JMIR Publications

ABSTRACT

South Africa (SA) has the largest HIV epidemic in the world; in KwaZulu-Natal (KZN) Province, over 40.8% of adults over 15 are living with HIV. Despite this, SA is home to only 3% of the world’s healthcare workers. Nurses constitute the largest group of providers in SA and experience high levels of burnout, which can contribute to negative patient outcomes for persons living with HIV (PWH), including reduced treatment adherence. Patient-provider relationships are the gateway to engagement and retention in HIV care yet relationships can be compromised in overburdened nurses. Nurse-centered interventions that offset these effects are urgently needed. The purpose of this study is to pilot an adapted resiliency-based mind-body intervention (the Relaxation Response Resiliency Program; the 3RP) for nurses that provide care for PWH in the public sector in SA. In Phase 1 [NIH Grant Number: R34MH131426; HREC Ethics Reference Number: 220813], we conducted focus group discussions to solicit feedback on: the role of culture and perceptions of stress; the lived experiences of stress; sources of stress (e.g., occupational, trauma-related); how stress impacts job functioning (specifically patient care); current coping strategies; and the proposed intervention modules (content, number of sessions, session duration, program length, use of coaches, mode of delivery (e.g., virtual, in-person, hybrid approaches), etc.). In this Phase 2, we will conduct a small proof-of-concept study (N = 8-10), followed by a randomized pilot (N = 60), of nurses that care for PWH in the public sector in SA to test the feasibility and acceptability of the adapted intervention.