Table 4.
Providers' and Family Members' Perceptions of Use of Mobile Phones for Antiretroviral Treatment (ART) Adherence and Health Promotion
| Theme | Representative quote |
|---|---|
| Perceived need for support for mental health promotion | “They [HIV-positive women] will be highly depressed. They think too much like who will look after me? Who will take care about my health? Then they think about their children's future, and how the society will look at them when they come to know that they have HIV. They also will have the worry to face husband and parents. All these thoughts push them to severe depression.” HCP_2 |
| “We have come across with one or two cases got admitted in inpatient department. They will be diagnosed and getting treated by the Psychiatrist. We will provide antidepressant tablets along with ART. Support is very important here. The family members may not be knowing that they are taking tablets and it is difficult to tell all. We treat them as their family members because they will not inform anybody that they are taking tablets.” HCP_8 | |
| Support for mobile phone counseling | “I have mobile. But she will not be with us always. At times for a change she will go and stay at my sister's home for more than one week. I also will go to work and will be back in home late night. So, if you call me during day time I won't be able to give your call. She would like to talk to you.” FM_1 |
| “We are happy to receive call from the nurse. … She has a mobile phone which is personal. It will be switched on always. There is no problem in providing a phone to her for making and receiving calls from the nurse.” FM_3 | |
| Perception of additional burden on nurses by increase in the number of unnecessary calls | “Once rapport is built, they will call you whenever is convenient for them or else call them according to their convenience. Being girls/ladies if you give your numbers to them, they might trouble you by calling very often. I had experienced it already and changed my SIM twice. Whether it is 11 or 12 in the night, they call me and tell they are having vomiting or fever. For small reasons they will get anxious and call us.” HCP_6 |
| “The call from a nurse will definitely help them. Our nurses don't have time. They will be comfortable talking to the nurse and it won't affect their personal life. They should make time to talk to you. It is better let the patient make call whenever they are free and have any problem.” HCP_10 | |
| Providers' suggestion to get the family's support first | “The mobile based intervention counseling is helpful if the condition at the home is good. If the family is not supportive and phone call comes to them there will definitely have problem arise. And the timing of call, family criteria and family response must be considered. We have to take all those in to consideration and then we have to proceed. … We should know when she will be free and when she can talk and whether there any chance to emerge new problem, etc. should assess first and then make call. Initially we can make a call once in three days or weekly once. As the days goes on we can call twice in a month or weekly once. If you start twice in a week, then you can switch to weekly once. Gradually we can reduce the frequency and by the time we can understand whether they got adjusted or not. According to the needs of each one we can plan.” HCP_7 |
| “Around 70% of them might talk over the phone about their issues if you call them according to their convenience … They will be available at their homes after 5pm. While calling them you need get their consent. If they agree you can call them around 5 times in a month.” HCP_9 | |
| Reservations in relation to whether women would like to receive phone counseling | “Females may have restriction to speak on mobile. Most of the people from our side will not be provided with a mobile. Some may have suspiciousness if they give mobile. Educated people may provide phone. If you convince their family they may speak. You can call them in the afternoon or in the evening. It will be good if you call one or two times in a week because they will be coming to take medicines. If you call them again and again they will feel bad.” HCP_8 |
| “Receiving such calls will be a problem for some women. It may create hindrance when they are with relatives or neighbors or else they are in any function.” FM_11 | |
| Suggestions for who can initiate the call, appropriate time to call, and how to maintain confidentiality | “We can call them once or twice in a week but it is advisable to talk when they call. When you call it may not be the right time to speak or some of the family members will be with her so she cannot discuss her problems and she may find it difficult to do so. So I feel you should talk to her when she calls instead of staff nurse calling them.” HCP_3 |
| “I think it will be good if you can make call to her. She will be comfortable sharing her health issues to the nurse over phone. She will be able to talk to the nurse in the afternoon. She will be free from all the works in the afternoon. It will be good if you make calls twice in a week and to let her call to the nurse whenever she is in need. Both the nurse call to her regularly and let her call to the nurse will be better option. So, whenever she wants to share anything she can call and the nurse also can check her condition in between. She has mobile phone. There are chances to have some problems at home when you call, so better you discuss with her and fix a time.” FM_5 |
ART, antiretroviral treatment; FM, family; HCP, healthcare provider.