folders, guidelines, adherence kits); | Taking and exploring scenes from real episodes; | Inform on social and programmatic resources, as well as constitutional rights | |
| Records specific situations and episodes that seem to be more important to cope on recording sheets | Decoding the scenes, and through active imagination and role-playing reinvent them; |
Constitutional rights; Recording decisions and plans for the future on recording sheets. |
|
| Talking about obstacle that are beyond individual action, and shared by other PLHIV; | |||
| Discussing individual and programmatic resources; | |||
| Professional and participant record and organizing a hierarchy of scenes and situations on recording sheet |
* ACCA is the acronym for “Abordagem Construcionista do Cuidado em Adesã”(Constructionist Care Approach to Adherence)