This assignment will focus on the psychological, sociological, and physiological impact of the Human Immunodeficiency Virus (HIV) on women during pregnancy, birth and early infancy. Therefore, this report will identify and describe five pieces of evidence-based information that is important for HIV infected women during pregnancy and what to expect after the birth of their baby.
The most apparent choice was to access the universities library resources to find evidence-based journals specifically relating to the topic. Additionally, the group used search engines which took them to a few patient information websites. This gave them some background knowledge on the subject and gave them a more specific idea to direct the searches to their chosen research areas. The search terms used were; ‘HIV in pregnant women and the psychological impact and support’, ‘HIV in pregnant women, emotional and sociological support’ and ‘HIV in pregnant women, physiological impact of what to expect and birth options’.
There is now evidence to show that there is no significant difference in the risk of transmission of HIV from mother to baby during a vaginal delivery compared to a caesarean section, so long as the woman has been taking Antiretroviral Therapy (ART) and their viral load is virtually undetectable before birth. ART has reduced the risk of transmission to below 0.5% in the UK (Hamlyn et al 2018).
Neonates carry maternal antibodies for the first few months of their life, assisting their immune system in this early stage (Edwards, 2015). All infants born to mothers with the HIV virus have the maternal HIV antibodies in their blood until all maternal antibodies are lost. They will test positive for HIV for the first few months of life (D’Auria et al, 2006), meaning they must be tested monthly to check their status. Psychological and social issues may arise due to the child’s unclear HIV status.
HIV positive pregnant women who have emotional support, such as mother mentor peer relationships, are more knowledgeable on how to avoid mother – infant transmission (McLeish et al, 2016). Anxiety of the stigma attached to being HIV positive often made mothers feel quite isolated (Flowers et al, 2006), however, when supported by “UK Positively Mother Mentor’ network, felt acceptance and hope for the future (Anderson et al, 2004). Unfortunately, not all mothers are fully accepted.
The risk of domestic violence towards women postnatally by their partners increases significantly if they are found to be HIV positive during their pregnancy. It is important for the mother to seek help from care professionals if they are suffering from intimate partner violence, as it can have drastic effects on their compliancy of antiretroviral medications (Groves et al, 2017). This can negatively affect the health of the neonate if the mother becomes too unwell to provide substantial care.
Treatment for pregnant mothers with HIV involves monitoring and antiretroviral medication. The monitoring is for viral levels in the blood and the lymphocyte levels in the body. There are six types of medication used, fusion inhibitors, CCR5 antagonists, integrase inhibitors, protease inhibitors, nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors. Three or four are normally used to successfully control the virus.
The group decided to not allocate a leader, resulting in all decisions being made together and providing all members the ability to contribute equally to the given assignment. This equal voice led to minor conflicts on how the group should structure the assignment, however theorists have found that conflicts in decision making results in an improved quality of a product (Amason, 1996) due to the increased conversation and research in the specific area.
Roles were allocated to group members at the first session for team members to immediately be aware of their responsibilities. This was done by allocating each of the five research topics to different members, with the remaining member being primarily in charge of editing. This organisation led to research being produced more efficiently as it eliminated the possibility of multiple members researching intensely on the same subject. As there was no team leader, roles were decided by members stating what areas they believed they would be best suited to investigate; this then ensured the best possible outcome for the research information. Role allocation has been found to be a necessary step in team management and its presence is vital in ensuring structure and in hand allowing the best possible outcome a team can attain (Humphrey et al, 2009).
The group had some difficulties during the assignment, one of them resulting in a miscommunication. This miscommunication meant that they had completed research on the wrong area, therefore preventing more efficient roles being allocated. However, this was picked up on quickly and corrected. The research they had done was provided to the member of the team who had researched the same area, to aid them in what they were putting together. In this case, the miscommunication was not a major setback as it was identified promptly and as a result, more emphasis was put on clarifying that everyone understood their set tasks for future meetings. This miscommunication differs to what the Roper model states. In the model it is said that the receiver should understand the message without fault rather than gain a different understanding to the sender (Roper et al, 1990). In the future the group could learn from this mistake to ensure they check that everyone would have had the same information and understanding to achieve what the Roper model states.
Another challenge that was faced was that since all members of the group are studying healthcare professions, everyone was due to go out on practice placements. Therefore, the group needed better time management for them to achieve the end goal. The Eisenhower model (Eisenhower, no date) states that what should have occurred first was focusing on important tasks and then scheduling the less urgent tasks to do at a later date, in other words to prioritise. The group did this by immediately working on part A before focusing on part B. The third part of the model states that other responsibilities that are important, but not urgent, were to be delegated. The group showed this by making one member in the group the role of editor. Whilst editing was an urgent task that needed to be done, it didn’t need to be done straight away. The final part of the model states; don’t do tasks that are neither important nor necessary (see appendix 1 for the image of the Eisenhower matrix). Unlike the model, the group did not make any decisions that were deemed unnecessary. This led to the team working effectively and in a timely manner to achieve their own personal deadlines. It could be argued that the groups desire to complete the task so quickly and to avoid any critical conflict was due to the environment, an early university task with people eager to be seen as good team workers and not wanting to criticise or be criticised in front of the group.
The group showed immense team working skills throughout the assignment; this was shown by how significantly each member contributed. Therefore, they were able produce large sums of research and written work both at team meetings, and in their own time between the arranged meetings (see appendix 2). The Tuckman model states that during the process of effective team-working there are several stages which are followed: forming, storming, norming and performing. The group worked well with this model to achieve their mutual end goal. In the forming stage, the model states that there is often a wide difference of opinion on certain subjects which was shown within the group at the beginning of the project when a small conflict arose regarding the structure of the assignment. The storming stage of the model states that tensions can arise due to possible power struggles between members. It states that interactions between members will in time become clearer and the end plan put in place may just be set to please certain members. The group was fortunate to not experience such a power struggles; all member’s points were valued and discussed in depth and work set among members was distributed more effectively. The group’s time-saving approach to the storming phase meant they could move onto the third stage (norming) swiftly. The norming phase is when all members of the team are completely aware of what everyone’s tasks are and are content with their given task – this is the stage in group work where maximum output is being produced (Tuckman, 1965).
The team was able to recognise which aspects of this project they wished to carry forwards into future projects and circumstances. They have found that time management is a key aspect to be implemented in future tasks. This would be achieved in future tasks by devising a plan of how to proceed with each meeting prior to the event. Consequently, the team would become more efficient and create effective communication, ergo keeping the project harmonious throughout.