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Sample records for nurses providing hiv

  1. Nurses' knowledge and skills in providing mental health care to people living with HIV/AIDS in Malawi.

    Science.gov (United States)

    Chorwe-Sungani, G

    2013-09-01

    Nurses are the majority of health-care professionals who frequently come in contact with people living with HIV/AIDS (PLWHA). However, most health workers such as nurses lack competence and confidence in dealing with the mental health problems (MHPs) of their clients in Malawi. The study aimed at exploring nurses' levels of knowledge and skills in providing mental health care to PLWHA. The study used a descriptive quantitative survey design. Ethical approval and permission were granted by relevant authorities to conduct the study. A convenient sample of 109 nurses was used. They gave written consent and completed self-administered questionnaires. Descriptive statistics namely: means, frequencies and percentages were used to analyse data. The findings suggest that nurses who care for PLWHA lack knowledge and skills to deal with MHPs of these people. Many participants (53.2%, n = 58) lacked knowledge and skills to care for PLWHA who have MHPs. Nurses are potentially essential human resource for dealing with MHPs of PLWHA in Malawi. Unfortunately, some nurses lack the necessary knowledge and skills to deal with MHPs. Nurses must be equipped with adequate knowledge and skills so that they are able to deal with MHPs of PLWHA.

  2. Nursing Care of HIV-Positive Women

    DEFF Research Database (Denmark)

    Nielsen, Ben; Martinsen, Bente

    2015-01-01

    to improve quality of life after being diagnosed with HIV, a sharp distinction between HIV and AIDS and a religious and spiritually coping. Identifying the emotional challenges women living with HIV face in their daily lives may help nurses obtain a clearer understanding and greater knowledge of how...... to provide HIV-positive women with effective care that empower and support these women in managing their chronic disease. However to ensure that nurses have the proper tools for effective care for women living with HIV European studies are essentials in relation to what emotional challenges these women...

  3. Ethnographic experiences of HIV-positive nurses in managing ...

    African Journals Online (AJOL)

    An ethnographic study with HIV-positive nurses was conducted from August 2005 to ... This process provided the nurses with a solid foundation for developing ... perceived stigma, psychosocial support, qualitative research, sub-Saharan Africa

  4. The Nursing Research Center on HIV/AIDS Health Disparities.

    Science.gov (United States)

    Holzemer, William L; Méndez, Marta Rivero; Portillo, Carmen; Padilla, Geraldine; Cuca, Yvette; Vargas-Molina, Ricardo L

    2004-01-01

    This report describes the partnership between the schools of nursing at the University of California San Francisco and the University of Puerto Rico to address the need for nursing research on HIV/AIDS health disparities. The partnership led to the creation of the Nursing Research Center on HIV/AIDS Health Disparities with funding from the National Institutes of Health/National Institute of Nursing Research. We provide background information on the disproportionate impact of the HIV/AIDS epidemic on racial and ethnic minorities, describe the major predictors of health disparities in persons at risk for or diagnosed with HIV/AIDS using the Outcomes Model for Health Care Research, and outline the major components of the Nursing Research Center. The center's goal is to improve health outcomes for people living with and affected by HIV/AIDS by enhancing the knowledge base for HIV/AIDS care.

  5. Attitudes and knowledge of nurses regarding HIV+/AIDS patients

    Directory of Open Access Journals (Sweden)

    Angeles Merino Godoy

    2004-06-01

    Full Text Available Objective: To know attitudes and knowledge of nursing personnel regarding HIV/AIDS patients in the Hospital General de Huelva. Methods: Descriptive cross-sectional study. Sample: Nursing staff of the Hospital General de Huelva (Registered nurses and Nursing auxiliar personnel randomised selected (N=980, n=88. Selected subjects were asked to answer a validated questionnaire including questions about personal and professional characteristics, attitudes about HIV+/AIDS patients and knowledge about HIV infection. Additionally, 8 interviews were performed to Nursing staff who suffered occupational accidents with HIV contaminated fluids. Another 8 interviews were performed to HIV+/AIDS patients about the nurses attitudes when working with them. Results: Participating subjects were worried about the risk of infection. A low rate of knowledge about HIV infection was observed. Conclusion: A modification of some attitudes of Nursing staff is mandatory as well as an improvement of specific knowledge about HIV infection and measures to avoid the infection in a professional setting. Strategies to improve nurses abilities when working with HIV+/AIDS patients should be provided.

  6. The role of HIV nursing consultants in the care of HIV-infected patients in Dutch hospital outpatient clinics

    NARCIS (Netherlands)

    Vervoort, Sigrid C. J. M.; Dijkstra, Boukje M.; Hazelzet, Esther E. B.; Grypdonck, Mieke H. F.; Hoepelman, Andy I. M.; Borleffs, Jan C. C.

    2010-01-01

    Objective: In the Netherlands HIV nursing consultants have participated in HIV-care since 1985: their profession has changed with developments in HIV-treatment over time. The study goal was to gather information about their role in HIV-care and to provide an useful example to other (HIV-)care settin

  7. The role of HIV nursing consultants in the care of HIV-infected patients in Dutch hospital outpatient clinics

    NARCIS (Netherlands)

    Vervoort, Sigrid C. J. M.; Dijkstra, Boukje M.; Hazelzet, Esther E. B.; Grypdonck, Mieke H. F.; Hoepelman, Andy I. M.; Borleffs, Jan C. C.

    2010-01-01

    Objective: In the Netherlands HIV nursing consultants have participated in HIV-care since 1985: their profession has changed with developments in HIV-treatment over time. The study goal was to gather information about their role in HIV-care and to provide an useful example to other (HIV-)care settin

  8. Medicare Provider Payment Data - Skilled Nursing Facilities

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Skilled Nursing Facility Utilization and Payment Public Use File (Skilled Nursing Facility PUF) provides information on services provided to Medicare...

  9. [Nursing students' perceptions on HIV serodiscordant partnerships].

    Science.gov (United States)

    Fernandes, Hugo; Horta, Ana Lúcia de Moraes

    2005-01-01

    This qualitative research aimed to identify undergraduate nursing students' perceptions on mixed-HIV-status couples. Social Representation Theory was used to get to know how the students feel, think and act towards HIV/aids serodiscordance. Six fourth-year nursing students were interviewed. Participants were between 20 and 26 years old. The "Projective Thematic Drawing" and a structure interview were used for data collection. Data were analyzed by means of "Thematic Content Analysis". The obtained data revealed the students' perceptions on serodiscordant couples. This study triggered future reflections/discussions on health education for mixed-HIV-status couples and nursing care.

  10. HIV stigma and nurse job satisfaction in five African countries.

    Science.gov (United States)

    Chirwa, Maureen L; Greeff, Minrie; Kohi, Thecla W; Naidoo, Joanne R; Makoae, Lucy N; Dlamini, Priscilla S; Kaszubski, Christopher; Cuca, Yvette P; Uys, Leana R; Holzemer, William L

    2009-01-01

    This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The Personal Satisfaction subscale was the highest in this sample, as in the other 2. Job satisfaction scores differed significantly among the 5 countries, and these differences were consistent across all subscales. A hierarchical regression showed that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influence on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These results provide new areas for intervention strategies that might enhance the work environment for nurses in these countries.

  11. HIV Stigma and Nurse Job Satisfaction in Five African Counties

    Science.gov (United States)

    Chirwa, Maureen L.; Greeff, Minrie; Kohi, Thecla W.; Naidoo, Joanne R.; Makoae, Lucy N.; Dlamini, Priscilla S.; Kaszubski, Christopher; Cuca, Yvette P.; Uys, Leana R.; Holzemer, William L.

    2009-01-01

    This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The subscale, Personal Satisfaction, was the highest in this sample as in the other 2. Job Satisfaction scores differed significantly among the 5 countries and these differences were consistent across all subscales. A hierarchical regression demonstrated that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influences on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These findings provide new areas for intervention strategies that might enhance the work environment for nurses in these countries. PMID:19118767

  12. International nurse education: implications for providers.

    Science.gov (United States)

    Cecchin, M

    1998-12-01

    This exploratory study conducted in 1996 described the profiles, roles and preparation of twelve South Australian registered nurses in relation to their provision of education programs for nurses from South East Asia. The research showed respondents were well qualified and highly experienced educators whose roles were complex. Their preparation for providing education programs for nurse from South East Asia had been haphazard and inadequate. Consequently respondents considered they were not fully prepared for the providing this specialised education. Career planning and a more strategic approach to the development of specific expertise are essential to support an international approach to nurse education. Nurse education that values intercultural awareness, and is multicultural and global would benefit both local and international students. Development of germane knowledge, skill, attitudes and behaviours is recommended to ensure excellence in the provision of international nurse education. An action research model is proposed as an alternative to traditional professional development to prepare providers of international education.

  13. Multicultural Nursing: Providing Better Employee Care.

    Science.gov (United States)

    Rittle, Chad

    2015-12-01

    Living in an increasingly multicultural society, nurses are regularly required to care for employees from a variety of cultural backgrounds. An awareness of cultural differences focuses occupational health nurses on those differences and results in better employee care. This article explores the concept of culturally competent employee care, some of the non-verbal communication cues among cultural groups, models associated with completing a cultural assessment, and how health disparities in the workplace can affect delivery of employee care. Self-evaluation of the occupational health nurse for personal preferences and biases is also discussed. Development of cultural competency is a process, and occupational health nurses must develop these skills. By developing cultural competence, occupational health nurses can conduct complete cultural assessments, facilitate better communication with employees from a variety of cultural backgrounds, and improve employee health and compliance with care regimens. Tips and guidelines for facilitating communication between occupational health nurses and employees are also provided.

  14. Nursing accounting competencies related to HIV in a Papua New Guinea context.

    Science.gov (United States)

    Brown, Alistair M

    2013-01-01

    Nursing administration is an important part of the campaign to eliminate HIV across Papua New Guinea (PNG). This paper considers the critical importance of developing nursing leadership in effective accounting competencies in relation to HIV projects in PNG. The results of the study's textual analysis of audit reports of the Auditor General of PNG revealed a failure on the part of PNG's main health agencies involved with its national HIV program to provide competent financial reporting. In light of these results, this study shows how improving accounting and other financial competencies among nursing leaders would benefit the implementation of the PNG HIV national strategy. The findings of this study have implications not only for the internal control of HIV nursing competencies but also for nursing leadership related to HIV issues in a developing-country context.

  15. Nurses' knowledge, attitudes about HIV, AIDS. A replication study.

    Science.gov (United States)

    Reeder, J M; Hamblet, J L; Killen, A R; King, C A; Uruburu, A

    1994-02-01

    The AIDS epidemic is now in its second decade and shows no sign of relenting. Unfortunately, however, the AORN study shows that perioperative nurses' knowledge regarding HIV and AIDS is not adequate to enable them to provide patient care while maintaining safe practices. Focused educational programs should be made available to perioperative nurses to help them apply universal precautions and OSHA standards to everyday practice. Perioperative nurses must become knowledgeable about the disease and sensitive to the needs of patients who have this illness. All nurses have a special obligation to care for all patients; education and management strategies that enable exploration of values, fears, and prejudices will help nurses understand their own beliefs and those of other individuals. Recommendations from this study may be viewed as a starting point for this perioperative education.

  16. Perception of the nursing team on pregnancy concerning infection caused by HIV

    Directory of Open Access Journals (Sweden)

    Marcela Araújo Galdino Caldas

    2016-04-01

    Full Text Available Objective: to identify the perception of the nursing team concerning pregnancy in the presence of HIV. Methods: this is a qualitative study made in a reference hospital. For data collection individual interviews were conducted and recorded with 15 nurses who provide care to women during their puerperal and/or pregnancy process. The data were described according to thematic analysis. Results: gestation in the presence of HIV is perceived as irresponsibility, misinformation, and concern with the risks of vertical transmission. The divergent statements of the nursing team point to the lack of understanding of pregnancy in terms of the needs and desires of people living with HIV which may favor an improper procedure and nursing assistance limited to the behavior and technical nursing care in order to reduce vertical transmission of HIV. Conclusion: it is necessary that in the education of health, in the several levels of nursing include matters concerning the gender, sexual and reproductive rights.

  17. Measuring HIV stigma for PLHAs and nurses over time in five African countries.

    Science.gov (United States)

    Holzemer, William L; Makoae, Lucy N; Greeff, Minrie; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Durrheim, Kevin; Cuca, Yvette; Uys, Yvette R

    2009-09-01

    The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association.

  18. Understanding HIV-related stigma among Indonesian nurses.

    Science.gov (United States)

    Waluyo, Agung; Culbert, Gabriel J; Levy, Judith; Norr, Kathleen F

    2015-01-01

    Evidence indicates widespread stigmatization of persons living with HIV (PLWH) in Indonesia. Such attitudes among health care workers could impede the country's policies for effective diagnosis and medical treatment of PLWH. Nonetheless, research to guide interventions to reduce stigma in health care settings is lacking. Also, the contributions of workplace, religion, and HIV knowledge to nurses' HIV-related stigma are poorly understood. Our cross-sectional study aimed to describe factors associated with nurses' stigmatizing attitudes toward PLWH. Four hundred nurses recruited from four hospitals in Jakarta, Indonesia, were surveyed using the Nurse AIDS Attitude Scale to measure stigma. Stigmatizing attitudes were significantly predicted by education, HIV training, perceived workplace stigma, religiosity, Islamic religious identification, and affiliation with the Islamic hospital. HIV knowledge was not a significant predictor of stigmatizing attitudes. Organization changes fostering workplace diversity are likely to substantially reduce stigmatizing attitudes in nurses. Copyright © 2015 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  19. Challenges to HIV service provision: the commonalities for nurses and social workers.

    Science.gov (United States)

    Olivier, C; Dykeman, M

    2003-10-01

    Interdisciplinary collaboration can be enhanced through an understanding of the challenges and needs associated with service provision. This study explores the experiences of 192 service providers, with additional comparisons of nurses and social workers. Service providers reported fear of contracting HIV, feeling helpless, problems getting up-to-date information, grief and inadequate referral resources. Except for many more nurses expressing worry about contracting HIV, nurses and social workers shared many of the same problems. In addition, both groups were concerned with the comprehensive health needs of people living with HIV/AIDS. Moreover, they demonstrated shared professional values such as the importance of self-awareness and professional knowledge, positive and non-judgemental attitudes, and non-discriminatory treatment of client groups. This commonality makes nurses and social workers natural allies in responding to the many challenges associated with HIV service provision. Study findings support collaboration in the areas of service delivery, policy development, advocacy and professional development.

  20. 护理人员HIV职业暴露风险认知对护理服务态度和行为意向的影响%Effect of Nurses'Risk Perception of Occupational HIV Exposure on Their Attitude and Behavioral Intention of Providing Nursing Care

    Institute of Scientific and Technical Information of China (English)

    史琰琰; 任书华; 陈先锋; 孙奕

    2014-01-01

    Objectives To explore the effect of nurses'risk perception of occupational HIV exposure on their atti-tude and behavioral intention of providing nursing care by constructing measurement model of risk perception. Methods Definition and Measurement Model of Risk Perception was defined,and questionnaire was designed on this basis.An anonymous survey was conducted among nurses of 4 conveniently selected comprehensive hospitals in Wuhan.Structural equation modeling was applied in the data analysis.Results Risk perception exerted negative effect on the attitude (standardized path coefficient =-0.1 6),the impact of the attitude on the behavioral intention was positive (standardized path coefficient =0.60),the risk perception exerted no direct impact on the behavioral intention and exerted negative effect of-0.10 on it.Self-efficacy could reduce nurses'risk perception,and facilitated positive attitude and behavioral intention of providing nursing care.Conclusions Nurses'risk perception of occupa-tional HIV exposure,attitude and behavioral intention was in line with KABP model.%目的采用构建的风险认知测量模型,探讨护理人员 HIV 职业暴露风险认知对护理服务态度、行为意向的影响。方法确定风险认知的定义和测量模型,在此基础上设计调查问卷,调查内容包括风险认知4维度、态度、行为意向、自我效能等。采用方便抽样的方法对武汉市4所三甲医院的护理人员匿名问卷调查,运用结构方程模型对调查结果进行分析。结果风险认知对护理人员对待 HIV 感染者的态度为负向影响(标准化路径系数为-0.16),态度对行为意向为正向影响(标准化路径系数为0.60),风险认知对行为意向没有直接影响,间接影响为-0.10。自我效能可以降低风险认知水平,促进其采取正向态度和行为意向。结论护理人员的 HIV 职业暴露风险认知与护理服务态度、行为意向的关系符合一般的知信行模型。

  1. Developing a competency-based curriculum in HIV for nursing schools in Haiti

    Directory of Open Access Journals (Sweden)

    Knebel Elisa

    2008-08-01

    Full Text Available Abstract Background Preparing health workers to confront the HIV/AIDS epidemic is an urgent challenge in Haiti, where the HIV prevalence rate is 2.2% and approximately 10 100 people are taking antiretroviral treatment. There is a critical shortage of doctors in Haiti, leaving nurses as the primary care providers for much of the population. Haiti's approximately 1000 nurses play a leading role in HIV/AIDS prevention, care and treatment. However, nurses do not receive sufficient training at the pre-service level to carry out this important work. Methods To address this issue, the Ministry of Health and Population collaborated with the International Training and Education Center on HIV over a period of 12 months to create a competency-based HIV/AIDS curriculum to be integrated into the 4-year baccalaureate programme of the four national schools of nursing. Results Using a review of the international health and education literature on HIV/AIDS competencies and various models of curriculum development, a Haiti-based curriculum committee developed expected HIV/AIDS competencies for graduating nurses and then drafted related learning objectives. The committee then mapped these learning objectives to current courses in the nursing curriculum and created an 'HIV/AIDS Teaching Guide' for faculty on how to integrate and achieve these objectives within their current courses. The curriculum committee also created an 'HIV/AIDS Reference Manual' that detailed the relevant HIV/AIDS content that should be taught for each course. Conclusion All nursing students will now need to demonstrate competency in HIV/AIDS-related knowledge, skills and attitudes during periodic assessment with direct observation of the student performing authentic tasks. Faculty will have the responsibility of developing exercises to address the required objectives and creating assessment tools to demonstrate that their graduates have met the objectives. This activity brought different

  2. Find Ryan White HIV/AIDS Medical Care Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Find Ryan White HIV/AIDS Medical Care Providers tool is a locator that helps people living with HIV/AIDS access medical care and related services. Users can...

  3. Patient satisfaction with health care services provided at HIV clinics ...

    African Journals Online (AJOL)

    Patient satisfaction with health care services provided at HIV clinics at Amana and ... with the general physical environment of the clinic and with services offered by ... Key words: Patient satisfaction, Antiretroviral therapy, HIV care services ...

  4. HIV knowledge and attitudes among providers in aging: results from a national survey.

    Science.gov (United States)

    Hughes, Anne K

    2011-09-01

    Within 5 years, half the U.S. HIV-infected population will be over age 50, and providers caring for older adults must deal with this reality. This study assessed attitudes toward people with HIV/AIDS and knowledge of HIV/AIDS among physicians with a geriatrics specialty, and nurses and social workers who specialize in gerontology. A survey mailed in 2008 to a random sample of U.S. providers yielded a 60% response rate. Main outcome measures included: Knowledge of HIV/AIDS, attitudes toward people with HIV/AIDS, and knowledge of issues related to HIV in older adults. General knowledge of HIV/AIDS was good with scores of 89%, 84%, and 81% for physicians, nurses, and social workers, respectively; groups differed significantly (F(2, 483)=18.626, page 50 varied widely; few answered correctly, with no significant differences by professional group (F(2,319)=2.82, p=0.06). These findings highlight the need for further education among providers who specialize in aging.

  5. Physical and psychosocial nursing care for patients with HIV infection.

    Science.gov (United States)

    O'Brien, M E; Pheifer, W G

    1993-06-01

    As suggested earlier we have chosen in this article to discuss only a small group of key physical and psychosocial concerns and needs associated with HIV and AIDS. These were the issues most frequently discussed by a study group of people living with HIV. We recognize, however, that holistic nursing intervention considers the totality of the individual living with HIV: body, mind, and spirit. It is to that end that the discussed nursing diagnoses and interventions are directed. Ultimately, the successful identification of and intervention in HIV related problems rests in the unique relationship between nurse and patient sharing as collaborators in the healing experience. The body of contemporary nursing and behavioral science research in the area of HIV/AIDS continues to grow. Presently the National Center for Nursing Research is supporting studies focusing on such areas as the use of designated versus general care settings for HIV patient care, quality of nursing care in HIV/AIDS, the effects of nurse-managed home care for AIDS patients, stress and coping in caregivers of AIDS children, the testing of interventions for black women with AIDS, and prevention studies (National Center for Nursing Research, personal communication, 1992). Nevertheless, as the HIV pandemic continues to grow and expand its demographic parameters, more research, particularly with such populations as women and children, is urgently needed. Studies exploring prevention issues and symptom management also are most important. Some suggestions for future study include examination of cultural variables associated with coping with HIV and AIDS; longitudinal research on surviving HIV over time; intervention studies to test specific nursing therapeutics in various settings such as hospital, home, and clinic; and finally, research describing the impact of HIV and AIDS on family functioning and adaptation. It is only through continued study of the impact of HIV, on both the individual living with HIV

  6. African and Caribbean Nurses' Decisions about HIV Testing: A Mixed Methods Study.

    Science.gov (United States)

    Harrowing, Jean N; Edwards, Nancy; Richter, Solina; Minnie, Karin; Rae, Tania

    2017-07-24

    Nurses in Jamaica, Kenya, South Africa, and Uganda are at risk for occupational exposure to HIV. Little is known about the experiences and policy supports related to nurses having themselves tested for the virus. This article reports a mixed-methods study about contextual influences on nurses' decision-making about HIV testing. Individual and focus group interviews, as well as a questionnaire on workplace polices and quality assurance and a human resource management assessment tool provided data. Fear of a positive diagnosis and stigma and lack of confidentiality along with gaps in the policy environment contributed to indecision about testing. There were significant differences in policy supports among countries. Institutional support must be addressed if improvements in HIV testing for health care workers are going to be effectively implemented. Future work is required to better understand how HRM policies intersect to create conditions of perceived vulnerability for HIV positive staff.

  7. Counselling about HIV serological status disclosure: nursing practice or law enforcement? a Foucauldian reflection.

    Science.gov (United States)

    O'Byrne, Patrick; Holmes, Dave; Roy, Marie

    2015-06-01

    Recently, focus groups and qualitative interviews with nurses who provide frontline care for persons living with HIV highlighted the contentiousness surrounding the seemingly innocuous activity of counselling clients about HIV-status disclosure, hereafter disclosure counselling. These empirical studies highlighted that while some nurses felt they should instruct clients to disclose their HIV-positive status if HIV transmission were possible, other nurses were equally adamant that such counselling was outside the nursing scope of practice. A review of these opposing perceptions about disclosure counselling, including an examination of the empirical evidence which supports each point, revealed that the dichotomous arguments needed to be nuanced. The empirical evidence about serostatus disclosure neither supported nor refuted either of these assertions; rather, it substantiated parts of each. To create this understanding, both empirical and theoretical works are used. First, the results of empirical studies about serostatus disclosure, or lack thereof and HIV transmission is presented; as part of this, Marks and Crepaz's HIV disclosure and exposure framework is examined. Second, the work of Michel Foucault on disciplinary and pastoral power is drawn from. The outcome is a nuanced understanding about the interrelationships between disclosure counselling and nursing practice and a final interpretation about what this understanding means for public health practice.

  8. Knowledge of nursing students towards HIV/AIDS in Nepal

    Directory of Open Access Journals (Sweden)

    Sita Parajulee

    2013-09-01

    Full Text Available Aims First case of Acquired Immuno Deficiency Syndrome (AIDS in Nepal was reported in the year 1988. Nurses are an integral part of the healthcare system and should be knowledgeable in providing care to AIDS patients. This study assessed the knowledge of nursing students towards HIV/AIDS, and the association (if any between the knowledge scores of the nursing students with their selected demographic variables. Materials and methods A cross sectional study was conducted evaluating the nursing student knowledge using a self designed questionnaire. The correct answers were given a score of ‘1’ and wrong answers were given a score of ‘0’ (total possible maximum score ‘18’. Results Among the total 165 nursing students, 121 of them filled the questionnaire (response rate of 73.33% and all of them were females. The mean ± SD age of the respondents was 18.3 ±1.75 years. The median (IQR of the overall total scores was 13.0 (11.5-15.0. There was an association between the knowledge scores of the respondents with ‘age’ (p=000, ‘course of the study’ (p=0.001. However, there was no statistically significant association between the knowledge scores with the ‘year of study’ of the respondents (p=0.109, ‘mode of finance’ (0.611 and ‘native’ of the students (0.173. Conclusion The study suggested that nursing students have a poor overall knowledge on AIDS and especially areas such as post exposure prophylaxis.The findings also suggested the need for providing adequate knowledge to the students during their regular class room teaching and clinical postings. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 27-33 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8697

  9. Attitudes and practices of hemophilia care providers involved in HIV risk-reduction counseling.

    Science.gov (United States)

    Meredith, K L; Hannan, J A; Green, T A; Wiley, S D

    1994-10-01

    Hemophilia physicians, nurses, and social workers attending a national conference were asked to complete a questionnaire assessing their attitudes and practices regarding HIV risk-reduction counseling. All of the 150 respondents reported recommending the use of condoms to their clients, but only two-thirds felt comfortable demonstrating a condom, while fewer could explain condom choices or how to make safe sex more pleasurable. Less than half questioned their clients about history of STDs, sexual practices, or level of sexual satisfaction. Those who devoted 50 percent or more time to HIV risk-reduction efforts reported being more complete in their assessment and more comfortable in their counseling role. Providers claimed it would help if they had more time (84%) and better skills (64%, especially nurses) for this practice. Because HIV prevention services in hemophilia are delivered by a team, further studies are required to determine the aggregate impact of their intervention on the client.

  10. Task-sharing with nurses to enhance access to HIV treatment in Côte d'Ivoire.

    Science.gov (United States)

    McNairy, Margaret L; Bashi, Jules B; Chung, Hannah; Wemin, Louise; Lorng, Marie-Nicole Akpro; Brou, Hermann; Nioble, Cyprien; Lokossue, A; Abo, Kouame; Achi, Delphine; Ouattara, Kiyali; Sess, Daniel; Sanogo, Pongathie Adama; Ekra, Alexandre; Ettiegne-Traore, Virginie; Diabate, Conombo J; Abrams, Elaine J; El-Sadr, Wafaa M

    2017-04-01

    We report the first national programme in Côte d'Ivoire to evaluate the feasibility of nurse-led HIV care as a model of task-sharing with nurses to increase coverage and decentralisation of HIV services. Twenty-six public HIV facilities implemented either a nurse-with-onsite-physician or a nurse-with-visiting-physician model of HIV task-sharing. Routinely collected patient data were reviewed to analyse patient characteristics of those enrolling in care and initiating antiretroviral therapy (ART). Retention, loss to programme and death were compared across facility-level characteristics. A total of 1224 patients enrolled in HIV care, with 666 initiating ART, from January 2012 to May 2013 (median follow-up 13 months). The majority (94%) were adults ≥15 years. Fourteen facilities provided ART initiation for the first time during the pilot period; 20 facilities were primary level. Nurse-led care with a visiting physician was provided in 14 of the primary-level facilities. Nurse-led ART care with an onsite physician was provided in all secondary-level facilities and six of the primary-level facilities. During the pilot, 567 (85%) of patients were retained, 28 (4.2%) died, 47 (7.1%) were lost to follow-up, and 24 (3.6%) transferred. Five deaths (10.9%) were recorded among children as compared to 23 deaths (3.7%) among adults (P = 0.037). There were no differences in retention by model of nurse-led ART care. Task-sharing of HIV care and ART initiation with nurses in Côte d'Ivoire is feasible. This pilot illustrates two models of nurse-led HIV care and has informed national policy on nurse-led HIV care in Côte d'Ivoire. © 2017 John Wiley & Sons Ltd.

  11. Provider attitudes toward IUD provision in Zimbabwe: perception of HIV risk and training implications.

    Science.gov (United States)

    Gaffikin, L; Phiri, A; McGrath, J; Zinanga, A; Blumenthal, P D

    1998-03-01

    This study was conducted to assess providers' attitudes toward the provision of long-term methods of contraception, in particular the IUD, and provider concerns about human immunodeficiency virus (HIV) in the context of family planning (FP) services. The data were collected using self-administered structured questionnaires. Between 65% and 80% of the public and private providers thought that the IUD is a good contraceptive method for Zimbabwean women. In addition, the majority of these two provider groups felt that neither the IUD nor tubal sterilization (TL) posed much risk of HIV infection to the client. A significant number of providers (especially the public nurses), however, thought that the provision of TL put the provider at high risk of HIV infection and a significant proportion of public nurses were also concerned about provider risk associated with providing IUD and injectables. To address such concerns, future training interventions should emphasize appropriate infection prevention practices associated with surgical FP method provision. Nurses, in particular, should be informed about the magnitude of risk associated with FP service provision and ways to protect themselves. Logistic activities also need to be strengthened so that legitimate concerns among providers regarding lack of adequate infection prevention supplies (e.g. gloves) in the field can be addressed.

  12. Nurses' evaluations of sources of information about HIV and AIDS.

    Science.gov (United States)

    Irving, K L; Ferguson, E; Cox, T; Farnsworth, W J

    1997-10-01

    Reviews of the literature indicate that nurses feel ill-informed about HIV/AIDS and that poor knowledge is associated with anxiety and negative attitudes towards infected patients and their care. Although some studies have sought to identify the sources of HIV/AIDS information available to nurses, few have attempted to understand how nurses evaluate such sources. In this study in 1992, 15 sources of HIV/AIDS information were identified during group discussions with nursing staff and nurse tutors. 277 nursing staff evaluated each of the sources in terms of perceived frequency (how often the source is used) and six items chosen to assess the usability and usefulness of each source (e.g. how informative the source is, how easy it is to understand). The results indicate that in-service training, basic training and professional colleagues are the sources evaluated most highly while posters and advertisements, television and radio and popular newspapers are the most frequently used sources of information. Trades unions' journals and pamphlets are the least frequently used sources of information and receive only modest evaluations. 20% of respondents report never having received any training regarding HIV and AIDS. Implications for the future provision of HIV/AIDS information and directions for further research are discussed.

  13. Developing ambulatory care clinics: nurse practitioners as primary providers.

    Science.gov (United States)

    Lamper-Linden, C; Goetz-Kulas, J; Lake, R

    1983-12-01

    While hospitals evaluate ambulatory clinics as a revenue-generating service alternative, nursing executives develop new areas for nursing practice in nurse-managed clinics. The authors describe the five-year growth of a nurse-managed ambulatory clinic providing primary health care to those aged 55 and older. The discussion explains nurse practitioner leadership and practice, and accountability between professions. The concept and structure of services and marketing strategies are elated to the people served. Financial feasibility, cost containment, and other factors demonstrate the clinic's contribution to its sponsoring hospital.

  14. Analysis of queries from nurses to the South African National HIV & TB Health Care Worker Hotline

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    Annoesjka Maria Swart

    2013-12-01

    Full Text Available Background. Since 2008, the Medicines Information Centre (MIC has run the South African National HIV & TB Health Care Worker Hotline which provides free information on patient treatment to all healthcare workers in South Africa. With the introduction of nurse-initiated management of antiretroviral therapy (NIMART in the public sector, the need for easy access to HIV and tuberculosis (TB information has increased, especially among nurses. The hotline aims to provide this, most importantly to nurses in rural areas, where clinical staff often have little access to peer review.Objective. To describe the queries received from nurses by the hotline between 1 March and 31 May 2012 and identify problem areas and knowledge gaps where nurses may require further training.Methods. All queries received from nurses during the study period were analysed. An experienced information pharmacist reviewed all queries to identify knowledge gaps.Results. During the study period, the hotline received a total of 1 479 HIV- and TB-related queries from healthcare workers. Of these, 386 were received from nurses, of which 254 (66% were NIMART-trained. The most common query subtopic was initiating antiretroviral therapy (ART (20%, followed by adverse drug reactions (18%. The most common knowledge gap identified was the ability to interpret laboratory results before initiating ART (10%.Discussion. We conclude that the hotline is providing clinical help to an increasing number of nurses on the topic of treating HIV and TB throughout South Africa. In addition, queries directed to the hotline may assist in identifying knowledge gaps for the further training of nurses.

  15. Personal values and attitudes toward people living with HIV among health care providers in Kazakhstan.

    Science.gov (United States)

    Tartakovsky, Eugene; Hamama, Liat

    2013-01-01

    Our study investigates the relationship between health care providers' personal value preferences and their attitudes toward people living with HIV (PLWH). The study was conducted among nurses (n = 38) and physicians (n = 87) working in HIV Centers in Kazakhstan. Significant relationships were found between the providers' personal value preferences and their attitudes toward PLWH: higher preferences for tradition and power values and lower preferences for benevolence values were associated with more negative attitudes toward PLWH. In addition, more years of experience working with PLWH was associated with more positive attitudes toward this population. Age, gender, family status, religiosity, occupation, and number of years working in health care were not related to the health care providers' attitudes toward PLWH. Theoretical and practical implications of the results obtained are discussed. Copyright © 2013 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  16. Understanding and responding to HIV/AIDS stigma and disclosure: an international challenge for mental health nurses.

    Science.gov (United States)

    Sowell, Richard L; Phillips, Kenneth D

    2010-06-01

    Stigma and discrimination are challenges in the care and treatment of persons with HIV infection worldwide. Fear of negative social consequences often causes persons with HIV/AIDS to keep their infection secret, resulting in negative psychological and physical outcomes and continued spread of the disease. Mental health nurses have a unique opportunity to influence the trajectory of HIV/AIDS though counseling and interventions that address HIV/AIDS stigma with clients, communities, and society. This article provides an in-depth examination of HIV/AIDS stigma and its relationship to nondisclosure as well as strategies to deal with these issues at individual and group levels.

  17. Follow-up evaluation of first two cohorts of graduates of the Zambian HIV nurse practitioner program

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    Universe H. Mulenga

    2015-01-01

    Conclusions: Findings are consistent with findings from the limited number of other published studies suggesting that nurses can provide high-quality care for patients with HIV and AIDS. Further research is recommended to assess the impact of such programs on morbidity and mortality indicators, and on staff retention and job satisfaction of nurses and also of the HNPs.

  18. HIV/AIDS EDUCATION OF HEALTH CARE PROVIDERS

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    Ljaljević Agima

    2015-03-01

    Full Text Available Introduction: The aim of this study was to determine perceptions of service providers in the healthcare on their awareness and knowledge about HIV/AIDS, as well as the relationship of the above parameters and the existence of stigma and discrimination against people with HIV/AIDS. Method: The type of the study was a behavioral cross sectional study. The survey was conducted in 2012, on a representative sample of health workers in Montenegro. The main survey instrument was specifically designed questionnaire that consisted of six parts, out of which one was related to knowledge about HIV and AIDS. Data were analyzed by methods of inferential statistics. Results: More than four out of ten respondents have never attended educational workshops on HIV/AIDS. Research has shown that there is a highly significant statistical correlation between estimates of their own knowledge about HIV / AIDS and previous educations. Almost two-thirds of respondents, who attended some type of education in the field of HIV/AIDS, believe to have a satisfactory level of knowledge in the area. Conclusion: Health care service providers evaluate their knowledge of HIV/AIDS as insufficient.

  19. Educating primary care providers about HIV disease: multidisciplinary interactive mechanisms.

    OpenAIRE

    Macher, A; Goosby, E; Barker, L; Volberding, P; Goldschmidt, R.; Balano, K B; Williams, A; Hoenig, L; Gould, B; Daniels, E.

    1994-01-01

    As HIV-related prophylactic and therapeutic research findings continue to evolve, the Health Resources and Services Administration (HRSA) of the Public Health Service has created multidisciplinary mechanisms to disseminate new treatment options and educate primary care providers at rural and urban sites throughout our nation's health care system. HRSA has implemented (a) the International State-of-the-Art HIV Clinical Conference Call Series, (b) the national network of AIDS Education and Trai...

  20. Predictors of burnout among HIV nurses in the Western Cape

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    Rizwana Roomaney

    2017-02-01

    Full Text Available Background: Burnout has been implicated as one of the reasons for key healthcare personnel, such as nurses, leaving their profession, resulting in insufficient staff to attend to patients.Objective: We investigated the predictors of three dimensions of burnout, namely emotional exhaustion, depersonalisation and personal accomplishment, among nurses in South Africa attending to patients living with HIV.Method: Participants were recruited at a large tertiary hospital in the Western Cape region, with the help of the assistant director of nursing at the hospital. They completed the Maslach Burnout Inventory, the Quantitative Workload Inventory, the Interpersonal Conflict at Work Scale, the Organisational Constraints Scale, the Death and Dying subscale of the Nursing Stress Scale, and the HIV and AIDS Stigma Instrument – Nurse.Results: We found elevated levels of burnout among the sample. Workload, job status and interpersonal conflict at work significantly explained more than one-third of the variance in emotional exhaustion (R² = 0.39, F(7, 102 = 9.28, p = 0.001. Interpersonal conflict, workload, organisational constraints and HIV stigma significantly explained depersonalisation (R² = 0.33, F(7, 102 = 7.22, p = 0.001. Job status and organisational constraints significantly predicted personal accomplishment (R² = 0.18, F(7, 102 = 3.12, p = 0.001.Conclusion: Factors such as workload, job status and interpersonal conflict in the work context, organisational constraints and stigma associated with HIV were found to be predictors of burnout in the sample of nurses. Our recommendations include developing and testing interventions aimed at reducing burnout among nurses, including reducing workload and creating conditions for less interpersonal conflict at work.

  1. Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing

    DEFF Research Database (Denmark)

    Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

    2016-01-01

    Objectives: In the context of HIV clinical care, open discussion regarding sexual health and reproductive plans has become increasingly relevant. The aim of this paper is to explore barriers to communication between providers and women living with HIV regarding childbearing. Methods: In....... Results: Four themes emerged describing barriers to communication, from the HIV-positive women’s point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider’s emphasis on ‘scientific’ facts, (iv......) ‘accidental pregnancy’. Conclusion: Existing evidence regarding effective provider-patient communication should be considered for its application for reproductive counseling among HIV infected women. Practice implications: These data demonstrate the need for current counseling guidelines to explore approaches...

  2. HIV and infant feeding counselling: challenges faced by nurse-counsellors in northern Tanzania

    Directory of Open Access Journals (Sweden)

    Blystad Astrid

    2007-07-01

    nurses in their role as infant feeding counsellors in pMTCT programmes and the urgent need to provide the training and support structure necessary to promote professional confidence and skills. The organisation of counselling services must to a larger extent take into account the local realities in which nurses construct their role as counsellors to HIV-positive childbearing women.

  3. Providing nursing care in a children's hospice.

    Science.gov (United States)

    Day, Alison

    Children who are admitted to hospices need specialist treatment that enables them to enjoy their childhood as much as possible while they receive the care they require. Their parents also have particular needs. During Children's Hospice Week, which started on September 21, the Association of Children's Hospices aims to raise awareness of the work done by children's hospices and the services they provide.

  4. Knowledge regarding postexposure prophylaxis of HIV among nurses

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    Dhital PS

    2017-04-01

    Full Text Available Puja Sharma Dhital,1 Sarojini Sharma,2 Pratik Poudel,3 Pankaj Raj Dhital4 1Adult Health Nursing, Nepal Polytechnic Institute, College of Nursing, 2Adult Health Nursing, BP Koirala Memorial Cancer Hospital, 3Department of Radiology, College of Medical Sciences, Bharatpur, 4Department of Agricultural Extension and Rural Sociology, Agriculture and Forestry University, Rampur, Nepal Abstract: Fifty nurses working in BP Koirala Memorial Cancer Hospital, Bharatpur, were selected by probability simple random sampling technique for determining the knowledge level about postexposure prophylaxis (PEP of HIV among nurses during 2014. A descriptive design, semistructured self-administered questionnaire was used for the study. The study showed that 48% of respondents had knowledge on the meaning of PEP, only 39.39% respondents were aware of the first aid management getting needle prick injury, 60% were aware of the best time to start PEP of HIV and 56% respondents had knowledge about the time schedule of HIV test after exposure. Although the respondents answered most of the questions correctly, they had knowledge deficit in certain areas. The respondents’ knowledge in this regard needs to be improved with time-to-time awareness program and periodic training, which ultimately helps to decrease the transmission of disease and reduces mortality and morbidity. Keywords: needle prick injury, transmission, PEP, HIV 

  5. Patient referral from nurses to doctors in a nurse-led HIV primary care clinic in South Africa: implications for training and support.

    Science.gov (United States)

    Venkatesh, Kartik K; de Bruyn, Guy; Lurie, Mark N; Lentle, Kgotso; Tshabangu, Nkeko; Moshabela, Mosa; Martinson, Neil A

    2010-11-01

    Health services in sub-Saharan Africa are under great pressure to provide adequate clinical care due to the continued HIV epidemic, and nurse-driven models of care are one means to address physician shortages. This case-control study examines the reasons for and correlates of patient referral from nurses to physicians at HIV primary care clinics in South Africa prior to initiating antiretroviral treatment. Ninety-seven HIV-infected cases who required physician consolation and 160 controls who did not require physician consultation (matched on gender, age, and date of clinic visit) were consecutively enrolled at both an urban and rural HIV primary care clinic during a 12-month period beginning in March 2006. Univariate and multivariate logistic regression models were used to assess correlates of patient referral to a physician. Cases were more likely to have lower CD4 cell counts and have WHO Stages III and IV disease compared to controls (pclinical diagnoses were associated with patient referral: tuberculosis, aplastic and other anemias, and lower respiratory tract infection (pNurses can provide adequate clinical and diagnostic management for certain clinical conditions to HIV-infected patients. Further studies are needed to examine specifically how HIV healthcare delivery can be scaled-up in resource-limited settings with a high burden of HIV, but with a minimal healthcare infrastructure.

  6. Providing nursing leadership in a community residential mental health setting.

    Science.gov (United States)

    Hughes, Frances A; Bamford, Anita

    2011-07-01

    The worldwide burden of mental illness is increasing. Strong leadership is increasingly emerging as a core component of good mental health nursing. The aim of this article is to demonstrate the ways in which nurses can provide strong and consistent leadership in a values-based practice environment that embodies respect for individuals' dignity and self-determination within a community residential mental health service, which provides a structural foundation for effective action. This is accomplished through the presentation of two vignettes, which highlight how the seemingly impossible becomes possible when an economic paradigm such as agency theory is exchanged for a sociological and psychological paradigm found in leadership as stewardship at the point of service. It is through stronger nursing leadership in mental health that stigma and discrimination can be reduced and better access to treatments and services can be gained by those with mental illness. Nurse leadership in mental health services is not new, but it is still relatively uncommon to see residential services for "high needs" individuals being led by nurses. How nurses meet the challenges faced by mental health services are often at the heart of effective leadership skills and strategies.

  7. Knowledge, attitudes and perceptions of nurses and nursing students towards HIV/AIDS

    Science.gov (United States)

    Vallejos, Irma Conejeros; Sánchez, Helga Emig; Lagunas, Lilian Ferrer; Valdés, Báltica Cabieses; Acosta, Rosina Cianelli

    2016-01-01

    Objective To describe attitudes, knowledge and perceptions of nurses and nursing students towards the people who live with HIV/AIDS (PLWHA). Methodology Bibliographic study in which six electronic databases were searched using the key words: “attitude”, “knowledge”, “nursing”, perceptions”, “HIV/AIDS”. Publications between 1998 and 2007 were considered. Results 560 articles limited by scientific researches or ministerial reports membership were retrieved. Finally a total of 38 publications were selected, the analysis showed that the level of knowledge of nurses and nursing students about PLWHA is good and the attitudes towards HIV/AIDS have improved over time. Nurses and nursing students have been able to identify both positive and negative aspects in the PLWHA care personally and professionally because there is a more favourable perception. Conclusion There are few studies in Latin America and Chile that study the attitudes and knowledge of the studied population towards PLWHA. According to publications found the knowledge and attitudes have improved because the perception is more favourable. PMID:27499563

  8. Knowledge, attitudes and acceptability to provider-initiated HIV ...

    African Journals Online (AJOL)

    and counseling: patients' perspectives in Moshi and Rombo Districts, ... Abstract: Provider-initiated HIV testing and counseling (PITC) is referred to as routine testing ... implement effective, efficient and user friendly PITC services in these settings. .... initiation of treatment and care, and introduction of risk-reduction strategies.

  9. Barriers to provider-initiated testing and counselling for children in a high HIV prevalence setting: a mixed methods study.

    Directory of Open Access Journals (Sweden)

    Katharina Kranzer

    2014-05-01

    Full Text Available There is a substantial burden of HIV infection among older children in sub-Saharan Africa, the majority of whom are diagnosed after presentation with advanced disease. We investigated the provision and uptake of provider-initiated HIV testing and counselling (PITC among children in primary health care facilities, and explored health care worker (HCW perspectives on providing HIV testing to children.Children aged 6 to 15 y attending six primary care clinics in Harare, Zimbabwe, were offered PITC, with guardian consent and child assent. The reasons why testing did not occur in eligible children were recorded, and factors associated with HCWs offering and children/guardians refusing HIV testing were investigated using multivariable logistic regression. Semi-structured interviews were conducted with clinic nurses and counsellors to explore these factors. Among 2,831 eligible children, 2,151 (76% were offered PITC, of whom 1,534 (54.2% consented to HIV testing. The main reasons HCWs gave for not offering PITC were the perceived unsuitability of the accompanying guardian to provide consent for HIV testing on behalf of the child and lack of availability of staff or HIV testing kits. Children who were asymptomatic, older, or attending with a male or a younger guardian had significantly lower odds of being offered HIV testing. Male guardians were less likely to consent to their child being tested. 82 (5.3% children tested HIV-positive, with 95% linking to care. Of the 940 guardians who tested with the child, 186 (19.8% were HIV-positive.The HIV prevalence among children tested was high, highlighting the need for PITC. For PITC to be successfully implemented, clear legislation about consent and guardianship needs to be developed, and structural issues addressed. HCWs require training on counselling children and guardians, particularly male guardians, who are less likely to engage with health care services. Increased awareness of the risk of HIV infection

  10. [Nursing consultation for patient with HIV: perspectives and challenges from nurses' view].

    Science.gov (United States)

    de Macêdo, Simara Moreira; Sena, Márcia Cristina Dos Santos; Miranda, Karla Corrêa Lima

    2013-01-01

    The study aims to examine how the nursing consultation is developed by the nurses workimg in in Outpatient Specialized Services on HIV / AIDS in the city of Fortaleza-CE. This is an exploratory and descriptive study with a qualitative approach that used content analysis as a technique for data analysis. To perform the nursing consultation, listening was reported by nurses as the main mechanism that enables the construction of empathy and trust relationship with the patient, allowing them to express their doubts, fears and anxieties. It also enables the spread of information and guidance about the pathology, as well as the convening of the subject for an active participation in the care process, trying to make them aware about the importance of the adherence to drug treatment. Nursing consultation configure itself as an educational moment, opportune for knowledge exchange and bonding.

  11. Validation of the integration of HIV and AIDS related nursing competencies into the undergraduate nursing curriculum in South Africa

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    Regis R. Marie Modeste

    2015-07-01

    Full Text Available Background: Being in its fourth decade, HIV remains an epidemic that requires combined efforts for the global fight. The strategies planned and implemented in the fight against HIV include reversing and halting the spread of HIV, increasing health care access, and strengthening the health care system. South Africa has made the fight one of its top priorities, and has developed plans to increase the role of nurses in the management of HIV, demonstrating its willingness, commitment and progress in the fight against HIV.Objective: This article presents the validation process conducted to confirm the integration and mapping of the HIV and AIDS related nursing competencies into the four-year Bachelor of Nursing programme at a university in South Africa.Methods: This study adopted a constructivist paradigm, using a qualitative approach, applyingthe design step of the process model of curriculum development, to validate the inte gration of the mapped HIV and AIDS related nursing competencies into the undergraduate nursing curriculum.Results: For each competency, outcomes were developed for each year. Participants confirmed completeness of outcomes and appropriateness of the mapping of the HIV and AIDS related outcomes into the nursing curriculum, as well as the feasibility and practicability of the integration.Conclusion: Required resources for integration of HIV and AIDS related nursing competencies, such as human resources and nurse educators’ continued personal development were identified, as well as barriers to integration, and measures to eliminate them were discussed. The importance of integration of HIV and AIDS nursing competencies into the curriculum was reiterated.

  12. Virtual Nursing Intervention Adjunctive to Conventional Care: The Experience of Persons Living With HIV.

    Science.gov (United States)

    Côté, José; Rouleau, Geneviève; Ramirez-Garcia, Pilar; Bourbonnais, Anne

    2015-10-20

    Persons living with HIV (PLHIV) must adhere optimally to antiretroviral therapy (ART) on a daily basis and for their lifetime to maintain an undetectable viral load, allowing them to preserve their health. Taking advantage of the opportunity that information and communication technologies provide to broaden intervention modalities and intensify clinical follow-up, a virtual nursing intervention consisting of four interactive computer sessions was developed to empower PLHIV to manage their ART and symptoms optimally. Compared with other types of information and communication technologies-assisted interventions such as text messages, HIV Treatment, Virtual Nursing Assistance and Education (VIH-TAVIE) requires a certain degree of active engagement on the part of the user to develop and strengthen the self-management skills to optimize adherence. After the intervention's impact on ART adherence was measured quantitatively, a qualitative study was undertaken to describe how users experience the intervention. Understanding how PLHIV perceive being assisted asynchronously by a virtual nurse was of particular interest. The objective of the study was to explore and describe how PLHIV experience VIH-TAVIE, that is, receiving customized asynchronous accompaniment via a virtual nurse. A qualitative study was conducted with 26 PLHIV (20 men, 6 women) who received all four VIH-TAVIE sessions. Participants had been diagnosed with HIV 14 years earlier on average and had been on ART for a mean period of 10 years. The sessions lasted 20-30 minutes each and were received two weeks apart. They are hosted by a virtual nurse who engages the user in a self-management skills-learning process for the purpose of treatment adherence. Semistructured interviews were conducted lasting 30-40 minutes to get participants to share their experience of the intervention through personal stories and what they thought and felt during their participation. Data were analyzed using Miles and Huberman

  13. Provider in triage: is this a place for nurse practitioners?

    Science.gov (United States)

    Bahena, Diana; Andreoni, Colleen

    2013-01-01

    The role of nurse practitioners (NPs) in emergency care continues to evolve. A new and exciting role is the provider-in-triage (PIT) role. This innovative role has been implemented in many emergency departments (EDs) across the country. It was developed primarily as a front-end strategy to improve throughput of patients receiving emergency care. The PIT process uses a provider, physician, NP, or physician assistant in the triage area. Patient satisfaction, quality measures, and financial improvements have been attributed to using a PIT. The emergency NP is an optimal choice for this role. Advanced emergency nursing knowledge, skills, and decision making confer the NP a cost-effective provider to improve throughput in the ED while providing quality emergency care.

  14. The Social Development Dimension Of The Nursing Profession In Managing HIV Cases

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    Sri Wahyuni

    2015-02-01

    studying health public health programs how the role of each profession respectively how should manage patients with HIV and the need for collaboration. The theme explored is the experience moral development to guide patients friendship and trust hope in treating patients with HIV and cooperation. Patients with HIV need support and encouragement not only a health problem but how to increase motivation to maintain the quality of life in the community by building a spiritual dimension the ability to be independent in terms of the economy and the ability to experience stigma discrimination to be faced by those in the community. Conclusions of this study were professional social workers and nurses are in the process of rehabilitation is a profession that is very influential. In this case the need for complementary capabilities in handling patients. Nurses must improve its ability to not only take care of the physical dimension but it required the ability to develop the social psychological and spiritual patient. Vice versa a social worker who controls the social dimension of the patients need to improve on the physical dimensions of the issue of the patients health. It needs to be improved by structuring the task and program development cooperation profess. The researches gave recommendations 1 develop the social psychological and spiritual by increasing the values of life as a nurse who works with the basic devotion to God and develop therapeutic communication skills. Providing training to the nurses in the workplace respectively by the method of practice in improving therapeutic communication capabilities make the procedure nursing care that explore the ability of communication theurapetic on the patient. 2 Improve the capability of knowledge in health by provide training to workers in the workplace each with its own methods of practice in improving the ability of HIV-disease control and how to maintain the health of patients after exposed to HIV disease. Make work procedures

  15. Nurse and Medical Provider Perspectives on Antibiotic Stewardship in Nursing Homes.

    Science.gov (United States)

    Scales, Kezia; Zimmerman, Sheryl; Reed, David; Beeber, Anna Song; Kistler, Christine E; Preisser, John S; Weiner, Bryan J; Ward, Kimberly; Fann, Amy; Sloane, Philip D

    2017-01-01

    To examine perspectives on antibiotic use and antibiotic stewardship of nurses and medical providers in nursing homes (NHs). Cross-sectional survey. NHs in North Carolina (N = 31). Nursing staff (n = 182) and medical providers (n = 50). Respondents completed a self-administered questionnaire about their perspectives on antibiotic use in their NH, the influence of residents and families on antibiotic prescribing decisions, and readiness to improve antibiotic stewardship. Open-ended questions on barriers to antibiotic stewardship were also asked. Linear mixed modeling was used to analyze differences between respondent groups and to test for associations with individual and organizational characteristics. All respondents supported reducing antibiotic use, although medical providers' support was significantly stronger (P = .005). When asked about their perception of residents' and family members' preference for antibiotic use in the case of suspected infection and the influence of that preference on antibiotic-prescribing decisions, respondents indicated that residents and families favor antibiotic use and influence prescribing decisions. Nurses reported a stronger perception than medical providers that families prefer antibiotics (P = .04) and influence prescribing decisions (P = .02). All respondents reported commitment and efficacy to change practices (mean 4.0-4.1 for nurses and 3.6-3.9 for medical providers on a 5-point scale). Four significant associations related to organizational and individual characteristics were found: directors of nursing and specialist nurses reported greater self-efficacy for changing practice than other nurses (P = .003), medical providers with a subspecialty (e.g., geriatrics) reported greater self-efficacy (P = .007) and commitment to change (P = .001) than those without a subspecialty, and medical providers specializing in hospice and palliative care rated family influence (P = .006) higher than those with other subspecialties

  16. Counselor-Versus Provider-Based HIV Screening in the Emergency Department: Results From the Universal Screening for HIV Infection in the Emergency Room (USHER) Randomized Controlled Trial

    Science.gov (United States)

    Walensky, Rochelle P.; Reichmann, William M.; Arbelaez, Christian; Wright, Elizabeth; Katz, Jeffrey N.; Seage, George R.; Safren, Steven A.; Hare, Anna Q.; Novais, Anna; Losina, Elena

    2012-01-01

    Objective We compare rates of rapid HIV testing, test offer, and acceptance in an urban emergency department (ED) when conducted by dedicated HIV counselors versus current members of the ED staff. Methods The Universal Screening for HIV Infection in the Emergency Room [USHER] trial is a prospective randomized controlled trial that implemented an HIV screening program in the ED of an urban tertiary medical center. ED patients were screened and consented for trial enrollment by an USHER research assistant. Eligible subjects were randomized to rapid HIV testing (oral OraQuick) offered by a dedicated counselor (counselor arm) or by an ED provider (provider arm). In the counselor arm, counselors—without other clinical responsibilities—assumed nearly all testing-related activities (consent, counseling, delivery of test results). In the provider arm, trained ED emergency service assistants (nursing assistants) consented and tested the participant in the context of other ED-related responsibilities. In this arm, ED house officers, physician assistants, or attending physicians provided HIV test results to trial participants. Outcome measures were rates of HIV testing and test offer among individuals consenting for study participation. Among individuals offered the test, test acceptance was also measured. Results From February 2007 through July 2008, 8,187 eligible patients were approached in the ED, and 4,855 (59%) consented and were randomized to trial participation. The mean age was 37 years, 65% were women, and 42% were white. The overall testing rate favored the counselor arm (57% versus 27%; P < .001); 80% (1,959/2,446) of subjects in the counselor arm were offered an HIV test compared with 36% (861/2,409) in the provider arm (P < .001). HIV test acceptance was slightly higher in the provider arm (counselor arm 71% versus provider arm 75%; P = .025). Conclusion Routine rapid HIV testing in the ED was accomplished more frequently by dedicated HIV counselors than by

  17. Harm reduction interventions in HIV care: a qualitative exploration of patient and provider perspectives.

    Science.gov (United States)

    Carlberg-Racich, Suzanne

    2016-01-01

    Background. A culture of stringent drug policy, one-size-fits-all treatment approaches, and drug-related stigma has clouded clinical HIV practice in the United States. The result is a series of missed opportunities in the HIV care environment. An approach which may address the broken relationship between patient and provider is harm reduction-which removes judgment and operates at the patient's stage of readiness. Harm reduction is not a routine part of care; rather, it exists outside clinic walls, exacerbating the divide between compassionate, stigma-free services and the medical system. Methods. Qualitative, phenomenological, semi-structured, individual interviews with patients and providers were conducted in three publicly-funded clinics in Chicago, located in areas of high HIV prevalence and drug use and serving African-American patients (N = 38). A deductive thematic analysis guided the process, including: the creation of an index code list, transcription and verification of interviews, manual coding, notation of emerging themes and refinement of code definitions, two more rounds of coding within AtlasTi, calculation of Cohen's Kappa for interrater reliability, queries of major codes and analysis of additional common themes. Results. Thematic analysis of findings indicated that the majority of patients felt receptive to harm reduction interventions (safer injection counseling, safer stimulant use counseling, overdose prevention information, supply provision) from their provider, and expressed anticipated gratitude for harm reduction information and/or supplies within the HIV care visit, although some were reluctant to talk openly about their drug use. Provider results were mixed, with more receptivity reported by advanced practice nurses, and more barriers cited by physicians. Notable barriers included: role-perceptions, limited time, inadequate training, and the patients themselves. Discussion. Patients are willing to receive harm reduction interventions from

  18. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Directory of Open Access Journals (Sweden)

    Jane N Mutanga

    Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early

  19. Trauma-Informed Decision-Making Among Providers and Victims of Intimate Partner Violence During HIV Testing: A Qualitative Study.

    Science.gov (United States)

    Williams, Jessica R; Gonzalez-Guarda, Rosa M; Ilias, Vanessa

    We explored the process of implementing an HIV testing program at an intimate partner violence (IPV) service agency from the client and provider perspectives. A qualitative descriptive approach was used wherein semi-structured interviews were conducted with 19 key informants (i.e., women with a history of IPV, HIV service providers, IPV service providers). Interviews focused on facilitators and barriers to HIV testing implementation, the decision-making process during HIV testing, and support needs. All interviews were recorded and transcribed. The text of the interviews was analyzed using directed content analysis. Unique factors were found to influence HIV testing in victims of IPV including potential for re-traumatization, readiness for testing, competing priorities, and the influence of children. The results provided important information that can be used to improve the implementation of HIV testing, tailoring processes so they are more trauma-informed; and better support individuals with a history of IPV. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  20. Radical or routine? Nurse practitioners, nurse-midwives, and physician assistants as abortion providers.

    Science.gov (United States)

    Freedman, Lori; Battistelli, Molly Frances; Gerdts, Caitlin; McLemore, Monica

    2015-05-01

    In 2013 California passed legislation that expanded the pool of eligible aspiration abortion providers to include advanced practice nurses, nurse-midwives, and physician-assistants. This law, enacted in 2014, is based on evidence generated by the Health Workforce Pilot Project #171, which examined the safety and effectiveness of aspiration abortion care provided by these clinicians as well as patient acceptability and satisfaction. This evidence and the resulting policy change build on international research and established workforce strategies used to expand access to safe abortion services for women worldwide, representing a radical departure from the legislative trend of constricting access in the United States. Copyright © 2015. Published by Elsevier Ltd.

  1. Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital

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    Nokwanda E. Bam

    2014-07-01

    Full Text Available Background: Whilst the discourse of palliative care in HIV management is largely documented and regarded as being an essential component, various authors have further argued that within the context of HIV care in sub-Saharan Africa, palliative care and exploration of the dimensions thereof is largely lacking. This article presents the lived experiences of nurses involved in palliative care, thus providing the perspective of nurses and the multi-faceted dimensions of the nature of caring inherent. Objectives: This study explored the respondents’ understanding of the concepts ‘caring’ and ‘terminal patient’ and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered. Methods: Qualitative research using Husserl’s approach of phenomenology design underpinned the study and Giorgi’s steps of analysis were used to make meaning of the data. Results: The concept ‘caring’ was experienced by the nurses as transforming the patients’ quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes. Conclusion: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context.

  2. Knowledge and attitudes to HIV/AIDS in Chinese registered nurses.

    Science.gov (United States)

    Li, Li; Li, Yinglan; Zeng, Kai; Wu, Ying

    2011-02-01

    To investigate the current knowledge and attitudes towards people living with HIV/AIDS (PWHAs) in Chinese registered nurses (RNs) and describe the relationships between the nurses' HIV/AIDS related knowledge and attitudes towards PWHAs. A cohort of 1350 RNs from 51 comprehensive hospitals in Hunan, China were studied over a 4-month period. A 3-stage random sampling method was used. The total correct rate in AIDS Knowledge Scale was 63.2%. Most nurses were good at conceptions of routes of AIDS infection and some basic characteristics, with more than 80% of the correct responses rate of relevant items. Their weakness was in the knowledge of some activities which would not transfer AIDS, such as "eating in a restaurant where the cook has AIDS may infect HIV", with less than 50% of the correct response rate of relevant items. As for attitudes, 94% of the nurses sympathized with HIV patients. About 82.7% of the nurses showed little sympathy to patients getting HIV by sexual promiscuity. Among all the AIDS related knowledge, nurses' conception of non-infectious activities was significantly related to their attitudes to HIV/AIDS. Chinese nurses waster well about HIV/AIDS basic characteristics and the routes of infection, and most nurses sympathize with PWHAs. Their weakness is in the knowledge of non-HIV-infectious activities and they hold different attitudes to those patients getting HIV/AIDS in different ways. There are some barriers for Chinese nurses to take care of all patients equally. Professional development programs are urgently needed to remedy this situation including clarifying the nurses' misconceptions on AIDS related knowledge, developing non-judgmental professional attitudes, and using universal prevention measures when they take care of all patients.

  3. The promotion of voluntary HIV testing among hostel dwellers by community nurses

    OpenAIRE

    2011-01-01

    M.Cur. The Sub-Sahara region is riddled with HIV/AIDS to such an extent it has became a pandemic. The challenge to control or to minimize further infections has been left to the community nurses. The community nurses' primary aim is to promote and prevent the spread of infection, especially HIV I AIDS, amongst vulnerable groups (Clemen-Stone, 2002-134 ). The under-utilisation of the voluntary HIV -testing facility by hostel dwellers is a cause of concern among nurses in this Southern Metro...

  4. HIV serostatus disclosure: Experiences and perceptions of people living with HIV/AIDS and their service providers in Gujarat, India

    Directory of Open Access Journals (Sweden)

    Sangita V Patel

    2012-01-01

    Full Text Available Background: Human immunodeficiency virus (HIV disclosure offers important benefits to people living with HIV/AIDS. However, fear of discrimination, blame, and disruption of family relationships can make disclosure a difficult decision. Barriers to HIV disclosure are influenced by the particular culture within which the individuals live. Although many studies have assessed such barriers in the U.S., very few studies have explored the factors that facilitate or prevent HIV disclosure in India. Understanding these factors is critical to the refinement, development, and implementation of a counseling intervention to facilitate disclosure. Materials and Methods: To explore these factors, we conducted 30 in-depth interviews in the local language with HIV- positive individuals from the Integrated Counselling and Testing Centre in Gujarat, India, assessing the experiences, perceived barriers, and facilitators to disclosure. To triangulate the findings, we conducted two focus group discussions with HIV medical and non-medical service providers, respectively. Results: Perceived HIV-associated stigma, fear of discrimination, and fear of family breakdown acted as barriers to HIV disclosure. Most people living with HIV/AIDS came to know of their HIV status due to poor physical health, spousal HIV-positive status, or a positive HIV test during pregnancy. Some wives only learned of their husbands′ HIV positive status after their husbands died. The focus group participants confirmed similar findings. Disclosure had serious implications for individuals living with HIV, such as divorce, maltreatment, ostracism, and decisions regarding child bearing. Interpretation and Conclusion: The identified barriers and facilitators in the present study can be used to augment training of HIV service providers working in voluntary counseling and testing centers in India.

  5. Knowledge and psychosocial wellbeing of nurses caring for people living with HIV/AIDS (PLWH

    Directory of Open Access Journals (Sweden)

    Lufuno Makhado

    2016-12-01

    Full Text Available The challenges of caring for people living with HIV (PLWH in a low-resource setting has had a negative impact on the nursing profession, resulting in a shortage of skilled nurses. In response to this shortage and perceived negative impact, we conducted a descriptive, cross-sectional study to describe the level of knowledge and psychosocial wellbeing of nurses caring for PLWH at a regional hospital in Limpopo Province, South Africa. A total of 233 nurses, the majority being female, participated and were stratified into professional nurses (n = 108, enrolled nurses (n = 58 and enrolled nursing auxiliaries (n = 66. Data were collected using HIV/AIDS knowledge questionnaire, Maslach Burnout Inventory; AIDS Impact Scale and Beck's Depression Inventory. The total knowledge score obtained by all the participants ranged from 2 to 16, with an average of 12.93 (SD = 1.92 on HIV/AIDS knowledge. Depersonalization (D (83.7% and emotional exhaustion (EE (53.2% were reported among participating nurses caring for PLWH. Burnout was higher among professional nurses as compared to both enrolled nurses and enrolled nursing auxiliaries. There was a moderate negative significant correlation between HIV knowledge with the nurses' emotional exhaustion (r = −0.592, depression (r = −0.584 and stigma and discrimination (r = −0.637. A moderate to high level of burnout was evident among all levels of nurses. These findings lead to the recommendations for support of nurses caring for PLWH that include structured nursing educational support, organisational support with respect to employee wellness programmes that address depression and work burnout, as well as social support. The provision of these support mechanisms has the potential of creating a positive practice environment for nurses in the Vhembe District of the Limpopo Province in particular, and South Africa in general, and in improved care for PLWH.

  6. School Nurses Save Lives: Can We Provide the Data?

    Science.gov (United States)

    Malone, Susan Kohl; Bergren, Martha Dewey

    2010-01-01

    Vigilance has been central to nursing practice since Florence Nightingale. Often, the nurse's work of surveillance goes unnoticed and the public never recognizes the value of the nurse's work. The 1999 Institute of Medicine report on hospital deaths due to preventable errors has lifted the veil shrouding professional vigilance. But how to measure…

  7. School Nurses Save Lives: Can We Provide the Data?

    Science.gov (United States)

    Malone, Susan Kohl; Bergren, Martha Dewey

    2010-01-01

    Vigilance has been central to nursing practice since Florence Nightingale. Often, the nurse's work of surveillance goes unnoticed and the public never recognizes the value of the nurse's work. The 1999 Institute of Medicine report on hospital deaths due to preventable errors has lifted the veil shrouding professional vigilance. But how to measure…

  8. Health care provider attitudes and beliefs about people living with HIV: Initial validation of the Health Care Provider HIV/AIDS Stigma Scale (HPASS).

    Science.gov (United States)

    Wagner, Anne C; Hart, Trevor A; McShane, Kelly E; Margolese, Shari; Girard, Todd A

    2014-12-01

    HIV stigma is a pressing concern for people living with HIV, and particularly when it is perpetuated by health care providers, as it may affect quality of life and access to health care services. The current study describes the development and initial validation of a contextually appropriate HIV stigma scale for health care providers in North America. A ground-up qualitative approach was used to develop the scale, and it was assessed psychometrically with health care trainees across Canada. The measure demonstrates excellent internal consistency reliability and test-retest reliability, as well as convergent and divergent validity. The study supports a tripartite model of HIV stigma consisting of stereotyping, prejudice and discrimination. The scale provides a new tool to assess HIV stigma in health care providers and can be used to inform training, intervention and self-evaluation of stigmatizing attitudes, beliefs and behaviors among providers.

  9. HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women's human rights?

    Science.gov (United States)

    Madhivanan, Purnima; Krupp, Karl; Kulkarni, Vinay; Kulkarni, Sanjeevani; Vaidya, Neha; Shaheen, Reshma; Philpott, Sean; Fisher, Celia

    2014-03-24

    In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Between February 2012 to March 2013, 14 HIV-positive women who had recently delivered a baby were recruited from HIV positive women support groups, Government of India Integrated Counseling and Testing Centers, and nongovernmental organizations in Mysore and Pune, India. In-depth interviews were conducted to examine their general experiences with antenatal healthcare; specific experiences around HIV counseling and testing; and perceptions about their care and follow-up treatment. Data were analyzed thematically using the human rights framework for HIV testing adopted by the United Nations and India's National AIDS Control Organization. While all of the HIV-positive women in the study received HIV and PMTCT services at a government hospital or antiretroviral therapy center, almost all reported attending a private clinic or hospital at some point in their pregnancy. According to the participants, HIV testing often occurred without consent; there was little privacy; breaches of confidentiality were commonplace; and denial of medical treatment occurred routinely. Among women living with HIV in this study, violations of their human rights occurred more commonly in private rather than public healthcare settings. There is an urgent need for capacity building among private healthcare providers to improve standards of practice with regard to informed consent process, HIV testing, patient confidentiality, treatment, and referral of pregnant women living with HIV.

  10. Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care

    Science.gov (United States)

    Caine, Vera; Mill, Judy; O’Brien, Kelly; Solomon, Patricia; Worthington, Catherine; Dykeman, Margaret; Gahagan, Jacqueline; Maina, Geoffrey; De Padua, Anthony; Arneson, Cheryl; Rogers, Tim; Chaw-Kant, Jean

    2016-01-01

    We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations. PMID:26644019

  11. Barriers to communication between HIV care providers (HCPs) and women living with HIV about child bearing: A qualitative study

    DEFF Research Database (Denmark)

    Ddumba-Nyanzi, Ismael; Kaawa-Mafigiri, David; Johannessen, Helle

    2016-01-01

    . Results: Four themes emerged describing barriers to communication, from the HIV-positive women’s point of view: (i) provider indifference or opposition to childbearing post HIV diagnosis, (ii) anticipation of negative response from provider, (iii) provider’s emphasis on ‘scientific’ facts, (iv...

  12. HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives

    Science.gov (United States)

    Sutton, Madeline; Anthony, Monique-Nicole; Vila, Christie; McLellan-Lemal, Eleanor; Weidle, Paul J.

    2010-01-01

    Context: Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties. Purpose: We surveyed providers in the…

  13. HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives

    Science.gov (United States)

    Sutton, Madeline; Anthony, Monique-Nicole; Vila, Christie; McLellan-Lemal, Eleanor; Weidle, Paul J.

    2010-01-01

    Context: Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties. Purpose: We surveyed providers in the…

  14. Culture and religion in nursing: providing culturally sensitive care.

    Science.gov (United States)

    Mendes, Aysha

    Last month, Aysha Mendes discussed the impact on care of personal beliefs held by both nurses and patients. This month, she delves into the aspects of culture and religion, which form important pieces of this puzzle, as well as the importance of culturally appropriate care provision in nursing practice.

  15. Fragmentation of maternal, child and HIV services: A missed opportunity to provide comprehensive care

    Directory of Open Access Journals (Sweden)

    Lyn J. Haskins

    2016-03-01

    Full Text Available Background: In South Africa, coverage of services for mothers and babies in the first year of life is suboptimal despite high immunisation coverage over the same time period. Integration of services could improve accessibility of services, uptake of interventions and retention in care.Aim: This study describes provision of services for mothers and babies aged under 1 year.Setting: Primary healthcare clinics in one rural district in KwaZulu-Natal, South Africa.Methods: All healthcare workers on duty and mothers exiting the clinic after attending well-child services were interviewed. Clinics were mapped to show the route through the clinic taken by mother–baby pairs receiving well-child services, where these services were provided and by whom.Results: Twelve clinics were visited; 116 health workers and 211 mothers were interviewed. Most clinics did not provide comprehensive services for mothers and children. Challenges of structural layout and deployment of equipment led to fragmented services provided by several different health workers in different rooms. Well-child services were frequently provided in public areas of the clinic or with other mothers present. In some clinics mothers and babies did not routinely see a professional nurse. In all clinics HIV-positive mothers followed a different route. Enrolled nurses led the provision of well-child services but did not have skills and training to provide comprehensive care.Conclusions: Fragmentation of clinic services created barriers in accessing a comprehensive package of care resulting in missed opportunities to provide services. Greater integration of services alongside immunisation services is needed.

  16. Perceptions of vaginal microbicides as an HIV prevention method among health care providers in KwaZulu-Natal, South Africa

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    Mantell Joanne E

    2007-03-01

    Full Text Available Abstract Background The promise of microbicides as an HIV prevention method will not be realized if not supported by health care providers. They are the primary source of sexual health information for potential users, in both the public and private health sectors. Therefore, the aim of this study was to determine perceptions of vaginal microbicides as a potential HIV prevention method among health care providers in Durban and Hlabisa, South Africa, using a combination of quantitative and qualitative methods. Results During 2004, semi structured interviews with 149 health care providers were conducted. Fifty seven percent of hospital managers, 40% of pharmacists and 35% of nurses possessed some basic knowledge of microbicides, such as the product being used intra-vaginally before sex to prevent HIV infection. The majority of them were positive about microbicides and were willing to counsel users regarding potential use. Providers from both public and private sectors felt that an effective microbicide should be available to all people, regardless of HIV status. Providers felt that the product should be accessed over-the-counter in pharmacies and in retail stores. They also felt a need for potential microbicides to be available free of charge, and packaged with clear instructions. The media was seen by health care providers as being an effective strategy for promoting microbicides. Conclusion Overall, health care providers were very positive about the possible introduction of an effective microbicide for HIV prevention. The findings generated by this study illustrated the need for training health care providers prior to making the product accessible, as well as the importance of addressing the potential barriers to use of the product by women. These are important concerns in the health care community, and this study also served to educate them for the day when research becomes reality.

  17. Cultural adaptation of a survey to assess medical providers' knowledge of and attitudes towards HIV/AIDS in Albania.

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    Shane D Morrison

    Full Text Available Though the HIV/AIDS epidemic in Southeastern Europe is one of low reported prevalence, numerous studies have described the pervasiveness of medical providers' lack of knowledge of HIV/AIDS in the Balkans. This study sought to culturally adapt an instrument to assess medical providers' knowledge of and attitudes towards HIV/AIDS in Albania. Cultural adaptation was completed through development of a survey from previously validated instruments, translation of the survey into Albanian, blinded back translation, expert committee review of the draft instrument, focus group pre-testing with community- and University Hospital Center of Tirana-based physicians and nurses, and test-retest reliability testing. Blinded back translation of the instrument supported the initial translation with slight changes to the idiomatic and conceptual equivalences. Focus group pre-testing generally supported the instrument, yet some experiential and idiomatic changes were implemented. Based on unweighted kappa and/or prevalence adjusted bias adjusted kappa (PABAK, 20 of the 43 questions were deemed statistically significant at kappa and/or PABAK ≥0.5, while 12 others did not cross zero on the 95% confidence interval for kappa, indicating their probable significance. Subsequently, an instrument to assess medical providers' knowledge of and attitudes toward HIV/AIDS for an Albanian population was developed which can be expanded within Albania and potentially to other countries within the Balkans, which have an Albanian-speaking population.

  18. Biological risk in nursing care provided in family health units

    National Research Council Canada - National Science Library

    Cardoso, Ana Carla Moreira; Figueiredo, Rosely Moralez de

    2010-01-01

    .... This exploratory and descriptive study characterizes the potential risk of biological exposure in procedures performed by nursing professionals in ten Family Health units in São Carlos-SP, Brazil...

  19. Stigma, social reciprocity and exclusion of HIV/AIDS patients with illicit drug histories: A study of Thai nurses' attitudes

    Directory of Open Access Journals (Sweden)

    Stoové Mark A

    2008-08-01

    Full Text Available Abstract Background Stigma is a key barrier for the delivery of care to patients living with HIV/AIDS (PLWHA. In the Asia region, the HIV/AIDS epidemic has disproportionately affected socially marginalised groups, in particular, injecting drug users. The effect of the stigmatising attitudes towards injecting drug users on perceptions of PLWHA within the health care contexts has not been thoroughly explored, and typically neglected in terms of stigma intervention. Methods Semi-structured interviews were conducted with a group of twenty Thai trainee and qualified nurses. Drawing upon the idea of 'social reciprocity', this paper examines the constructions of injecting drug users and PLWHA by a group of Thai nurses. Narratives were explored with a focus on how participants' views concerning the high-risk behaviour of injecting drug use might influence their attitudes towards PLWHA. Results The analysis shows that active efforts were made by participants to separate their views of patients living with HIV/AIDS from injecting drug users. While the former were depicted as patients worthy of social support and inclusion, the latter were excluded on the basis that they were perceived as irresponsible 'social cheaters' who pose severe social and economic harm to the community. Absent in the narratives were references to wider socio-political and epidemiological factors related to drug use and needle sharing that expose injecting drug users to risk; these behaviours were constructed as individual choices, allowing HIV positive drug users to be blamed for their seropositive status. These attitudes could potentially have indirect negative implications on the nurses' opinions of patients living with HIV/AIDS more generally. Conclusion Decreasing the stigma associated with illicit drugs might play crucial role in improving attitudes towards patients living with HIV/AIDS. Providing health workers with a broader understanding of risk behaviours and redirecting

  20. Evaluation of a community-based mental health drug and alcohol nurse in the care of people living with HIV/AIDS.

    Science.gov (United States)

    Allen, J; Hamilton, A; Nunn, R; Crock, L; Frecker, J; Burk, N

    2009-03-01

    There is a growing need for advanced practice mental health and drug and alcohol nursing roles in the care of people living with HIV/AIDS; however, limited publications address these domains. This study evaluated a community-based mental health drug and alcohol nurse role caring for people living with HIV/AIDS (Mental Health D&A Nurse) in a large not-for-profit district nursing organization providing care to people living with HIV/AIDS in an Australian city. Outcomes from a client assessment and 6-8-week follow-up by the Mental Health D&A Nurse are presented as captured by the Depression Anxiety Stress Scales (DASS 21), Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Health of the Nation Outcome Scales (HONOS) and WHOQoL BREF. Mean scores and caseness were analysed, and significant differences were found on the 'impairment' and 'social problems' subscales of the HONOS. Results of semi-structured interviews with clients describe effective and supportive mental health care and health-promoting education following visits by the Mental Health D&A Nurse. These positive findings support continuing implementation of the role within this community setting and indicate that even greater benefits will ensue as the role develops further. Findings are of interest to clinicians and policy makers seeking to implement similar roles in community-based HIV/AIDS care.

  1. [Reflections on nursing assistance provided to the parturient].

    Science.gov (United States)

    Velho, Manuela Beatriz; de Oliveira, Maria Emília; dos Santos, Evanguelia Kotzias Atherino

    2010-01-01

    The objective of this bibliographic study is to identify the state of the art of production published in the area of obstetrics nursing involving the birth process, to contribute to future investigations, and to assist in reflection upon this theme. Data was collected through the bibliographic analysis of the LILACS, MEDLINE, Cochrane Library, and SciELO databases. Descriptors used: nurse-midwives, childbirth work, normal childbirth, and Nursing care. Five studies were selected and later catalogued in bibliographic files. The themes selected were: professional regulation, care, assistance given, link established, educational actions, administrative activities, and difficulties. While the studies recognize this professional as a capacitated, legally backed professional who offers humanized assistance and thus reaffirms normal vaginal delivery, thus proportioning dignity, security, and autonomy to the delivering mother much still needs to written in order for the same autonomy and ethical-legal respect is acquired for health care professionals and clientele.

  2. Evaluation of nurse providers of comprehensive abortion care using MVA in Nepal.

    Science.gov (United States)

    Basnett, I; Shrestha, M K; Shah, M; Pearson, E; Thapa, K; Andersen, K L

    2012-01-01

    Although Nepal's maternal mortality ratio has fallen over the past decade, unsafe abortion remains a leading cause of maternal morbidity and mortality. A key strategy for improving access to safe abortion services is to train mid-level providers such as nurses in comprehensive abortion care (CAC). The Family Health Division of the Nepal Ministry of Health trained an initial cohort of 96 nurses to provide first trimester CAC services using manual vacuum aspiration (MVA) between September 2006 and July 2009. This study evaluates the acceptability and quality of CAC services provided by trained nurses in Nepal. Five assessments were used to evaluate post-training service provision on CAC: facility logbooks registry, nurse provider interviews, facility assessments, facility manager interviews and procedure observation checklists. Ninety-two nurses from 50 facilities participated in the evaluation. Descriptive statistics are reported. Overall, 5,600 women received CAC services from 42 facilities where nurses were providing services between June 2009 and April 2010. Complications were experienced by 68 surgical abortion clients (1.6%) and 12 medical abortion clients (1.2%). All nurses reported that clients were happy to receive care from them, and 67% of facility managers reported that clients preferred nurse providers over physicians or had no preference. Facility managers and nurses reported a need for additional support, including further training and improved drug and equipment supply. Trained nurses provide high quality CAC services in Nepal. Additional support in the form of facilitative supervision and training should be considered to strengthen CAC service provision.

  3. An Integrated Intervention for Increasing Clinical Nurses' Knowledge of HIV/AIDS-Related Occupational Safety.

    Science.gov (United States)

    He, Liping; Lu, Zhiyan; Huang, Jing; Zhou, Yiping; Huang, Jian; Bi, Yongyi; Li, Jun

    2016-11-07

    Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses' knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300) were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ² = 86.34, p = 0.00), and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4%) and post-test (66.6%) (χ² = 73.2, p = 0.00). When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly. The pre

  4. Patients' satisfaction with the quality of nursing care provided: the Saudi experience.

    Science.gov (United States)

    Atallah, Mohammad A; Hamdan-Mansour, Ayman M; Al-Sayed, Mohammad M; Aboshaiqah, Ahmad E

    2013-12-01

    Patient's satisfaction has emerged as a central focus of health-care delivery during the last decades, and nursing care became one significant component of patient's satisfaction. The purpose of this study is to examine patients' satisfaction with quality of nursing care provided in Saudi Arabia. Cross-sectional descriptive correctional design was used to recruit 100 patients from one regional hospital in Saudi Arabia. Data collected using structured interview from patients related to six dimensions of nursing care. Patients had a high level of satisfaction with nursing care provided (86% agreement rate). Language (56% disagreement rate), discharge information (56% disagreement rate) and availability (20% disagreement rate) have been identified with the lowest rates of patients satisfaction. Nursing leaders and health-care administrators need to maintain quality nursing care and develop strategies for improving nursing care emphasizing language as barrier and strategies of information dissemination.

  5. The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N).

    Science.gov (United States)

    Uys, Leana R; Holzemer, William L; Chirwa, Maureen L; Dlamini, Priscilla S; Greeff, Minrie; Kohi, Thecla W; Makoae, Lucia N; Stewart, Anita L; Mullan, Joseph; Phetlhu, René D; Wantland, Dean J; Durrheim, Kevin L; Cuca, Yvette P; Naidoo, Joanne R

    2009-02-01

    Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n=251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n=244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions.

  6. Who should provide continuous renal replacement therapies? Nephrology nurses are better prepared to provide CRRT.

    Science.gov (United States)

    Ellis, Kathy

    2007-01-01

    Although critical care nurses are fully capable of learning CRRT, there are substantial, irrefutable challenges to achieving and sustaining proficiency. There is also diminished opportunity and motivation for critical care nurses to advance CRRT practice through quality initiatives, education, or research when it is a small piece of their practice. Consequently, I believe that it is incumbent upon acute care nephrology nurses to clarify the magnitude and value of what we do and to support our critical care colleagues in doing what they do best. The debate as to who should perform CRRT began in an effort to explore the better opportunity for cost-saving; but, in the end, it really boils down to the better opportunity for life-saving. I suspect improving outcomes for patients requiring CRRT will ultimately save hospitals more money than the short-sighted gains from critical care nurses performing tasks outside of universally-applied critical care RN processes.

  7. Perspectives of Never-in-Care HIV-Positive Patients and Providers in Rakai, Uganda

    Directory of Open Access Journals (Sweden)

    Gertrude Nakigozi

    2013-01-01

    Full Text Available Background. Early entry into HIV care is low in Sub-Saharan Africa. In Rakai, about a third (31.5% of HIV-positive clients who knew their serostatus did not enroll into free care services. This qualitative study explored barriers to entry into care from HIV-positive clients who had never enrolled in care and HIV care providers. Methods. We conducted 48 in-depth interviews among HIV-infected individuals aged 15–49 years, who had not entered care within six months of result receipt and referral for free care. Key-informant interviews were conducted with 12 providers. Interviews were audio-recorded and transcripts subjected to thematic content analysis based on the health belief model. Results. Barriers to using HIV care included fear of stigma and HIV disclosure, women’s lack of support from male partners, demanding work schedules, and high transport costs. Programmatic barriers included fear of antiretroviral drug side effects, long waiting and travel times, and inadequate staff respect for patients. Denial of HIV status, belief in spiritual healing, and absence of AIDS symptoms were also barriers. Conclusion. Targeted interventions to combat stigma, strengthen couple counseling and health education programs, address gender inequalities, and implement patient-friendly and flexible clinic service hours are needed to address barriers to HIV care.

  8. PERCEPTIONS OF INDONESIAN PRACTICAL NURSES TOWARDS UPDATING CAPABILITY TO PROVIDE CARE: A QUALITATIVE STUDY

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    Fitri Arofiati

    2017-02-01

    Full Text Available Background: Capability to provide care can be recognized as the combination of nursing knowledge, skills, and attitude of care which is dynamic. Objective: This study aims to explore the perceptions of practical nurses towards updating capability to provide care. Methods: A descriptive qualitative study was conducted to explore the deep understanding of practical nurses towards updating capability to provide care. Data were gathered using in-depth interview with 25 practical nurses from different areas of practices, three times focus group discussion (FGD and participant-observation. Qualitative content analysis model was applied to anaylze the data. Result: There were two themes emerged from data: 1 Internal perceptions of updating capacity to provide care, with three subthemes: Having great expectation, Being confidence as a professional nurse, and Developing Self-Initiation, 2 External contexts driving perception of practicing nurses, with two subthemes: Giving best care and Acquiring requirement. Conclusions: The findings indicated that updating capacity to provide care supports practical nurses to provide better nursing services to patients and meet the regulation of nursing professionalism.

  9. Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care.

    Science.gov (United States)

    Caine, Vera; Mill, Judy; O'Brien, Kelly; Solomon, Patricia; Worthington, Catherine; Dykeman, Margaret; Gahagan, Jacqueline; Maina, Geoffrey; De Padua, Anthony; Arneson, Cheryl; Rogers, Tim; Chaw-Kant, Jean

    2016-01-01

    We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  10. "In reality, it is complex and difficult": UK nurses' perspectives on "treatment as prevention" within HIV care.

    Science.gov (United States)

    Evans, Catrin; Bennett, Juliet; Croston, Michelle; Brito-Ault, Nathaniel; Bruton, Jane

    2015-01-01

    Globally, clinical guidelines for HIV treatment are being altered to reflect new research showing that successful treatment with antiretroviral therapies (ART) can prevent the onward transmission of HIV. As a result, health care services are being challenged to find ways to roll out "treatment as prevention" (TasP) as a public health measure. In theory, TasP requires individuals to start ART as soon as they are diagnosed - for public health reasons - which may be some time before ART for that individual is required for clinical reasons. There is currently little research on the acceptability of TasP from a patient or provider perspective. This paper reports findings from a qualitative study that sought to explore UK nurses' views and experiences of TasP in HIV care. Ten HIV specialist nurses, purposively selected from across the country, were interviewed. Results suggest that, although positive about TasP in principle, nurses hold several reservations about its implementation in practice. Perceived benefits of TasP include reassurance for patients that their loved ones are protected and that immediate care is available. Concerns include the possibility of sexual dis-inhibition or coercion within sexual relationships. In the UK context, decisions around TasP are still being made on a highly individualised patient by patient basis, within a philosophy of holistic care and partnership working. As such, the research participants called for more resources to support information giving, risk assessment and decision-making. The results show that translating a public health treatment approach into individual patient care is complex, potentially time-consuming and may alter traditional provider-patient dynamics. The findings from this study suggest that in-depth research is needed to understand better the patient, community and provider experience as TasP becomes more widely rolled out.

  11. Empathy and avoidance in treating patients living with HIV/AIDS (PLWHA) among service providers in China.

    Science.gov (United States)

    Lin, Chunqing; Li, Li; Wan, Dai; Wu, Zunyou; Yan, Zhihua

    2012-01-01

    This study aims to investigate health care providers' empathy levels and its association with avoidance in providing service to patients living with HIV/AIDS (PLWHA) in China. A total of 1760 health service providers were randomly sampled from 40 county hospitals in two provinces of China. Using a self-administered questionnaire, participants' demographic characteristics, work history, empathy level, and avoidance attitudes toward PLWHA were collected in a cross-sectional survey. Empathy was higher among participants aged 31-40 years, those who had an associated medical degree, and those who had served in the medical profession for less than 20 years. Nurses, younger providers, and providers with lower education tended to avoid contact with PLWHA. Multiple linear regression model showed that a higher level of empathic attitude toward patients was significantly negatively associated with avoidance attitude toward PLWHA. Service providers' empathy level plays an important role in providing quality care to HIV-infected patients. Future stigma reduction interventions should cultivate empathy as a platform for understanding, effective communication, and trusting provider-patient relationships. PLWHA could potentially benefit from attitudinal change in medical settings.

  12. Providing Health Care and Education To Migrant Farmworkers in Nurse-Managed Centers.

    Science.gov (United States)

    Guasasco, Charlene; Heuer, Loretta Jean; Lausch, Cheryl

    2002-01-01

    Migrant Health Service, Inc., was established to address the health needs of migrant farmworkers and their families. Ten satellite nurse-managed centers and two mobile units use a voucher system to provide financial support for clients. The centers also provide clinical experiences for nursing students. (Contains 22 references.) (JOW)

  13. The views of undergraduate nursing students on caring for patients with HIV/AIDS

    Directory of Open Access Journals (Sweden)

    MM Madumo

    2006-09-01

    Full Text Available A qualitative, exploratory and descriptive study was conducted with the purpose of exploring and describing the views of undergraduate nursing students on caring for HIV/AIDS patients. The study population consisted of BCur III nursing students studying at the Medical University of Southern Africa (Medunsa. Participants were purposively selected. Focus group interviews were used as a data collection instrument. Guided by a group moderator and responding to a central research question, participants shared their views about caring for HIV/AIDS patients. Tesch’s qualitative method of data analysis, as described by Cresswell (1994:155, was used to analyse the data. Caring for HIV/AIDS patients evoked emotions such as fear, anger and frustration among undergraduate nursing students. Students expressed needs such as the acquisition of knowledge and a reduction in the stigmatisation of patients with HIV/ AIDS, while the data analysis revealed demands such as more intensive clinical accompaniment by lecturers and antiretroviral therapy delivery by government. Suggested solutions included student participation in HIV/AIDS prevention campaigns and the upholding of patients’ rights. Curriculum innovation was recommended to improve students’ knowledge of HIV/AIDS and to ensure the provision of quality care for these patients.

  14. Nursing students’ perception of clinical learning experiences as provided by the nursing staff in the wards

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    N. R. C. TIakula

    1993-05-01

    Full Text Available A descriptive survey was carried out, using convenience and systematic sampling in order to better understand the manner in which student nurses perceive their clinical experience in the hospital. Data were collected from 80 subjects in 4 nursing colleges using a critical incident technique. Positive and negative experiences are described,

  15. Knowledge, attitudes and practices towards patients with HIV/AIDS in staff nurses in one university hospital in Sicily

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    Marina Marranzano

    2013-03-01

    Full Text Available Background: nurses’ knowledge, attitudes and practices towards patients with HIV/AIDS are of ongoing interest, especially in developing countries. Nothing or very little is known about Italian nurses.Methods: HIV/AIDS knowledge, attitudes and behaviours of the nurses (n=107 from one university hospital inCatania,Sicily, were documented. Comparisons among nurses belonging to different Operative Units (O.U. were conducted by the chi-square test (P<0.05.Results: although HIV was nurses’ main concern in regard to contracting infections in the workplace (54%, the vast majority of them (98% had never refused an HIV/AIDS patient care assignment. Moreover, despite their concern of being more at risk of contracting HIV than the general population (41%, a not negligible percentage of nurses did not use gloves routinely (21% and only a few treated all patients as potentially HIV-positive (9%. The vast majority of the respondents knew the meaning of AIDS (87% and of a positive serological test (78%. On the contrary, a relatively low percentage of them knew what is the ‘window period’ (62% and were acquainted with HIV pathophysiology (65%. No statistically significant differences in terms of risk perception were found between nurses who had previously attended an HIV/AIDS workshop, lecture or specific course (43% and nurses who did not (57%. Level of knowledge was positively associated to age (P=0.000 and to education (P=0.016, and it was found higher in nurses working in a O.U. of Infectious Diseases.Conclusions: data from our study show that also in developed countries, such as Italy, nurses could have some misconceptions and concerns about HIV/AIDS. The importance of examining the impact of continuing education on nurses’ preparedness to care for patients with HIV/AIDS and to prevent the risks of occupational HIV transmission is discussed. 

  16. Challenges with couples, serodiscordance and HIV disclosure: healthcare provider perspectives on delivering safer conception services for HIV-affected couples, South Africa

    Directory of Open Access Journals (Sweden)

    Tamaryn L Crankshaw

    2014-03-01

    Full Text Available Introduction: Introduction Safer conception interventions should ideally involve both members of an HIV-affected couple. With serodiscordant couples, healthcare providers will need to manage periconception risk behaviour as well tailor safer conception strategies according to available resources and the HIV status of each partner. Prior to widespread implementation of safer conception services, it is crucial to better understand provider perspectives regarding provision of care since they will be pivotal to the successful delivery of safer conception. This paper reports on findings from a qualitative study exploring the viewpoints and experiences of doctors, nurses, and lay counsellors on safer conception care in a rural and in an urban setting in Durban, South Africa. Methods: We conducted six semistructured individual interviews per site (a total of 12 interviews as well as a focus group discussion at each clinic site (a total of 13 additional participants. All interviews were coded in Atlas.ti using a grounded theory approach to develop codes and to identify core themes and subthemes in the data. Results: Managing the clinical and relationship complexities related to serodiscordant couples wishing to conceive was flagged as a concern by all categories of health providers. Providers added that, in the HIV clinical setting, they often found it difficult to balance their professional priorities, to maintain the health of their clients, and to ensure that partners were not exposed to unnecessary risk, while still supporting their clients’ desires to have a child. Many providers expressed concern over issues related to disclosure of HIV status between partners, particularly when managing couples where one partner was not aware of the other's status and expressed the desire for a child. Provider experiences were that female clients most often sought out care, and it was difficult to reach the male partner to include him in the consultation

  17. HIV patient and provider feedback on a telehealth collaborative care for depression intervention.

    Science.gov (United States)

    Drummond, Karen L; Painter, Jacob T; Curran, Geoffrey M; Stanley, Regina; Gifford, Allen L; Rodriguez-Barradas, Maria; Rimland, David; Monson, Thomas P; Pyne, Jeffrey M

    2017-03-01

    In the HIV Translating Initiatives for Depression into Effective Solutions project, we conducted a randomized controlled effectiveness and implementation trial comparing depression collaborative care with enhanced usual care in Veterans Health Administration HIV clinics in the US. An offsite HIV depression care team including a psychiatrist, a depression care manager (DCM), and a clinical pharmacist provided collaborative care using a stepped-care model of treatment and made recommendations to providers through the electronic health record system. The DCM delivered care management to HIV patients through phone calls, performing routine assessments and providing counseling in self-management and problem-solving. The DCM documented all calls in each patient's electronic medical record. In this paper we present results from interviews conducted with patients and clinical staff in a multi-stage formative evaluation (FE). We conducted semi-structured FE interviews with 26 HIV patients and 30 clinical staff at the three participating sites during and after the trial period to gather their experiences and perspectives concerning the intervention components. Interviews were transcribed verbatim and analyzed using rapid content analysis techniques. Patients reported high satisfaction with the depression care manager (DCM) phone calls. Both HIV and mental health providers reported that the DCM's chart notes in the electronic health record were very helpful, and most felt that a dedicated DCM for HIV patients is ideal to meet patient needs. Sites encountered barriers to achieving and maintaining universal depression screening, but had greater success when such screening was incorporated into routine intake processes. FE results demonstrated that depression care management via telehealth from an offsite team is acceptable and helpful to both HIV patients and their providers. Given that a centralized offsite depression care team can deliver effective, cost-effective, cost

  18. Provider-initiated HIV testing in rural Haiti: low rate of missed opportunities for diagnosis of HIV in a primary care clinic

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    Freedberg Kenneth A

    2007-11-01

    Full Text Available Abstract As HIV treatment is scaled-up in resource-poor settings, the timely identification of persons with HIV infection remains an important challenge. Most people with HIV are unaware of their status, and those who are often present late in the course of their illness. Free-standing voluntary counseling and testing sites often have poor uptake of testing. We aimed to evaluate a 'provider-initiated' HIV testing strategy in a primary care clinic in rural resource-poor Haiti by reviewing the number of visits made to clinic before an HIV test was performed in those who were ultimately found to have HIV infection. In collaboration with the Haitian Ministry of Health, a non-governmental organization (Partners In Health scaled up HIV care in central Haiti by reinforcing primary care clinics, instituting provider-initiated HIV testing and by providing HIV treatment in the context of primary medical care, free of charge to patients. Among a cohort of people with HIV infection, we assessed retrospectively for delays in or 'missed opportunities' for diagnosis of HIV by the providers in one clinic. Of the first 117 patients diagnosed with HIV in one clinic, 100 (85% were diagnosed at the first medical encounter. Median delay in diagnosis for the remaining 17 was only 62 days (IQR 19 – 122; range 1 – 272. There was no statistical difference in CD4 cell count between those with and without a delay. 3787 HIV tests were performed in the period reviewed. Provider-initiated testing was associated with high volume uptake of HIV testing and minimal delay between first medical encounter and diagnosis of HIV infection. In scale up of HIV care, provider-initiated HIV testing at primary care clinics can be a successful strategy to identify patients with HIV infection.

  19. The impact of nurse-driven targeted HIV screening in 8 emergency departments: study protocol for the DICI-VIH cluster-randomized two-period crossover trial.

    Science.gov (United States)

    Leblanc, Judith; Rousseau, Alexandra; Hejblum, Gilles; Durand-Zaleski, Isabelle; de Truchis, Pierre; Lert, France; Costagliola, Dominique; Simon, Tabassome; Crémieux, Anne-Claude

    2016-02-01

    the control and targeted groups respectively, a sample size of 140,000 patients was estimated corresponding to 8,750 patients per ED and per period. Inclusions started in June 2014. Results are expected by mid-2016. The DICI-VIH study is the first large randomized controlled trial designed to assess nurse-driven targeted HIV screening. This study can provide valuable information on HIV screening in health care settings. ClinicalTrials.gov: NCT02127424 (29 April 2014).

  20. [Training future nurses in providing care for patients who committed criminal acts].

    Science.gov (United States)

    Corvest, Karina; Royer, Gilles Ripaille-Le; Dugardin, Thierry

    2011-01-01

    Providing care for patients who have carried out criminal acts is a source of questioning for caregivers, who must position themselves in this specific care relationship. For three years, the nursing training institute (IFSI) in Orthez has offered students an optional module in criminology. Through discussions and critical reflection, its aim is to enable future nurses to be better prepared.

  1. Online learning communities can provide support for nurses preparing for certification examinations.

    Science.gov (United States)

    Pethtel, Pam

    2005-01-01

    Achieving certification is a benefit to the nurses, to their patients, and to the organizations that support them. Developing an online learning community is a simple way for the institution to offer support to the nursing staff. Providing the resources for creation of online learning communities demonstrates the facility's commitment to communication, education, and professional development.

  2. Nurse-midwifery education through graduate programs to provide a sufficient number of high quality nurse-midwives

    Directory of Open Access Journals (Sweden)

    Kyung Hye Lee

    2006-12-01

    Full Text Available There is a decrease in the number of new midwives, resulting from the shutdown of midwifery education program in hospitals due to a decrease in birthrate in the Republic of Korea. To solve this problem, the current medical laws on midwifery education system in Korea should be revised; nurse-midwifery specialist programs must be established in educational institutes with nursing programs. To support this argument, the midwifery education programs of America, Europe, Australia, and Japan have been discussed, and a nurse-midwifery specialist curriculum at the master s level, based on the nurse-practitioner system of Korea, has been suggested. Since this assertion is very important and urgent for solving the future population problem of Korea and providing health care for women and children, it should be realized into action immediately.

  3. Nurse-midwifery education through graduate programs to provide a sufficient number of high quality nurse-midwives.

    Science.gov (United States)

    Lee, Kyung Hye

    2006-01-01

    There is a decrease in the number of new midwives, resulting from the shutdown of midwifery education program in hospitals due to a decrease in birthrate in the Republic of Korea. To solve this problem, the current medical laws on midwifery education system in Korea should be revised; nurse-midwifery specialist programs must be established in educational institutes with nursing programs. To support this argument, the midwifery education programs of America, Europe, Australia, and Japan have been discussed, and a nurse-midwifery specialist curriculum at the master's level, based on the nurse-practitioner system of Korea, has been suggested. Since this assertion is very important and urgent for solving the future population problem of Korea and providing health care for women and children, it should be realized into action immediately.

  4. HIV Primary Care Providers – Screening, Knowledge, Attitudes and Behaviors related to Alcohol Interventions

    Science.gov (United States)

    Chander, Geetanjali; Monroe, Anne K.; Crane, Heidi M.; Hutton, Heidi E.; Saag, Michael S.; Cropsey, Karen; Eron, Joseph J.; Quinlivan, E. Byrd; Geng, Elvin; Mathews, William Christopher; Boswell, Stephen; Rodriquez, Benigno; Ellison, Megan; Kitahata, Mari M.; Moore, Richard D.; McCaul, Mary E.

    2016-01-01

    Background Alcohol has particularly harmful health effects in HIV-infected patients; therefore, HIV clinics are an important setting for integration of brief alcohol intervention and alcohol pharmacotherapy to improve patient outcomes. Current practices of alcohol screening, counseling, and prescription of pharmacotherapy by HIV providers are unknown. Methods We conducted a cross-sectional survey of HIV providers from 8 HIV clinical sites across the United States. Surveys queried knowledge and use of alcohol screening, brief advice, counseling and pharmacotherapy, confidence and willingness to prescribe pharmacotherapy and barriers to their use of alcohol pharmacotherapy. We used multivariable logistic regression to examine provider factors associated with confidence and willingness to prescribe pharmacotherapy. Results Providers (N=158) were predominantly female (58%) and Caucasian (73%); almost half were infectious disease physicians and 31% had been in practice 10–20 years. Most providers (95%) reported always or usually screening for alcohol use, although only 10% reported using a formal screening tool. Over two-thirds never or rarely treated alcohol-dependent patients with pharmacotherapy themselves. Most (71%) referred alcohol-dependent patients for treatment. Knowledge regarding alcohol pharmacotherapy was low. The major barrier to prescribing pharmacotherapy was insufficient training on use of pharmacotherapy. Provider confidence ratings were positively correlated with their practice patterns. Conclusions HIV providers reported high rates of screening for alcohol use, though few used a formal screening tool. Most providers referred alcohol dependent patients to outside resources for treatment. Few reported prescribing alcohol pharmacotherapy. Increased training alcohol pharmacotherapy may increase confidence in prescribing and use of these medications in HIV care settings. PMID:26857898

  5. The benefits and challenges of providing nursing student clinical rotations in the intensive care unit.

    Science.gov (United States)

    Swinny, Betsy; Brady, Melanie

    2010-01-01

    The goal of providing a clinical rotation in a basic nursing program is to integrate skills and knowledge from the classroom setting into the clinical practice setting. In the intensive care unit (ICU), nursing students have the ability to learn about the complex health issues of critically ill patients, practice selected technical skills, and develop communication skills. There are both benefits and challenges to having nursing students in the intensive care setting. With preparation, the student is able to immerse in the ICU environment, acquire new knowledge and skills, and participate alongside the nurse caring for critically ill patients. The staff nurse must balance patient care with the added responsibilities of helping the student meet the clinical goals. It is optimal to have faculty that are also intensive care clinically competent and can facilitate the clinical experience. The school, the hospital, and the ICU need to collaborate to provide a positive clinical experience that is safe for the patient. In return, the hospital can recruit student nurses and clinical faculty. Planned with thought and intention, rotations in the ICU can be an ideal clinical setting for upper-level student nurses to learn the role of the registered nurse.

  6. Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes.

    Science.gov (United States)

    Hyer, Kathryn; Brown, Lisa M; Christensen, Janelle J; Thomas, Kali S

    2009-11-01

    This article documents the experience of 291 Florida nursing homes during the 2004 hurricane season. Using quantitative and qualitative methods, the authors described and compared the challenges nurses encountered when evacuating residents with their experiences assisting residents of facilities that sheltered in place. The primary concerns for evacuating facilities were accessing appropriate evacuation sites for residents and having ambulance transportation contracts honored. The main issue for facilities that sheltered in place was the length of time it took for power to be restored. Barriers to maintaining resident health during disasters for those who evacuated or sheltered in place are identified.

  7. [Implementation of nurse demand managment in primary health care service providers in Catalonia].

    Science.gov (United States)

    Brugués Brugués, Alba; Cubells Asensio, Irene; Flores Mateo, Gemma

    2017-04-14

    To describe and analyse the implementaction of nurse demand managment (NDM) among health care providers in Catalonia from 2005 to 2014. Cross sectional survey. Participants All service providers in Catalonia (n=37). Main measurements Interviews with nurse manager of each health care provides about ht barriers and facilitators concerning NDM. Facilitators and barriers were classified into 3 types: (i)health professional (competence, attitudes, motivation for change and individual characteristics); (ii)social context (patients and companions), and (iii)system related factors (organization and structure, economic incentives). Of the 37 providers, 26 (70.3%) have implemented the Demand Management Nurse (NDM). The main barriers identified are the nurse prescriptin regulation, lack of knowledge and skills of nurses, and the lack of protocols at the start of implantation. Among the facilitators are the specific training of professionals, a higher ratio of nurses to doctors, consensus circuits with all professionals and linking the implementation of NDM to economic incentives. NDM is consolidated in Catalonia. However, the NDM should be included in the curricula of nursing degree and continuing education programs in primary care teams. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  8. Addressing the intersections of violence and HIV/AIDS: a qualitative study of service providers.

    Science.gov (United States)

    DiStefano, Anthony S; Hubach, Randolph D

    2011-01-01

    This article examines what measures health care and social service providers take to address intersections between various forms of violence and HIV/AIDS in the delivery of services to their clients/patients. We operated within an organizationallinteractional uncertainty theoretical framework and analyzed qualitative interview data from 30 providers offering services related to violence or HIV/AIDS in the San Francisco Bay Area. We found that providers used several strategies to mitigate crossover risk, but they enacted these measures on a case-by-case basis and tended not to follow a dedicated and complete protocol with every client/patient. We also identify nine factors that affected providers' capacity to discern and effectively address violence-HIV/AIDS intersections, present providers' descriptions of their needs in terms of addressing crossover risk, and discuss implications for interventions.

  9. Barriers to and acceptability of provider-initiated HIV testing and counselling and adopting HIV-prevention behaviours in rural Uganda: a qualitative study.

    Science.gov (United States)

    Kiene, Susan M; Sileo, Katelyn; Wanyenze, Rhoda K; Lule, Haruna; Bateganya, Moses H; Jasperse, Joseph; Nantaba, Harriet; Jayaratne, Kia

    2015-02-01

    In Uganda, a nationwide scale-up of provider-initiated HIV testing and counselling presents an opportunity to deliver HIV-prevention services to large numbers of people. In a rural Ugandan hospital, focus group discussions and key informant interviews were conducted with outpatients receiving provider-initiated HIV testing and counselling and staff to explore the HIV-prevention information, motivation and behavioural skills strengths and weaknesses, and community-level and structural barriers to provider-initiated HIV testing and counselling acceptability and HIV prevention among this population. Strengths and weakness occurred at all levels, and results suggest brief client-centred interventions during provider-initiated HIV testing and counselling may be an effective approach to increase prevention behaviours in outpatient settings.

  10. Evaluation of a multimodal, distance learning HIV management course for clinical care providers in India.

    Science.gov (United States)

    Chang, Larry William; Kadam, Dileep B; Sangle, Shashi; Narayanan, Shivakumar; Borse, Rohidas T; McKenzie-White, Jane; Bowen, Craig W; Sisson, Stephen D; Bollinger, Robert C

    2012-01-01

    Distance learning is an important tool for training HIV health workers. However, there is limited evidence on design and evaluation of distance learning HIV curricula and tools. We therefore designed, implemented, and evaluated a distance learning course on HIV management for clinical care providers in India. After course completion, participant scores rose significantly from a pretest (78.4% mean correct) compared with the posttest (87.5%, P < .001). After course completion, participants were more likely to be confident in starting an initial antiretroviral (ARV) regimen, understanding ARV toxicities, encouraging patient adherence, diagnosing immune reconstitution syndrome, and monitoring patients on ARV medications (P ≤ .05). All participants (100%) strongly agreed/agreed that they would recommend this course to others, and most of them (96%) strongly agreed/agreed that they would take a course in this format again. A pragmatic approach to HIV curriculum development and evaluation resulted in reliable learning outcomes, as well as learner satisfaction and improvement in knowledge.

  11. Survey of HIV care providers on management of HIV serodiscordant couples - assessment of attitudes, knowledge, and practices.

    Science.gov (United States)

    Scherer, Matthew L; Douglas, Nataki C; Churnet, Bethlehem H; Grossman, Lisa C; Kline, Melissa; Yin, Michael T; Sauer, Mark V; Olender, Susan A

    2014-01-01

    Human immunodeficiency virus (HIV) serodiscordant couples are at risk of sexual transmission of HIV between the infected and uninfected partner. We assessed New York area care providers for people living with HIV regarding attitudes, knowledge, and practice patterns toward fertility and conception in serodiscordant couples. Data were collected via a survey distributed in October 2013. Seventeen percent of respondents reported prescribing antiretroviral preexposure prophylaxis (PrEP) for a woman in a serodiscordant couple, and 38% percent of respondents reported having counseled serodiscordant couples on timed, unprotected intercourse without PrEP. Respondents who reported being "very" familiar with the data on HIV transmission in serodiscordant couples were more likely to report counseling their patients in timed, unprotected intercourse compared with those who reported less familiarity with the data (41% vs. 8%, p = 0.001). Although only 20% reported being "very" or "somewhat" familiar with the data on the safety of sperm washing with intrauterine insemination, those who did were more likely to have reported referring a patient for assisted reproductive technology (61% vs. 32%, p = 0.006). Effective patient counseling and referral for appropriate reproductive options were associated with knowledge of the literature pertaining to these options. This emphasizes the need for further provider education on reproductive options and appropriate counseling for serodiscordant couples.

  12. Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes.

    Science.gov (United States)

    Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia

    2017-05-01

    Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.

  13. HIV health-care providers' burnout: can organizational culture make a difference?

    Science.gov (United States)

    Ginossar, Tamar; Oetzel, John; Hill, Ricky; Avila, Magdalena; Archiopoli, Ashley; Wilcox, Bryan

    2014-01-01

    One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p organizational culture (i.e., critical appraisal) was positively related to depersonalization (p < .005, R(2) = .18). These findings suggest that effective organizational communication interventions might protect HIV health-care providers from burnout.

  14. Brief Sexual Histories and Routine HIV/STD Testing by Medical Providers

    Science.gov (United States)

    Lanier, Yzette; Castellanos, Ted; Barrow, Roxanne Y.; Jordan, Wilbert C.; Caine, Virginia

    2014-01-01

    Abstract Clinicians who routinely take patient sexual histories have the opportunity to assess patient risk for sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), and make appropriate recommendations for routine HIV/STD screenings. However, less than 40% of providers conduct sexual histories with patients, and many do not receive formal sexual history training in school. After partnering with a national professional organization of physicians, we trained 26 (US and US territory-based) practicing physicians (58% female; median age=48 years) regarding sexual history taking using both in-person and webinar methods. Trainings occurred during either a 6-h onsite or 2-h webinar session. We evaluated their post-training experiences integrating sexual histories during routine medical visits. We assessed use of sexual histories and routine HIV/STD screenings. All participating physicians reported improved sexual history taking and increases in documented sexual histories and routine HIV/STD screenings. Four themes emerged from the qualitative evaluations: (1) the need for more sexual history training; (2) the importance of providing a gender-neutral sexual history tool; (3) the existence of barriers to routine sexual histories/testing; and (4) unintended benefits for providers who were conducting routine sexual histories. These findings were used to develop a brief, gender-neutral sexual history tool for clinical use. This pilot evaluation demonstrates that providers were willing to utilize a sexual history tool in clinical practice in support of HIV/STD prevention efforts. PMID:24564387

  15. Nurses as providers of emotional support to patients with MDR-TB.

    Science.gov (United States)

    Chalco, K; Wu, D Y; Mestanza, L; Muñoz, M; Llaro, K; Guerra, D; Palacios, E; Furin, J; Shin, S; Sapag, R

    2006-12-01

    To identify the forms and means of emotional support that nurses provide to patients living with multidrug-resistant tuberculosis (MTR-TB) in Lima, Peru. A fundamental role of nurses is to provide emotional support, defined as all the strategies that a health team employs to assure the psychosocial well-being of the patient. However, neither the forms of emotional support nor the means used by nurses in resource-poor settings have been much written about. This paper describes a qualitative study of a team of seven nurses working in a programme that provides individualized MDR-TB treatment to patients in Lima, Peru. It describes the various forms of support that facilitated the ability of patients to adhere to treatment despite socio-economic difficulties, social stigma, drug side effects, problems related to different stages of treatment and concurrent illnesses/special situations. Qualitative study methods were employed over the course of 8 years to observe nurses and patients in an MDR-TB treatment programme. These included participant observation, structured observation sessions of nurses with their patients and focus groups with seven nurses. Through theme and content analyses of qualitative data, ten situations related to MDR-TB treatment were found. These ten issues served as an analytical framework used to identify and discuss the various types of emotional support provided by both formal and informal means. This type of support focused on problems related to different stages of treatment, social stigma of the illness, treatment adherence, side effects, socio-economic difficulties, death and concurrent illnesses/special situations. The essential role of the nurse as a provider of emotional support in the development or implementation of similar programmes with MDR-TB should, in future, be taken into account.

  16. [Social representations on HIV/AIDS among adolescentes: implications for nursing care].

    Science.gov (United States)

    Thiengo, Maria Aparecida; de Oliveira, Denize Cristina; Rodrigues, Benedita Maria Rêgo Deusdará

    2005-03-01

    With the objective of discussing the implications of the social representations of HIV/AIDS for the interpersonal relations and the practices for protection among adolescents, 15 semidirective interviews were carried out with adolescents, both with and without HIV, assisted at a Hospital School in Rio de Janeiro. The software ALCESTE 4.5 was used for the data analysis. It was observed that the social representation of AIDS is structured around cognitions connected to prevention, revealing a contradiction between the knowledge and the practices reported by the group. It is suggested that the nursing practices should be directed towards the reduction of the distance between practices, representations and scientific knowledge.

  17. Ethical challenges and opportunities for nurses in HIV and AIDS community-based participatory research in Jamaica

    NARCIS (Netherlands)

    Davison, C.M.; Kahwa, E.; Atkinson, U.; Hepburn-Brown, C.; Aiken, J.; Dawkins, P.; Rae, T.; Edwards, N.; Roelofs, S.; MacFarlane, D.

    2013-01-01

    As part of a multinational program of research, we undertook a community-based participatory research project in Jamaica to strengthen nurses' engagement in HIV and AIDS policy. Three leadership hubs were purposefully convened and included small groups of people (6-10) from diverse HIV and AIDS

  18. Ethical challenges and opportunities for nurses in HIV and AIDS community-based participatory research in Jamaica

    NARCIS (Netherlands)

    Davison, C.M.; Kahwa, E.; Atkinson, U.; Hepburn-Brown, C.; Aiken, J.; Dawkins, P.; Rae, T.; Edwards, N.; Roelofs, S.; MacFarlane, D.

    2013-01-01

    As part of a multinational program of research, we undertook a community-based participatory research project in Jamaica to strengthen nurses' engagement in HIV and AIDS policy. Three leadership hubs were purposefully convened and included small groups of people (6-10) from diverse HIV and AIDS stak

  19. Stigma and discrimination against people living with HIV by healthcare providers, Southwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Feyissa Garumma T

    2012-07-01

    Full Text Available Abstract Background Stigma and discrimination against people living with human immunodeficiency virus (HIV are obstacles in the way of effective responses to HIV. Understanding the extent of stigma / discrimination and the underlying causes is necessary for developing strategies to reduce them. This study was conducted to explore stigma and discrimination against PLHIV amongst healthcare providers in Jimma zone, Southwest Ethiopia. Methods A cross-sectional study, employing quantitative and qualitative methods, was conducted in 18 healthcare institutions of Jimma zone, during March 14 to April 14, 2011. A total of 255 healthcare providers responded to questionnaires asking about sociodemographic characteristics, HIV knowledge, perceived institutional support and HIV-related stigma and discrimination. Factor analysis was employed to create measurement scales for stigma and factor scores were used in one way analysis of variance (ANOVA, T-tests, Pearson’s correlation and multiple linear regression analyses. Qualitative data collected using key-informant interviews and Focus Group Discussions (FGDs were employed to triangulate with the findings from the quantitative survey. Results Mean stigma scores (as the percentages of maximum scale scores were: 66.4 for the extra precaution scale, 52.3 for the fear of work-related HIV transmission, 49.4 for the lack of feelings of safety, 39.0 for the value-driven stigma, 37.4 for unethical treatment of PLHIV, 34.4 for discomfort around PLHIV and 31.1 for unofficial disclosure. Testing and disclosing test results without consent, designating HIV clients and unnecessary referral to other healthcare institutions and refusal to treat clients were identified. Having in-depth HIV knowledge, the perception of institutional support, attending training on stigma and discrimination, educational level of degree or higher, high HIV case loads, the presence of ART service in the healthcare facility and claiming to be

  20. Effectiveness of train-the-trainer HIV education: a model from Vietnam.

    Science.gov (United States)

    Williams, Ann Bartley; Le, Suu Thi; Colby, Donn; Thu Le, Trang Thi; Pollack, Todd; Cosimi, Lisa

    2014-01-01

    As HIV prevention and treatment efforts expand around the globe, local capacity-building to update and maintain nurses' HIV competence is essential. The purpose of this project was to develop and sustain a national network of nurse-trainers who could provide ongoing HIV continuing education and training experiences to Vietnamese nurses. Over the course of 6 years, 87 nurses received training to become HIV trainers; their HIV knowledge increased significantly (p = .001), as did teaching self-confidence (p = .001 to .007). The 87 nurses subsequently reported training more than 67,000 health care workers. Recipients of train-the-trainer-led workshops demonstrated increased HIV knowledge (p = .001) and increased willingness to provide nursing care for HIV-infected patients (p = .001). The program demonstrated that including a substantial amount of instruction in pedagogical strategies and experiential learning could enhance knowledge transfer, expand education outreach, and contribute to sustainable HIV competence among nurses.

  1. Providing oral care in haematological oncology patients: nurses' knowledge and skills.

    Science.gov (United States)

    Potting, Carin M J; Mank, Arno; Blijlevens, Nicole M A; Donnelly, J Peter; van Achterberg, Theo

    2008-09-01

    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care improve when education in oral care is provided to nurses in charge of patients who are at risk of oral mucositis. This intervention study consists of a baseline test on the knowledge and skills of nurses of the haematology wards of two different hospitals. Oral care education sessions were given in one hospital and follow-up tests were performed in both hospitals. Nursing records were examined and observations of nurses performing oral care were made at baseline as well as at follow-up. The results show significant differences in the scores for knowledge and skills before and after the education, whereas there was no difference in scores at the two points in time for the comparison hospital, where no education had taken place. The records test showed no differences at baseline or follow-up for the two groups. Observations showed that nurses who followed the education session implemented the oral care protocol considerably better than those who did not attended. Education in oral care has a positive influence on the knowledge and skills of nurses who care for patient at risk of oral mucositis, but not on the quality of oral care documentation.

  2. Punica granatum (Pomegranate juice provides an HIV-1 entry inhibitor and candidate topical microbicide

    Directory of Open Access Journals (Sweden)

    Li Yun-Yao

    2004-10-01

    Full Text Available Abstract Background For ≈ 24 years the AIDS pandemic has claimed ≈ 30 million lives, causing ≈ 14,000 new HIV-1 infections daily worldwide in 2003. About 80% of infections occur by heterosexual transmission. In the absence of vaccines, topical microbicides, expected to block virus transmission, offer hope for controlling the pandemic. Antiretroviral chemotherapeutics have decreased AIDS mortality in industrialized countries, but only minimally in developing countries. To prevent an analogous dichotomy, microbicides should be: acceptable; accessible; affordable; and accelerative in transition from development to marketing. Already marketed pharmaceutical excipients or foods, with established safety records and adequate anti-HIV-1 activity, may provide this option. Methods Fruit juices were screened for inhibitory activity against HIV-1 IIIB using CD4 and CXCR4 as cell receptors. The best juice was tested for inhibition of: (1 infection by HIV-1 BaL, utilizing CCR5 as the cellular coreceptor; and (2 binding of gp120 IIIB and gp120 BaL, respectively, to CXCR4 and CCR5. To remove most colored juice components, the adsorption of the effective ingredient(s to dispersible excipients and other foods was investigated. A selected complex was assayed for inhibition of infection by primary HIV-1 isolates. Results HIV-1 entry inhibitors from pomegranate juice adsorb onto corn starch. The resulting complex blocks virus binding to CD4 and CXCR4/CCR5 and inhibits infection by primary virus clades A to G and group O. Conclusion These results suggest the possibility of producing an anti-HIV-1 microbicide from inexpensive, widely available sources, whose safety has been established throughout centuries, provided that its quality is adequately standardized and monitored.

  3. Client and provider perspectives on new HIV prevention tools for MSM in the Americas.

    Directory of Open Access Journals (Sweden)

    Sheri A Lippman

    Full Text Available Men who have sex with men (MSM in the Americas require targeted, combination HIV prevention approaches. We solicited client and provider perspectives on emerging prevention interventions including HIV pre-exposure prophylaxis (PrEP and HIV self-tests through focus groups and in-depth interviews with 130 MSM and 41 providers across four sites: New York, San Francisco, Lima, and Rio de Janeiro. Among the MSM participants, we identified three prevention typologies: non-condom users, inconsistent condom users, and consistent condom users. Northern and Southern MSM differed in the variety of harm reduction strategies utilized: where U.S. MSM relied on condom use as well as disclosure and seroadaptive behaviors for prevention, condom use without disclosure or serostatus discussions was the norm in South America. Interest in new prevention technologies was shaped by the social context. U.S. MSM preferences differed by typology, such that non-condom users were interested in taking PrEP and using home HIV tests. MSM in Brazil, regardless of typology, were interested in exploring new prevention options. MSM in Peru demonstrated moderate interest but were less comfortable with adopting new strategies. MSM and providers' opinions differed substantially with respect to new prevention options. Across sites, most providers were reticent to engage with new prevention options, though some NGO-based providers were more supportive of exploring new prevention tools. Both clients and providers will need to be engaged in developing integrated prevention strategies for MSM.

  4. Male circumcision for HIV prevention in India: emerging viewpoints and practices of health care providers.

    Science.gov (United States)

    Sinha, Anju; Chandhiok, Nomita; Sahay, Seema; Deb, Sibnath; Bharat, Shalini; Gupta, Abhilasha; Bhatt, Sripad; Kanthe, Vidisha; Kumar, Bijesh; Joglekar, Neelam; Paranjape, Ramesh; Mehendale, Sanjay

    2015-01-01

    A compelling case for promoting male circumcision (MC) as an intervention for reducing the risk of heterosexually acquired HIV infection was made by dissemination of the results of three studies in Africa. The WHO/UNAIDS recommendation for MC for countries like India, where the epidemic in concentrated in high-risk groups, advocates MC for specific population groups such as men at higher risk for HIV acquisition. A multicentre qualitative study was conducted in four geographically distinct districts (Belgaum, Kolkata, Meerut and Mumbai) in India during June 2009 to June 2011. Two categories of health care providers: Registered Healthcare Providers (RHCPs) and traditional circumcisers were interviewed by trained research staff who had received master's level education using interview guides with probes and open-ended questions. Respondents were selected using purposive sampling. A comparative analysis of the perspectives of the RHCP vs. traditional circumcisers is presented. Representatives of both categories of providers expressed the need for Indian data on MC. Providers feared that promoting circumcision might jeopardize/undermine the progress already made in the field of condom promotion. Reservation was expressed regarding its adoption by Hindus. Behavioural disinhibition was perceived as an important limitation. A contrast in the practice of circumcision was apparent between the traditional and the trained providers. MC should be mentioned as a part of comprehensive HIV prevention services in India that includes HIV counselling and testing, condom distribution and diagnosis and treatment of sexually transmitted infections. It should become an issue of informed personal choice rather than ethnic identity.

  5. Retained in HIV Care But Not on Antiretroviral Treatment: A Qualitative Patient-Provider Dyadic Study

    Science.gov (United States)

    Christopoulos, Katerina A.; Olender, Susan; Lopez, Andrea M.; Lekas, Helen-Maria; Jaiswal, Jessica; Mellman, Will; Geng, Elvin; Koester, Kimberly A.

    2015-01-01

    Background Patients retained in HIV care but not on antiretroviral therapy (ART) represent an important part of the HIV care cascade in the United States. Even in an era of more tolerable and efficacious ART, decision making in regards to ART offer and uptake remains complex and calls for exploration of both patient and provider perspectives. We sought to understand reasons for lack of ART usage in patients meeting the Health Resources Services Administration definition of retention as well as what motivated HIV primary care appointment attendance in the absence of ART. Methods and Findings We conducted a qualitative study consisting of 70 in-depth interviews with ART-naïve and ART-experienced patients off ART and their primary care providers in two urban safety-net HIV clinics in San Francisco and New York. Twenty patients and their providers were interviewed separately at baseline, and 15 dyads were interviewed again after at least 3 mo and another clinic visit in order to understand any ART use in the interim. We applied dyadic analysis to our data. Nearly all patients were willing to consider ART, and 40% of the sample went on ART, citing education on newer antiretroviral drugs, acceptance of HIV diagnosis, social support, and increased confidence in their ability to adhere as facilitators. However, the strength of the provider recommendation of ART played an important role. Many patients had internalized messages from providers that their health was too good to warrant ART. In addition, providers, while demonstrating patient-centered care through sensitivity to patients experiencing psychosocial instability, frequently muted the offer of ART, at times unintentionally. In the absence of ART, lab monitoring, provider relationships, access to social services, opiate pain medications, and acute symptoms motivated care. The main limitations of this study were that treatment as prevention was not explored in depth and that participants were recruited from academic

  6. A changing landscape: mapping provider organisations for community nursing services in England.

    Science.gov (United States)

    Spilsbury, Karen; Pender, Sue

    2015-01-01

    To scope the provision of community nursing services in England after implementation of the Transforming Community Services Programme. Over the past decade, significant UK policy initiatives have shaped the structure, organisation and responsibilities of community nursing services. Understanding these organisational changes is important in the context of organisations seeking to deliver 'care closer to home'. A systematic mapping exercise to scope and categorise community nursing service organisation provider models. There are 102 provider organisations representing a range of organisational models. Two-thirds of these organisations have structurally integrated with another NHS Trust. Smaller numbers reorganised to form community trusts or community interest companies. Only a few services have been tendered to an accredited willing provider while a small number have yet to establish their new service model. Local discretion appears to have dominated the choice of organisational form. National policies have driven the reorganisation of community nursing services and we have been able to describe, for the first time, these 'transformed' structures and organisations. Providing detail of these 'new' models of service provision, and where these have been introduced, is new information for nurse managers, policy makers and organisational leaders, as well as researchers. © 2013 John Wiley & Sons Ltd.

  7. Evaluating the implementation of nurse-initiated HIV rapid testing in three Veterans Health Administration substance use disorder clinics.

    Science.gov (United States)

    Conners, E E; Hagedorn, H J; Butler, J N; Felmet, K; Hoang, T; Wilson, P; Klima, G; Sudzina, E; Anaya, H D

    2012-11-01

    Individuals with substance use disorders (SUDs) are at higher risk of HIV infection, yet recent studies show rates of HIV testing are low among this population. We implemented and evaluated a nurse-initiated HIV oral rapid testing (NRT) strategy at three Veterans Health Administration SUD clinics. Implementation of NRT includes streamlined nurse training and a computerized clinical reminder. The evaluation employed qualitative interviews with staff and a quantitative evaluation of HIV testing rates. Barriers to testing included lack of laboratory support and SUD nursing resistance to performing medical procedures. Facilitators included the ease of NRT integration into workflow, engaged management and an existing culture of disease prevention. Six-months post intervention, rapid testing rates at SUD clinics in sites 1, 2, and 3 were 5.0%, 1.1% and 24.0%, respectively. Findings indicate that NRT can be successfully incorporated into some types of SUD subclinics with minimal perceived impact on workflow and time.

  8. Providers' Perceptions of and Receptivity toward Evidence-Based HIV Prevention Interventions

    Science.gov (United States)

    Owczarzak, Jill; Dickson-Gomez, Julia

    2011-01-01

    Since 1999, the Centers for Disease Control and Prevention have trained over 10,000 service providers from more than 5,000 agencies to implement evidence-based HIV prevention interventions through its Diffusion of Effective Behavioral Interventions DEBI) program. Based on in-depth, semistructured interviews with a convenience sample of 22 HIV…

  9. Cultural Diversity Training: The Necessity of Cultural Competence for Health Care Providers and in Nursing Practice.

    Science.gov (United States)

    Young, Susan; Guo, Kristina L

    2016-01-01

    The purpose of this article is to discuss the need to provide culturally sensitive care to the growing number of diverse health care consumers. A literature review of national standards and research on cultural competency was conducted and specifically focused on the field of nursing. This study supports the theory that cultural competence is learned over time and is a process of inner reflection and awareness. The domains of awareness, skill, and knowledge are essential competencies that must be gained by health care providers and especially for nurses. Although barriers to providing culturally sensitive care exist, gaining a better understanding of cultural competence is essential to developing realistic education and training techniques, which will lead to quality professional nursing practice for increasingly diverse populations.

  10. [Providing end-of-life nursing care to children with cancer].

    Science.gov (United States)

    Lu, Chi-Wen; Wong, Tai-Tong; Mu, Pei-Fan

    2011-08-01

    There has been little qualitative research in Taiwan on the experiences of nurses who encounter the moment of child's death from their own perspective. Using a phenomenological approach, this study worked to understand the essence of the caring experience for nurses at the moment of a cancer child's death from the nurses' own perspectives. Researchers used Colaizzi's (1978) phenomenological method and collected data using purposive sampling and in-depth, tape-recorded interviews. Data were analyzed using the Colaizzi (1978) method. Ten registered nurses from a medical center participated into this study. The trustworthiness of the study was examined using Lincoln and Guba (1985) principles. Five major themes emerged, including introspection on caring for dying children after their death; coping patterns of nurses; toleration and ability to help to ensure the child has a good death; facing death and consoling the soul; and accompanying parents though the moment of death. Study findings provide evidence-based information on nurses to care for cancer children and their families facing the moment of death.

  11. Epidemiology of tuberculosis in a high HIV prevalence population provided with enhanced diagnosis of symptomatic disease.

    Directory of Open Access Journals (Sweden)

    Elizabeth L Corbett

    2007-01-01

    Full Text Available BACKGROUND: Directly observed treatment short course (DOTS, the global control strategy aimed at controlling tuberculosis (TB transmission through prompt diagnosis of symptomatic smear-positive disease, has failed to prevent rising tuberculosis incidence rates in Africa brought about by the HIV epidemic. However, rising incidence does not necessarily imply failure to control tuberculosis transmission, which is primarily driven by prevalent infectious disease. We investigated the epidemiology of prevalent and incident TB in a high HIV prevalence population provided with enhanced primary health care. METHODS AND FINDINGS: Twenty-two businesses in Harare, Zimbabwe, were provided with free smear- and culture-based investigation of TB symptoms through occupational clinics. Anonymised HIV tests were requested from all employees. After 2 y of follow-up for incident TB, a culture-based survey for undiagnosed prevalent TB was conducted. A total of 6,440 of 7,478 eligible employees participated. HIV prevalence was 19%. For HIV-positive and -negative participants, the incidence of culture-positive tuberculosis was 25.3 and 1.3 per 1,000 person-years, respectively (adjusted incidence rate ratio = 18.8; 95% confidence interval [CI] = 10.3 to 34.5: population attributable fraction = 78%, and point prevalence after 2 y was 5.7 and 2.6 per 1,000 population (adjusted odds ratio = 1.7; 95% CI = 0.5 to 6.8: population attributable fraction = 14%. Most patients with prevalent culture-positive TB had subclinical disease when first detected. CONCLUSIONS: Strategies based on prompt investigation of TB symptoms, such as DOTS, may be an effective way of controlling prevalent TB in high HIV prevalence populations. This may translate into effective control of TB transmission despite high TB incidence rates and a period of subclinical infectiousness in some patients.

  12. Health care provider satisfaction with telephone consultations provided by pharmacists and physicians at the National HIV/AIDS Clinicians' Consultation Center.

    Science.gov (United States)

    Sherman, Elizabeth M; Cocohoba, Jennifer M; Neff, Sarah E; Dong, Betty J

    2011-12-01

    The federally funded National HIV/AIDS Clinicians' Consultation Center (NCCC) offers US health care providers expert telephone consultations for managing HIV/AIDS and occupational exposures to blood-borne pathogens through 3 telephone services: the National Clinicians' Post-Exposure Prophylaxis Hotline (PEPline), the National HIV Telephone Consultation Service (Warmline), and the Perinatal HIV Hotline. Callers to the NCCC receive consultation from either a clinical pharmacist (PharmD) or a physician (MD) with HIV expertise. To compare the satisfaction of NCCC callers who received clinical consultations from clinical pharmacists and physicians with HIV expertise. We prospectively mailed 1256 satisfaction surveys to NCCC health care provider callers during a 7-month period. Survey recipients were not aware that satisfaction surveys compared PharmD and MD consultation services. Respondents rated their level of agreement with 8 statements about the quality of consultation, the quality of clinical information given, and future calls to the NCCC. Survey return rates were 43% for PEPline and 40% for Warmline and Perinatal HIV Hotline combined. Overall, caller satisfaction with the telephone consultation service was extremely high (>4 in all categories on a 1-5 Likert scale). There was no significant difference in PEPline caller satisfaction ratings between PharmD and MD consultations. Callers to the Warmline and Perinatal HIV Hotline agreed with all 8 satisfaction statements. For the following 3 statements, however, satisfaction was higher when Warmline and Perinatal HIV Hotline consultation was provided by an MD: "Overall, I was pleased with the quality of my consultation" (p = 0.04); "I would use this service again" (p HIV/AIDS telephone consultation service. By measuring callers' survey response to PharmD and MD consultations, the importance of the clinicians' contributions to this advanced HIV/AIDS consultation service is documented.

  13. The managerial duties of the nurse in charge of a unit in combating the spreading of HIV/AIDS.

    Science.gov (United States)

    Isaacs, D; Jooste, K

    2004-08-01

    The charge sister has an essential role to play in combating the spreading of the HIV in the environment of the nursing unit. The HIV/AIDS dilemma is a reality in the health care environment. On a daily basis nurses is treating patients with the HIV. Through the basic conceptual framework of the management process, the charge sister can play her part and contribute in keeping the disease under control in her work environment. An explorative, descriptive study was done through a structured questionnaire with four open questions. This study was aimed at developing and formulating guidelines to be included in a policy to be used in the combating of spreading of HIV in the health care unit by the charge sister and her staff. The results indicate the absence of policy regarding the prevention of the spreading of the HIV, necessary for orientation and in service training of staff.

  14. The managerial duties of the nurse in charge of a unit in combating the spreading of HIV/AIDS

    Directory of Open Access Journals (Sweden)

    D. Isaacs

    2004-09-01

    Full Text Available The charge sister has an essential role to play in combating the spreading of the HIV in the environment of the nursing unit. The HIV/AIDS dilemma is a reality in the health care environment. On a daily basis nurses is treating patients with the HIV. Through the basic conceptual framework of the management process, the charge sister can play her part and contribute in keeping the disease under control in her work environment. An explorative, descriptive study was done through a structured questionnaire with four open questions. This study was aimed at developing and formulating guidelines to be included in a policy to be used in the combating of spreading of HIV in the health care unit by the charge sister and her staff. The results indicate the absence of policy regarding the prevention of the spreading of the HIV, necessary for orientation and in service training of staff.

  15. Acceptability, feasibility and challenges of implementing an HIV prevention intervention for people living with HIV/AIDS among healthcare providers in Mozambique: results of a qualitative study.

    Science.gov (United States)

    Jaiantilal, Prafulta; Gutin, Sarah A; Cummings, Beverley; Mbofana, Francisco; Rose, Carol Dawson

    2015-01-01

    Despite the Mozambique government's efforts to curb human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), national prevalence is 11.5% and support is needed to expand HIV-related services and improve program quality. Positive prevention (PP) programs, which prioritize HIV prevention with people living with HIV and AIDS (PLHIV), have been recognized as an important intervention for preventing new HIV infections. To address this, an evidence-based PP training intervention was implemented with HIV healthcare providers in Mozambique. This study focuses on the acceptability and feasibility of a PP intervention in HIV clinics from the healthcare provider perspective. In-depth interviews were conducted with 31 healthcare providers from three provinces who participated in PP trainings in Mozambique. Interview data were coded using content analysis. Study data suggest that healthcare providers found PP acceptable, feasible to implement in their HIV work in clinic settings, and valued this strategy to improve HIV prevention. The PP training also led providers to feel more comfortable counseling their patients about prevention, with a more holistic approach that included HIV testing, treatment and encouraging PLHIV to live positively. While overall acceptance of the PP training was positive, several barriers to feasibility surfaced in the data. Patient-level barriers included resistance to disclosing HIV status due to fear of stigma and discrimination, difficulty negotiating for condom use, difficulty engaging men in testing and treatment, and the effects of poverty on accessing care. Providers also identified work environment barriers including high patient load, time constraints, and frequent staff turnover. Recognizing PP as an important intervention, healthcare providers should be trained to provide comprehensive prevention, care and treatment for PLHIV. Further work is needed to explore the complex social dynamics and cultural challenges such as

  16. Building Trust and Relationships Between Patients and Providers: An Essential Complement to Health Literacy in HIV Care.

    Science.gov (United States)

    Dawson-Rose, Carol; Cuca, Yvette P; Webel, Allison R; Solís Báez, Solymar S; Holzemer, William L; Rivero-Méndez, Marta; Sanzero Eller, Lucille; Reid, Paula; Johnson, Mallory O; Kemppainen, Jeanne; Reyes, Darcel; Nokes, Kathleen; Nicholas, Patrice K; Matshediso, Ellah; Mogobe, Keitshokile Dintle; Sabone, Motshedisi B; Ntsayagae, Esther I; Shaibu, Sheila; Corless, Inge B; Wantland, Dean; Lindgren, Teri

    2016-01-01

    Health literacy is important for access to and quality of HIV care. While most models of health literacy acknowledge the importance of the patient-provider relationship to disease management, a more nuanced understanding of this relationship is needed. Thematic analysis from 28 focus groups with HIV-experienced patients (n = 135) and providers (n = 71) identified a long-term and trusting relationship as an essential part of HIV treatment over the continuum of HIV care. We found that trust and relationship building over time were important for patients with HIV as well as for their providers. An expanded definition of health literacy that includes gaining a patient's trust and engaging in a process of health education and information sharing over time could improve HIV care. Expanding clinical perspectives to include trust and the importance of the patient-provider relationship to a shared understanding of health literacy may improve patient experiences and engagement in care.

  17. Evaluation of nurses' perceptions on providing patient decision support with cardiopulmonary resuscitation.

    Science.gov (United States)

    Pyl, Nicole; Menard, Prudy

    2012-01-01

    The decision whether to receive cardiopulmonary resuscitation (CPR) is a decision in which the personal values of the patient must be considered along with information about the risks and benefits of the treatment. A decision aid can be used to provide patient decision support to a patient who is seriously ill and needs to consider CPR options. The goal of this project was to identify the barriers and facilitators to using a CPR decision aid, through evaluating nursing perceptions on providing patient decision support. Using a needs assessment, it was determined that implementing a patient decision aid for CPR status in the Acute Monitor Area (AMA) of The Ottawa Hospital would be an excellent quality improvement project. The nurses who chose to participate were given an education session regarding patient decision support. Questionnaires were distributed to evaluate their views of patient decision support and decision aids before and after the education session and implementation of the CPR decision aid. Questionnaire results did not indicate a significant change between before or after education session and decision aid implementation. Qualitative reports did indicate that nurses generally have positive attitudes toward patient decision support and decision aids. The nurses identified specific barriers and facilitators in their commentaries. This clinically relevant data supports the idea that patient decision support should be integrated into daily nursing practice.

  18. "Why can't I pass these exams?": providing individualized feedback for nursing students.

    Science.gov (United States)

    Wiles, Lynn L

    2015-03-01

    The nursing literature on examination remediation and testing feedback strategies focuses primarily on NCLEX-RN success and remediation, rather than on the course examinations taken by students throughout program curricula. Students deemed at risk for NCLEX-RN failure likely have displayed poor performance on examinations long before graduation and licensure testing. Individualized examination feedback that identifies students' specific weaknesses is superior to correct answer feedback. The feedback grid described in this article demonstrates one method of providing structured, individualized feedback using the nursing process, Bloom's taxonomy, and NCLEX-RN blueprints. The feedback grid helped students to identify patterns in knowledge gaps, determine the correct answers to missed examination questions, and improve test scores in a critical care nursing course.

  19. Feasibility and effectiveness of provider initiated HIV testing and counseling of TB suspects in Vizianagaram district, South India.

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    Shanta Achanta

    Full Text Available BACKGROUND: Though internationally recommended, provider initiated HIV testing and counseling (PITC of persons suspected of tuberculosis (TB is not a policy in India; HIV seroprevalence among TB suspects has never been reported. The current policy of PITC for diagnosed TB cases may limit opportunities of early HIV diagnosis and treatment. We determined HIV seroprevalence among persons suspected of TB and assessed feasibility and effectiveness of PITC implementation at this earlier stage in the TB diagnostic pathway. METHODS: All adults examined for diagnostic sputum microscopy (TB suspects in Vizianagaram district (population 2.5 million, in November-December 2010, were offered voluntary HIV counseling and testing (VCT and assessed for TB diagnosis. RESULTS: Of 2918 eligible TB suspects, 2465(85% consented to VCT. Among these, 246(10% were HIV-positive. Of the 246, 84(34% were newly diagnosed as HIV (HIV status not known previously. To detect a new case of HIV infection, the number needed to screen (NNS was 26 among 'TB suspects', comparable to that among 'TB patients'. Among suspects aged 25-54 years, not diagnosed as TB, the NNS was 17. CONCLUSION: The seroprevalence of HIV among 'TB suspects' was as high as that among 'TB patients'. Implementation of PITC among TB suspects was feasible and effective, detecting a large number of new HIV cases with minimal additional workload on staff of HIV testing centre. HIV testing of TB suspects aged 25-54 years demonstrated higher yield for a given effort, and should be considered by policy makers at least in settings with high HIV prevalence.

  20. Knowledge and uptake of occupational post-exposure prophylaxis amongst nurses caring for people living with HIV

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    Lufuno Makhado

    2016-02-01

    Full Text Available Background: Nurses caring for people living with HIV (PLWH are at higher risk of exposure to the human immunodeficiency virus (HIV by needle sticks, cuts, getting body fluids in their eyes or mouth and skin when bruised or affected by dermatitis.Objectives: To determine knowledge, insight and uptake of occupational post-exposure prophylaxis (OPEP amongst nurses caring for PLWH.Method: A cross-sectional descriptive design was used in this study. Stratified random sampling was used to sample 240 nurses. The study was conducted in a regional hospital in Limpopo province. Both parametric and non-parametric statistics were employed to analyse data.Results: A total of 233 nurses participated in the study. Sixty per cent (n = 138 of all nurses had a situation at work when they thought that they were infected by HIV and 100 (43% nurses had experienced the situation once or more in the past 12 month. Approximately 40% did not know what PEP (post-exposure prophylaxis is, and 22% did not know or were not sure if it was available in the hospital. Only few participants (n = 68, 29% had sought PEP and most (n = 37, 54% of them did not receive PEP when they needed it. There was a significant association between the knowledge and availability of PEP (r = 0.622.Conclusion: The study recommend an urgent need for policy makers in the health sector to put in place policies, guidelines and programmes that will rapidly scale up PEP services in health care settings, so that preventable occupationally acquired HIV infection can be minimised amongst nurses.Keywords: Post-Exposure Prophylaxis; Nurses; HIV, Occupational Exposure; PLWH

  1. Providing the family-nurse partnership programme through interpreters in England.

    Science.gov (United States)

    Barnes, Jacqueline; Ball, Mog; Niven, Lisa

    2011-07-01

    This study looks at the delivery of the Family-Nurse Partnership (FNP) in England with interpreters. This home-visiting programme for vulnerable, young first-time mothers is known in the USA as the Nurse-Family Partnership (NFP). FNP is manualised with a number of fidelity targets and stretch objectives. This study covers the first two phases, pregnancy and infancy (up to 12 months). The programme relies on the development of a close nurse-client relationship. Interpreters can be a barrier for therapeutic work with vulnerable groups. The aims are to determine from quantitative and qualitative data whether the FNP programme can be delivered with fidelity in the presence of an interpreter and to explore issues concerned with the impact of interpreters on relationships. Statistical comparisons were made of delivery objectives over 2 years, from April 2007 to February 2009, in the 10 sites in England, spread across all nine Government Office Regions providing FNP. Forty-three clients had an interpreter at some point and 1261 did not. Qualitative interviews were conducted between April and May 2009 with 30 stakeholders (nurses, clients, interpreters). In relation to quantitative indicators, the percentage of planned content covered in visits was lower with interpreters (pregnancy 90% vs. 94%; infancy 88% vs. 93%) and both understanding and involvement of clients, as judged by nurses on 5-point scales, were lower (understanding, pregnancy 4.3 vs. 4.6, infancy 3.8 vs. 4.5; involvement, pregnancy 4.4 vs. 4.7, infancy 3.7 vs. 4.5). The interpreter was not thought by nurses to impede the development of a collaborative client-nurse relationship unless the interpreter and client became too close, but some nurses and clients reported that they would rather manage without an interpreter. Some stress was noted for nurses delivering the programme with an interpreter. More research is needed to determine the extent to which interpreters accurately convey the programme's strength

  2. Sources of moral distress for nursing staff providing care to residents with dementia.

    Science.gov (United States)

    Spenceley, Shannon; Witcher, Chad Sg; Hagen, Brad; Hall, Barry; Kardolus-Wilson, Arron

    2017-10-01

    The World Health Organization estimates the number of people living with dementia at approximately 35.6 million; they project a doubling of this number by 2030 and tripling by 2050. Although the majority of people living with a dementia live in the community, residential facility care by nursing care providers is a significant component of the dementia journey in most countries. Research has also shown that caring for persons with dementia can be emotionally, physically, and ethically challenging, and that turnover in nursing staff in residential care settings tends to be high. Moral distress has been explored in a variety of settings where nurses provide acute or intensive care. The concept, however, has not previously been explored in residential facility care settings, particularly as related to the care of persons with dementia. In this paper, we explore moral distress in these settings, using Nathaniel's definition of moral distress: the pain or anguish affecting the mind, body, or relationships in response to a situation in which the person is aware of a moral problem, acknowledges moral responsibility, makes a moral judgment about the correct action and yet, as a result of real or perceived constraints, cannot do what is thought to be right. We report findings from a qualitative study of moral distress in a single health region in a Canadian province. Our aim in this paper is to share findings that elucidate the sources of moral distress experienced by nursing care providers in the residential care of people living with dementia.

  3. Anal Cancer Screening in an Urban HIV Clinic: Provider Perceptions and Practice.

    Science.gov (United States)

    Sowah, Leonard Anang; Buchwald, Ulrike K; Riedel, David J; Gilliam, Bruce L; Khambaty, Mariam; Fantry, Lori; Spencer, Derek E; Weaver, Jeffery; Taylor, Gregory; Skoglund, Mary; Amoroso, Anthony; Redfield, Robert R

    2015-01-01

    In this article, we sought to understand the perceptions and practice of providers on anal cancer screening in HIV-infected patients. Providers in an academic outpatient HIV practice were surveyed. Data were analyzed to determine the acceptability and perceptions of providers on anal Papanicolaou tests. Survey response rate was 55.3% (60.7% among male and 47.4% among female providers). One-third of the providers had received screening requests from patients. Female providers had higher self-rated comfort with anal Papanicolaou tests, with a mean score of 7.1 (95% confidence interval [CI] 4.7-9.5) compared to 3.6 (95% CI 1.5-5.7) for male providers, P = .02. Sixty-seven percent of male providers and 37.5% of female providers would like to refer their patients for screening rather than perform the test themselves. Only 54.2% of our providers have ever performed anal cytology examination. Our survey revealed that not all providers were comfortable performing anal cancer screening for their patients.

  4. Messages on pregnancy and family planning that providers give women living with HIV in the context of a Positive Health, Dignity, and Prevention intervention in Mozambique

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    Hilliard S

    2014-12-01

    Full Text Available Starr Hilliard, Sarah A Gutin, Carol Dawson Rose Department of Community Health Systems, School of Nursing, University of California at San Francisco, San Francisco, CA, USA Background: Family planning is an important HIV prevention tool for women living with HIV (WLHIV. In Mozambique, the prevalence of HIV among women of reproductive age is 13.1% and the average fertility rate is high. However, family planning and reproductive health for WLHIV are under-addressed in Mozambique. This study explores provider descriptions of reproductive health messages in order to identify possible barriers and facilitators to successfully addressing family planning and pregnancy concerns of WLHIV. Methods: In 2006, a Positive Health, Dignity, and Prevention program was introduced in Mozambique focused on training health care providers to work with patients to reduce their transmission risks. Providers received training on multiple components, including family planning and prevention of mother-to-child transmission (PMTCT. In-depth interviews were conducted with 31 providers who participated in the training in five rural clinics in three provinces. Data were analyzed using qualitative content analysis. Results: Analysis showed that providers' clinical messages on family planning, pregnancy, and PMTCT for WLHIV could be arranged along a continuum. Provider statements ranged from saying that WLHIV should not become pregnant and condoms are the only valid form of family planning for WLHIV, to suggesting that WLHIV can have safe pregnancies. Conclusion: These data indicate that many providers continue to believe that WLHIV should not have children and this represents a challenge for integrating family planning into the care of WLHIV. Also, not offering WLHIV a full selection of family planning methods severely limits their ability to protect themselves from unintended pregnancies and to fully exercise their reproductive rights. Responding to the reproductive health

  5. Cell-Associated Viral Burden Provides Evidence of Ongoing Viral Replication in Aviremic HIV-2-Infected Patients▿

    Science.gov (United States)

    Soares, Rui S.; Tendeiro, Rita; Foxall, Russell B.; Baptista, António P.; Cavaleiro, Rita; Gomes, Perpétua; Camacho, Ricardo; Valadas, Emília; Doroana, Manuela; Lucas, Margarida; Antunes, Francisco; Victorino, Rui M. M.; Sousa, Ana E.

    2011-01-01

    Viremia is significantly lower in HIV-2 than in HIV-1 infection, irrespective of disease stage. Nevertheless, the comparable proviral DNA burdens observed for these two infections indicate similar numbers of infected cells. Here we investigated this apparent paradox by assessing cell-associated viral replication. We found that untreated HIV-1-positive (HIV-1+) and HIV-2+ individuals, matched for CD4 T cell depletion, exhibited similar gag mRNA levels, indicating that significant viral transcription is occurring in untreated HIV-2+ patients, despite the reduced viremia (undetectable to 2.6 × 104 RNA copies/ml). However, tat mRNA transcripts were observed at significantly lower levels in HIV-2+ patients, suggesting that the rate of de novo infection is decreased in these patients. Our data also reveal a direct relationship of gag and tat transcripts with CD4 and CD8 T cell activation, respectively. Antiretroviral therapy (ART)-treated HIV-2+ patients showed persistent viral replication, irrespective of plasma viremia, possibly contributing to the emergence of drug resistance mutations, persistent hyperimmune activation, and poor CD4 T cell recovery that we observed with these individuals. In conclusion, we provide here evidence of significant ongoing viral replication in HIV-2+ patients, further emphasizing the dichotomy between amount of plasma virus and cell-associated viral burden and stressing the need for antiretroviral trials and the definition of therapeutic guidelines for HIV-2 infection. PMID:21159859

  6. An exploration of the services provided by the clinical nurse specialist within one NHS trust.

    Science.gov (United States)

    Martin, P J

    1999-05-01

    This study examines the services provided by clinical nurse specialists within one acute and community NHS Trust. The title 'clinical nurse specialist' (CNS) is used widely within health care services and describes a multitude of roles and service provision. Lack of role clarity impacts upon human resources, service delivery and the post holder. Patients, carers and health care professionals were invited to participate in focus groups. Groups sought information about the services provided by the CNS. The research adopted a grounded theory approach in order to generate a locally recognizable description of the services. From the data analysis eight technical services carried out by the CNSs emerged. Analysis also identified three areas where the CNS provided added value. The findings are discussed in relation to relevant literature. Recommendations are made concerning effective and efficient use of this important staff resource.

  7. Community burden of undiagnosed HIV infection among adolescents in Zimbabwe following primary healthcare-based provider-initiated HIV testing and counselling: A cross-sectional survey.

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    Victoria Simms

    2017-07-01

    Full Text Available Children living with HIV who are not diagnosed in infancy often remain undiagnosed until they present with advanced disease. Provider-initiated testing and counselling (PITC in health facilities is recommended for high-HIV-prevalence settings, but it is unclear whether this approach is sufficient to achieve universal coverage of HIV testing. We aimed to investigate the change in community burden of undiagnosed HIV infection among older children and adolescents following implementation of PITC in Harare, Zimbabwe.Over the course of 2 years (January 2013-January 2015, 7 primary health clinics (PHCs in southwestern Harare implemented optimised, opt-out PITC for all attendees aged 6-15 years. In February 2015-December 2015, we conducted a representative cross-sectional survey of 8-17-year-olds living in the 7 communities served by the study PHCs, who would have had 2 years of exposure to PITC. Knowledge of HIV status was ascertained through a caregiver questionnaire, and anonymised HIV testing was carried out using oral mucosal transudate (OMT tests. After 1 participant taking antiretroviral therapy was observed to have a false negative OMT result, from July 2015 urine samples were obtained from all participants providing OMTs and tested for antiretroviral drugs to confirm HIV status. Children who tested positive through PITC were identified from among survey participants using gender, birthdate, and location. Of 7,146 children in 4,251 eligible households, 5,486 (76.8% children in 3,397 households agreed to participate in the survey, and 141 were HIV positive. HIV prevalence was 2.6% (95% CI 2.2%-3.1%, and over a third of participants with HIV were undiagnosed (37.7%; 95% CI 29.8%-46.2%. Similarly, among the subsample of 2,643 (48.2% participants with a urine test result, 34.7% of those living with HIV were undiagnosed (95% CI 23.5%-47.9%. Based on extrapolation from the survey sample to the community, we estimated that PITC over 2 years identified

  8. Representações sociais do cuidado prestado aos pacientes soropositivos ao HIV Representaciones sociales de la atención prestada a los pacientes seropositivos al VIH Social representations of the care provided to HIV seropositive patients

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    Gláucia Alexandre Formozo

    2010-04-01

    Rio de Janeiro and the subject 20 nursing assistants and 20 nurses. The data collection took place through semi-structured and used for its analysis software ALCESTE 4.7. Among the nursing assistants were characterized about the content of the daily nursing care provided to patients with HIV/AIDS, whereas the nurses have content back to their quality of life. Thus it was concluded that the social representation of nursing assistants is anchored in the practical elements of daily care, while nurses anchored in the knowledge reified.

  9. Role of ethical beliefs and attitudes of dental students in providing care for HIV/AIDS patients

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    Saad Ahmed Khan

    2017-01-01

    Conclusion: Dental students’ ethical beliefs about HIV/AIDS were not consistent with the ethical principles as stated in the code of ethics and they held negative attitudes towards PLWHAs. Ethical beliefs were found to be a determinant that may influence future attitudes of these students towards individuals with HIV/AIDS when providing care.

  10. Feeding assistance needs of long-stay nursing home residents and staff time to provide care.

    Science.gov (United States)

    Simmons, Sandra F; Schnelle, John F

    2006-06-01

    To describe the staff time requirements to provide feeding assistance to nursing home residents who require three different types of assistance to improve oral food and fluid intake (social stimulation, verbal cuing, or both; physical guidance; or full physical assistance) and to determine whether physically dependent residents require more staff time, as defined in the national Resource Utilization Group System (RUGS) used for reimbursement. Descriptive. Six skilled nursing homes. Ninety-one long-stay residents with low oral intake who responded to improved feeding assistance. Research staff conducted direct observations of usual nursing home care for 2 consecutive days (total of six meals) to measure oral food and fluid consumption (total percentage eaten) and staff time spent providing assistance (minutes and seconds). Research staff then implemented a standardized graduated-assistance protocol on 2 separate days (total of six meals) that enhanced residents' oral food and fluid intake. Staff time to provide feeding assistance that improved food and fluid consumption was comparable across different levels of eating dependency. Across all levels, residents required an average of 35 to 40 minutes of staff time per meal; thus, residents who needed only supervision and verbal cuing required just as much time as those who were physically dependent on staff for eating. The current RUGS system used for reimbursement likely underestimates the staff time required to provide feeding assistance care that improves oral intake.

  11. The diffusion of innovation in nursing regulatory policy: removing a barrier to medication administration training for child care providers.

    Science.gov (United States)

    Torre, Carolyn T; Crowley, Angela A

    2011-08-01

    Safe medication administration is an essential component of high-quality child care. Its achievement in New Jersey was impeded by a controversy over whether teaching child care providers medication administration involves registered nurses in the process of nursing delegation. Through the theoretical framework of the Diffusion of Innovation, this paper examines how the interpretation of regulatory policy related to nursing practice in New Jersey was adjusted by the Board of Nursing following a similar interpretation of regulatory policy by the Board of Nursing in Connecticut. This adjustment enabled New Jersey nurses to continue medication administration training for child care providers. National data supporting the need for training child care providers in medication administration is presented, the Diffusion of Innovation paradigm is described; the Connecticut case and the New Jersey dilemma are discussed; the diffusion process between the two states is analyzed and an assessment of the need for further change is made.

  12. HIV/AIDS knowledge among first year MBBS, Nursing, Pharmacy students of a health university, India

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    Sandeep Sachdeva

    2011-01-01

    Full Text Available Objective: To determine level of HIV/AIDS knowledge among first-year MBBS, nursing and pharmacy students of a health university. Materials and Methods: A pre-designed, pre-tested, anonymous self-administered, semi-structured questionnaire was circulated among available 129, 53 and 55 first-year MBBS, nursing and pharmacy students during Oct′ 09. Data entry, management and analysis were carried out using MS excel and software statistical package. Result: Out of the total 237 students, there were 123 (51.9% female and 103 (44.0% students from rural native place. A majority of students were able to correctly write the full form of AIDS (95.8% in comparison to HIV (72.6% and the difference between two terminologies were known to 87.6%, 81.1% and 70.9% of MBBS, nursing and pharmacy students, respectively. All four common routes of transmission of infection and methods of prevention were known to majority of the lot. However, injecting drug users (IDU and truck driver as a risk category was correctly reported by 67.5% and 55.3% students, whereas 35.9% incorrectly mentioned that smoking is a risk factor for acquiring infection. A statistically significant (P <0.05 proportion of MBBS followed by nursing and pharmacy students were aware that infection neither spreads by social activities like handshake/playing nor by mosquito bite. However, low level was ascertained with regard to items related to non-curability of infection (57.4% and availability of anti-retro viral therapy (27.4%. Conclusion: Overall high level of knowledge was recorded in the present study with a difference noted among students in three professional streams.

  13. [Nursing Experience With Providing Wound Care for a Newborn With Epidermolysis Bullosa].

    Science.gov (United States)

    Hsu, Hsiao-Hui; Zheng, Xin-Yi; Hsu, Mei-Yu

    2015-12-01

    Epidermolysis bullosa (EB) is a rare hereditary, chromosomal disease of the skin. Life-threatening septicemia may result if appropriate care is not provided to alleviate the extensive skin irritation that is the main symptom of this disease. This case report describes the experience of the author in nursing a wound area on a newborn that was suspected of being caused by EB. This wound area comprised blisters and peeling skin that covered 30% of the entire skin area of the infant. A holistic assessment conducted from December 1st, 2013 to January 7th, 2014 revealed that this large of an area of damage to the skin and mucosa considerably complicated the task of wound care and caused severe pain to the infant. In response to the special needs of this case, our medical team conducted a literature review of wound care for this rare disease. Based on the suggestions of previous empirical studies, nursing measures for the skin, mucosa, and wounds of the newborn were then administered through inter-team cooperation. These actions effectively reduced the pain, controlled the infection, and accelerated wound healing. In addition, progressive contact was used to guide the primary caregivers of the newborn, which alleviated their physical and psychological stresses effectively. The caregivers were educated systematically on wound care and guided to learn techniques for nursing and dressing wounds. Thus, these caregivers were better prepared to continue providing wound care at home. We suggest that healthcare professionals reference empirical studies when providing care to EB newborns during the acute-care period and provide wound care and supportive therapies to control the occurrence of complications using a multidisciplinary team-care model. In addition, social resources should be used effectively in nursing care plans to mitigate the effect of this rare disease on families.

  14. HIV prevention services received at health care and HIV test providers by young men who have sex with men: an examination of racial disparities.

    Science.gov (United States)

    Behel, Stephanie K; MacKellar, Duncan A; Valleroy, Linda A; Secura, Gina M; Bingham, Trista; Celentano, David D; Koblin, Beryl A; Lalota, Marlene; Shehan, Douglas; Torian, Lucia V

    2008-09-01

    We investigated whether there were racial/ethnic differences among young men who have sex with men (MSM) in their use of, perceived importance of, receipt of, and satisfaction with HIV prevention services received at health care providers (HCP) and HIV test providers (HTP) that explain racial disparities in HIV prevalence. Young men, aged 23 to 29 years, were interviewed and tested for HIV at randomly sampled MSM-identified venues in six U.S. cities from 1998 through 2000. Analyses were restricted to five U.S. cities that enrolled 50 or more black or Hispanic MSM. Among the 2,424 MSM enrolled, 1,522 (63%) reported using a HCP, and 1,268 (52%) reported having had an HIV test in the year prior to our interview. No racial/ethnic differences were found in using a HCP or testing for HIV. Compared with white MSM, black and Hispanic MSM were more likely to believe that HIV prevention services are important [respectively, AOR, 95% confidence interval (CI): 3.0, 1.97 to 4.51 and AOR, 95% CI: 2.7, 1.89 to 3.79], and were more likely to receive prevention services at their HCP (AOR, 95% CI: 2.5, 1.72 to 3.71 and AOR, 95% CI: 1.7, 1.18 to 2.41) and as likely to receive counseling services at their HTP. Blacks were more likely to be satisfied with the prevention services received at their HCP (AOR, 95% CI: 1.7, 1.14 to 2.65). Compared to white MSM, black and Hispanic MSM had equal or greater use of, perceived importance of, receipt of, and satisfaction with HIV prevention services. Differential experience with HIV prevention services does not explain the higher HIV prevalence among black and Hispanic MSM.

  15. Australian practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease.

    Science.gov (United States)

    Cass, Sarah; Ball, Lauren; Leveritt, Michael

    2014-01-01

    Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term 'basic' varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

  16. A smartphone application to educate undergraduate nursing students about providing care for infant airway obstruction.

    Science.gov (United States)

    Kim, Shin-Jeong; Shin, Hyewon; Lee, Jungeun; Kang, SoRa; Bartlett, Robin

    2017-01-01

    This study had two aims: (a) to develop a smartphone-based application and (b) to evaluate the effectiveness of the application by measuring nursing students' knowledge, skills, and confidence in simulated performance when providing that care. We conducted a randomized trial using a pre- and post-test design at a university in Korea. Seventy-three junior nursing students participated. A smartphone-based app using a video was developed for the experimental group and one time lecture-based education was designed for the control group. We provided the app and information about its use to the experimental group, and we encouraged its use. We provided classroom instruction to the control group. Then, learning outcomes were evaluated. The smartphone-based education group showed significantly higher scores on skills (t=4.774, psmartphone-based education may be an effective method to use in nursing education related to teaching infant airway obstruction. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. An overview of patients' preference for, and satisfaction with, care provided by general practitioners and nurse practitioners.

    NARCIS (Netherlands)

    Laurant, M.G.H.; Hermens, R.P.M.G.; Braspenning, J.C.C.; Akkermans, R.P.; Sibbald, B.; Grol, R.P.T.M.

    2008-01-01

    AIM AND OBJECTIVES: To assess patients' views on the care provided by nurse practitioners compared with that provided by general practitioners and to determine factors influencing these views. BACKGROUND: Many countries have sought to shift aspects of primary care provision from doctors to nurses. I

  18. Nurses' perception of the quality of care they provide to hospitalized drug addicts: testing the theory of reasoned action.

    Science.gov (United States)

    Natan, Merav Ben; Beyil, Valery; Neta, Okev

    2009-12-01

    A correlational design was used to examine nursing staff attitudes and subjective norms manifested in intended and actual care of drug users based on the Theory of Reasoned Action. One hundred and thirty-five nursing staff from three central Israeli hospitals completed a questionnaire examining theory-based variables as well as sociodemographic and professional characteristics. Most respondents reported a high to very high level of actual or intended care of drug users. Nurses' stronger intentions to provide quality care to drug users were associated with more positive attitudes. Nursing staff members had moderately negative attitudes towards drug users. Nurses were found to hold negative stereotypes of drug addict patients and most considered the management of this group difficult. Positive attitudes towards drug users, perceived expectations of others and perceived correctness of the behaviour are important in their effect on the intention of nurses to provide high-quality care to hospitalized patients addicted to drugs.

  19. A partnership approach to providing on-site HIV services for probationers and parolees: a pilot study from Alabama, USA

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    Bronwen Lichtenstein

    2016-07-01

    Full Text Available Introduction: HIV in the United States is concentrated in the South, an impoverished region with marked health disparities and high rates of incarceration, particularly among African Americans. In the Deep South state of Alabama, a policy directive to reduce prison overcrowding has diverted large numbers of convicted felons to community supervision. Probation and parole offices have yet to provide the HIV education and testing services that are offered in state prisons. This study sought to implement on-site HIV services for probationers and parolees through an intersectoral programme involving law enforcement, university and HIV agency employees. The three main objectives were to (1 involve probation/parole officers in planning, execution and assessment of the programme, (2 provide HIV education to the officers and (3 offer voluntary pretest HIV counselling and testing to probationers and parolees. Methods: The partnered programme was conducted between October and December 2015. Offenders who were recently sentenced to probation (“new offenders”, received HIV education during orientation. Offenders already under supervision prior to the programme (“current offenders” learned about the on-site services during scheduled office visits. Outcomes were measured through officer assessments, informal feedback and uptake of HIV services among offenders. Results: A total of 86 new and 249 current offenders reported during the programme (N=335. Almost one-third (31.4% of new offenders sought HIV testing, while only 3.2% of current offenders were screened for HIV. Refusals among current offenders invoked monogamy, time pressures, being tested in prison, fear of positive test results and concerns about being labelled as gay or unfaithful to women partners. Officers rated the programme as worthwhile and feasible to implement at other offices. Conclusions: The partnership approach ensured support from law enforcement and intersectoral cooperation

  20. Providing learning support to nursing students: a study of two universities.

    Science.gov (United States)

    Ooms, Ann; Fergy, Sue; Marks-Maran, Di; Burke, Linda; Sheehy, Karen

    2013-03-01

    In universities where significant numbers of nursing students come from non-traditional backgrounds, and where an equally significant proportion of students have English as a second language, provision of learning support is essential to ensure success and progression, and to prevent attrition. This paper presents an evaluative study of the support services provided to undergraduate nursing students in two universities in the United Kingdom (UK). Both universities have significant numbers of students from non-traditional backgrounds and who have English as a second language, and both institutions have in place a large array of student support mechanisms. The aims of the study were to identify all existing student support mechanisms across the two universities, to illuminate the profile of students who enter pre-registration programmes at the two universities (age, gender, educational background) and to measure the perceptions of students of the use and usefulness of the support mechanisms provided by their university. Survey method evaluative research was the chosen research approach. Findings showed that the support services that appear to have the greatest impact on student success in their nursing programme are the programme leaders/module teachers, small study skills groups (known as APPL and L2L) and, for the 50% of students who required it, academic literacy and numeracy support sessions. For students who have English as a second language and with non-traditional entry qualifications, numeracy and academic literacy support is particularly valued.

  1. [Nursing fundamentals: critical incidents related to care provided in supervised training].

    Science.gov (United States)

    Valsecchi, Elizabeth Amâncio de Souza da Silva; Nogueira, Maria Suely

    2002-01-01

    The course of Nursing fundamentals introduces the students to supervised training and can result in anxiety and tension. Therefore, the purpose of this study was to identify positive/negative aspects related to the care provided during the supervised training, based on the critical incidents technique. The subjects were students of the 2 degrees, 3 degrees and 4 degrees years of the Nursing Undergraduate Program offered by the State University of Maringá-PR. Authors identified 95 reports: 48(50.5%) positive and 47(49.5) negative. The positive aspects were related to the faculty's presence mediating the teaching-learning process; and the negative ones were related to the professionals insensibility regarding pain and death.

  2. Individual attitudes and perceived social norms: Reports on HIV/AIDS-related stigma among service providers in China

    Science.gov (United States)

    Li, Li; Liang, Li-Jung; Wu, Zunyou; Lin, Chunqing; Wen, Yi

    2009-01-01

    This study examined HIV/AIDS-related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor-nurse ratio of each hospital or clinic. Lab technicians were over-sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV-related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs. Cette étude a examiné le VIH/SIDA lié à stigmatisation parmi les agences chinoises fournissant des soins en comparant leurs attitudes

  3. An Assessment of Communication Competencies Needed by Intermediate-Level Health Care Providers: A Study of Nurse-Patient, Nurse-Doctor, Nurse-Nurse Communication Relationships.

    Science.gov (United States)

    Morse, Ben W.; Piland, Richard N.

    1981-01-01

    Found statistically significant differences across the three relationships for the importance of communication skills such as listening, routine information exchange, management of conflict, small group communication, etc. This study allows speech communication instructors to articulate the competencies needed by nurses across relationships. (PD)

  4. Nurses experiences in palliative care of terminally-ill HIV patients in a level 1 district hospital

    National Research Council Canada - National Science Library

    Bam, Nokwanda E; Naidoo, Joanne R

    2014-01-01

    ... for terminally-ill patients with HIV and how these experiences influence the nature of care rendered. Methods: Qualitative research using Husserl's approach of phenomenology design underpinned the study and Giorgi's steps of analysis were used to make meaning of the data. Results: The concept 'caring' was experienced by the nurses as tr...

  5. Diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds.

    Science.gov (United States)

    Carolan, Mary

    2014-05-01

    To explore diabetes nurse educators' experiences of providing care for women, with gestational diabetes mellitus, from disadvantaged backgrounds and to gather information which would assist with the development of an educational programme that would support both women and diabetes educators. Rates of gestational diabetes mellitus have increased dramatically in recent years. This is concerning as gestational diabetes mellitus is linked to poorer pregnancy outcomes including hypertension, stillbirth, and nursery admission. Poorest outcomes occur among disadvantaged women. gestational diabetes mellitus is also associated with maternal type 2 diabetes and with child obesity and type 2 diabetes among offspring. Effective self-management of gestational diabetes mellitus reduces these risks. Diabetes nurse educators provide most education and support for gestational diabetes mellitus self-management. An interpretative phenomenological analysis approach, as espoused by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51), provided the framework for this study. The views of six diabetes educators were explored through in-depth interviewing. Interviews were transcribed verbatim and analysed according to steps outlined by Smith and Osborn (Qualitative Psychology: A Practical Guide to Research Methods, 2008, Sage, London, 51). Three themes emerged from the data: (1) working in a suboptimal environment, (2) working to address the difficulties and (3) looking to the future. Throughout, the diabetes nurse educators sought opportunities to connect with women in their care and to make the educational content understandable and meaningful. Low literacy among disadvantaged women has a significant impact on their understanding of gestational diabetes mellitus information. In turn, catering for women with low literacy contributes to increased workloads for diabetes nurse educators, making them vulnerable to burnout. There is a need

  6. Lost opportunities to identify and treat HIV-positive patients: results from a baseline assessment of provider-initiated HIV testing and counselling (PITC) in Malawi.

    Science.gov (United States)

    Ahmed, Saeed; Schwarz, Monica; Flick, Robert J; Rees, Chris A; Harawa, Mwelura; Simon, Katie; Robison, Jeff A; Kazembe, Peter N; Kim, Maria H

    2016-04-01

    To assess implementation of provider-initiated testing and counselling (PITC) for HIV in Malawi. A review of PITC practices within 118 departments in 12 Ministry of Health (MoH) facilities across Malawi was conducted. Information on PITC practices was collected via a health facility survey. Data describing patient visits and HIV tests were abstracted from routinely collected programme data. Reported PITC practices were highly variable. Most providers practiced symptom-based PITC. Antenatal clinics and maternity wards reported widespread use of routine opt-out PITC. In 2014, there was approximately 1 HIV test for every 15 clinic visits. HIV status was ascertained in 94.3% (5293/5615) of patients at tuberculosis clinics, 92.6% (30,675/33,142) of patients at antenatal clinics and 49.4% (6871/13,914) of patients at sexually transmitted infection clinics. Reported challenges to delivering PITC included test kit shortages (71/71 providers), insufficient physical space (58/71) and inadequate number of HIV counsellors (32/71) while providers from inpatient units cited the inability to test on weekends. Various models of PITC currently exist at MoH facilities in Malawi. Only antenatal and maternity clinics demonstrated high rates of routine opt-out PITC. The low ratio of facility visits to HIV tests suggests missed opportunities for HIV testing. However, the high proportion of patients at TB and antenatal clinics with known HIV status suggests that routine PITC is feasible. These results underscore the need to develop clear, standardised PITC policy and protocols, and to address obstacles of limited health commodities, infrastructure and human resources. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  7. Professional quality of life of Japanese nurses/midwives providing abortion/childbirth care.

    Science.gov (United States)

    Mizuno, Maki; Kinefuchi, Emiko; Kimura, Rumiko; Tsuda, Akiko

    2013-08-01

    This study explored the relationship between professional quality of life and emotion work and the major stress factors related to abortion care in Japanese obstetric and gynecological nurses and midwives. Between October 2011 and January 2012, questionnaires that included questions concerning eight stress factors, the Professional Quality of Life Scale, and the Japanese version of the Frankfurt Emotional Work Scale, were answered by 255 nurses and midwives working in abortion and childbirth services. Professional Quality of Life scores (compassion fatigue, compassion satisfaction, burnout) were significantly associated with stress factors and emotion work. Multiple regression analysis revealed that of all the evaluated variables, the Japanese version of the Frankfurt Emotional Work Scale score for negative emotions display was the most significant positive predictor of compassion fatigue and burnout. The stress factors "thinking that the aborted fetus deserved to live" and "difficulty in controlling emotions during abortion care" were associated with compassion fatigue. These findings indicate that providing abortion services is a highly distressing experience for nurses and midwives.

  8. Knowledge of Toxoplasmosis among Doctors and Nurses Who Provide Prenatal Care in an Endemic Region

    Directory of Open Access Journals (Sweden)

    Laura Berriel da Silva

    2011-01-01

    Full Text Available Congenital toxoplasmosis is a potentially severe infection and its prevention is most often based on serological screening in pregnant women. Many cases could be prevented by simple precautions during pregnancy. Aiming to assess the knowledge about toxoplasmosis among professionals working in antenatal care in a high prevalent region, a questionnaire was administered to 118 obstetric nurses and physicians attending at primary care units and hospitals. The questionnaire was self-completed and included questions on diagnosis, clinical issues, and prevention. Only 44% of total answers were corrected. Lower scores were observed among those with over 10 years of graduation, working in primary care units, and nurses. Errors were mainly observed in questions of prevention and diagnosis. As congenital toxoplasmosis is a mother-to-child (MTC transmitted disease, early diagnosis and treatment can prevent serious and irreversible fetal damage. Thus, doctors and nurses who provide prenatal care must be appropriately trained on prophylactic, diagnostic, and clinical aspects of toxoplasmosis. The authors suggest that measures should be taken for continuing education regarding toxoplasmosis in pregnancy.

  9. Effectiveness of Counseling Provided by Primary Care Doctors and Nurses in Increasing Glaucoma Screening Rates

    Directory of Open Access Journals (Sweden)

    Witold Rezner

    2014-01-01

    Full Text Available Introduction. An effective screening that can prevent glaucoma-related blindness largely depends on successful recruitment. This study was to assess the effectiveness of one-on-one counseling carried out by primary care doctors and nurses to increase glaucoma screening rates. Material and Methods. The study, carried out in an urban primary care center, involved 308 persons aged 35–87 years who were assigned to a doctor’s, nurse’s, or control group (N=109, 110, and 89, resp.. Interventions by doctors and nurses included a brief one-on-one counseling session, while only a screening history was taken from controls. The number of people in each group with a positive screening status was assessed by telephone interview three months after the visit. Results. The percentage of persons in the nurse’s counseling group who claimed being subjected to screening was more than four times higher than in the control group (20.9% versus 4.5%, P=0.002. The doctor’s interventions resulted in almost a tripled screening rate as compared to the control group (12.8% versus 4.5%, P=0.052. There was no significant difference between screening rates in doctor’s and nurse’s groups (P= 0.212. Conclusions. In the studied population, counseling provided by nurses proved to be an efficacious method to encourage patients to undergo glaucoma screening.

  10. Knowledge of toxoplasmosis among doctors and nurses who provide prenatal care in an endemic region.

    Science.gov (United States)

    da Silva, Laura Berriel; de Oliveira, Raquel de Vasconcelos Carvalhaes; da Silva, Marizete Pereira; Bueno, Wendy Fernandes; Amendoeira, Maria Regina Reis; de Souza Neves, Elizabeth

    2011-01-01

    Congenital toxoplasmosis is a potentially severe infection and its prevention is most often based on serological screening in pregnant women. Many cases could be prevented by simple precautions during pregnancy. Aiming to assess the knowledge about toxoplasmosis among professionals working in antenatal care in a high prevalent region, a questionnaire was administered to 118 obstetric nurses and physicians attending at primary care units and hospitals. The questionnaire was self-completed and included questions on diagnosis, clinical issues, and prevention. Only 44% of total answers were corrected. Lower scores were observed among those with over 10 years of graduation, working in primary care units, and nurses. Errors were mainly observed in questions of prevention and diagnosis. As congenital toxoplasmosis is a mother-to-child (MTC) transmitted disease, early diagnosis and treatment can prevent serious and irreversible fetal damage. Thus, doctors and nurses who provide prenatal care must be appropriately trained on prophylactic, diagnostic, and clinical aspects of toxoplasmosis. The authors suggest that measures should be taken for continuing education regarding toxoplasmosis in pregnancy.

  11. A qualitative study on feedback provided by students in nurse education.

    Science.gov (United States)

    Chan, Zenobia C Y; Stanley, David John; Meadus, Robert J; Chien, Wai Tong

    2017-08-01

    This study aims to help nurse educators/academics understand the perspectives and expectations of students providing their feedback to educators about teaching performance and subject quality. The aim of this study is to reveal students' voices regarding their feedback in nurse education in order to shed light on how the current student feedback practice may be modified. A qualitative study using focus group inquiry. Convenience sampling was adopted and participants recruited from one school of nursing in Hong Kong. A total of 66 nursing students from two pre-registration programs were recruited for seven focus group interviews: one group of Year 1 students (n=21), two groups of Year 3 students (n=27), and four groups of Final Year students (n=18). The interviews were guided by a semi-structured interview guideline and the interview narratives were processed through content analysis. The trustworthiness of this study was guaranteed through peer checking, research meetings, and an audit trail. The participants' privacy was protected throughout the study. Four core themes were discerned based on the narratives of the focus group interviews: (1) "timing of collecting feedback at more than one time point"; (2) "modify the questions being asked in collecting student feedback"; (3) "are electronic means of collecting feedback good enough?; and (4) "what will be next for student feedback?". This study is significant in the following three domains: 1) it contributed to student feedback because it examined the issue from a student's perspective; 2) it explored the timing and channels for collecting feedback from the students' point of view; and 3) it showed the preferred uses of student feedback. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  12. Emergency medical service, nursing, and physician providers' perspectives on delirium identification and management.

    Science.gov (United States)

    LaMantia, Michael A; Messina, Frank C; Jhanji, Shola; Nazir, Arif; Maina, Mungai; McGuire, Siobhan; Hobgood, Cherri D; Miller, Douglas K

    2017-04-01

    Purpose of the study The study objective was to understand providers' perceptions regarding identifying and treating older adults with delirium, a common complication of acute illness in persons with dementia, in the pre-hospital and emergency department environments. Design and methods The authors conducted structured focus group interviews with separate groups of emergency medical services staff, emergency nurses, and emergency physicians. Recordings of each session were transcribed, coded, and analyzed for themes with representative supporting quotations identified. Results Providers shared that the busy emergency department environment was the largest challenge to delirium recognition and treatment. When describing delirium, participants frequently detailed hyperactive features of delirium, rather than hypoactive features. Participants shared that they employed no clear diagnostic strategy for identifying the condition and that they used heterogeneous approaches to treat the condition. To improve care for older adults with delirium, emergency nurses identified the need for more training around the management of the condition. Emergency medical services providers identified the need for more support in managing agitated patients when in transport to the hospital and more guidance from emergency physicians on what information to collect from the patient's home environment. Emergency physicians felt that delirium care would be improved if they could have baseline mental status data on their patients and if they had access to a simple, accurate diagnostic tool for the condition. Implications Emergency medical services providers, emergency nurses, and emergency physicians frequently encounter delirious patients, but do not employ clear diagnostic strategies for identifying the condition and have varying levels of comfort in managing the condition. Clear steps should be taken to improve delirium care in the emergency department including the development of mechanisms

  13. Perceptions of tuberculosis patients on provider-initiated HIV testing and counseling--a study from south India.

    Directory of Open Access Journals (Sweden)

    Beena E Thomas

    Full Text Available BACKGROUND: The acceptability and feasibility of provider-initiated HIV testing and counseling (PITC in many settings across Asia with concentrated HIV epidemics is not known. A pilot study of the PITC policy undertaken within the public health care systems in two districts in India offered the opportunity to understand patient's perspectives on the process of referral for HIV testing and linking to HIV treatment and care. METHODS: We conducted a cross-sectional study of randomly selected TB patients registered by the TB control program between July and November 2007 in two districts in south India. Trained interviewers met patients shortly after TB diagnosis and administered a structured questionnaire. Patients were assessed regarding their experience with HIV status assessment, referral for counseling and testing, and for HIV-infected patients the counseling itself and subsequent referral for HIV treatment and care. RESULTS: Of the 568 interviewed TB patients, 455 (80% reported being referred for HIV testing after they presented to the health facility for investigations or treatment for TB. Over half the respondents reported having to travel long distances and incurred financial difficulties in reaching the Integrated Counselling and Testing Centre (ICTC and two-thirds had to make more than two visits. Only 48% reported having been counseled before the test. Of the 110 HIV-infected patients interviewed, (including 43 with previously-known positive HIV status and 67 detected by PITC, 89 (81% reported being referred for anti-retroviral treatment (ART; 82 patients reached the ART centre but only 44 had been initiated on ART. CONCLUSIONS: This study provides the first evidence from India that routine, provider-initiated voluntary HIV testing of TB patients is acceptable, feasible and can be achieved with very high efficiency under programmatic conditions. While PITC is useful in identifying new HIV-infected patients so that they can be

  14. Providers' lack of knowledge about herpes zoster in HIV-infected patients is among barriers to herpes zoster vaccination.

    Science.gov (United States)

    Aziz, M; Kessler, H; Huhn, G

    2013-06-01

    Identification of perceptions about herpes zoster (HZ) disease, vaccine effectiveness and safety, and vaccine recommendations may impact immunization practices of physicians for HIV-infected patients. A survey was used to quantify knowledge of HZ as well as determine physician immunization perceptions and practices. There were 272/1700 respondents (16%). Correct answers for the incidence of varicella zoster virus (VZV) infection in adults and incidence of HZ in HIV-infected patients were recorded by 14% and 10% of providers, respectively. Providers reported poor knowledge of the incidence of disease recurrence in HIV-infected patients (41% correct), potency of HZ vaccine (47.5% correct) and mechanism of protection against reactivation of VZV (66% correct). Most (88%) agreed that HZ was a serious disease, and 73% believed that the burden of disease made vaccination important. A majority (75%) did not vaccinate HIV patients with HZ vaccine regardless of antiretroviral therapy status. Barriers to administration included safety concerns, concern that vaccine would not prevent HZ, risk of HZ dissemination, reimbursement issues and lack of Infectious Diseases Society of America (IDSA) guidelines. Only 38% of providers agreed that CDC guidelines were clear and 50% believed that clinical trials were needed prior to use of HZ vaccine in HIV-infected patients. Education about HZ is needed among HIV providers. Providers perceived vaccination as important, but data on vaccine safety and clear guidance from the CDC on this issue are lacking.

  15. Use of electronic personal health record systems to encourage HIV screening: an exploratory study of patient and provider perspectives

    Directory of Open Access Journals (Sweden)

    McInnes D Keith

    2011-08-01

    Full Text Available Abstract Background When detected, HIV can be effectively treated with antiretroviral therapy. Nevertheless in the U.S. approximately 25% of those who are HIV-infected do not know it. Much remains unknown about how to increase HIV testing rates. New Internet outreach methods have the potential to increase disease awareness and screening among patients, especially as electronic personal health records (PHRs become more widely available. In the US Department of Veterans' Affairs medical care system, 900,000 veterans have indicated an interest in receiving electronic health-related communications through the PHR. Therefore we sought to evaluate the optimal circumstances and conditions for outreach about HIV screening. In an exploratory, qualitative research study we examined patient and provider perceptions of Internet-based outreach to increase HIV screening among veterans who use the Veterans Health Administration (VHA health care system. Findings We conducted two rounds of focus groups with veterans and healthcare providers at VHA medical centers. The study's first phase elicited general perceptions of an electronic outreach program to increase screening for HIV, diabetes, and high cholesterol. Using phase 1 results, outreach message texts were drafted and then presented to participants in the second phase. Analysis followed modified grounded theory. Patients and providers indicated that electronic outreach through a PHR would provide useful information and would motivate patients to be screened for HIV. Patients believed that electronic information would be more convenient and understandable than information provided verbally. Patients saw little difference between messages about HIV versus about diabetes and cholesterol. Providers, however, felt patients would disapprove of HIV-related messages due to stigma. Providers expected increased workload from the electronic outreach, and thus suggested adding primary care resources and devising

  16. HIV and cancer in Africa: mutual collaboration between HIV and cancer programs may provide timely research and public health data

    Directory of Open Access Journals (Sweden)

    Mbulaiteye Sam M

    2011-10-01

    Full Text Available Abstract The eruption of Kaposi sarcoma (KS and aggressive non-Hodgkin lymphoma (NHL in young homosexual men in 1981 in the West heralded the onset of the human immunodeficiency virus (HIV infection epidemic, which remains one of the biggest challenges to global public health and science ever. Because KS and NHL were increased >10,000 and 50-600 times, respectively, with HIV, they were designated AIDS defining cancers (ADC. Cervical cancer (CC, increased 5-10 times was also designated as an ADC. A few other cancers are elevated with HIV, including Hodgkin lymphoma (10 times, anal cancer (15-30 times, and lung cancer (4 times are designated as non-AIDS defining cancers (NADCs. Since 1996 when combination antiretroviral therapy (cART became widely available in the West, dramatic decreases in HIV mortality have been observed and substantial decrease in the incidence of ADCs. Coincidentally, the burden of NADCs has increased as people with HIV age with chronic HIV infection. The impact of HIV infection on cancer in sub-Saharan Africa, where two thirds of the epidemic is concentrated, remains poorly understood. The few studies conducted indicate that risks for ADCs are also increased, but quantitatively less so than in the West. The risks for many cancers with established viral associations, including liver and nasopharynx, which are found in Africa, do not appear to be increased. These data are limited because of competing mortality, and cancer is under diagnosed, pathological confirmation is rare, and cancer registration not widely practiced. The expansion of access to life-extending cART in sub-Saharan Africa, through programs such as the Global Fund for AIDS, Malaria, and Tuberculosis and the US President's Emergency Program for AIDS Relief (PEPFAR, is leading to dramatic lengthening of life of HIV patients, which will likely influence the spectrum and burden of cancer in patients with HIV. In this paper, we review current literature and explore

  17. [Living With Tolerable Burden: Exploring the Ethical Self of Nurses Who Provide End-of-Life Care].

    Science.gov (United States)

    Liu, Ying-Chun; Tai, Yu-Lun; Chiang, Hsien-Hsien

    2017-04-01

    Providing end-of-life (EOL) care elicits complex emotions in nurses in the context of modern medicine. Nurses must not only watch their patients succumb to disease and death but also witness their suffering. This qualitative study adopted the perspective of "the other", as proposed by Emmanuel Levinas, to understand the experience of nurses who provide EOL care and the possibilities of nurses build up their ethical selves within the context of modern medicine. The study used interpretative phenomenology and group dialogue. Thirteen nurses who had EOL care experience were included. Data were drawn from the six transcripts of the group sessions, the researcher's diaries, and participants' feedback sheets. Interpretative phenomenological analysis was used to analyze the data. The findings showed that nurses not only execute medical procedures but are also capable of self-molding into ethical subjects. The categories of participant experiences included: (1) encountering the death; (2) encountering my inner self; and (3) greeting the death. EOL nursing does not require abstract or decontextualized knowledge, but rather requires more experiential knowledge. EOL care may inspire nurses to become ethical persons and to gain wisdom if they shift away from a self-centered perspective to receive "the other". This study illustrates that EOL care should not depend solely on ethical codes or principles but should also adopt the attitudes of "for the other".

  18. A pilot study of a nurse-delivered cognitive behavioral therapy intervention (Ziphamandla) for adherence and depression in HIV in South Africa.

    Science.gov (United States)

    Andersen, Lena S; Magidson, Jessica F; O'Cleirigh, Conall; Remmert, Jessica E; Kagee, Ashraf; Leaver, Matthew; Stein, Dan J; Safren, Steven A; Joska, John

    2016-04-26

    Depression is prevalent among people living with HIV in South Africa and interferes with adherence to antiretroviral therapy. This study evaluated a nurse-delivered, cognitive behavioral therapy intervention for adherence and depression among antiretroviral therapy users with depression in South Africa (n = 14). Primary outcomes were depression, antiretroviral therapy adherence, feasibility, and acceptability. Findings support robust improvements in mood through a 3-month follow up. Antiretroviral therapy adherence was maintained during the intervention period. Participant retention supports acceptability; however, modest provider fidelity despite intensive supervision warrants additional attention to feasibility. Future effectiveness research is needed to evaluate this nurse-delivered cognitive behavioral therapy intervention for adherence and depression in this context.

  19. Factors That Impact Registered Nurses' Decisions to Continue Providing Care to Older Adults

    Science.gov (United States)

    Bosfield, Saundra

    2013-01-01

    The purpose of this study was to investigate if there is a significant difference in the following: (a) nurses' likelihood to remain in geriatrics between age groups (those over 40 years of age and those under 40 years of age); (b) nurses' likelihood to remain in geriatrics and personality traits; (c) nurses' likelihood to remain in geriatrics…

  20. TQM/CQI: providing a steady supply of nurses for the future.

    Science.gov (United States)

    Neuhs, H P

    1994-01-01

    The recent emphasis on total quality management and continuous quality improvement (TQM/CQI) is a positive way to improve the professional status of nurses and minimize repetitive cycles of nursing shortages. The author reviews the history and the current status of the supply and demand for nursing personnel, and suggests solutions for preventing shortages that incorporate TQM/CQI strategies.

  1. Ineffective Staff, Ineffective Supervision, or Ineffective Administration? Why Some Nursing Homes Fail to Provide Adequate Care.

    Science.gov (United States)

    Sheridan, John E.; And Others

    1992-01-01

    This study involved 530 nursing staff working in 25 for-profit and nonprofit nursing homes, 2 of which failed to meet residential care standards. Nursing home climate in failed homes was perceived as being significantly lower in human relations and higher in laissez-faire and status orientation dimensions that the climate in the successful homes.…

  2. The impact of university provided nurse electronic medical record training on health care organizations: an exploratory simulation approach.

    Science.gov (United States)

    Abrahamson, Kathleen; Anderson, James G; Borycki, Elizabeth M; Kushniruk, Andre W; Malovec, Shannon; Espejo, Angela; Anderson, Marilyn

    2015-01-01

    Training providers appropriately, particularly early in their caregiving careers, is an important aspect of electronic medical record (EMR) implementation. Considerable time and resources are needed to bring the newly hired providers 'up to speed' with the actual use practices of the organization. Similarly, universities lose valuable clinical training hours when students are required to spend those hours learning organization-specific EMR systems in order to participate in care during clinical rotations. Although there are multiple real-world barriers to university/health care organization training partnerships, the investment these entities share in training care providers, specifically nurses, to use and understand EMR technology encourages a question: What would be the cumulative effect of integrating a mutually agreed upon EMR system training program in to nursing classroom training on downstream hospital costs in terms of hours of direct caregiving lost, and benefits in terms of number of overall EMR trained nurses hired? In order to inform the development of a large scale study, we employed a dynamic systems modeling approach to simulate the theoretical relationships between key model variables and determine the possible effect of integrating EMR training into nursing classrooms on hospital outcomes. The analysis indicated that integrating EMR training into the nursing classroom curriculum results in more available time for nurse bedside care. Also, the simulation suggests that efficiency of clinical training can be potentially improved by centralizing EMR training within the nursing curriculum.

  3. Psychosocial correlates of patient–provider family planning discussions among HIV-infected pregnant women in South Africa

    Directory of Open Access Journals (Sweden)

    Rodriguez VJ

    2017-04-01

    Full Text Available Violeta J Rodriguez,1 Ryan R Cook,1 Stephen M Weiss,1 Karl Peltzer,2–4 Deborah L Jones1 1Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; 2HIV/AIDS/STIs and TB (HAST Research Programme, Human Sciences Research Council, Pretoria, South Africa; 3ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand; 4Department of Psychology, University of Limpopo, Turfloop, South Africa Abstract: Patient–provider family planning discussions and preconception counseling can reduce maternal and neonatal risks by increasing adherence to provider recommendations and antiretroviral medication. However, HIV-infected women may not discuss reproductive intentions with providers due to anticipation of negative reactions and stigma. This study aimed to identify correlates of patient–provider family planning discussions among HIV-infected women in rural South Africa, an area with high rates of antenatal HIV and suboptimal rates of prevention of mother-to-child transmission (PMTCT of HIV. Participants were N=673 pregnant HIV-infected women who completed measures of family planning discussions and knowledge, depression, stigma, intimate partner violence, and male involvement. Participants were, on average, 28 ± 6 years old, and half of them had completed at least 10–11 years of education. Most women were unemployed and had a monthly income of less than ~US$76. Fewer than half of the women reported having family planning discussions with providers. Correlates of patient–provider family planning discussions included younger age, discussions about PMTCT of HIV, male involvement, and decreased stigma (p < 0.05. Depression was indirectly associated with patient–provider family planning discussions through male involvement (b = −0.010, bias-corrected 95% confidence interval [bCI] [−0.019, −0.005]. That is, depression decreased male involvement, and in turn, male involvement

  4. Clinical Scholar Model: providing excellence in clinical supervision of nursing students.

    Science.gov (United States)

    Preheim, Gayle; Casey, Kathy; Krugman, Mary

    2006-01-01

    The Clinical Scholar Model (CSM) is a practice-education partnership focused on improving the outcomes of clinical nursing education by bridging the academic and service settings. An expert clinical nurse serves as a clinical scholar (CS) to coordinate, supervise, and evaluate the clinical education of nursing students in collaboration with school of nursing faculty. This article describes the model's evolution, how the model is differentiated from traditional clinical instruction roles and responsibilities, and the benefits to the collaborating clinical agency and school of nursing.

  5. Changes in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units

    Science.gov (United States)

    Hoonakker, Peter L T; Carayon, Pascale; Brown, Roger L; Cartmill, Randi S; Wetterneck, Tosha B; Walker, James M

    2013-01-01

    Background Implementation of Computerized Provider Order Entry (CPOE) has many potential advantages. Despite the potential benefits of CPOE, several attempts to implement CPOE systems have failed or met with high levels of user resistance. Implementation of CPOE can fail or meet high levels of user resistance for a variety of reasons, including lack of attention to users’ needs and the significant workflow changes required by CPOE. User satisfaction is a critical factor in information technology implementation. Little is known about how end-user satisfaction with CPOE changes over time. Objective To examine ordering provider and nurse satisfaction with CPOE implementation over time. Methods We conducted a repeated cross-sectional questionnaire survey in four intensive care units of a large hospital. We analyzed the questionnaire data as well as the responses to two open-ended questions about advantages and disadvantages of CPOE. Results Users were moderately satisfied with CPOE and there were interesting differences between user groups: ordering providers and nurses. User satisfaction with CPOE did not change over time for providers, but it did improve significantly for nurses. Results also show that nurses and providers are satisfied with different aspects of CPOE. PMID:23100129

  6. Ethical standards for the occupational health-nursing practitioner regarding the HIV positive person in the workplace

    Directory of Open Access Journals (Sweden)

    A C Botes

    2001-01-01

    Full Text Available The occupational health-nursing practitioner often becomes involved in ethical dilemmas with regard to the handling of HIV-positive people in the workplace in that the interests of the HIV-positive people conflict with the interests of the employer.

    Opsomming
    Die beroepsgesondheidsverpleegkundige raak dikwels in etiese dilemmas betrokke ten opsigte van die hantering van die MIV-positiewe persoon by die werkplek deurdat die belange van die MIV-positiewe persoon botsend is met die belange van die werkgewer. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

  7. Knowledge, attitudes and perceptions of pharmacy and nursing students towards male circumcision and HIV in a KwaZulu-Natal University, South Africa

    Directory of Open Access Journals (Sweden)

    Panjasaram V. Naidoo

    2012-07-01

    Full Text Available Background: Male circumcision is currently being promoted in South Africa as a HumanImmunodeficiency Virus (HIV prevention method. Effective implementation requires thathealthcare providers should believe in the procedure’s efficacy and should possess a positiveattitude. A study was undertaken amongst pharmacy and nursing students with differentobjectives.Objectives: To ascertain students’ knowledge, attitudes and perceptions regarding malecircumcision and (HIV prevention.Method: A descriptive cross-sectional study using anonymous questionnaires was undertakenamongst 4th year pharmacy and nursing students studying at a university in KwaZulu-Natal,after obtaining their consent. Data were captured and analysed using SPSS version 15.Results: A response rate of 83.18% and a mean knowledge score of 66.43% with relativelypositive attitudes (62.7 were obtained; 85.4% of the respondents felt that promoting malecircumcision is appropriate, with all Muslim students (n < 11 supporting the promotion ofmale circumcision. Even though all Muslim students supported male circumcision, only 3students were willing to perform the procedure if adequately trained (p < 0.03. The majorityof the female students were unwilling to perform the procedure (p < 0.005. A third of therespondents indicated that male circumcision would both undermine existing protectivebehaviours and strategies as well as increase riskier sexual behaviour. Over 54% of therespondents believed that the South African Health System would be able to cope with themassive male circumcision drive. The majority of the respondents favoured the procedure tobe done at birth. Pain was cited as the most important reason for not wanting to be circumcised.Conclusion: Pharmacy and nursing students have a moderate knowledge of male circumcisionand HIV prevention with relatively positive attitudes. The majority felt that promoting malecircumcision is appropriate and should be encouraged.

  8. Understanding the Challenges of Providing Holistic Oncology Nursing Care in Nigeria

    Science.gov (United States)

    Nwozichi, Chinomso Ugochukwu; Ojewole, Foluso; Oluwatosin, Abimbola O.

    2017-01-01

    This article describes the current state of cancer nursing and the various challenges that hinder the provision of effective nursing care to cancer patients in Nigeria. The major issue identified was the lack of specialized oncology nursing education which should actually form a basis for nurses to practice in the oncology setting. Other issues include poor facilities for oncology nursing care, lack of specific cancer centers resulting in the management of cancer patients in non-specialist wards. It is therefore recommended that solidified structure be put in place in order to establish and strengthen the nursing curriculum which has a strong potential for improving the knowledge and skills of nurses to care for people living with cancer in Nigeria. PMID:28217725

  9. A compensatory mutation provides resistance to disparate HIV fusion inhibitor peptides and enhances membrane fusion.

    Directory of Open Access Journals (Sweden)

    Matthew P Wood

    Full Text Available Fusion inhibitors are a class of antiretroviral drugs used to prevent entry of HIV into host cells. Many of the fusion inhibitors being developed, including the drug enfuvirtide, are peptides designed to competitively inhibit the viral fusion protein gp41. With the emergence of drug resistance, there is an increased need for effective and unique alternatives within this class of antivirals. One such alternative is a class of cyclic, cationic, antimicrobial peptides known as θ-defensins, which are produced by many non-human primates and exhibit broad-spectrum antiviral and antibacterial activity. Currently, the θ-defensin analog RC-101 is being developed as a microbicide due to its specific antiviral activity, lack of toxicity to cells and tissues, and safety in animals. Understanding potential RC-101 resistance, and how resistance to other fusion inhibitors affects RC-101 susceptibility, is critical for future development. In previous studies, we identified a mutant, R5-tropic virus that had evolved partial resistance to RC-101 during in vitro selection. Here, we report that a secondary mutation in gp41 was found to restore replicative fitness, membrane fusion, and the rate of viral entry, which were compromised by an initial mutation providing partial RC-101 resistance. Interestingly, we show that RC-101 is effective against two enfuvirtide-resistant mutants, demonstrating the clinical importance of RC-101 as a unique fusion inhibitor. These findings both expand our understanding of HIV drug-resistance to diverse peptide fusion inhibitors and emphasize the significance of compensatory gp41 mutations.

  10. To be involved or not: factors that influence nurses' involvement in providing treatment decisional support in advanced cancer.

    Science.gov (United States)

    Barthow, Christine; Moss, Cheryle; McKinlay, Eileen; McCullough, Leslie; Wise, Debbie

    2009-02-01

    Decisional support is a multifaceted process of facilitating patients' decision making regarding treatment choices. Effective decisional support practices of nurses in relation to the use of anticancer therapies in patients with advanced disease are central to quality cancer care. A recent qualitative descriptive study (n=21) exploring the decision making practices of doctors and nurses in one tertiary cancer centre in New Zealand identified many complexities associated with nurses and their participation in decisional support. The study revealed that cancer nurses had varied opinions about the meaning and importance of their roles in treatment related decision making. This variation was significant and led the researchers to undertake a detailed secondary exploration of factors that impacted on the nurses' involvement in the provision of decisional support. Four key groups of factors were identified. These were factors relating to degree of knowledge, level of experience, beliefs and understandings about nursing roles and cancer therapies, and structural interfaces in the work setting. Understanding these factors is important because it allows modification of the conditions which impact on the ability to provide effective decisional care. It also provides some understanding of clinical drivers associated with nurses' decisional support work with patients who have advanced cancer.

  11. Preventing HIV transmission among Iranian prisoners: Initial support for providing education on the benefits of harm reduction practices

    Directory of Open Access Journals (Sweden)

    Millson Peggy

    2008-06-01

    Full Text Available Abstract Background Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. Methods A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM and prisoners' risky HIV-related behaviors was examined. Results Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Conclusion Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices.

  12. Preventing HIV transmission among Iranian prisoners: initial support for providing education on the benefits of harm reduction practices.

    Science.gov (United States)

    Eshrati, Babak; Asl, Rahim Taghizadeh; Dell, Colleen Anne; Afshar, Parviz; Millson, Peggy Margaret E; Kamali, Mohammad; Weekes, John

    2008-06-09

    Harm reduction is a health-centred approach that seeks to reduce the health and social harms associated with high-risk behaviors, such as illicit drug use. The objective of this study is to determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and their high-risk practices while in prison. A cross-sectional study was conducted in 2004. The study population was a random selection of 100 men incarcerated at Rajaei-Shahr prison. The data were collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. The relationship between components of the Health Belief Model (HBM) and prisoners' risky HIV-related behaviors was examined. Calculating Pearson's correlation coefficient, a significant, positive association was found between the benefit component of the HBM and prisoners not engaging in HIV high-risk behaviors. Educational harm reduction initiatives that promote the effectiveness of strategies designed to reduce the risk of HIV transmission may decrease prisoners' high-risk behaviors. This finding provides initial support for the Iran prison system's current offering of HIV/AIDS harm reduction programming and suggests the need to offer increased education about the effectiveness of HIV prevention practices.

  13. Evaluating nurses' implementation of an infant-feeding counseling protocol for HIV-infected mothers: The Ban Study in Lilongwe, Malawi.

    Science.gov (United States)

    Ferguson, Yvonne Owens; Eng, Eugenia; Bentley, Margaret; Sandelowski, Margarete; Steckler, Allan; Randall-David, Elizabeth; Piwoz, Ellen G; Zulu, Cynthia; Chasela, Charles; Soko, Alice; Tembo, Martin; Martinson, Francis; Tohill, Beth Carlton; Ahmed, Yusuf; Kazembe, Peter; Jamieson, Denise J; van der Horst, Charles; Adair, Linda; Ahmed, Yusuf; Ait-Khaled, Mounir; Albrecht, Sandra; Bangdiwala, Shrikant; Bayer, Ronald; Bentley, Margaret; Bramson, Brian; Bobrow, Emily; Boyle, Nicola; Butera, Sal; Chasela, Charles; Chavula, Charity; Chimerang'ambe, Joseph; Chigwenembe, Maggie; Chikasema, Maria; Chikhungu, Norah; Chilongozi, David; Chiudzu, Grace; Chome, Lenesi; Cole, Anne; Corbett, Amanda; Corneli, Amy; Duerr, Ann; Eliya, Henry; Ellington, Sascha; Eron, Joseph; Farr, Sherry; Ferguson, Yvonne Owens; Fiscus, Susan; Galvin, Shannon; Guay, Laura; Heilig, Chad; Hoffman, Irving; Hooten, Elizabeth; Hosseinipour, Mina; Hudgens, Michael; Hurst, Stacy; Hyde, Lisa; Jamieson, Denise; Joaki, George; Jones, David; Kacheche, Zebrone; Kamanga, Esmie; Kamanga, Gift; Kampani, Coxcilly; Kamthunzi, Portia; Kamwendo, Deborah; Kanyama, Cecilia; Kashuba, Angela; Kathyola, Damson; Kayira, Dumbani; Kazembe, Peter; Knight, Rodney; Kourtis, Athena; Krysiak, Robert; Kumwenda, Jacob; Loeliger, Edde; Luhanga, Misheck; Madhlopa, Victor; Majawa, Maganizo; Maida, Alice; Marcus, Cheryl; Martinson, Francis; Thoofer, Navdeep; Matika, Chrissie; Mayers, Douglas; Mayuni, Isabel; McDonough, Marita; Meme, Joyce; Merry, Ceppie; Mita, Khama; Mkomawanthu, Chimwemwe; Mndala, Gertrude; Mndala, Ibrahim; Moses, Agnes; Msika, Albans; Msungama, Wezi; Mtimuni, Beatrice; Muita, Jane; Mumba, Noel; Musis, Bonface; Mwansambo, Charles; Mwapasa, Gerald; Nkhoma, Jacqueline; Pendame, Richard; Piwoz, Ellen; Raines, Byron; Ramdas, Zane; Rublein, John; Ryan, Mairin; Sanne, Ian; Sellers, Christopher; Shugars, Diane; Sichali, Dorothy; Snowden, Wendy; Soko, Alice; Spensley, Allison; Steens, Jean-Marc; Tegha, Gerald; Tembo, Martin; Thomas, Roshan; Tien, Hsiao-Chuan; Tohill, Beth; van der Horst, Charles; Waalberg, Esther; Wiener, Jeffrey; Wilfert, Cathy; Wiyo, Patricia; Zgambo, Onnocent; Zimba, Chifundo

    2009-04-01

    A process evaluation of nurses' implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of mother-to-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIV-infected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Study's outcomes.

  14. Brief Training of HIV Medical Providers Increases Their Frequency of Delivering Prevention Counselling to Patients at Risk of Transmitting HIV to Others

    Science.gov (United States)

    Patel, Shilpa N.; Marks, Gary; Gardner, Lytt; Golin, Carol E.; Shinde, Sanjyot; O'Daniels, Christine; Wilson, Tracey E.; Quinlivan, E. Byrd; Banderas, Julie W.

    2013-01-01

    Objective: The aim of this study was to examine whether brief training of human immunodeficiency virus (HIV) medical providers increased the frequency with which they routinely delivered prevention counselling to patients, and whether patient characteristics were associated with receipt of that counselling. Design: Longitudinal. Setting: Seven HIV…

  15. Partnership working by default: district nurses and care home staff providing care for older people.

    Science.gov (United States)

    Goodman, Claire; Robb, Nadia; Drennan, Vari; Woolley, Rosemary

    2005-11-01

    Older people residents in care homes that only offer residential care rely on primary health care services for medical and nursing needs. Research has investigated the demands that care homes staff and residents make on general practice, but not the involvement of other members of the primary health care team. This paper describes two consecutive studies completed in 2001 and 2003 that involved focus groups and survey methods of enquiry conducted in two settings: an England shire and inner London. The research questions that both studies had in common were (1) What is the contribution of district nursing and other primary care services to care homes that do not have on-site nursing provision? (2) What strategies promote participation and collaboration between residents, care home staff and NHS primary care nursing staff? and (3) What are the current obstacles and aids to effective partnership working and learning? A total of 74 community-based nurses and care home managers and staff took part in 10 focus groups, while 124 care home managers (73% of the 171 surveyed) and 113 district nurse team leaders (80% of the 142 surveyed) participated in the surveys. Findings from both studies demonstrated that nurses were the most frequent NHS professional visiting care homes. Although care home managers and district nurses believed that they had a good working relationship, they had differing expectations of what the nursing contribution should be and how personal and nursing care were defined. This influenced the range of services that older people had access to and the amount of training and support care home staff received from district nurses and the extent to which they were able to develop collaborative and reciprocal patterns of working. Findings indicate that there is a need for community-based nursing services to adopt a more strategic approach that ensures older people in care homes can access the services they are entitled to and receive equivalent health care to

  16. Prevention of unintended pregnancy and HIV/STIs among Latinos in rural communities: perspectives of health care providers.

    Science.gov (United States)

    Branch, Meredith; Harvey, S Marie; Zukoski, Ann P; Warren, Jocelyn

    2010-08-01

    Latino women in the United States are disproportionately at risk for unintended pregnancy, HIV, and sexually transmitted infections (STIs). We conducted nine focus groups with health care practitioners who provide reproductive health care to Latinos in rural areas of the Northwest. From the practitioner perspective, we explored barriers and facilitators to the acquisition and use of contraceptives and to the prevention of HIV/STIs among rural Latinos. Suggestions for improving reproductive health care included Spanish-language resources/materials and convenient contraceptive methods. Findings provide context to the complex issues related to unintended pregnancy and disease prevention among Latinos residing in rural communities.

  17. Comparing doctors' and nurses' accounts of how they provide emotional care for parents of children with acute lymphoblastic leukaemia.

    Science.gov (United States)

    Forsey, Mary; Salmon, Peter; Eden, Tim; Young, Bridget

    2013-02-01

    Despite the emphasis that communication skills training (CST) programmes place on attending to the emotional care of patients, evidence suggests that practitioners neglect this aspect of patient care. We describe and compare doctors' and nurses' accounts of managing the emotional care of parents of children with leukaemia, with the overall objective of examining how their accounts might inform training and policy. Audio-recorded qualitative interviews with 30 doctors and nurses working in six UK paediatric oncology and haematology treatment centres were analysed interpretatively, drawing on the constant comparative method. Doctors' and nurses' descriptions of managing emotional care differed markedly. Doctors described reassuring parents through their ongoing clinical care of the child and by explaining the potentially curative nature of treatment. Doctors did not think they could reassure parents by eliciting and explicitly discussing parents' fears. In contrast, nurses relied on psychological skills and explicit discussion of parents' emotions to provide reassurance. Both doctors and nurses relied on each other to ensure that parents' emotional needs were met by the multidisciplinary team rather than by individual practitioners. Nurses' accounts of providing emotional care resembled the emphasis on explicit emotional talk in CST. However, doctors' accounts indicated that they provided emotional care in ways that diverged markedly from expectations in CST but that were more consistent with their biomedical and authoritative role in patient care. These findings may have implications for CST in future revisions of guidelines, but work is first needed to explore parents' perspectives on emotional care. Copyright © 2011 John Wiley & Sons, Ltd.

  18. The Roy Adaptation Model: A Theoretical Framework for Nurses Providing Care to Individuals With Anorexia Nervosa.

    Science.gov (United States)

    Jennings, Karen M

    2017-08-18

    Using a nursing theoretical framework to understand, elucidate, and propose nursing research is fundamental to knowledge development. This article presents the Roy Adaptation Model as a theoretical framework to better understand individuals with anorexia nervosa during acute treatment, and the role of nursing assessments and interventions in the promotion of weight restoration. Nursing assessments and interventions situated within the Roy Adaptation Model take into consideration how weight restoration does not occur in isolation but rather reflects an adaptive process within external and internal environments, and has the potential for more holistic care.

  19. An assessment of the Zimbabwe ministry of health and child welfare provider initiated HIV testing and counselling programme

    Directory of Open Access Journals (Sweden)

    Sibanda Euphemia L

    2012-05-01

    Full Text Available Abstract Background Provider-initiated HIV testing and counselling (PITC is widely recommended to ensure timely treatment of HIV. The Zimbabwe Ministry of Health introduced PITC in 2007. We aimed to evaluate institutional capacity to implement PITC and investigate patient and health care worker (HCW perceptions of the PITC programme. Methods Purposive selection of health care institutions was conducted among those providing PITC. Study procedures included 1 assessment of implementation procedures and institutional capacity using a semi-structured questionnaire; 2 in-depth interviews with patients who had been offered HIV testing to explore perceptions of PITC, 3 Focus group discussions with HCW to explore views on PITC. Qualitative data was analysed according to Framework Analysis. Results Sixteen health care institutions were selected (two central, two provincial, six district hospitals; and six primary care clinics. All institutions at least offered PITC in part. The main challenges which prevented optimum implementation were shortages of staff trained in PITC, HIV rapid testing and counselling; shortages of appropriate counselling space, and, at the time of assessment, shortages of HIV test kits. Both health care workers and patients embraced PITC because they had noticed that it had saved lives through early detection and treatment of HIV. Although health care workers reported an increase in workload as a result of PITC, they felt this was offset by the reduced number of HIV-related admissions and satisfaction of working with healthier clients. Conclusion PITC has been embraced by patients and health care workers as a life-saving intervention. There is need to address shortages in material, human and structural resources to ensure optimum implementation.

  20. "I have lost sexual interest …"-challenges of balancing personal and professional lives among nurses caring for people living with HIV and AIDS in Limpopo, South Africa.

    Science.gov (United States)

    Sofolahan, Yewande; Airhihenbuwa, Collins; Makofane, Daisy; Mashaba, Ephraim

    2010-01-01

    As part of a capacity-building research project, this study examined the extent to which caring for people living with HIV and AIDS (PLWHA) affects both professional and personal relationships of nurse caregivers. The data were collected using focus group interviews with 17 female nurses at two Limpopo hospitals. The PEN-3 cultural model was used as a theoretical framework for exploring how nurses balance job demands with family responsibilities. The results generated three themes: the multiple identities nurses experience within their family and professional lives; nurse attitudes related to patient gender; and stigma experienced by nurses who care for PLWHA. Caring for PLWHA influences nurses' personal and professional lives by interfering with their perceptions and emotions as they relate to spousal, parental, and gendered relationships. The findings offer insight into factors requiring consideration when designing interventions to help nurses cope with the stress associated with caring for PLWHA while simultaneously managing family responsibilities.

  1. Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.

    Science.gov (United States)

    Beach, Mary Catherine; Roter, Debra L; Saha, Somnath; Korthuis, P Todd; Eggly, Susan; Cohn, Jonathan; Sharp, Victoria; Moore, Richard D; Wilson, Ira B

    2015-09-01

    Medication adherence is essential in HIV care, yet provider communication about adherence is often suboptimal. We designed this study to improve patient-provider communication about HIV medication adherence. We randomized 26 providers at three HIV care sites to receive or not receive a one-hour communication skills training based on motivational interviewing principles applied to medication adherence. Prior to routine office visits, non-adherent patients of providers who received the training were coached to discuss adherence with their providers. Patients of providers who did not receive the training providers were not coached. We audio-recorded and coded patient-provider interactions using the roter interaction analysis system (RIAS). There was more dialogue about therapeutic regimen in visits with intervention patients and providers (167 vs 128, respectively, p=.004), with the majority of statements coming from providers. These visits also included more brainstorming solutions to nonadherence (41% vs. 22%, p=0.026). Intervention compared with control visit providers engaged in more positive talk (44 vs. 38 statements, p=0.039), emotional talk (26 vs. 18 statements, ppatient opinion (3 vs. 2 statements, p=0.009). A brief provider training combined with patient coaching sessions, improved provider communication behaviors and increased dialogue regarding medication adherence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Development of a scale for "difficulties felt by ICU nurses providing end-of-life care" (DFINE): a survey study.

    Science.gov (United States)

    Kinoshita, Satomi; Miyashita, Mitsunori

    2011-08-01

    To develop a scale for assessing "difficulties felt by intensive care unit (ICU) nurses providing end-of-life care" (DFINE). A questionnaire survey of nurses in ICUs at general hospitals in the Kanto region, Japan. The scale was evaluated by exploratory factor analysis, calculation of Cronbach's α and test-retest reliability. The Frommelt Attitudes Toward Care of the Dying Scale (FATCOD-B-J) and the Nursing Job Stressor Scale (NJSS) were used to investigate concurrent validity. Respondents were 224 ICU nurses (response rate, 78%) at 18 hospitals. Five factors comprising 28 items were identified, involving difficulties related to: "the purpose of the ICU is recovery and survival"; "nursing system and model nurse for end-of-life care"; "building confidence in end-of-life care"; "caring for patients and families at end-of-life"; and "converting from curative care to end-of-life care". Cronbach's α for each factor ranged from 0.61 to 0.8. In terms of test-retest reliability, intraclass correlations for each factor ranged from 0.62 to 0.72. "Building confidence in end-of-life care" in DFINE showed a negative correlation with "positive attitudes towards caring for dying patient" in the FATCOD-B-J (r=-0.4). "Nursing system and model nurse for end-of-life care" in DFINE showed a positive correlation with "conflict with other nursing staffs" (r=0.32) and "conflict with physicians/autonomy" (r=0.31) in the NJSS. DFINE demonstrated acceptable reliability and validity. However, additional surveys need to be conducted with a larger sample to further characterise the scale. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Service Learning: Providing the Building Blocks for a Socially Responsible Nursing Role

    Science.gov (United States)

    Johnson, Judith M.

    2013-01-01

    An explanatory correlational study was conducted to explore whether and to what extent a relationship between hours of participation in service learning and commitment to social responsibility exists for students enrolled in pre-licensure baccalaureate-nursing programs currently participating in the Nursing Licensure Compact. The convenience…

  4. Windows to the Future: Can the United Nations Sustainable Development Goals Provide Opportunities for Nursing?

    Science.gov (United States)

    Benton, David C; Ferguson, Stephanie L

    2016-01-01

    Windows of opportunity are wide open for the nursing profession to actively participate and engage in the policy implementation, evaluation, and achievement of the United Nations Sustainable Development Goals. Nurses bring valuable perspectives as members of diverse governance structures and offer a range of solutions that can help governments pursue and achieve the Sustainable Development Goals and targets by 2030.

  5. Service Learning: Providing the Building Blocks for a Socially Responsible Nursing Role

    Science.gov (United States)

    Johnson, Judith M.

    2013-01-01

    An explanatory correlational study was conducted to explore whether and to what extent a relationship between hours of participation in service learning and commitment to social responsibility exists for students enrolled in pre-licensure baccalaureate-nursing programs currently participating in the Nursing Licensure Compact. The convenience…

  6. Providing nursing care to Ebola virus disease patients: China Ebola Treatment Unit experience

    Directory of Open Access Journals (Sweden)

    Cao Jie

    2015-12-01

    Full Text Available Principle of “Extreme Caution” is never to be underestimated in order to reach the “Zero Infection” goal among medical and nursing staff. Ebola virus disease is not a “horrible monsters” if medical and nursing staff strictly follow personal protection principles.

  7. Provider-initiated HIV counselling and testing (PICT) in the mentally ill

    African Journals Online (AJOL)

    the social drift associated with mental illness (e.g. poverty, ... ill population and many mental health settings do not encourage. HIV testing. Studies ..... Geneva: WHO, 2011. http://www.unaids.org/en/media/unaids/contentassets/documents/.

  8. Implementation of Symptom Protocols for Nurses Providing Telephone‐Based Cancer Symptom Management: A Comparative Case Study

    Science.gov (United States)

    Green, Esther; Ballantyne, Barbara; Tarasuk, Joy; Skrutkowski, Myriam; Carley, Meg; Chapman, Kim; Kuziemsky, Craig; Kolari, Erin; Sabo, Brenda; Saucier, Andréanne; Shaw, Tara; Tardif, Lucie; Truant, Tracy; Cummings, Greta G.; Howell, Doris

    2016-01-01

    ABSTRACT Background The pan‐Canadian Oncology Symptom Triage and Remote Support (COSTaRS) team developed 13 evidence‐informed protocols for symptom management. Aim To build an effective and sustainable approach for implementing the COSTaRS protocols for nurses providing telephone‐based symptom support to cancer patients. Methods A comparative case study was guided by the Knowledge to Action Framework. Three cases were created for three Canadian oncology programs that have nurses providing telephone support. Teams of researchers and knowledge users: (a) assessed barriers and facilitators influencing protocol use, (b) adapted protocols for local use, (c) intervened to address barriers, (d) monitored use, and (e) assessed barriers and facilitators influencing sustained use. Analysis was within and across cases. Results At baseline, >85% nurses rated protocols positively but barriers were identified (64‐80% needed training). Patients and families identified similar barriers and thought protocols would enhance consistency among nurses teaching self‐management. Twenty‐two COSTaRS workshops reached 85% to 97% of targeted nurses (N = 119). Nurses felt more confident with symptom management and using the COSTaRS protocols (p < .01). Protocol adaptations addressed barriers (e.g., health records approval, creating pocket versions, distributing with telephone messages). Chart audits revealed that protocols used were documented for 11% to 47% of patient calls. Sustained use requires organizational alignment and ongoing leadership support. Linking Evidence to Action Protocol uptake was similar to trials that have evaluated tailored interventions to improve professional practice by overcoming identified barriers. Collaborating with knowledge users facilitated interpretation of findings, aided protocol adaptation, and supported implementation. Protocol implementation in nursing requires a tailored approach. A multifaceted intervention approach increased nurses’ use

  9. The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease

    National Research Council Canada - National Science Library

    Martin, Louise; Leveritt, Michael D; Desbrow, Ben; Ball, Lauren E

    2014-01-01

    Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing...

  10. [Identification of educational needs among patients with HIV and their health care providers].

    Science.gov (United States)

    Araya G, Alejandra; Carrasco A, Paola; Loayza G, Carla; Fernández S, Ana María; Pérez C, Carlos; Lasso B, Martín

    2013-05-01

    The success of educational interventions depends on the integration of educational programs into clinical practice. To determine the educational needs and perceived barriers of people living with HIV (PHIV) and their health care providers (HCP). Qualitative study conducted in 60 PHIV and 10 HCP. For data collection, a semi-structured in-depth interview was applied, addressing the educational needs (content, methodology, person, time, physical location) and identified barriers to implement an educational program for PHIV Content analysis technique was used for data analysis. PHIV and their HCP identified the same educational needs as the following: general-related content, psychological, sexual and secondary prevention aspects of the disease. Individual sessions with written material and web pages were identified as important resources to support education. Both PHIV and professionals expressed their willingness to participate in educational programs, but the most commonly identified barrier was lack of time. This study identifies the key elements to include in an educational program for Chilean PHIV from the user and professional perspective.

  11. Nursing diagnoses in persons with HIV/aids: an approach based on Horta’s conceptual model

    Directory of Open Access Journals (Sweden)

    Juliana de Oliveira Faria

    2013-05-01

    Full Text Available This study aims at identifying nursing diagnoses in hospitalized persons with HIV/AIDS. It is a cross-sectional study carried out with 30 patients admitted at an infectious and parasitic disease clinic inside a teaching hospital in the state of Minas Gerais from March to September 2011. In order to identify the diagnoses, the NANDA Taxonomy II system was applied, together with an instrument based on Horta’s conceptual model. The most common nursing diagnoses were: ineffective protection (100%, risk of vascular trauma (86.7%, imbalanced nutrition - less than body requirements (76.7%, impaired physical mobility (53.3% and acute pain (53.3%. These diagnoses are relevant to manage the planning of nursing interventions towards the actual requirements with the purpose of promoting better health conditions to these patients.

  12. Experiences of lay counsellors who provide VCT for PMTCT of HIV and AIDS in the Capricorn district, Limpopo Province

    Directory of Open Access Journals (Sweden)

    R. N. Malema

    2010-06-01

    Full Text Available Human Immune Deficiency Virus (HIV and Acquired Immune-Deficiency Syndrome (AIDS still carry a stigma in the community. Many people do not know their status and they are still reluctant to be tested including pregnant women despite the fact that Voluntary Counselling and Testing (VCT is offered for free in South Africa. In South Africa VCT for HIV and AIDS is offered by lay counsellors in public hospitals and clinics. The study conducted by Mate, Bennet, Mphatswe, Barker and Rollins (2009:5483 outlined that in South Africa the prevention of mother-to-child transmission (PMTCT of HIV guidelines have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. A qualitative, exploratory, descriptive and contextual study was conducted in 15 public clinics of the Polokwane Municipality in the Capricorn District, Limpopo Province. The purpose of the study was to determine the experiences of the lay counsellors who provide VCT for the PMTCT of HIV and AIDS in the Capricorn District, Limpopo Province. Data were collected through one-to-one interviews using a semi-structured guide (De Vos et al, 2006:296. The findings of the study reflected the following: the content of training and counselling skills received by lay counsellors were satisfactory, there was lack of counsellor support and in-service education. A program for in-service education and support for all lay counsellors who have had VCT training should be conceptualised and implemented.

  13. Professional nurses' views regarding stigma and discrimination in the care of HIV and AIDS patients in rural hospitals of the Limpopo province, South Africa.

    Science.gov (United States)

    Manganye, Bumani S; Maluleke, Thelmah X; Lebese, Rachel T

    2013-03-01

    The aim of the study was to determine the views of professional nurses on the manifestations of HIV and AIDS stigma and discrimination and their influence on the quality of care rendered to people living with HIV and AIDS in three rural hospitals of Limpopo province, South Africa. The study was qualitative, exploratory, descriptive and contextual in nature. The population included all professional nurses registered with the South African Nursing Council who were working with confirmed HIV-positive patients in the three hospitals and had received specialised training in voluntary counselling and testing (VCT), antiretrovirals (ARV), prevention of mother-to-child transmission (PMTCT) and couple counselling. A purposive sampling method was used to select both the wards and participants, based on set criteria. A total of 9 wards (6 adult medical and 3 maternity) and 37 participants were selected. Focus group discussions and semi-structured and key informant interviews were conducted. Data were analysed using a combination of data analysis guidelines from different sources. Results revealed that professional nurses were aware of the existence of HIV and AIDS stigma and discrimination in their wards and regarded these as bad and improper care of HIV-positive patients. Behaviour included leaving care of HIV patients to junior members of staff with limited skills and knowledge of HIV and AIDS; showing HIV-positive patients that their disease was dangerous and contagious; judgmental behaviour towards and stereotyping of HIV-positive patients; and regarding patients with HIV and AIDS as uncooperative and problematic in the wards.

  14. An Integrated Curriculum of Nursing, Nutrition, Exercise, and Drugs for Health Care Providers of the Elderly (Project NNED).

    Science.gov (United States)

    Summit-Portage Area Health Education Network, Akron, OH.

    This document is intended to give health care providers interdisciplinary information concerning drugs, nutrition, and exercise to help them enhance health maintenance of the elderly. Prepared as part of Project NNED, (Nursing, Nutrition, Exercise, and Drugs), an integrated curriculum for health care providers of the elderly, the document includes…

  15. Cross border nursing.

    Science.gov (United States)

    Cutshall, P

    1993-01-01

    In 1989, the Canadian Nurses Association asked a professional nurse from British Columbia to help nurses in Nepal develop their association an work on nursing legislation. Nepal had about 3000 nurses, including assistant nurse-midwives, 500 of whom were members of the Trained Nurses Association of Nepal (TNAN). It wanted to expand nursing's contribution to health care in Nepal. The nurses wanted to increase the visibility of the association, to become a self-sustaining organization, to establish a licensing law, and to improve the availability of continuing education. The Canadian nurse helped the Nepalese nurses with a workshop on association management covering record keeping and meeting plans. She helped a newly formed committee with licensing law and with decision factors in pursuing self-regulation for nursing. She discussed a work plan and a lobby strategy. She helped another committee develop objectives for the next year. A follow-up visit the next year revealed that the office was operating well and the association was keeping good records. TNAN sponsored workshops on professionalism and leadership. This visit yielded further progress on a licensing law and on identifying ways to become self-sufficient. The nurses discussed the Norwegian Nurses Association's (NNA) interest in providing funds to buy a building for TNAN use and to derive income from rent. NNA eventually donated the funds. By the 1992 visit, the nurses had revised and registered their constitution and bylaws. They had sponsored workshops on HIV/AIDS and mental health. The name was now the Nursing Association of Nepal (NAN). The newly created executive council had met frequently. NAN had expanded from 6 to 11 local branches. It had created 5 committees: fund raising, research, international coordination, nurses welfare, and publications. A workshop in western Nepal centered on quality nursing care. NAN had a role in the government's progress in primary health care and mental health services.

  16. The meaning of mental health nurses experience of providing one-to-one observations: a phenomenological study.

    Science.gov (United States)

    Rooney, C

    2009-02-01

    There has been much recent literature about the need for appropriate policies and approaches to ensure that patient's rights and standards of care are safeguarded. The focus from national policy is on suicide reduction and prevention, and the nursing literature has concentrated on the importance of engaging the patient and ensuring that there is the least amount of restriction possible. A research study was carried out to explore the perspective of mental health nurses working in these intensive situations, using a purposive sample of nursing staff from the local National Health Service Trust's acute units. A phenomenological approach to the study was chosen to allow an in-depth exploration of the issues--'seeing things up close'--using the philosophy of Husserl as a base. The key areas of enquiry were: to explore and amplify the experiences of nurses undertaking constant observations, including any effects that may have on nurses; to gain further understanding of the dynamics and processes involved; to discover information that can inform and support development needs. Individual taped interviews were carried out with six nurses working in an acute admission ward, and these were then transcribed and analysed using Giorgi's method of analysis. The results of this analysis showed that nurses are keenly aware of some of the professional and ethical tensions involved in the process of keeping patients safe while trying to promote recovery. Results have implications for policies, preparation and support of staff, and provide some further insights into the nature of this experience for nursing staff who are caring for patients who are presenting with risks to themselves.

  17. Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers.

    Science.gov (United States)

    Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha

    2015-08-12

    The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the

  18. Workplace health and safety issues among community nurses: a study regarding the impact on providing care to rural consumers

    Science.gov (United States)

    Terry, Daniel; Lê, Quynh; Nguyen, Uyen; Hoang, Ha

    2015-01-01

    Objectives The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client’s homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and

  19. Tracking working status of HIV/AIDS-trained service providers by means of a training information monitoring system in Ethiopia

    Directory of Open Access Journals (Sweden)

    Nadew Mesrak

    2009-04-01

    Full Text Available Abstract Background The Federal Ministry of Health of Ethiopia is implementing an ambitious and rapid scale-up of health care services for the prevention, care and treatment of HIV/AIDS in public facilities. With support from the United States President's Emergency Plan for AIDS Relief, 38 830 service providers were trained, from early 2005 until December 2007, in HIV-related topics. Anecdotal evidence suggested high attrition rates of providers, but reliable quantitative data have been limited. Methods With that funding, Jhpiego supports a Training Information Monitoring System, which stores training information for all HIV/AIDS training events supported by the same funding source. Data forms were developed to capture information on providers' working status and were given to eight partners who collected data during routine site visits on individual providers about working status; if not working at the facility, date of and reason for leaving; and source of information. Results Data were collected on 1744 providers (59% males in 53 hospitals and 45 health centres in 10 regional and administrative states. The project found that 32.6% of the providers were no longer at the site, 57.6% are still working on HIV/AIDS services at the same facility where they were trained and 10.4% are at the facility, but not providing HIV/AIDS services. Of the providers not at the facility, the two largest groups were those who had left for further study (27.6% and those who had gone to another public facility (17.6%. Of all physicians trained, 49.2% had left the facility. Regional and cadre variation was found, for example Gambella had the highest percent of providers no longer at the site (53.7% while Harari had the highest percentage of providers still working on HIV/AIDS (71.6%. Conclusion Overall, the project found that the information in the Training Information Monitoring System can be used to track the working status of trained providers. Data generated from

  20. Do tests devised to detect recent HIV-1 infection provide reliable estimates of incidence in Africa?

    Science.gov (United States)

    Sakarovitch, Charlotte; Rouet, Francois; Murphy, Gary; Minga, Albert K; Alioum, Ahmadou; Dabis, Francois; Costagliola, Dominique; Salamon, Roger; Parry, John V; Barin, Francis

    2007-05-01

    The objective of this study was to assess the performance of 4 biologic tests designed to detect recent HIV-1 infections in estimating incidence in West Africa (BED, Vironostika, Avidity, and IDE-V3). These tests were assessed on a panel of 135 samples from 79 HIV-1-positive regular blood donors from Abidjan, Côte d'Ivoire, whose date of seroconversion was known (Agence Nationale de Recherches sur le SIDA et les Hépatites Virales 1220 cohort). The 135 samples included 26 from recently infected patients (180 days), and 15 from patients with clinical AIDS. The performance of each assay in estimating HIV incidence was assessed through simulations. The modified commercial assays gave the best results for sensitivity (100% for both), and the IDE-V3 technique gave the best result for specificity (96.3%). In a context like Abidjan, with a 10% HIV-1 prevalence associated with a 1% annual incidence, the estimated test-specific annual incidence rates would be 1.2% (IDE-V3), 5.5% (Vironostika), 6.2% (BED), and 11.2% (Avidity). Most of the specimens falsely classified as incident cases were from patients infected for >180 days but <1 year. The authors conclude that none of the 4 methods could currently be used to estimate HIV-1 incidence routinely in Côte d'Ivoire but that further adaptations might enhance their accuracy.

  1. MDS 3.0 for Nursing Homes and Swing Bed Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The MDS is a powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs) and non-critical access hospital...

  2. Moral Distress in Nurses Providing Direct Patient Care at an Academic Medical Center.

    Science.gov (United States)

    Sirilla, Janet; Thompson, Kathrynn; Yamokoski, Todd; Risser, Mark D; Chipps, Esther

    2017-04-01

    Moral distress is the psychological response to knowing the appropriate action but not being able to act due to constraints. Previous authors reported moral distress among nurses, especially those that work in critical care units. The aims of this study were: (1) to examine the level of moral distress among nurses who work at an academic health system, (2) to compare the level of moral distress in nurses who work across specialty units at an academic health system, (3) to compare moral distress by the demographic characteristics of nurses and work experience variables, and (4) to identify demographic characteristics and type of clinical setting that may predict which nurses are at high risk for moral distress. A cross-sectional survey design was used with staff nurses who work on inpatient units and ambulatory units at an academic medical center. The moral distress scale-revised (MDS-R) was used to assess the intensity and frequency of moral distress. The overall mean MDS-R score in this project was low at 94.97 with mean scores in the low to moderate range (44.57 to 134.58). Nurses who work in critical care, perioperative services, and procedure areas had the highest mean MDS-R scores. There have been no previous reports of higher scores for nurses working in perioperative and procedure areas. There was weak positive correlation between MDS-R scores and years of experience (Rho = .17, p = .003) but no correlation between age (Rho = .02, p = .78) or education (Rho = .05, p = .802) and moral distress. Three variables were found useful in predicting moral distress: the type of unit and responses to two qualitative questions related to quitting their job. Identification of these variables allows organizations to focus their interventions. © 2017 Sigma Theta Tau International.

  3. Integrated opioid substitution therapy and HIV care: a qualitative systematic review and synthesis of client and provider experiences.

    Science.gov (United States)

    Guise, Andy; Seguin, Maureen; Mburu, Gitau; McLean, Susie; Grenfell, Pippa; Islam, Zahed; Filippovych, Sergii; Assan, Happy; Low, Andrea; Vickerman, Peter; Rhodes, Tim

    2017-03-10

    People who use drugs in many contexts have limited access to opioid substitution therapy and HIV care. Service integration is one strategy identified to support increased access. We reviewed and synthesized literature exploring client and provider experiences of integrated opioid substitution therapy and HIV care to identify acceptable approaches to care delivery. We systematically reviewed qualitative literature. We searched nine bibliographic databases, supplemented by manual searches of reference lists of articles from the database search, relevant journals, conferences, key organizations and consultation with experts. Thematic synthesis was used to develop descriptive themes in client and provider experiences. The search yielded 11 articles for inclusion, along with 8 expert and policy reports. We identify five descriptive themes: the convenience and comprehensive nature of co-located care, contrasting care philosophies and their role in shaping integration, the limits to disclosure and communication between clients and providers, opioid substitution therapy enabling HIV care access and engagement, and health system challenges to delivering integrated services. The discussion explores how integrated opioid substitution therapy and HIV care needs to adapt to specific social conditions, rather than following universal approaches. We identify priorities for future research. Acceptable integrated opioid substitution therapy and HIV care for people who use drugs and providers is most likely through co-located care and relies upon attention to stigma, supportive relationships and client centred cultures of delivery. Further research is needed to understand experiences of integrated care, particularly delivery in low and middle income settings and models of care focused on community and non-clinic based delivery.

  4. Moral distress in nurses providing direct care on inpatient oncology units.

    Science.gov (United States)

    Sirilla, Janet

    2014-10-01

    Moral distress is defined as knowing the right thing to do when policy constraints do not allow for appropriate choices. The purpose of the current study was to explore the existence of moral distress in oncology nurses with a cross-sectional survey completed by nurses working on inpatient units at a midwestern cancer hospital. Investigators distributed the Moral Distress Scale-Revised to all direct care staff nurses. The main research variables were moral distress, level of education, age, and type of unit. Most of the 73 nurses had low to moderate scores, and two had high scores. No significant correlations were observed among age or years of experience. Type of unit and level of moral distress were correlated, and an inverse relationship between level of education and moral distress was found. Moral distress exists in nurses who work on oncology units irrespective of experience in oncology or the specific unit. Nurses must be aware of the existence of moral distress and finds ways to reduce potential emotional problems.

  5. Nursing care provided to young people in two health centers compared with Watson Theory

    Directory of Open Access Journals (Sweden)

    María Alejandra Pichardo Meza

    2012-10-01

    Full Text Available This article has as objective to present the analysis of the care given by the nursing personnel to the young adult population in the Clinic of Pain Control and Palliative Care and in the Onco-hematology Service of the Max Peralta Hospital, related to Jean Watson’s theoretical proposal. The study corresponds to a joint research of parallel type with concurrent triangulation. The study populations were made up by twenty-six young adult people (who face morbid process health or chronic pain condition and four nursing professionals who worked in the Clinic of Pain Control and Palliative Care and in the Onco-hematology Service of the Max Peralta Hospital. A self-executed questionnaire and a semi-structured interview were used to collect the information, which was analyzed using the “SPSS” program and the qualitative categories, respectively. Results: The ten elements of the “Human Care Theory” can be included in the care given by the nursing personnel to the young adult population who faces morbid process health or chronic pain condition. The nursing care mainly focuses on the young adult population quality of life throughout education and pain management. The young adult population perceives a warm, pleasant and human nursing care. Conclusion: Nursing personnel put into practice elements of the Jean Watson’s theoretical proposal even when they do not know it.

  6. Empathy and avoidance in treating patients living with HIV/AIDS (PLWHA) among service providers in China

    OpenAIRE

    Lin, Chunqing; Li, Li; WAN, Dai; Wu, Zunyou; Yan, Zhihua

    2012-01-01

    This study aims to investigate health care providers’ empathy levels and its association with avoidance in providing service to patients living with HIV/AIDS (PLWHA) in China. A total of 1760 health service providers were randomly sampled from 40 county hospitals in two provinces of China. Using a self-administered questionnaire, participants’ demographic characteristics, work history, empathy level, and avoidance attitudes toward PLWHA were collected in a cross-sectional survey. Empathy was ...

  7. “Being a Nurse Is Not My Gender, It’s What I Was Professionally Trained to Do” : The Experiences of Male Nurses in Providing Intimate Care to Female Patients at a Health Care Facility in Central Finland

    OpenAIRE

    Nipuli, Laura; Salmon, Courtney

    2015-01-01

    Over the years statistics have shown that there has been an increase in the number of active male nurses. Despite these increases, the question of the appropriateness of male nurses providing intimate care to female patients still lingers. The aim of this study was to find out the experiences of male nurses while providing intimate care to female patients. The purpose was to collect data that can be used to inform future nurses about the experience of male nurses in providing such intimate ca...

  8. The nurse practitioner's role in managing dyslipidemia and other cardiovascular risk factors in HIV-infected patients: impact of antiretroviral therapy.

    Science.gov (United States)

    Willard, Suzanne

    2006-01-01

    The beneficial effects of antiretroviral therapy (ART) for the treatment of HIV disease have been accompanied by metabolic changes associated with an increased risk of cardiovascular disease. These changes, which include dyslipidemia, change in body fat distribution, and insulin resistance, resemble the symptoms of metabolic syndrome. Protease inhibitors, nucleoside analogue reverse transcriptase inhibitors, and nonnucleoside reverse transcriptase inhibitors have all been associated with dyslipidemia to varying degrees. In addition, patients on ART show an increased risk of myocardial infarction and other cardiovascular events. According to the recommendations of the National Cholesterol Education Program and the Adult AIDS Clinical Trial Group, health care providers should assess cardiovascular risk before starting ART and then continue to monitor lipid levels. Treatment of ART-associated dyslipidemia should follow the following sequence: therapeutic lifestyle changes, lipid-lowering drug therapy, and finally, modifying ART if necessary. By providing education, support, and follow-up care, nurse practitioners can help to implement these steps.

  9. HIV-1 Viral RNA Dynamics at the Plasma Membrane May Provide Insight into Viral Assembly | Poster

    Science.gov (United States)

    Many aspects of how infectious viruses assemble in cells have yet to be completely deciphered. However, as reported in a recent Journal of Virology paper, researchers may be one step closer to understanding how HIV-1, the virus that causes AIDS, assembles and replicates.

  10. Safer Conception Methods and Counseling: Psychometric Evaluation of New Measures of Attitudes and Beliefs Among HIV Clients and Providers.

    Science.gov (United States)

    Woldetsadik, Mahlet Atakilt; Goggin, Kathy; Staggs, Vincent S; Wanyenze, Rhoda K; Beyeza-Kashesya, Jolly; Mindry, Deborah; Finocchario-Kessler, Sarah; Khanakwa, Sarah; Wagner, Glenn J

    2016-06-01

    With data from 400 HIV clients with fertility intentions and 57 HIV providers in Uganda, we evaluated the psychometrics of new client and provider scales measuring constructs related to safer conception methods (SCM) and safer conception counselling (SCC). Several forms of validity (i.e., content, face, and construct validity) were examined using standard methods including exploratory and confirmatory factor analysis. Internal consistency was established using Cronbach's alpha correlation coefficient. The final scales consisted of measures of attitudes towards use of SCM and delivery of SCC, including measures of self-efficacy and motivation to use SCM, and perceived community stigma towards childbearing. Most client and all provider measures had moderate to high internal consistency (alphas 0.60-0.94), most had convergent validity (associations with other SCM or SCC-related measures), and client measures had divergent validity (poor associations with depression). These findings establish preliminary psychometric properties of these scales and should facilitate future studies of SCM and SCC.

  11. The Role of Emotional Avoidance, the Patient-Provider Relationship, and Other Social Support in ART Adherence for HIV+ Individuals.

    Science.gov (United States)

    Berghoff, Christopher R; Gratz, Kim L; Portz, Kaitlin J; Pinkston, Megan; Naifeh, James A; Evans, Shenell D; Konkle-Parker, Deborah J; Tull, Matthew T

    2017-03-06

    Adherence to antiretroviral therapy (ART) is associated with positive health outcomes among HIV+ patients. However, non-adherence remains high. Though factors that account for non-adherence remain unclear, social support has been consistently associated with ART adherence. As such, identifying malleable factors that hinder patients' ability to form supportive relationships may have consequence for improving ART adherence. Emotional avoidance (EA) may be one such factor given that it has been linked to difficulties in social situations. The present study examined relations among EA, the patient-provider relationship, other sources of social support, and ART adherence within a sample of HIV+ ART-prescribed patients. High EA was related to poor adherence and patient-provider relationships. EA was indirectly related to poor adherence through poorer patient-provider interactions. The indirect relation of EA to ART adherence through other sources of social support was not significant. Implications for developing targeted behavioral interventions focused on improving ART adherence are discussed.

  12. Evaluation of a Brief Intervention to Improve the Nursing Care of Young Children in a High HIV and AIDS Setting

    Directory of Open Access Journals (Sweden)

    Linda M. Richter

    2012-01-01

    Full Text Available The HIV epidemic in South Africa is putting great strain on health services, including the inpatient care of young children. Caregivers and young children (107 pairs and 17 nurses participated in an intervention to improve the care of young children in hospital in a high HIV and AIDS setting. The intervention addressed caregiver expectations about admission and treatment, responsive feeding, coping with infant pain and distress, assistance with medical procedures, and preparation for discharge and home care. Following a preparatory and piloting phase, measures of nurse burnout, caregiver physical and emotional well-being, and caregiver-child interaction were made before and after intervention. No changes were found between before and after intervention on assessments of caregiver wellbeing. However, mothers in the postintervention phase rated nurses as more supportive; mother-child interaction during feeding was more relaxed and engaged, and babies were less socially withdrawn. While the intervention proved useful in improving certain outcomes for children and their caregivers, it did not address challenging hospital and ward administration or support needed by caregivers at home following discharge. To address the latter need, the intervention has been extended into the community through home-based palliative care and support.

  13. Substance abuse and HIV: considerations with regard to methamphetamines and other recreational drugs for nursing practice and research.

    Science.gov (United States)

    Gorman, E M; Carroll, R T

    2000-01-01

    Substance use continues to be closely associated with both HIV infection and treatment considerations in all at-risk populations. Among those groups heretofore not well characterized epidemiologically or clinically are those dual-risk men who have sex with other men (MSM) and use and/or inject drugs. Of particular current concern with regard to drug-using MSM is the growth in popularity of a group of recreational or so-called party drugs associated with specific social and sexual environments and networks. Chief among these drugs are hallucinogens, such as MDMA, ketamine, and GHB, and stimulants, such as cocaine, amphetamines, and methamphetamine. Increased methamphetamine use by MSM is particularly alarming because of its reported associations with high-risk injecting and sexual behaviors. Preliminary data are reported from an ethnographic exploration of MSM methamphetamine users in the Pacific Northwest of the United States. Case studies drawn from the data illustrate the complex and variable patterns of methamphetamine use among MSM. Finally, implications for nursing are discussed, and "upstream nursing" is suggested as a means of patient advocacy for HIV nurses working with substance-using populations.

  14. Key findings: a qualitative assessment of provider and patient perceptions of HIV/AIDS in South Africa.

    Science.gov (United States)

    Ransom, James; Johnson, Anton F

    2009-01-01

    In 1997, at the Davos International Economic Forum, Nelson Mandela stated that "the poor, the vulnerable, the unschooled, the socially marginalized, the women, and the children, those who bear the burden of colonial legacy-these are the sectors of society which bear the burden of AIDS" (Richter, 2001). Nearly a decade later, that statement still holds true, especially in Mr. Mandela's home country. South Africa continues to have one of the world's highest prevalence ratios of HIV infection (UNAIDS, 2002). This paper explores the significance of perceptions, knowledge, practices, and attitudes toward HIV/AIDS in two important groups in South Africa: health care providers based in public health clinics and their patients. This paper will assess the provider-patient interaction from the perspective of members of the South African HIV/AIDS treatment and prevention community. The analysis will examine the results of in-depth interviews and focus group discussions with providers and patients, respectively, in two of South Africa's nine provinces. Between December 2002 and April 2003 in Guateng and KwaZulu-Natal provinces, we conducted (1) in-depth interviews of a spectrum of health care providers at five local public health clinics and (2) focus groups of patients who patronize those clinics. The results show that there are gaps in the HIV/AIDS knowledge of some of the health care providers and that the participants' health beliefs and practices are embedded in the social conditions in which they live and work, which has a ripple effect on their risk behaviors and trumps any intervention messages from their health care providers and larger public health intervention messages.

  15. Attitudes of Saudi Nursing Students on AIDS and Predictors of Willingness to Provide Care for Patients in Central Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mostafa A. Abolfotouh

    2013-08-01

    Full Text Available This study aimed to assess acquired immune deficiency syndrome (AIDS-related knowledge, attitudes, and risk perception among Saudi nursing students, and to identify predictors of their willingness to provide care for patients with AIDS. A cross-sectional study of 260 baccalaureate nursing students at King Saud bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, was done using a previously validated instrument. Students’ knowledge percentage mean score (PMS on AIDS was 72.93 ± 10.67 reflecting an average level of knowledge. There were many misconceptions about how AIDS is transmitted, for example, use of same toilets and bathrooms and washing clothes together (24.9%, swimming (53.7%, and coughing and sneezing (49.6%. Nursing students reported an overall negative attitude toward AIDS, with a PMS of 43.48 ± 9.21. The majority of students agreed that AIDS patients should be isolated from other patients (83%, and should not share the room with other noninfected patients (81.8%, and some reported that people living with AIDS deserve what has happened to them (24.7%. After controlling for confounders, students’ poor knowledge and negative attitude were associated only with having never been given nursing education as their primary university education “Stream 2 students” (p = .012 and p = .01, respectively. These findings have implications for development of teaching strategies and curricular approaches for nursing to address this health care issue.

  16. Achieving pregnancy safely: perspectives on timed vaginal insemination among HIV-serodiscordant couples and health-care providers in Kisumu, Kenya.

    Science.gov (United States)

    Mmeje, Okeoma; van der Poel, Sheryl; Workneh, Meklit; Njoroge, Betty; Bukusi, Elizabeth; Cohen, Craig R

    2015-01-01

    In female-positive HIV-serodiscordant couples desiring children, home timed vaginal insemination (TVI) of semen during the fertile period along with consistent condom use may reduce the risk of HIV transmission when the man is HIV-uninfected. In sub-Saharan Africa, up to 45% of HIV-infected women desire to have more children. HIV viral load assessment is not routinely available in low-resource countries for monitoring adherence and response to antiretroviral therapy. Therefore, in these settings, timed unprotected intercourse without assurance of HIV viral suppression may pose unnecessary risks. TVI, a simple and affordable intervention, can be considered an adjunct method and option of safer conception for HIV prevention with treatment of the HIV-infected partner and/or pre-exposure prophylaxis. We conducted five mixed and single-sex focus group discussions comprised of 33 HIV-serodiscordant couples and health-care providers in the Nyanza region of Kenya to assess the acceptability and feasibility of TVI as a safer method of conception. The transcribed data were analyzed using a grounded theory approach. We found that educating and counseling HIV-serodiscordant couples on TVI could make it an acceptable and feasible safer conception method when associated with frequent communication and home visits by health-care providers. The findings of this study indicate that implementation studies that integrate training and counseling of HIV-serodiscordant couples and health-care providers on TVI combined with consistent condom use are needed. Acknowledging and supporting the reproductive choice and needs of female positive, male negative HIV-serodiscordant couples who desire children should also include the use of assisted reproductive services at the same time as pharmaceutical options that prevent sexual HIV transmission.

  17. PTSD in psychiatric nurses and other mental health providers: a review of the literature.

    Science.gov (United States)

    Jacobowitz, William

    2013-11-01

    Psychiatric nurses are subject to a high rate of assault by patients. The stress of exposure to assault and the potential for assault appear to impact nurses' emotional states in the form of post-traumatic stress and post-traumatic stress disorder (PTSD). Most studies report a prevalence rate of PTSD in this population of between 9-10%. Training in the management of aggressive patients, participating in Critical Incident Debriefing, and having routine structured debriefing meetings may play a role in facilitating the development of resilience in nurses with respect to the risk of PTSD. Knowledge about the state of the science regarding aggression and PTSD is necessary for clinicians and researchers to develop and test effective strategies. This article presents a review of the current literature on this topic.

  18. Clinical Evaluation of BioPlex 2200 HIV Ag-Ab, an Automated Screening Method Providing Discrete Detection of HIV-1 p24 Antigen, HIV-1 Antibody, and HIV-2 Antibody

    OpenAIRE

    Salmona, Maud; Delarue, Severine; Delaugerre, Constance; Simon, François; Maylin, Sarah

    2014-01-01

    Early and accurate diagnosis is essential for optimal therapeutic outcomes in patients infected with HIV. Currently, none of the commercially available fourth-generation assays differentiate HIV-1 and HIV-2 antibodies (Ab) or the HIV-1 p24 antigen (Ag). The aim of this study was to evaluate the performance of a novel assay, the BioPlex 2200 HIV Ag-Ab. This assay uses a multiplex flow immunoassay design allowing the simultaneous detection and identification of antibodies to HIV-1 (groups M and...

  19. Being an HIV-positive mother: meanings for HIV-positive women and for professional nursing staff Ser-madre HIV-positivo: significados para las mujeres HIV-positivo y para la enfermería Ser-mãe HIV-positivo: significados para mulheres HIV-positivo e para a enfermagem

    Directory of Open Access Journals (Sweden)

    Marisa Monticelli

    2007-09-01

    Full Text Available OBJECTIVES: To comprehend the meanings of being an HIV-positive mother for HIV-positive women and for professional nursing staff of shared in-patient maternity wards, and to identify similarities and contrasts present in these meanings. METHODS: This was a descriptive and comparative secondary analysis study of data from two previous larger studies conducted in Public Hospitals of the Greater Florianopolis Area, Santa Catarina, Brazil. Data was collected through observation and interviews. RESULTS: For HIV-positive women the main meaning of being an HIV-positive mother was being a "super-mom" while for professional nursing staff the meaning was being "resistant." The meaning of being super-mom focuses on the motherhood role, which may be incompatible with the condition of carrier of the HIV virus. The meaning of being resistant does not fit with the experience of being mother. CONCLUSION: The meanings attributed by HIV-positive women, compared to those attributed by professional nursing staff, suggest prejudice, social stigma, and symbolic vulnerability.OBJETIVO: comprender los significados de ser-madre VIH positivo para mujeres VIH positivo y para trabajadoras de enfermería de unidades de alojamiento conjunto e identificar las similitudes y contrastes presentes en esos significados. MÉTODOS: estudio descriptivo y comparado, en el que se utilizó datos de dos investigaciones anteriores, desarrolladas en unidades de alojamiento conjunto de maternidades públicas de la Gran Florianópolis, (Santa Catarina-Brasil, recolectados por medio de observaciones participantes y entrevistas. RESULTADOS: para las mujeres VIH positivo, esas mujeres son "mamazonas" y para las trabajadoras de enfermería, esas mujeres son "resistentes", evidenciándose ciertas representaciones relativas al papel materno, como absolutamente incompatibles con la condición de portadoras del virus. Para la enfermería, el hecho de que la puérpera sea VIH positivo no "combina

  20. Nothing changes, nobody cares: understanding the experience of emergency nurses physically or verbally assaulted while providing care.

    Science.gov (United States)

    Wolf, Lisa A; Delao, Altair M; Perhats, Cydne

    2014-07-01

    Workplace violence has been recognized as a violent crime that requires targeted responses from employers, law enforcement, and the community. According to data from the Bureau of Labor Statistics, the most common source of nonfatal injuries and illnesses requiring days away from work in the health care and social assistance industry was assault on the health care worker. What is not well understood are the precursors and sequelae of violence perpetrated against emergency nurses and other health care workers by patients and visitors. The purpose of this study was to better understand the experience of emergency nurses who have been physically or verbally assaulted while providing patient care in US emergency departments. The study was conducted using a qualitative descriptive exploratory design. The sample consisted of 46 written narratives submitted by e-mail by emergency nurses describing the experience of violence while providing care at work. Narrative analysis and constant comparison were used to identify emerging themes in the narratives. "Environmental," "personal," and "cue recognition" were identified as the themes. Overall, nurses believed that violence was endemic to their workplace and that both limited recognition of cues indicating a high-risk person or environment and a culture of acceptance of violence were barriers to mitigation. These findings are consistent with the extant literature but with an added contribution of clearly identifying an underlying cultural acceptance of violence in the emergency department, as well as a distinct lack of cue recognition, in this sample of emergency nurses. Copyright © 2014 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  1. The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease.

    Science.gov (United States)

    Martin, Louise; Leveritt, Michael D; Desbrow, Ben; Ball, Lauren E

    2014-04-01

    Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing. The self-perceived knowledge, skills and attitudes of practice nurses in providing nutrition care has not been widely investigated. The aim of the present study was to investigate the perceptions of Australian practice nurses on the provision of nutrition care for chronic disease management, including specific nutrition-related activities. A cross-sectional online survey was completed by 181 Australian practice nurses in 2013. Descriptive analyses were conducted on each survey item. The survey sample was tested for representation of the Australian practice nurse workforce, and associations between respondents' demographic characteristics and responses to survey items were explored. Almost all practice nurses (89%) felt it was important to address diet whenever they cared for a patient. Over half of practice nurses (61%) were unsure if their practices were effective in increasing patients' compliance with nutritional recommendations. Nearly all practice nurses (98%) perceived further education on nutrition would assist them in their role. Practice nurses perceive they have an important role and favourable attitudes towards providing nutrition care; however, further training and education to enhance their self-perceived effectiveness is warranted. Future research should clarify whether an increase in nutrition-focused training results in improved effectiveness of nutrition care provided by practice nurses in terms of patient health outcomes.

  2. Vets, denialists and rememberers: social typologies of patient adherence and non-adherence to HAART from the perspective of HIV care providers.

    Science.gov (United States)

    Orchard, Treena; Salters, Kate; Palmer, Alexis; Michelow, Warren; Lepik, Katherine J; Hogg, Robert

    2015-01-01

    For many people living with HIV/AIDS taking highly active antiretroviral therapy (HAART) is difficult due to various individual and social factors, including the side effects of these medications, HIV/AIDS stigma and poor patient-provider relationships. Most studies that examine barriers to and facilitators of adherence to HAART have been conducted with people on these medications, which is critical to improving adherence among various HIV-affected groups. Less attention has been paid to the experiences of HIV care providers, which is an important gap in the literature considering the key role they play in the delivery of HAART and the management of patient treatment plans. This paper presents findings from a qualitative pilot study that explored how HIV care providers assess adherence and non-adherence to HAART among their HIV-positive patients in Vancouver, British Columbia. Drawing upon individual interviews conducted with HIV physicians (n = 3), social service providers (n = 3) and pharmacists (n = 2), this discussion focuses on the social typologies our participants use to assess patient success and failure related to adherence. Eleven unique categories are featured and the diversity within and across these categories illustrate a broad spectrum of adherence-related behaviours among patients and the social meanings providers attribute to these behaviours. As one of the first explorations of the social typologies used by HIV care providers to assess patient performance on HAART, these data contribute valuable insights into the experiences of providers within the context of adherence-related care delivery.

  3. Diagnostic accuracy of fine needle aspiration cytology in providing a diagnosis of cervical lymphadenopathy among HIV-infected patients.

    Science.gov (United States)

    Muyanja, David; Kalyesubula, Robert; Namukwaya, Elizabeth; Othieno, Emmanuel; Mayanja-Kizza, Harriet

    2015-03-01

    Opportunistic infections and malignancies cause lymphadenopathy in HIV-infected patients. The use and accuracy of fine needle aspiration cytology in diagnosing of cervical lymphadenopathy among HIV-infected patients is not well studied in Uganda. The aim of this study was to determine the diagnostic accuracy of fine needle aspiration cytology in providing a diagnosis of cervical lymphadenopathy among HIV-infected patients in Uganda. We consecutively recruited adult HIV-infected patients with cervical lymphadenopathy admitted to Mulago Hospital medical wards. Clinical examination, fine needle aspiration and lymph node biopsy were performed. We estimated the sensitivity, specificity; negative and positive predictive values using histology as the gold standard. We enrolled 108 patients with a mean age of 33 years (range, 18-60), 59% were men and mean CD4 was 83(range, 22-375) cells/mm(3). The major causes of cervical lymphadenopathy were: tuberculosis (69.4%), Kaposi's sarcoma-KS (10.2%) and reactive adenitis (7.4%). Overall fine needle aspiration cytology accurately predicted the histological findings in 65 out of 73 cases (89%) and missed 7 cases (9.5%). With a sensitivity of 93.1%, specificity of 100%, positive predictive value of 100% and negative predictive value of 78.7% for tuberculosis and 80%; 98.4%;88.9% and 98.9% for KS respectively. No fine needle aspiration complications were noted. Fine needle aspiration cytology is safe and accurate in the diagnosis of tuberculosis and KS cervical lymphadenopathy among HIV-positive patients.

  4. Practice nurses mental health provide space to patients to discuss unpleasant emotions.

    NARCIS (Netherlands)

    Griep, E.C.M.; Noordman, J.; Dulmen, A.M. van

    2016-01-01

    WHAT IS KNOWN ON THE SUBJECT? A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them.

  5. Diabetes specialist nurse as main care provider for patients with type 2 diabetes

    NARCIS (Netherlands)

    Houweling, S. T.; Kleefstra, N.; van Hateren, K. J. J.; Kooy, A.; Groenier, K. H.; ten Vergert, E.; Meyboom-de Jong, B.; Bilo, H. J. G.

    2009-01-01

    Background: The objective of this study was to determine whether the management of type 2 diabetes (DM2) can be transferred from an internist to a nurse specialised in diabetes (NSD). Methods: Ninety-three patients with DM2 referred by their general practitioner were randomised; 84 patients complete

  6. Training the Primary Care Internist to Provide Care in Skilled Nursing Facilities.

    Science.gov (United States)

    Robbins, John A.

    1983-01-01

    A pilot program at the University of California, Davis, that incorporated skilled nursing facility training into the required curriculum of their primary care internal medicine residency is described. The goal was to increase the residents' knowledge in the care of geriatric patients. (MLW)

  7. Providing oral care in haematological oncology patients: nurses' knowledge and skills.

    NARCIS (Netherlands)

    Potting, C.M.J.; Mank, A.; Blijlevens, N.M.A.; Donnelly, J.P.; Achterberg, T. van

    2008-01-01

    In the international literature, the most commonly recommended intervention for managing oral mucositis is good oral care, assuming that nurses have sufficient knowledge and skills to perform oral care correctly. The aim of the present study was to investigate if knowledge and skills about oral care

  8. Social Media Providing an International Virtual Elective Experience for Student Nurses

    Directory of Open Access Journals (Sweden)

    Paula M. Procter

    2017-04-01

    Full Text Available The advances in social media offer many opportunities for developing understanding of different countries and cultures without any implications of travel. Nursing has a global presence and yet it appears as though students have little knowledge of the health and social care needs and provision outside their local environment. Our collaboration across three countries, New Zealand, United Kingdom, and the United States of America, brought the two themes together with the aim of senior student nurses having a communication channel to explore public health issues in each country. Using a closed Facebook™ page, third year undergraduate adult nursing students were invited to take part in a three month pilot study to test the feasibility of virtual collaboration through exchanging public health issues. Here we report upon the collaboration, operation of the social media, and main findings of the study. Three core areas will be reported upon, these being the student’s views of using social media for learning about international perspectives of health, seeing nursing as a global profession and recommendations for future development of this positively reviewed learning technique. To conclude consideration will be given to further development of this work by the collaborative team expanding the countries involved.

  9. Diabetes specialist nurse as main care provider for patients with type 2 diabetes

    NARCIS (Netherlands)

    Houweling, S. T.; Kleefstra, N.; van Hateren, K. J. J.; Kooy, A.; Groenier, K. H.; ten Vergert, E.; Meyboom-de Jong, B.; Bilo, H. J. G.

    2009-01-01

    Background: The objective of this study was to determine whether the management of type 2 diabetes (DM2) can be transferred from an internist to a nurse specialised in diabetes (NSD). Methods: Ninety-three patients with DM2 referred by their general practitioner were randomised; 84 patients complete

  10. Practice nurses mental health provide space to patients to discuss unpleasant emotions.

    NARCIS (Netherlands)

    Griep, E.C.M.; Noordman, J.; Dulmen, A.M. van

    2016-01-01

    WHAT IS KNOWN ON THE SUBJECT? A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them.

  11. Nurses' willingness to take care of people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)--does a teaching intervention make a difference?

    Science.gov (United States)

    Mockiene, Vida; Suominen, Tarja; Välimäki, Maritta; Razbadauskas, Arturas; Caplinskas, Saulius; Martinkenas, Arvydas

    2011-08-01

    The aim of this study is to describe the impact of an education intervention programme on nurses' willingness to care for HIV-positive people in Lithuania. The study utilizes a randomized controlled trial design (RCT). The total sample comprises 185 nurses working in medical, surgical and gynaecological units, and primary health care centres from the same hospital areas in three Lithuanian hospitals. The data were analyzed using SPSS 12.0 and descriptive statistics. Our educational intervention did not have an impact on the nurses' willingness to take care of people living with HIV (PLHIV), as their level of willingness was high already before the education intervention. Further research on this issue is needed to try to understand the forces acting on our nursing staff in order to ensure appropriate care for PLHIV. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Assessment of utilization of provider-initiated HIV testing and counseling as an intervention for prevention of mother to child transmission of HIV and associated factors among pregnant women in Gondar town, North West Ethiopia

    Directory of Open Access Journals (Sweden)

    Malaju Marelign

    2012-05-01

    Full Text Available Abstract Background Detection of maternal HIV infection early in pregnancy is critical for prevention of mother to child transmission of HIV/AIDS. Most efforts have focused on VCT as the primary means of encouraging people to become aware of their HIV status. However, its uptake is low in many parts of sub-Saharan Africa including Ethiopia. Provider-initiated HIV testing and counseling provides a critical opportunity to diagnose HIV infection, to begin chronic care, and to prevent mother to child transmission. However, little is known about its acceptance and associated factors among pregnant women in the country and particularly in the present study area. Methods Health institution based cross-sectional quantitative study was conducted in Gondar town from July 22-August 18, 2010. A total of 400 pregnant women were involved in the study using stratified sampling technique and multiple logistic regression analysis was employed using SPSS version 16. Results A total of 400 pregnant women actively participated in this study and 330 (82.5% of them accepted provider-initiated HIV testing and counseling to be tested for HIV and 70(17.5% of them refused. Acceptance of provider-initiated HIV testing and counseling was positively associated with greater number of antenatal care visits [Adj. OR (95%CI=2.64(1.17, 5.95], residing in the urban areas[Adj. OR (95%CI=2.85(1.10, 7.41], having comprehensive knowledge on HIV [Adj. OR (95%CI=4.30(1.72, 10.73], positive partners reaction for HIV positive result [Adj. OR (95%CI=8.19(3.57, 18.80] and having knowledge on prevention of mother to child transmission of HIV[Adj. OR (95%CI=3.27(1.34, 7.94], but negatively associated with increased maternal age and education level. Conclusion Utilization of provider-initiated HIV testing and counseling during antenatal care was relatively high among pregnant women in Gondar town. Couple counseling and HIV testing should be strengthened to promote provider-initiated HIV

  13. Perceived empathy of service providers mediates the association between perceived discrimination and behavioral intention to take up HIV antibody testing again among men who have sex with men.

    Directory of Open Access Journals (Sweden)

    Jing Gu

    Full Text Available HIV antibody testing is a key measure of HIV prevention for men who have sex with men (MSM. The World Health Organization recommends sexually active and at-risk MSM to take up HIV antibody testing regularly. This study aimed to investigate the prevalence of behavioral intention to take up HIV antibody testing in the next six months among Hong Kong MSM who were ever-testers. An anonymous cross-sectional survey recruited 326 MSM who had taken up HIV antibody testing from gay-friendly venues and internet in Hong Kong. Of the participants, 40.8% had had unprotected anal intercourse with regular or non-regular male sex partners in the last six months; they were at risk of HIV transmission despite experience in HIV antibody testing. Only 37.2% showed a strong intention to take up HIV antibody testing again in the next six months. Adjusted analysis showed that both perceived discrimination toward Hong Kong MSM (AOR = .60, 95% CI: .36-.98 and the CARE Measure assessing perceived empathy of service providers (AOR = 1.05, 95% CI: 1.02-1.08 were significantly associated with intention for retesting. Perceived discrimination, however, became statistically non-significant (AOR = .68, 95% CI: .41-1.14, when both CARE Measure and perceived discrimination entered into the adjusted model. It is warranted to increase HIV retesting rate by removing perceived discrimination and reducing the negative effect of perceived discrimination through enhancement of empathy of service providers.

  14. Perceived empathy of service providers mediates the association between perceived discrimination and behavioral intention to take up HIV antibody testing again among men who have sex with men.

    Science.gov (United States)

    Gu, Jing; Lau, Joseph T F; Wang, Zixin; Wu, Anise M S; Tan, Xuhui

    2015-01-01

    HIV antibody testing is a key measure of HIV prevention for men who have sex with men (MSM). The World Health Organization recommends sexually active and at-risk MSM to take up HIV antibody testing regularly. This study aimed to investigate the prevalence of behavioral intention to take up HIV antibody testing in the next six months among Hong Kong MSM who were ever-testers. An anonymous cross-sectional survey recruited 326 MSM who had taken up HIV antibody testing from gay-friendly venues and internet in Hong Kong. Of the participants, 40.8% had had unprotected anal intercourse with regular or non-regular male sex partners in the last six months; they were at risk of HIV transmission despite experience in HIV antibody testing. Only 37.2% showed a strong intention to take up HIV antibody testing again in the next six months. Adjusted analysis showed that both perceived discrimination toward Hong Kong MSM (AOR = .60, 95% CI: .36-.98) and the CARE Measure assessing perceived empathy of service providers (AOR = 1.05, 95% CI: 1.02-1.08) were significantly associated with intention for retesting. Perceived discrimination, however, became statistically non-significant (AOR = .68, 95% CI: .41-1.14), when both CARE Measure and perceived discrimination entered into the adjusted model. It is warranted to increase HIV retesting rate by removing perceived discrimination and reducing the negative effect of perceived discrimination through enhancement of empathy of service providers.

  15. Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE.

    Science.gov (United States)

    Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L

    2016-02-01

    To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote

  16. Nurse-led hepatocellular carcinoma surveillance clinic provides an effective method of monitoring patients with cirrhosis.

    Science.gov (United States)

    Nazareth, Saroj; Leembruggen, Nadine; Tuma, Rhoda; Chen, Sook-Ling; Rao, Samarth; Kontorinis, Nick; Cheng, Wendy

    2016-06-01

    The aim of this study is to examine the acceptability and effectiveness of a nurse-led hepatocellular carcinoma (HCC) surveillance clinic in high-risk patients with cirrhosis/advanced fibrosis. Early detection of HCC is associated with better treatment outcomes and improved survival. International guidelines recommend 6-monthly surveillance of patients at risk of developing HCC. A nurse-led HCC surveillance protocol was established to support patients in adherence to surveillance protocols. The design used was retrospective document analysis. Retrospective analysis of healthcare records of patients referred to the clinic between August 2009 and December 2015. Extracted data included attendance of clinic visits, blood testing, ultrasound or other imaging, and outcomes. Ultrasound was attended within 6 months in 30.3% of cases and within 7 months in 71.2% of cases. The median time between Nurse-Led Clinic appointments, ultrasound scans and blood testing did not exceed 9 months. First year FibroScans were attended by 82.9% (63/76) patients; endoscopy was indicated for 42 and attended by 35 (83.3%) patients. Lesions were identified in 16 patients (21.5%) and HCC diagnosed in two patients. One patient died because of HCC and one to sub-dural haematoma. Nurse-led HCC surveillance was an effective method of monitoring patients with cirrhosis at high risk of developing HCC. Well-defined protocols enable timely identification of patients with HCC or hepatic decompensation so that management strategies can be implemented without delay. The potential benefits identified by this study warrant further, rigorous evaluation.

  17. Providing a healthy work environment for nurses: the influence on retention.

    Science.gov (United States)

    Cohen, Jayne; Stuenkel, Diane; Nguyen, Quyen

    2009-01-01

    Differences in registered nurses' (RNs) perceptions of their work environment were measured with the Insel and Moos' Work Environment Scale to identify factors in the work environment that may influence retention. Statistically significant differences for perceptions of supervisor support and innovation were found between those RNs who left their unit or hospital during a 24-month period and those who stayed. Implementing strategies to promote retention of RNs to ensure safe, quality patient care is essential.

  18. Patient-Provider Engagement and Chronic Pain in Drug-Using, Primarily African American Persons Living with HIV/AIDS.

    Science.gov (United States)

    Mitchell, Mary M; Nguyen, Trang Q; Maragh-Bass, Allysha C; Isenberg, Sarina R; Beach, Mary Catherine; Knowlton, Amy R

    2016-10-27

    Among disadvantaged persons living with HIV/AIDS (PLHIV), patient-provider engagement, which has been defined as patient-provider relationships that promote the use of health care services and are characterized by active listening and supportive decision making, has been associated with antiretroviral therapy (ART) maintenance and viral suppression. However, chronic pain, depression, and substance use, all of which are prevalent in this population, can reduce the quality of patient-provider engagement. We hypothesized a model in which chronic pain, depression, and substance use would be associated with poorer patient-provider engagement, which would be positively associated with adherence, with the latter associated positively with viral suppression. We analyzed data from the BEACON study, which included surveys from 383 PLHIV who were primarily African American, on ART, and had histories of drug use. Due to six missing cases on the chronic pain variable, we used data from 377 respondents in a structural equation model. Chronic pain and depressive symptoms were significantly associated with poorer patient-provider engagement, while substance use was associated with better engagement. Patient-provider engagement in turn was associated with better ART adherence, which was associated with higher viral suppression. Results suggest the role of chronic pain in poor patient-physician engagement in this population, which has potential implications for quality of HIV patient care and health outcomes. Findings suggest the need for attention to patient-provider engagement in PLHIV.

  19. Provider-Initiated HIV Testing for Migrants in Spain: A Qualitative Study with Health Care Workers and Foreign-Born Sexual Minorities

    NARCIS (Netherlands)

    Navaza, B.; Abarca, H.; Bisoffi, F.; Pool, R.; Roura, M.

    2016-01-01

    Introduction Provider-initiated HIV testing (PITC) is increasingly adopted in Europe. The success of the approach at identifying new HIV cases relies on its effectiveness at testing individuals most at risk. However, its suitability to reach populations facing overlapping vulnerabilities is under re

  20. Health care and social service providers' observations on the intersection of HIV/AIDS and violence among their clients and patients.

    Science.gov (United States)

    DiStefano, Anthony S; Cayetano, Reggie T

    2011-07-01

    Associations between HIV/AIDS and several forms of violence have been demonstrated in recent research. We conducted qualitative interviews with 30 providers who offered services related to HIV/AIDS or violence to identify specific manifestations of HIV/AIDS-violence intersections, factors that explain why HIV/AIDS and violence intersect in client/patient populations, and the theoretical salience of providers' narratives. Providers confirmed links between HIV/AIDS and violent victimization, and yielded new insights into crossover risk between HIV/AIDS and suicidality, nonsuicidal self-harm, and witnessing and perpetrating violence. We also isolated 20 explanatory factors, including substance use, poor mental health, sex work/trading sex, and sexual orientation/gender identity. Narratives were consistent with syndemics theory, indicating that HIV/AIDS and violence fueled each other's occurrence and magnified the health-related burden on affected client/patient populations, often under conditions of health and social disparity. Providers contribute a novel perspective on our understanding of HIV/AIDS-violence syndemics that shows promise in informing future interventions and practice.

  1. Provider-Initiated HIV Testing for Migrants in Spain : A Qualitative Study with Health Care Workers and Foreign-Born Sexual Minorities

    NARCIS (Netherlands)

    Navaza, B.; Abarca, H.; Bisoffi, F.; Pool, R.; Roura, M.

    2016-01-01

    Introduction Provider-initiated HIV testing (PITC) is increasingly adopted in Europe. The success of the approach at identifying new HIV cases relies on its effectiveness at testing individuals most at risk. However, its suitability to reach populations facing overlapping vulnerabilities is under re

  2. HIV testing among pregnant women living with HIV in India: are private healthcare providers routinely violating women’s human rights?

    OpenAIRE

    Madhivanan, Purnima; Krupp, Karl; Kulkarni, Vinay; Kulkarni, Sanjeevani; Vaidya, Neha; Shaheen, Reshma; Philpott, Sean; Fisher, Celia

    2014-01-01

    Background In India, approximately 49,000 women living with HIV become pregnant and deliver each year. While the government of India has made progress increasing the availability of prevention of mother-to-child transmission of HIV (PMTCT) services, only about one quarter of pregnant women received an HIV test in 2010, and about one-in-five that were found positive for HIV received interventions to prevent vertical transmission of HIV. Methods Between February 2012 to March 2013, 14 HIV-posit...

  3. Exploring intentions to discriminate against patients living with HIV/AIDS among future healthcare providers in Malaysia.

    Science.gov (United States)

    Earnshaw, Valerie A; Jin, Harry; Wickersham, Jeffrey; Kamarulzaman, Adeeba; John, Jacob; Altice, Frederick L

    2014-06-01

    Stigma towards people living with HIV/AIDS (PLWHA) is strong in Malaysia. Although stigma has been understudied, it may be a barrier to treating the approximately 81 000 Malaysian PLWHA. The current study explores correlates of intentions to discriminate against PLWHA among medical and dental students, the future healthcare providers of Malaysia. An online, cross-sectional survey of 1296 medical and dental students was conducted in 2012 at seven Malaysian universities; 1165 (89.9%) completed the survey and were analysed. Socio-demographic characteristics, stigma-related constructs and intentions to discriminate against PLWHA were measured. Linear mixed models were conducted, controlling for clustering by university. The final multivariate model demonstrated that students who intended to discriminate more against PLWHA were female, less advanced in their training, and studying dentistry. They further endorsed more negative attitudes towards PLWHA, internalised greater HIV-related shame, reported more HIV-related fear and disagreed more strongly that PLWHA deserve good care. The final model accounted for 38% of the variance in discrimination intent, with 10% accounted for by socio-demographic characteristics and 28% accounted for by stigma-related constructs. It is critical to reduce stigma among medical and dental students to eliminate intentions to discriminate and achieve equitable care for Malaysian PLWHA. Stigma-reduction interventions should be multipronged, addressing attitudes, internalised shame, fear and perceptions of deservingness of care. © 2014 John Wiley & Sons Ltd.

  4. Language and Culture in Health Literacy for People Living with HIV: Perspectives of Health Care Providers and Professional Care Team Members.

    Science.gov (United States)

    Mogobe, Keitshokile Dintle; Shaibu, Sheila; Matshediso, Ellah; Sabone, Motshedisi; Ntsayagae, Esther; Nicholas, Patrice K; Portillo, Carmen J; Corless, Inge B; Rose, Carol Dawson; Johnson, Mallory O; Webel, Allison; Cuca, Yvette; Rivero-Méndez, Marta; Solís Báez, Solymar S; Nokes, Kathleen; Reyes, Darcel; Kemppainen, Jeanne; Reid, Paula; Sanzero Eller, Lucille; Lindgren, Teri; Holzemer, William L; Wantland, Dean

    2016-01-01

    Low health literacy has been linked to inadequate engagement in care and may serve as a contributor to poor health outcomes among people living with HIV and AIDS. The purpose of this paper was to examine the perspectives of health care providers and professional care team members regarding health literacy in HIV disease. A secondary data analysis was conducted from a qualitative study aimed at understanding factors that help an HIV positive person to manage their HIV disease. Data were collected from sites in Botswana, the US, and Puerto Rico. In the parent study, data were collected through focus group discussions with 135 people living with HIV, 32 HIV health care providers (HCPs), and 39 HIV professional care team members (PCTMs). SPSS was used to analyze quantitative data while ATLAS.ti was used to analyze qualitative data. The findings from analyses of the perspectives of HCPs/PCTMs suggested that linguistic and cultural factors were important themes in the exchange of HIV information between health care providers and PLHIV. These themes included ineffective communication, health seeking behavior, cultural facilitators, and complementary and alternative/traditional healing methods. Thus, this study suggests that language and culture have a major role in health literacy for PLHIV.

  5. Language and Culture in Health Literacy for People Living with HIV: Perspectives of Health Care Providers and Professional Care Team Members

    Directory of Open Access Journals (Sweden)

    Keitshokile Dintle Mogobe

    2016-01-01

    Full Text Available Low health literacy has been linked to inadequate engagement in care and may serve as a contributor to poor health outcomes among people living with HIV and AIDS. The purpose of this paper was to examine the perspectives of health care providers and professional care team members regarding health literacy in HIV disease. A secondary data analysis was conducted from a qualitative study aimed at understanding factors that help an HIV positive person to manage their HIV disease. Data were collected from sites in Botswana, the US, and Puerto Rico. In the parent study, data were collected through focus group discussions with 135 people living with HIV, 32 HIV health care providers (HCPs, and 39 HIV professional care team members (PCTMs. SPSS was used to analyze quantitative data while ATLAS.ti was used to analyze qualitative data. The findings from analyses of the perspectives of HCPs/PCTMs suggested that linguistic and cultural factors were important themes in the exchange of HIV information between health care providers and PLHIV. These themes included ineffective communication, health seeking behavior, cultural facilitators, and complementary and alternative/traditional healing methods. Thus, this study suggests that language and culture have a major role in health literacy for PLHIV.

  6. Comprehensiveness of HIV care provided at global HIV treatment sites in the IeDEA consortium: 2009 and 2014

    Directory of Open Access Journals (Sweden)

    Cristin Q Fritz

    2017-01-01

    Conclusions: The availability of viral load monitoring remains suboptimal and should be a focus for site capacity, particularly in East and Southern Africa, where the majority of those initiating on ART reside. However, the comprehensiveness of care provided increased over the past 5 years and was related to type of funding received (publicly funded and PEPFAR supported.

  7. Attitudes of practicing nurses as predictors of intended care behavior with persons who are HIV positive: testing the Ajzen-Fishbein Theory of Reasoned Action.

    Science.gov (United States)

    Laschinger, H K; Goldenberg, D

    1993-12-01

    The purpose of this descriptive correlational study was to examine practicing nurses' attitudes, subjective norms, and intentions to care for HIV positive patients, using the Theory of Reasoned Action. One hundred and forty-one subjects completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (1980). Consistent with the theory, nurses' attitudes and subjective norms were found to be significant predictors of intentions to care for persons who are HIV positive (R2 = 0.27). Personal beliefs found to discriminate between intenders and nonintenders were those related to possible consequences for self, family, and friends, but not job-related consequences. Normative beliefs which discriminated between groups were also related to nonprofessional referents' expectations. In addition, qualitative data showed persistent concerns about occupational risk for contracting AIDS. Based on the results of this research, it is recommended that nurse educators in both clinical and academic settings, target specific educational/training interventions to include transmission, prevention, as well as exploration of feelings, attitudes, beliefs, and behavioral intentions about HIV-related topics. Further theory-based research and testing of interventions to change practicing nurses' attitudes and beliefs about HIV disease are advocated.

  8. A novel system for providing compatible blood to patients during surgery: "self-service" electronic blood banking by nursing staff.

    Science.gov (United States)

    Cheng, G; Chiu, D S; Chung, A S; Wong, H F; Chan, M W; Lui, Y K; Choy, F M; Chan, J C; Chan, A H; Lam, S T; Fan, T C

    1996-04-01

    A good blood bank must be able to provide compatible blood units promptly to operating room patients with minimal wastage. A "self-service" by nursing staff blood banking system that is safe, efficient, and well-accepted has been developed. Specific blood units are no longer assigned to surgical patients who have a negative pretransfusion antibody screen, irrespective of the type of surgery. A computer-generated list of the serial numbers of all group-identical blood units currently in the blood bank inventory is provided for each patient. The units themselves are not labeled with a patient's name. The group O list will be provided for group O patients, the group A list for group A patients, and so forth. Should the patient require transfusion during surgery, the operating room nurses go to the refrigerator, remove any group-identical unit, and check the serial number of the unit against the serial numbers on the patient's list. If the serial number is on that list, the blood bank will accept responsibility for compatibility. The system was implemented in 1995. Since implementation, a total of 2154 patients have undergone operations at this hospital. Thirty-two patients received more than 10 units of red cells each. There were no transfusion errors. The crossmatch-to-transfusion ratio was reduced from 1.67 to 1.12. Turnaround time for supplying additional or urgent units to patients in operating room was shortened from 33 to 2.5 minutes. There was no incidence of a blood unit's serial number not being on the list. Work by nurses and technical staff was reduced by nearly 50 percent. The "self-service" (by nursing staff) blood banking system described is safe and efficient. It saves staff time and can be easily set up.

  9. 艾滋病病毒感染孕产妇的护理%Nursing care on pregnant women with HIV infection

    Institute of Scientific and Technical Information of China (English)

    孙蓉晖

    2015-01-01

    目的:探讨艾滋病病毒感染孕妇剖宫产护理方法。方法:2010年5月-2014年8月收治经HIV确认阳性孕妇18例,均给予产前与产后的护理干预。结果:18例HIV阳性孕产妇皆行剖宫产,所产婴儿无一例感染HIV,无一例医护工作者感染。结论:加强HIV孕产妇及婴儿合适的护理,是有效保障母婴健康及控制新生儿艾滋病流行的重要保证。%Objective:To explore the nursing methods of cesarean section in pregnancy with HIV infection.Methods:18 pregnant women confirmed as HIV positive were selected from May 2010 to August 2014.They were given nursing intervention in antenatal and postpartum.Results:All of those 18 pregnant women with HIV positive were treated by caesarean births,no infants infected HIV,and none of the medical workers infected.Conclusion:Strengthening the appropriate nursing on HIV maternal and their infants is very important to guarantee maternal and child health and control of neonatal AIDS epidemic.

  10. An e-health driven laboratory information system to support HIV treatment in Peru: E-quity for laboratory personnel, health providers and people living with HIV

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    Caballero N Patricia

    2009-12-01

    Full Text Available Abstract Background Peru has a concentrated HIV epidemic with an estimated 76,000 people living with HIV (PLHIV. Access to highly active antiretroviral therapy (HAART expanded between 2004-2006 and the Peruvian National Institute of Health was named by the Ministry of Health as the institution responsible for carrying out testing to monitor the effectiveness of HAART. However, a national public health laboratory information system did not exist. We describe the design and implementation of an e-health driven, web-based laboratory information system - NETLAB - to communicate laboratory results for monitoring HAART to laboratory personnel, health providers and PLHIV. Methods We carried out a needs assessment of the existing public health laboratory system, which included the generation and subsequent review of flowcharts of laboratory testing processes to generate better, more efficient streamlined processes, improving them and eliminating duplications. Next, we designed NETLAB as a modular system, integrating key security functions. The system was implemented and evaluated. Results The three main components of the NETLAB system, registration, reporting and education, began operating in early 2007. The number of PLHIV with recorded CD4 counts and viral loads increased by 1.5 times, to reach 18,907. Publication of test results with NETLAB took an average of 1 day, compared to a pre-NETLAB average of 60 days. NETLAB reached 2,037 users, including 944 PLHIV and 1,093 health providers, during its first year and a half. The percentage of overall PLHIV and health providers who were aware of NETLAB and had a NETLAB password has also increased substantially. Conclusion NETLAB is an effective laboratory management tool since it is directly integrated into the national laboratory system and streamlined existing processes at the local, regional and national levels. The system also represents the best possible source of timely laboratory information for

  11. Knowledge and behaviour of nurse/midwives in the prevention of vertical transmission of HIV in Owerri, Imo State, Nigeria: a cross-sectional study

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    Onibokun Adenike

    2007-10-01

    Full Text Available Abstract Background Mother-to-Child Transmission (MTCT of HIV remains the main mode of acquisition of HIV in children. Transmission of HIV may occur during pregnancy, delivery or breastfeeding. Studies have shown that some specific interventions help to reduce the transmission of the virus to the baby. In order to target safe, rational and effective intervention to reduce MTCT of HIV, it is necessary to ensure that the nurse/midwife has knowledge of the strategies for the prevention of vertical transmission of HIV. Method The cross-sectional design was utilized to determine the knowledge and behaviour of nurse/midwives in the prevention of vertical transmission of HIV in Owerri, Imo State, Nigeria. The study sample consisted of 155 nurse/midwives drawn from three selected hospitals through stratified random sampling method. Official permission was obtained from the institutions and consent from participants. Data was collected through the use of a self administered questionnaire. Information sought included respondents' demographic characteristics, knowledge about and behaviour of prevention of vertical transmission as well as factors influencing behaviour. Results Findings revealed that nurse/midwives had moderate level of knowledge with mean score of 51.4%. The mean score on behaviour was 52.5%, major factors that influence behaviour in these settings were mainly fear of getting infected, irregular supply of resources like gloves, goggles, sharp boxes, and water supply was not regular also. Hypotheses tested revealed that there is a positive relationship between knowledge and behaviour (r = 0.583, p = 0.00. Knowledge level of nurse/midwives who had educational exposure was not different from those who did not (t = 1.439, p = 0.152. There was a significant difference in the knowledge of nurse/midwives who had experience in managing pregnant women living with HIV/AIDS and those who did not (t = 2.142, p = 0.03. Also, there was a significant

  12. Resource utilization and cost-effectiveness of counselor- vs. provider-based rapid point-of-care HIV screening in the emergency department.

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    Rochelle P Walensky

    Full Text Available BACKGROUND: Routine HIV screening in emergency department (ED settings may require dedicated personnel. We evaluated the outcomes, costs and cost-effectiveness of HIV screening when offered by either a member of the ED staff or by an HIV counselor. METHODS: We employed a mathematical model to extend data obtained from a randomized clinical trial of provider- vs. counselor-based HIV screening in the ED. We compared the downstream survival, costs, and cost-effectiveness of three HIV screening modalities: 1 no screening program; 2 an ED provider-based program; and 3 an HIV counselor-based program. Trial arm-specific data were used for test offer and acceptance rates (provider offer 36%, acceptance 75%; counselor offer 80%, acceptance 71%. Undiagnosed HIV prevalence (0.4% and linkage to care rates (80% were assumed to be equal between the screening modalities. Personnel costs were derived from trial-based resource utilization data. We examined the generalizability of results by conducting sensitivity analyses on offer and acceptance rates, undetected HIV prevalence, and costs. RESULTS: Estimated HIV screening costs in the provider and counselor arms averaged $8.10 and $31.00 per result received. The Provider strategy (compared to no screening had an incremental cost-effectiveness ratio of $58,700/quality-adjusted life year (QALY and the Counselor strategy (compared to the Provider strategy had an incremental cost-effectiveness ratio of $64,500/QALY. Results were sensitive to the relative offer and acceptance rates by strategy and the capacity of providers to target-screen, but were robust to changes in undiagnosed HIV prevalence and programmatic costs. CONCLUSIONS: The cost-effectiveness of provider-based HIV screening in an emergency department setting compares favorably to other US screening programs. Despite its additional cost, counselor-based screening delivers just as much return on investment as provider based-screening. Investment in

  13. Diabetes Mellitus Care Provided by Nurse Practitioners vs Primary Care Physicians.

    Science.gov (United States)

    Kuo, Yong-Fang; Goodwin, James S; Chen, Nai-Wei; Lwin, Kyaw K; Baillargeon, Jacques; Raji, Mukaila A

    2015-10-01

    To compare processes and cost of care of older adults with diabetes mellitus cared for by nurse practitioners (NPs) with processes and cost of those cared for by primary care physicians (PCPs). Retrospective cohort study. Primary care in communities. Individuals with a diagnosis of diabetes mellitus in 2009 who received all their primary care from NPs or PCPs were selected from a national sample of Medicare beneficiaries (N = 64,354). Propensity score matching within each state was used to compare these two cohorts with regard to rate of eye examinations, low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (HbA1C) testing, nephropathy monitoring, specialist consultation, and Medicare costs. The two groups were also compared regarding medication adherence and use of statins, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (for individuals with a diagnosis of hypertension), and potentially inappropriate medications (PIMs). Nurse practitioners and PCPs had similar rates of LDL-C testing (odds ratio (OR) = 1.01, 95% confidence interval (CI) = 0.94-1.09) and nephropathy monitoring (OR = 1.05, 95% CI = 0.98-1.03), but NPs had lower rates of eye examinations (OR = 0.89, 95% CI = 0.84-0.93) and HbA1C testing (OR = 0.88, 95% CI = 0.79-0.98). NPs were more likely to have consulted cardiologists (OR = 1.29, 95% CI = 1.21-1.37), endocrinologists (OR = 1.64, 95% CI = 1.48-1.82), and nephrologists (OR = 1.90, 95% CI = 1.67-2.17) and more likely to have prescribed PIMs (OR = 1.07, 95% CI = 1.01-1.12). There was no statistically significant difference in adjusted Medicare spending between the two groups (P = .56). Nurse practitioners were similar to PCPs or slightly lower in their rates of diabetes mellitus guideline-concordant care. NPs used specialist consultations more often but had similar overall costs of care to PCPs. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  14. Factors influencing frontline health service providers' likelihood to recommend a future, preventive HIV vaccine to key populations in Karnataka, south India.

    Science.gov (United States)

    McClarty, Leigh M; Lorway, Robert R; Ramanaik, Satyanarayana; Wylie, John; Becker, Marissa L

    2015-01-29

    The HIV epidemic in the south Indian state of Karnataka disproportionately burdens key populations of men who have sex with men and female sex workers. Despite having successfully reduced HIV incidence among certain key populations through the use of targeted intervention, India's HIV epidemic remains one of its greatest public health issues. The best long-term strategy for managing the global HIV epidemic might involve a preventive vaccine; however, vaccine availability cannot guarantee its accessibility or acceptability. Vaccine recommendations from frontline health service providers have previously been identified as useful strategies to enhance vaccine uptake among target groups. This study used structured interviews to explore frontline health service providers' self-identified likelihood to recommend a future, preventive HIV vaccine to key populations in Karnataka. A modified social ecological model was then used to categorise factors that might prevent health service providers from recommending an HIV vaccine. Overall, 83% of health service providers reported that they would be very likely to recommend an HIV vaccine to men who have sex with men and female sex workers, while less than one-third of participants identified one or more barrier to vaccine recommendation. Intrapersonal, interpersonal, and structural/political factors were most commonly reported to act as potential barriers to future HIV vaccine recommendation among health service providers in Karnataka. This study adds to the limited body of literature focussing on future HIV vaccine acceptability in low- and middle-income countries and highlights some of the several complexities surrounding vaccine acceptability and uptake among key populations in Karnataka. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.

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    Susanne Sjöström

    Full Text Available The objective of the present study is to calculate the cost-effectiveness of early medical abortion performed by nurse-midwifes in comparison to physicians in a high resource setting where ultrasound dating is part of the protocol. Non-physician health care professionals have previously been shown to provide medical abortion as effectively and safely as physicians, but the cost-effectiveness of such task shifting remains to be established.A cost effectiveness analysis was conducted based on data from a previously published randomized-controlled equivalence study including 1180 healthy women randomized to the standard procedure, early medical abortion provided by physicians, or the intervention, provision by nurse-midwifes. A 1.6% risk difference for efficacy defined as complete abortion without surgical interventions in favor of midwife provision was established which means that for every 100 procedures, the intervention treatment resulted in 1.6 fewer incomplete abortions needing surgical intervention than the standard treatment. The average direct and indirect costs and the incremental cost-effectiveness ratio (ICER were calculated. The study was conducted at a university hospital in Stockholm, Sweden.The average direct costs per procedure were EUR 45 for the intervention compared to EUR 58.3 for the standard procedure. Both the cost and the efficacy of the intervention were superior to the standard treatment resulting in a negative ICER at EUR -831 based on direct costs and EUR -1769 considering total costs per surgical intervention avoided.Early medical abortion provided by nurse-midwives is more cost-effective than provision by physicians. This evidence provides clinicians and decision makers with an important tool that may influence policy and clinical practice and eventually increase numbers of abortion providers and reduce one barrier to women's access to safe abortion.

  16. Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Sjöström, Susanne; Kopp Kallner, Helena; Simeonova, Emilia; Madestam, Andreas; Gemzell-Danielsson, Kristina

    2016-01-01

    The objective of the present study is to calculate the cost-effectiveness of early medical abortion performed by nurse-midwifes in comparison to physicians in a high resource setting where ultrasound dating is part of the protocol. Non-physician health care professionals have previously been shown to provide medical abortion as effectively and safely as physicians, but the cost-effectiveness of such task shifting remains to be established. A cost effectiveness analysis was conducted based on data from a previously published randomized-controlled equivalence study including 1180 healthy women randomized to the standard procedure, early medical abortion provided by physicians, or the intervention, provision by nurse-midwifes. A 1.6% risk difference for efficacy defined as complete abortion without surgical interventions in favor of midwife provision was established which means that for every 100 procedures, the intervention treatment resulted in 1.6 fewer incomplete abortions needing surgical intervention than the standard treatment. The average direct and indirect costs and the incremental cost-effectiveness ratio (ICER) were calculated. The study was conducted at a university hospital in Stockholm, Sweden. The average direct costs per procedure were EUR 45 for the intervention compared to EUR 58.3 for the standard procedure. Both the cost and the efficacy of the intervention were superior to the standard treatment resulting in a negative ICER at EUR -831 based on direct costs and EUR -1769 considering total costs per surgical intervention avoided. Early medical abortion provided by nurse-midwives is more cost-effective than provision by physicians. This evidence provides clinicians and decision makers with an important tool that may influence policy and clinical practice and eventually increase numbers of abortion providers and reduce one barrier to women's access to safe abortion.

  17. How does care coordination provided by registered nurses "fit" within the organisational processes and professional relationships in the general practice context?

    Science.gov (United States)

    Ehrlich, Carolyn; Kendall, Elizabeth; St John, Winsome

    2013-01-01

    The aim of this study was to develop understanding about how a registered nurse-provided care coordination model can "fit" within organisational processes and professional relationships in general practice. In this project, registered nurses were involved in implementation of registered nurse-provided care coordination, which aimed to improve quality of care and support patients with chronic conditions to maintain their care and manage their lifestyle. Focus group interviews were conducted with nurses using a semi-structured interview protocol. Interpretive analysis of interview data was conducted using Normalization Process Theory to structure data analysis and interpretation. Three core themes emerged: (1) pre-requisites for care coordination, (2) the intervention in context, and (3) achieving outcomes. Pre-requisites were adequate funding mechanisms, engaging organisational power-brokers, leadership roles, and utilising and valuing registered nurses' broad skill base. To ensure registered nurse-provided care coordination processes were sustainable and embedded, mentoring and support as well as allocated time were required. Finally, when registered nurse-provided care coordination was supported, positive client outcomes were achievable, and transformation of professional practice and development of advanced nursing roles was possible. Registered nurse-provided care coordination could "fit" within the context of general practice if it was adequately resourced. However, the heterogeneity of general practice can create an impasse that could be addressed through close attention to shared and agreed understandings. Successful development and implementation of registered nurse roles in care coordination requires attention to educational preparation, support of the individual nurse, and attention to organisational structures, financial implications and team member relationships.

  18. The nurse specialist as main care-provider for patients with type 2 diabetes in a primary care setting : effects on patient outcomes

    NARCIS (Netherlands)

    Vrijhoef, HJM; Diederiks, JPM; Spreeuwenberg, C; Wolffenbuttel, BHR; van Wilderen, LJGP

    2002-01-01

    A solution to safeguard high quality diabetes care may be to allocate care to the nurse specialist. By using a one group pretest-posttest design with additional comparisons, this study evaluated effects on patient outcomes of a shared care model with the diabetes nurse as main care-provider for pati

  19. NURSING CARE APPROCH MODEL (NCAM–PAKAR ON THE INCREASING OF COGNITIF AND BIOLOGICAL ADAPTATION RESPONSES PATIENT WITH HIV INFECTION

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    Nursalam Nursalam

    2017-04-01

    Full Text Available Introduction: PAKAR model that focused on coping strategy and social support (nurse, family and patients lead to positive coping mechanism through the learning process. The purpose of the study was to examine the effect of PAKAR toward adaptive response on PWH infection. PNI and nursing sciences from Roy paradigm were used in this study. Method: Quasy-experimental pre-post-test non randomized control group design is used in this study. Forty (40 PWH infections in Intermediate Department Care for Infection Disease (UPIPI Dr. Soetomo hospital in Surabaya were selected and non-randomized assignment divided into 2 groups of 20, experiment and control group. In vitro- test were used to measure biological response change: cortical, CD4, IFNγ, and Anti-HIV. Psychological, social, and spiritual response were measured and observed by using questionnaires, in depth interview and Focus Group Discussion. A Multivariate analysis was used to evaluate the data of biological response and non-parametric test: Wilcoxon and Mann Whitney were used to measure cognitive response. Result: Result showed that there were significantly differences on cognitive response between PAKAR and Standard, namely; spiritual response on be patient, social response on emotional stable, and acceptance response on anger and bargaining. In addition, biological response were significantly differences between the groups with F = 0.497 and p = 0.000. The cortical and Anti-HIV variables were the pattern contribution between the groups, with 77.5%. The increase the number of CD4 was found to be the dominance factor that was correlated toward the positive of cognitive response caused by PAKAR. Discussion: PAKAR model that focused on coping strategy and utilizing social support lead to treat cognitive response PWH infection. The model is based on nursing science theory (Roy and Hall combined with psychoneuroimmunology paradigm that is able to induce immune response modulation, especially the

  20. Effectiveness of the Rural Trauma Team Development Course for Educating Nurses and Other Health Care Providers at Rural Community Hospitals.

    Science.gov (United States)

    Zhu, Thein Hlaing; Hollister, Lisa; Scheumann, Christopher; Konger, Jennifer; Opoku, Dazar

    2016-01-01

    The study evaluates (1) health care provider perception of the Rural Trauma Team Development Course (RTTDC); (2) improvement in acute trauma emergency care knowledge; and (3) early transfer of trauma patients from rural emergency departments (EDs) to a verified trauma center. A 1-day, 8-hour RTTDC was given to 101 nurses and other health care providers from nine rural community hospitals from 2011 to 2013. RTTDC participants completed questionnaires to address objectives (1) and (2). ED and trauma registry data were queried to achieve objective (3) for assessing reduction in ED time (EDT), from patient arrival to decision to transfer and ED length of stay (LOS). The RTTDC was positively perceived by health care providers (96.3% of them completed the program). Significant improvement in 13 of the 19 knowledge items was observed in nurses. Education intervention was an independent predictor in reducing EDT by 28 minutes and 95% confidence interval (CI) [-57, -0.1] at 6 months post-RTTDC, and 29 minutes and 95% CI [-53, -6] at 12 months post-RTTDC. Similar results were observed with ED LOS. The RTTDC is well-perceived as an education program. It improves acute trauma emergency care knowledge in rural health care providers. It promotes early transfer of severely injured patients to a higher level of care.

  1. Necessidades de qualificação da equipe de enfermagem para a assistência aos clientes portadores do HIV e da Aids Qualification needs of the nursing team for the assistance of Clients with HIV and Aids

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    Anna Luiza de Fátima Pinho Lins Gryschek

    2000-09-01

    Full Text Available Discorre-se sobre as necessidades de qualificação específica das equipes de enfermagem dos Centros de Referência de Doenças Sexualmente Transmissíveis e Aids da Secretaria Municipal da Saúde de São Paulo, para a assistência aos clientes portadores do HIV e da Aids. Foram enviados questionários abertos, para todos os profissionais da equipe de enfermagem de todas as unidades do Programa Municipal de DST/Aids. Do total de 671 profissionais de enfermagem, 453 responderam ao questionário. Como necessidades de qualificação foram apontadas: biossegurança, preparo e administração de medicamentos específicos e assistência de enfermagem aos clientes com HIV e Aids.This study discourses about the especific training needs of the nursing teams of the Centers of Reference of Sexual Transmissible Diseases (STD and Aids from the STD/Aids Program of the Health Secretary of the Township of São Paulo for the assistance of clients with HIV and Aids. From a total of 671 nursing workers, 453 answered the questionnaire. They identified the following training needs: contents related to standard precautions, preparation and administration of specific drugs and other general nursing care to HIV + clients.

  2. An Evaluation of the Quality of Nursing Care Provided for Vascular Access in Hemodialysis Patients

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    Hamid Reza Chamanzari

    2015-10-01

    Full Text Available Introduction: Care for vascular access of patients undergoing hemodialysis is a critical issue. Inflammation and subsequent infection are the major factors which threaten patients' health and diminish effectiveness of hemodialysis. Therefore, this study aimed to evaluate the severity and incidence of inflammation of vascular access in hemodialysis patients. Materials and Methods: This cross-sectional study was conducted on 90 patients undergoing hemodialysis in Emam Reza and Montazerie Hospitals in Mashhad, June, 2014. Evaluation of inflammation severity over the course of one month (12 hemodialysis sessions was performed by means of an inflammation tool designed by the Board of Nursing. Data were analyzed using SPSS version 16, and performing descriptive and Chi-square tests.  Results:The mean and standard deviation of incidence of inflammation in the first session of hemodialysis was 3.2±1.3 cases. The mean and standard deviation of the intensity of inflammation was 12.5±4.7. Conclusion: Since inflammation of vascular access in hemodialysis patients impairs their safety and health improvement, necessary measures to reduce this complication must be taken.

  3. Dialysis purification of integrase-DNA complexes provides high-resolution atomic force microscopy images: dimeric recombinant HIV-1 integrase binding and specific looping on DNA.

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    Tatsuaki Tsuruyama

    Full Text Available It remains difficult to obtain high-resolution atomic force microscopy images of HIV-1 integrase bound to DNA in a dimeric or tetrameric fashion. We therefore constructed specific target DNAs to assess HIV-1 integrase binding and purified the complex by dialysis prior to analysis. Our resulting atomic force microscopy analyses indicated precise size of binding human immunodeficiency virus type 1 (HIV-1 recombinant integrase in a tetrameric manner, inducing formation of a loop-like or figure-eight-like secondary structure in the target DNA. Our findings regarding the target DNA secondary structure provide new insights into the intermediate states of retroviral integration.

  4. Dialysis purification of integrase-DNA complexes provides high-resolution atomic force microscopy images: dimeric recombinant HIV-1 integrase binding and specific looping on DNA.

    Science.gov (United States)

    Tsuruyama, Tatsuaki; Nakai, Tonau; Ohmori, Rei; Ozeki, Munetaka; Tamaki, Keiji; Yoshikawa, Kenichi

    2013-01-01

    It remains difficult to obtain high-resolution atomic force microscopy images of HIV-1 integrase bound to DNA in a dimeric or tetrameric fashion. We therefore constructed specific target DNAs to assess HIV-1 integrase binding and purified the complex by dialysis prior to analysis. Our resulting atomic force microscopy analyses indicated precise size of binding human immunodeficiency virus type 1 (HIV-1) recombinant integrase in a tetrameric manner, inducing formation of a loop-like or figure-eight-like secondary structure in the target DNA. Our findings regarding the target DNA secondary structure provide new insights into the intermediate states of retroviral integration.

  5. Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme.

    Science.gov (United States)

    Mbombo, Nomafrench; Bimerew, Million

    2012-11-14

    South Africa (SA) has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT). However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we described teaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg's competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.

  6. Concordance between nurses' perception of their ability to provide spiritual care and the identified spiritual needs of hospitalized patients: A cross-sectional observational study.

    Science.gov (United States)

    Wu, Li-Fen; Koo, Malcolm; Tseng, Hui-Chen; Liao, Yu-Chen; Chen, Yuh-Min

    2015-12-01

    Spiritual care is essential to the well-being of patients, and nurses provide spiritual care as a fundamental part of nursing practice. In this study, we investigated the spiritual care needs of hospitalized patients to determine whether the perceived knowledge of nurses corresponded with these spiritual care needs. A cross-sectional study was conducted on 1351 hospitalized patients and 200 registered nurses recruited from a medical center in central Taiwan. A questionnaire, including the 21-item Spiritual Care Needs Inventory (patient and nurse version) and basic demographic information, was distributed to eligible participants. The top three items of the spiritual care needs expressed by the hospitalized patients were respect for privacy and dignity, showing concern, and guidance in gaining a sense of hope in life; the percentages of nurses not knowing how to provide these spiritual care needs were 0%, 1%, and 15%, respectively. The spiritual care needs of patients showed a significant relationship with the knowledge of nurses, suggesting that the perceived knowledge of the nurses generally corresponded with the spiritual care items that the patients required most.

  7. Acceptance of Provider Initiated HIV Testing and Counseling among Tuberculosis Patients in East Wollega Administrative Zone, Oromia Regional State, Western Ethiopia

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    Wakjira Kebede

    2014-01-01

    Full Text Available Human immunodeficiency virus (HIV is a powerful risk factor for the development of tuberculosis. This study assessed the acceptance and associated factors that can affect provider initiated HIV testing and counseling (PITC among tuberculosis patients at the East Wollega administrative zone, Oromia regional state, western Ethiopia, from January to August, 2010. A single population proportion formula is used to calculate the total sample size of 406 and the cluster sampling technique was used to select 13 health centers that provide PITC services. The sample size was proportionally allocated to each health center. The study participants were selected using a simple random sampling technique using the lottery method. Structured questionnaire was used for collection of sociodemographic data. From the total of study subjects, 399 (98.2% TB patients were initiated for HIV test and 369 (92.5% patients accepted the initiation. Of those, 353 (95.5% patients had taken HIV test and received their results. According to the reviewed documents, the prevalence of HIV among tuberculosis (TB patients in the study area was 137 (33.7%. The logistic regression result showed the PITC was significantly associated with their knowledge about HIV (AOR = 3.22, 95% CI: 1.3–7.97, self-perceived risk (AOR = 2.93, 95% CI: 1.12–7.66, educational status (AOR = 3.51, 95% CI: 1.13–10.91, and knowledge on transmission of HIV/AIDS (AOR = 7.56, 95% CI: 1.14–40.35 which were significantly associated with the acceptance of PITC among TB patients. Therefore, this study’s results showed, the prevalence of HIV among TB patient was high; to enhance the acceptance of PITC among TB patients, health extension workers must provide health education during home-to-home visiting. TB treatment supervisors also provide counseling intensively for all forms of TB patients during their first clinical encounter.

  8. Fertility and contraceptive decision-making and support for HIV infected individuals: client and provider experiences and perceptions at two HIV clinics in Uganda

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    Wanyenze Rhoda K

    2013-02-01

    Full Text Available Abstract Background Some people living with HIV/AIDS (PLHIV want to have children while others want to prevent pregnancies; this calls for comprehensive services to address both needs. This study explored decisions to have or not to have children and contraceptive preferences among PLHIV at two clinics in Uganda. Methods This was a qualitative cross-sectional study. We conducted seventeen focus group discussions and 14 in-depth interviews with sexually active adult men and women and adolescent girls and boys, and eight key informant interviews with providers. Overall, 106 individuals participated in the interviews; including 84 clients through focus group discussions. Qualitative latent content analysis technique was used, guided by key study questions and objectives. A coding system was developed before the transcripts were examined. Codes were grouped into categories and then themes and subthemes further identified. Results In terms of contraceptive preferences, clients had a wide range of preferences; whereas some did not like condoms, pills and injectables, others preferred these methods. Fears of complications were raised mainly about pills and injectables while cost of the methods was a major issue for the injectables, implants and intrauterine devices. Other than HIV sero-discordance and ill health (which was cited as transient, the decision to have children or not was largely influenced by socio-cultural factors. All adult men, women and adolescents noted the need to have children, preferably more than one. The major reasons for wanting more children for those who already had some were; the sex of the children (wanting to have both girls and boys and especially boys, desire for large families, pressure from family, and getting new partners. Providers were supportive of the decision to have children, especially for those who did not have any child at all, but some clients cited negative experiences with providers and information gaps for

  9. Barriers and facilitators adolescent females living with HIV face in accessing contraceptive services: a qualitative assessment of providers' perceptions in western Kenya.

    Science.gov (United States)

    Hagey, Jill M; Akama, Eliud; Ayieko, James; Bukusi, Elizabeth A; Cohen, Craig R; Patel, Rena C

    2015-01-01

    Avoiding unintended pregnancies is important for the health of adolescents living with HIV and has the additional benefit of preventing potential vertical HIV transmission. Health facility providers represent an untapped resource in understanding the barriers and facilitators adolescents living with HIV face when accessing contraception. By understanding these barriers and facilitators to contraceptive use among adolescent females living with HIV, this study aimed to understand how best to promote contraception within this marginalized population. We conducted structured in-depth interviews with 40 providers at 21 Family AIDS Care & Education Services - supported clinics in Homabay, Kisumu and Migori counties in western Kenya from July to August 2014. Our interview guide explored the providers' perspectives on contraceptive service provision to adolescent females living with HIV with the following specific domains: contraception screening and counselling, service provision, commodity security and clinic structure. Transcripts from the interviews were analyzed using inductive content analysis. According to providers, interpersonal factors dominated the barriers adolescent females living with HIV face in accessing contraception. Providers felt that adolescent females fear disclosing their sexual activity to parents, peers and providers, because of repercussions of perceived promiscuity. Furthermore, providers mentioned that adolescents find seeking contraceptive services without a male partner challenging, because some providers and community members view adolescents unaccompanied by their partners as not being serious about their relationships or having multiple concurrent relationships. On the other hand, providers noted that institutional factors best facilitated contraception for these adolescents. Integration of contraception and HIV care allows easier access to contraceptives by removing the stigma of coming to a clinic solely for contraceptive services. Youth

  10. Decliners of provider-initiated HIV testing and counselling: Characteristics of participants who refused HIV testing in a population survey in Zambia

    Institute of Scientific and Technical Information of China (English)

    Pascalina; Chanda-Kapata; William; Ngosa; Albertina; Ngomah; Moraes; Nicole; Maddox; Nathan; Kapata

    2015-01-01

    Objective: To assess the prevalence of HIV infection, to highlight HIV-testing refusal rates among participants in a population-based tuberculosis survey and to assess the implication for programme implementation.Methods: This cross-sectional study on the characteristics of participants who refused HIV testing was conducted in a national survey in Zambia. All eligible participants were aged above 15 years and included in the analysis.Results: Out of the 44 791 tuberculosis survey participants, 14 164(31.6%) refused to participate in HIV testing. The unemployed, rural dwellers, married, and those aged 15-24 years were associated with higher refusal rates.Conclusions: Strategies to improve HIV testing acceptance are necessary. Qualitative research is recommended to understand the reasons for testing refusals so that remedial interventions can be implemented.

  11. California's "Bridge to Reform": Identifying Challenges and Defining Strategies for Providers and Policymakers Implementing the Affordable Care Act in Low-Income HIV/AIDS Care and Treatment Settings: e90306

    National Research Council Canada - National Science Library

    Patrick T Hazelton; Wayne T Steward; Shane P Collins; Stuart Gaffney; Stephen F Morin; Emily A Arnold

    2014-01-01

    .... For many people living with HIV, this has required transition either from the HIV-specific coverage of the Ryan White program to the more comprehensive coverage provided by the county-run Low-Income...

  12. An Exploration of Specialist Palliative Care Nurses' Experiences of Providing Care to Hospice Inpatients from Minority Ethnic Groups-Implication for Religious and Spiritual Care

    National Research Council Canada - National Science Library

    Andrea Henry; Fiona Timmins

    2016-01-01

      The aim of this research study was to gain an understanding of nurses' experiences of providing care to patients from minority ethnic groups within the specialist palliative care inpatient unit of an Irish hospice...

  13. Attitudes, Knowledge, and Correlates of Self-Efficacy for the Provision of Safer Conception Counseling Among Ugandan HIV Providers.

    Science.gov (United States)

    Goggin, Kathy; Finocchario-Kessler, Sarah; Staggs, Vincent; Woldetsadik, Mahlet Atakilt; Wanyenze, Rhoda K; Beyeza-Kashesya, Jolly; Mindry, Deborah; Khanakwa, Sarah; Wagner, Glenn J

    2015-12-01

    High rates of childbearing desires (59%) and serodiscordant partnerships (50%) among people living with HIV (PHLA) in Uganda highlight the need for safer conception counseling (SCC). Provider attitudes about counseling PLHA on the use of safer conception methods (SCM) have been explored in qualitative studies, but published quantitative investigations are scarce. Data from 57 Ugandan providers were collected to examine providers' attitudes about childbearing among PLHA and engagement in discussions about childbearing, as well as their knowledge, interest, self-efficacy, and intentions to provide SCC. Correlates of self-efficacy for the provision of SCC were explored to inform the development of training programs. Providers reported a general awareness of most SCM, especially timed unprotected intercourse (TUI); but just over half felt they knew enough to counsel clients in the future and all wanted more training. Childbearing was discussed with less than a third of reproductive aged patients and was mostly initiated by patients. Most providers saw value in providing SCC and believed that most aspects of SCM would be acceptable to their clients, but numerous barriers were endorsed. Self-efficacy was greatest among providers who had had more childbearing conversations, greater SCM awareness, perceived fewer barriers and greater intentions to counsel on TUI. Providers evidence fewer stigmatizing attitudes than in the past. However, those who endorsed more stigmatizing attitudes evidenced a trend for reporting lower self-efficacy for providing SCC. Training will need to simultaneously focus on increasing providers' SCC knowledge and skills while instilling a more realistic appraisal of the risks of assisting couples to employ SCM versus doing nothing.

  14. Integrating early palliative care for patients with HIV: provider and patient perceptions of symptoms and need for services.

    Science.gov (United States)

    Lofgren, Sarah; Friedman, Rachel; Ghermay, Rahwa; George, Maura; Pittman, John Richard; Shahane, Amit; Zeimer, Dorothy; Del Rio, Carlos; Marconi, Vincent C

    2015-12-01

    Increasingly clinicians are using palliative care to address the symptomatic and psychosocial effects of disease often missed by routine clinical care, termed "early" palliative care. Within an inner-city medical center, we began a program to integrate early palliative care into HIV inpatient care. Patient symptom burden and desired services were assessed and compared to provider perceptions of patient's needs. From 2010-2012, 10 patients, with a median CD4+ T-cell count of 32.5 cells/μL, and 34 providers completed the survey. Providers ranked their patients' fatigue, sadness, anxiety, sexual dysfunction, and body image significantly higher than patients it for themselves. Patients ranked medical care, pharmacy, social work, physical therapy, and housing as significantly more important to them than providers estimated them to be. These differences may reflect the fact that physicians often overlook patients' unmet basic needs. Early palliative care may narrow this gap between providers' and patients' perceptions of needs through good communication and targeting barriers, such as housing instability, which are vital to overcome for consistent long-term follow up.

  15. The impact of caring for persons living with HIV and AIDS on the mental health of nurses in the Limpopo Province

    Directory of Open Access Journals (Sweden)

    M Davhana-Maselesele

    2008-09-01

    Full Text Available This study assessed the impact of caring for AIDS sufferers on the mental health of nurses. This assessment was measured against the level of burnout, stress and depression among 174 nurses caring for people living with HIV and AIDS in Limpopo Province, South Africa. A structured questionnaire was used for data collection. The questionnaire incorporated the AIDS Impact Scale (AIS, Maslach Burnout Inventory (MBI, Beck Depression Inventory (BDI and the participants’ demographic and professional profiles. Participants were conveniently selected from five selected hospitals in Limpopo Province. The study participants’ valuation using the AIS showed that nurses tended to develop strong bonds and relationships with the patients; felt frustrated by their inability to help the terminally ill AIDS sufferers and were subsequently affected by the death of their patients. Personal accomplishments of the nurses remained high and the levels of emotional exhaustion and depersonalization levels were low. The BDI showed that over 3 out of 4 nurses were experiencing between mild mood disturbance and extreme depression. Higher average scores were noted for items of the depression scale like sadness, dissatisfaction, fatigue and low level of energy. The findings highlight the need to develop psychological support programmes for nurses caring for AIDS patients and promote the provision of social incentives and recognition of the role of nurses in AIDS care.

  16. Reduce HIV Risk

    Science.gov (United States)

    ... Our research has demonstrated remarkable success in reducing HIV risk-associated sexual behaviors among African American adolescents and adults." Read More "Nursing Research" Articles Nursing Research / Improve Hospital-to-Home Transitions / Reduce ...

  17. Non-physician providers of obstetric care in Mexico: Perspectives of physicians, obstetric nurses and professional midwives

    Science.gov (United States)

    2012-01-01

    Background In Mexico 87% of births are attended by physicians. However, the decline in the national maternal mortality rate has been slower than expected. The Mexican Ministry of Health’s 2009 strategy to reduce maternal mortality gives a role to two non-physician models that meet criteria for skilled attendants: obstetric nurses and professional midwives. This study compares and contrasts these two provider types with the medical model, analyzing perspectives on their respective training, scope of practice, and also their perception and/or experiences with integration into the public system as skilled birth attendants. Methodology This paper synthesizes qualitative research that was obtained as a component of the quantitative and qualitative study that evaluated three models of obstetric care: professional midwives (PM), obstetric nurses (ON) and general physicians (GP). A total of 27 individual interviews using a semi-structured guide were carried out with PMs, ONs, GPs and specialists. Interviews were transcribed following the principles of grounded theory, codes and categories were created as they emerged from the data. We analyzed data in ATLAS.ti. Results All provider types interviewed expressed confidence in their professional training and acknowledge that both professional midwives and obstetric nurses have the necessary skills and knowledge to care for women during normal pregnancy and childbirth. The three types of providers recognize limits to their practice, namely in the area of managing complications. We found differences in how each type of practitioner perceived the concept and process of birth and their role in this process. The barriers to incorporation as a model to attend birth faced by PMs and ONs are at the individual, hospital and system level. GPs question their ability and training to handle deliveries, in particular those that become complicated, and the professional midwifery model particularly as it relates to a clinical setting, is

  18. Cultural events provided by employer and occupational wellbeing of employees: A cross-sectional study among hospital nurses.

    Science.gov (United States)

    Tuisku, Katinka; Pulkki-Råback, Laura; Virtanen, Marianna

    2016-09-27

    Occupational well-being in health care is essential for the quality of care and productivity. Some of the major challenges facing hospital nurses are the personnel turnover, emotional loading and health care reforms. After primary occupational safety and risk management, complementary positive health promotion approaches with cultural interventions can be experimented. To examine the association between well-being indicators of hospital nurses and their participation in cultural events provided by the employer (theater, concerts, exhibitions, museums, sight-seeing, and musicals) during past 6 months. Subjective well-being was measured by work engagement, workplace support for new ideas, work satisfaction and experienced stress. A dose-dependent association was found between participation in cultural events and positive psychology parameters of occupational well-being (support for new ideas and work engagement), but the experience of stress was unrelated to participation in cultural events. Collective participation has a positive covariant effect on work engagement and seems to mediate the innovative work climate measured by workplace support for new ideas. Collective cultural events for employees may promote positive aspects of occupational wellbeing.

  19. A pilot study: Reiki for self-care of nurses and healthcare providers.

    Science.gov (United States)

    Brathovde, Angela

    2006-01-01

    The purpose of this study was to determine if Reiki energy therapy, level I, was taught as a self-care practice to healthcare providers, would their caring perceptions change? Methodological triangulation technique, including a self-report caring scale and interviews, was used, demonstrating positive changes in perceptions of participants' caring behaviors.

  20. Nurses and Dietitians Differ in Food Safety Information Provided to Highly Susceptible Clients

    Science.gov (United States)

    Buffer, Janet; Kendall, Patricia; Medeiros, Lydia; Schroeder, Mary; Sofos, John

    2013-01-01

    Objective: To determine content, education channels, and motivational factors that influence what health professionals teach about safe food handling to populations who are highly susceptible for foodborne illnesses. To assess the differences in information provided by health professionals to highly susceptible populations. Design: Descriptive,…

  1. The Operational Preparedness of United States Air Force Certified Registered Nurse Anesthetists to Provide Trauma Anesthesia

    Science.gov (United States)

    1999-10-01

    deployed in field hospitals and must be well versed in the management of trauma (Bellamy, 1995 ). To this end, the anesthesia provider needs to be trained...result of aggression encountered during peacekeeping missions such as those recently undertaken. Bellamy ( 1995 ) has shown that ninety percent of combat...Flavel, Brown, Schon, Spiro and Vygotsky . In this model, McAulife states that the best way to learn and instruct others is by a method of case based

  2. A Qualitative Study of Patients' Attitudes toward HIV Testing in the Dental Setting

    OpenAIRE

    Nancy VanDevanter; Joan Combellick; M. Katherine Hutchinson; Joan Phelan; Daniel Malamud; Donna Shelley

    2012-01-01

    An estimated 1.1 million people in the USA are living with HIV/AIDS. Nearly 200,000 of these individuals do not know that they are infected. In 2006, the CDC recommended that all healthcare providers routinely offer HIV screening to adolescent and adult patients. Nurse-dentist collaborations present unique opportunities to provide rapid oral HIV screening to patients in dental clinic settings and reach the many adults who lack primary medical providers. However, little is known about the ...

  3. Nurse practitioners as primary care providers with their own patient panels and organizational structures: A cross-sectional study.

    Science.gov (United States)

    Poghosyan, Lusine; Liu, Jianfang; Norful, Allison A

    2017-05-25

    Health care systems globally are facing challenges of meeting the growing demand for primary care services due to a shortage of primary care physicians. Policy makers and administrators are searching for solutions to increase the primary care capacity. The effective utilization of nurse practitioners (NPs) has been proposed as a solution. However, organizations utilize NPs in variable capacities. In some settings, NPs serve as primary care providers delivering ongoing continuous care to their patients, referred to as patient panels, whereas in other settings they deliver episodic care. Little is known about why organizations deploy NPs differently. Investigate the NP role in care delivery-primary care providers with the own patient panels or delivering episodic care-within their organizations and understand how work environments affect their role. A cross-sectional survey design was used to collect data from primary care NPs. The study was conducted in one state in the United States (Massachusetts). Data from 163 primary care organizations was obtained, which employed between one to 12 NPs. 807 NPs recruited from the Massachusetts Provider Database received mail surveys; 314 completed and returned the survey, yielding a response rate of 40%. The survey contained measures of NP role in care delivery and work environment. NP role was measured by an item asking NPs to report if they deliver ongoing continuous care to their patient panel or if they do not have patient panel. The work environment was measured with the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ). The multilevel Cox regression models investigated the influence of organization-level work environment on NP role in care delivery. About 45% of NPs served as primary care providers with their own patient panel. Organization-level Independent Practice and Support subscale, an NP-PCOCQ subscale, had a significant positive effect on NP role (risk ratio=2.33; 95% CI: 1

  4. Adherence to HAART : A study of patient's perspectives and HIV nurse consultants' strategies

    NARCIS (Netherlands)

    Vervoort, S.C.J.M.

    2009-01-01

    The aim of this thesis was to gain deeper insight in the influences of adherence to highly active antiretroviral therapy (HAART), to examine the underlying processes at play and to explore the current adherence practice in the HIV care in the Netherlands. In designing the framework to develop an

  5. Challenges in Providing HIV and Sexuality Education to Learners with Disabilities in South Africa: The Voice of Educators

    Science.gov (United States)

    de Reus, Liset; Hanass-Hancock, Jill; Henken, Sophie; van Brakel, Wim

    2015-01-01

    People with disabilities are at increased risk of exposure to HIV, yet they lack access to HIV prevention, treatment care and support including sexuality education. Lack of knowledge, skills and confidence of educators teaching sexuality education to learners with disabilities is related to this increased vulnerability. This study identifies…

  6. Provider-Initiated HIV Testing for Migrants in Spain: A Qualitative Study with Health Care Workers and Foreign-Born Sexual Minorities.

    Directory of Open Access Journals (Sweden)

    Barbara Navaza

    Full Text Available Provider-initiated HIV testing (PITC is increasingly adopted in Europe. The success of the approach at identifying new HIV cases relies on its effectiveness at testing individuals most at risk. However, its suitability to reach populations facing overlapping vulnerabilities is under researched. This qualitative study examined HIV testing experiences and perceptions amongst Latin-American migrant men who have sex with men and transgender females in Spain, as well as health professionals' experiences offering HIV tests to migrants in Barcelona and Madrid.We conducted 32 in-depth interviews and 8 discussion groups with 38 Latin-American migrants and 21 health professionals. We imported verbatim transcripts and detailed field work notes into the qualitative software package Nvivo-10 and applied to all data a coding framework to examine systematically different HIV testing dimensions and modalities. The dimensions analysed were based on the World Health Organization "5 Cs" principles: Consent, Counselling, Connection to treatment, Correctness of results and Confidentiality.Health professionals reported that PITC was conceptually acceptable for them, although their perceived inability to adequately communicate HIV+ results and resulting bottle necks in the flow of care were recurrent concerns. Endorsement and adherence to the principles underpinning the rights-based response to HIV varied widely across health settings. The offer of an HIV test during routine consultations was generally appreciated by users as a way of avoiding the embarrassment of asking for it. Several participants deemed compulsory testing as acceptable on public health grounds. In spite of--and sometimes because of--partial endorsement of rights-based approaches, PITC was acceptable in a population with high levels of internalised stigma.PITC is a promising approach to reach sexual minority migrants who hold high levels of internalised stigma but explicit extra efforts are needed

  7. A parameter for IL-10 and TGF-ß mediated regulation of HIV-1 specific T cell activation provides novel information and relates to progression markers.

    Directory of Open Access Journals (Sweden)

    Andreas Lind

    predicted by classical activation parameters and may thus provide additional information on HIV-specific immunity. R(AC and other assessments of regulation deserve further in-depth exploration.

  8. A parameter for IL-10 and TGF-ß mediated regulation of HIV-1 specific T cell activation provides novel information and relates to progression markers.

    Science.gov (United States)

    Lind, Andreas; Brekke, Kristin; Pettersen, Frank Olav; Mollnes, Tom Eirik; Trøseid, Marius; Kvale, Dag

    2014-01-01

    predicted by classical activation parameters and may thus provide additional information on HIV-specific immunity. R(AC) and other assessments of regulation deserve further in-depth exploration.

  9. African-Americans' perceptions of health care provider cultural competence that promote HIV medical self-care and antiretroviral medication adherence.

    Science.gov (United States)

    Gaston, Gina B

    2013-01-01

    Most studies of cultural competence in healthcare examine healthcare providers' definitions of cultural competence practices. This study is unique in that it examines the relationship between African-American patients' perceptions of the cultural competence of their HIV healthcare providers and the adherence of these patients to medical self-care and antiretroviral therapy (ART). This cross-sectional, exploratory, descriptive study was conducted at the Ruth Rothstein CORE Center in Chicago, Illinois. The sample consisted of 202 HIV-positive African-Americans who completed surveys during clinic visits. Multiple measures were used, including the Patient Assessments of Cultural Competency survey instrument developed by the Department of Health and Human Services Agency for Healthcare Research and Quality. Medical self-care was measured using the advice and instructions scale and the self-care symptom management for people living with HIV/AIDS categorical scale. ART adherence was measured using the Adherence Behaviors Self-Report and Adherence Self-Report scales. The data revealed many significant correlations between variables. The more patients believed that providers should integrate culture in HIV treatment; the better their reported health (F1,138=0.151, P=0.05) and the more they followed their provider's advice and instructions (medical self-care; F1,138=0.029, P=0.05). Participants who trusted their providers engaged in more medical self-care (F1,138=0.280, P=0.01). More shared treatment decisions were reported among participants who had higher levels of education (F1,127=0.337, P=0.05). Findings of this study indicate the need for increased attention to the role of cultural competence in HIV/AIDS care. Understanding patient perceptions of provider cultural competence has the potential to improve HIV treatment adherence and health outcomes.

  10. Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

    Directory of Open Access Journals (Sweden)

    Dukers-Muijrers Nicole HTM

    2012-12-01

    Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

  11. Challenges faced by health-care providers offering infant-feeding counseling to HIV-positive women in sub-Saharan Africa: a review of current research.

    Science.gov (United States)

    Tuthill, Emily L; Chan, Jessica; Butler, Lisa M

    2015-01-01

    Exclusive breastfeeding (EBF) has been identified as the optimal nutrition and critical behavior in attaining human immunodeficiency virus (HIV)-free infant survival in resource-limited settings. Health-care providers (HCPs) in clinic- and community-settings throughout sub-Saharan Africa (sSA) provide infant-feeding counseling. However, rates of EBF at 6 months of age are suboptimal. HCPs are uniquely positioned to educate HIV-positive mothers and provide support by addressing known barriers to EBF. However, limited evidence exists on the experiences faced by HCPs in providing counseling on infant feeding to HIV-positive women. Our objective is to describe experiences faced by HCPs when delivering infant-feeding counseling in the context of HIV in program settings in sSA. We searched a range of electronic databases, including PubMed, CINAHL, and PsycINFO from January 1990 to February 2013, in addition to hand-searching, cross-reference searching, and personal communications. The search was limited to publications in English. Empirical studies of HCP experiences providing infant-feeding counseling in the prevention of mother-to-child transmission (PMTCT) of HIV programs in sSA were selected. We identified 10 peer-reviewed articles reporting HCP challenges in infant-feeding counseling that met inclusion criteria. Articles included qualitative, cross-sectional and mixed-method studies, and cumulatively reported 31 challenges faced by HCPs. Among the challenges identified, the most commonly reported were personal beliefs held by the HCPs toward infant feeding in the context of HIV, contradictory messages, staff workload, directive counseling styles, and a lack of practical strategies to offer mothers, often leading to improvised counseling approaches. Counseling strategies need to be developed that are relevant, meaningful, and responsive to the needs of both HCPs and mothers.

  12. A qualitative analysis of provider barriers and solutions to HIV testing for substance users in a small, largely rural southern state.

    Science.gov (United States)

    Wright, Patricia B; Curran, Geoffrey M; Stewart, Katharine E; Booth, Brenda M

    2013-01-01

    Integrating HIV testing programs into substance use treatment is a promising avenue to help increase access to HIV testing for rural drug users. Yet few outpatient substance abuse treatment facilities in the United States provide HIV testing. The purpose of this study was to identify barriers to incorporating HIV testing with substance use treatment from the perspectives of treatment and testing providers in Arkansas. We used purposive sampling from state directories to recruit providers at state, organization, and individual levels to participate in this exploratory study. Using an interview guide, the first and second authors conducted semistructured individual interviews in each provider's office or by telephone. All interviews were recorded, transcribed verbatim, and entered into ATLAS.ti software (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany). We used constant comparison and content analysis techniques to identify codes, categories, and primary patterns in the data. The sample consisted of 28 providers throughout the state, 18 from the substance use system and 10 from the public/ community health system. We identified 7 categories of barriers: environmental constraints, policy constraints, funding constraints, organizational structure, limited inter- and intra-agency communication, burden of responsibility, and client fragility. This study presents the practice-based realities of barriers to integrating HIV testing with substance use treatment in a small, largely rural state. Some system and/or organization leaders were either unaware of or not actively pursuing external funds available to them specifically for engaging substance users in HIV testing. However, funding does not address the system-level need for coordination of resources and services at the state level. © 2013 National Rural Health Association.

  13. The Effect of Motivational Interviewing-Based Counseling During Outpatient Provider Initiated HIV Testing on High-Risk Sexual Behavior in Rural Uganda.

    Science.gov (United States)

    Kiene, Susan M; Bateganya, Moses H; Lule, Haruna; Wanyenze, Rhoda K

    2016-09-01

    Provider-initiated HIV testing and counseling (PITC) has rapidly expanded in many countries including Uganda. However, because it provides HIV prevention information without individualized risk assessment and risk reduction counseling it may create missed opportunities for effective HIV prevention counseling. Our objective was to assess the effect of a brief motivational interviewing-based intervention during outpatient PITC in rural Uganda compared to Uganda's standard-of-care PITC at reducing HIV transmission-relevant sexual risk behavior. We enrolled 333 (160 control, 173 intervention) participants in a historical control trial to test the intervention vs. standard-of-care. Participants received PITC and standard-of-care or the intervention counseling and we assessed sexual risk behavior at baseline and 3 and 6 months follow-up. The intervention condition showed 1.5-2.4 times greater decreases in high risk sexual behavior over time compared to standard-of-care (p = 0.015 and p = 0.004). These data suggest that motivational interviewing based counseling during PITC may be a promising intervention to reduce high-risk sexual behavior and potentially reduce risk of HIV infection.

  14. Eliminating Perinatal HIV Transmission

    Centers for Disease Control (CDC) Podcasts

    2012-11-26

    In this podcast, CDC’s Dr. Steve Nesheim discusses perinatal HIV transmission, including the importance of preventing HIV among women, preconception care, and timely HIV testing of the mother. Dr. Nesheim also introduces the revised curriculum Eliminating Perinatal HIV Transmission intended for faculty of OB/GYN and pediatric residents and nurse midwifery students.  Created: 11/26/2012 by Division of HIV/AIDS Prevention.   Date Released: 11/26/2012.

  15. Analysis of the organization of nursing care provided for disabled children in special education institutions in northwest Poland.

    Science.gov (United States)

    Gawłowska-Lichota, Katarzyna; Wróbel, Agnieszka; Brodowski, Jacek; Karakiewicz, Beata

    2009-06-01

    It often happens that handicapped children and teenagers need to be taught in special educational centres. One of the specialists working in a special school should be a nurse having appropriate professional and methodical skills. The research involved nurses employed in 36 special education institutions in 2006/2007 in the area of North-West Poland. The organization of work was analysed on the basis of specially constructed questionnaires. The average working time of nurses employed in special education institutions was 16 hours and 12 minutes per week. In the group of nurses examined, 69% persons have completed qualifications and 5% specialty courses. Nurses cooperate mainly with speech therapists, educationalists, psychologists, rehabilitators, specialists in surdo-pedagogy and oligophreno-pedagogy. However, they attended meetings with parents very occasionally (8%) and rarely participated in staff meetings (8%). Besides, 29% of participants met with parents exclusively in case of emergency. Nurses' working time in special education institutions according to the norms or work organization. Not all nurses working with disabled pupils have the required qualifications such as the completed specialty or qualification courses. Nurses working in special education do not fully use the possibility of cooperation with the families of disabled pupils and specialists in the therapeutic team.

  16. A clinician-nurse model to reduce early mortality and increase clinic retention among high-risk HIV-infected patients initiating combination antiretroviral treatment

    Directory of Open Access Journals (Sweden)

    Braitstein Paula

    2012-02-01

    Full Text Available Abstract Background In resource-poor settings, mortality is at its highest during the first 3 months after combination antiretroviral treatment (cART initiation. A clear predictor of mortality during this period is having a low CD4 count at the time of treatment initiation. The objective of this study was to evaluate the effect on survival and clinic retention of a nurse-based rapid assessment clinic for high-risk individuals initiating cART in a resource-constrained setting. Methods The USAID-AMPATH Partnership has enrolled more than 140,000 patients at 25 clinics throughout western Kenya. High Risk Express Care (HREC provides weekly or bi-weekly rapid contacts with nurses for individuals initiating cART with CD4 counts of ≤100 cells/mm3. All HIV-infected individuals aged 14 years or older initiating cART with CD4 counts of ≤100 cells/mm3 were eligible for enrolment into HREC and for analysis. Adjusted hazard ratios (AHRs control for potential confounding using propensity score methods. Results Between March 2007 and March 2009, 4,958 patients initiated cART with CD4 counts of ≤100 cells/mm3. After adjusting for age, sex, CD4 count, use of cotrimoxazole, treatment for tuberculosis, travel time to clinic and type of clinic, individuals in HREC had reduced mortality (AHR: 0.59; 95% confidence interval: 0.45-0.77, and reduced loss to follow up (AHR: 0.62; 95% CI: 0.55-0.70 compared with individuals in routine care. Overall, patients in HREC were much more likely to be alive and in care after a median of nearly 11 months of follow up (AHR: 0.62; 95% CI: 0.57-0.67. Conclusions Frequent monitoring by dedicated nurses in the early months of cART can significantly reduce mortality and loss to follow up among high-risk patients initiating treatment in resource-constrained settings.

  17. Peer mentoring supports the learning needs of nurses providing palliative care in a rural acute care setting.

    Science.gov (United States)

    Rabbetts, Lyn

    2017-06-02

    A specific set of assessment scales can underpin the management of distressing symptoms of patients requiring palliative care. A research assistant supported nurses working in a rural hospital setting during the introduction of these scales. A secondary analysis was conducted to further explore the qualitative data of a previously reported mixed-method study. In particular, the experiences of nurses working alongside a research assistant in the facilitation of using a new assessment form. Purposeful sampling was employed: participating nurses were invited to attend one of three focus group meetings. Data analysis revealed three main themes: a contact person, coach/mentor and extra help initiatives. Three to four subthemes corresponded with each main theme. Findings suggest nurses benefit from having someone to assist in learning about new documentation. Nurses respond positively to mentorship and practical guidance when integrating a new assessment form into routine evidence-based practice.

  18. Perspectives of healthcare providers and HIV-affected individuals and couples during the development of a Safer Conception Counseling Toolkit in Kenya: stigma, fears, and recommendations for the delivery of services.

    Science.gov (United States)

    Mmeje, Okeoma; Njoroge, Betty; Akama, Eliud; Leddy, Anna; Breitnauer, Brooke; Darbes, Lynae; Brown, Joelle

    2016-01-01

    Reproduction is important to many HIV-affected individuals and couples and healthcare providers (HCPs) are responsible for providing resources to help them safely conceive while minimizing the risk of sexual and perinatal HIV transmission. In order to fulfill their reproductive goals, HIV-affected individuals and their partners need access to information regarding safer methods of conception. The objective of this qualitative study was to develop a Safer Conception Counseling Toolkit that can be used to train HCPs and counsel HIV-affected individuals and couples in HIV care and treatment clinics in Kenya. We conducted a two-phased qualitative study among HCPs and HIV-affected individuals and couples from eight HIV care and treatment sites in Kisumu, Kenya. We conducted in-depth interviews (IDIs) and focus group discussions (FGDs) to assess the perspectives of HCPs and HIV-affected individuals and couples in order to develop and refine the content of the Toolkit. Subsequently, IDIs were conducted among HCPs who were trained using the Toolkit and FGDs among HIV-affected individuals and couples who were counseled with the Toolkit. HIV-related stigma, fears, and recommendations for delivery of safer conception counseling were assessed during the discussions. One hundred and six individuals participated in FGDs and IDIs; 29 HCPs, 49 HIV-affected women and men, and 14 HIV-serodiscordant couples. Participants indicated that a safer conception counseling and training program for HCPs is needed and that routine provision of safer conception counseling may promote maternal and child health by enhancing reproductive autonomy among HIV-affected couples. They also reported that the Toolkit may help dispel the stigma and fears associated with reproduction in HIV-affected couples, while supporting them in achieving their reproductive goals. Additional research is needed to evaluate the Safer Conception Toolkit in order to support its implementation and use in HIV care and

  19. Appraisal of HIV Counseling and Testing Services Provided for Pregnant Women in Selected Government Hospitals in Ibadan Metropolis, Nigeria

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    Olanipekun Asiyanbola

    2016-04-01

    Full Text Available HIV counseling and testing (HCT is a critical gateway to treatment, care, and support services. For pregnant women, it is to access prevention of mother-to-child-transmission (PMTCT services. However, not much has been done to appraise this service from the perspective of the recipients in Nigeria. This study documents the appraisal of the HCT services received at the antenatal care (ANC services in three government hospitals in Ibadan, Nigeria, from the perspectives of pregnant women. Data were collected using focus group discussion guide among purposively selected 40 (21 primigravida and 19 multigravida pregnant women. Observation and inventory checklists were used to collect data on procedures and basic requirements of HCT. Content analysis was used to analyze the data. Participants were neither counseled nor given opportunity to voluntarily participate in HCT services as it was made compulsory before accessing ANC. Test results were reportedly handed over directly to participants without post-test counseling. Observation of HCT procedure showed that guidelines for counseling were not strictly adhered to. Inventory of facilities, staff, and materials revealed inadequate staffing, lack of a dedicated counseling room, and inadequate antiretroviral drugs and test kits. The HCT services as provided for pregnant women are fraught with procedural inadequacies. Training and supervision of health care workers as well as provision of resources are needed to address the situation.

  20. HIV/AIDS患者负性心理状况分析及护理对策%Analysis on negative psychological statue in HIV/AIDS patients and nursing strategy

    Institute of Scientific and Technical Information of China (English)

    杨翠芳; 卢斯汉; 陈丽莹; 何昕

    2008-01-01

    目的 对HIV/AIDS患者心理卫生状况进行测评分析,探讨其护理对策.方法 采用症状自评量表(SCL-90)、抑郁自评量表(SDS)、焦虑自评量表(SAS)对102例HIV/AIDS患者进行问卷测评.结果 75.49%的HIV/AIDS患者存在程度不同的心理卫生问题,除敌对情绪外,躯体化、强迫、人际关系、抑郁、焦虑、恐怖、偏执、精神病性等因子分均较常模明显异常.抑郁和焦虑主观感受的发生率分别为67.65%和43.13%.结论 大部分HIV/AIDS患者心理卫生状况存在明显异常,抑郁、焦虑等发生率高,针对患者的负性情绪,给予相应的心理干预和护理对策,以改善患者心理健康状况,对提高患者的生存质量很有必要.%Objective To study and analyze the negative psychological statue in HIV/AIDS patients and explore the nursing strategy.Methods The data of 102 HIV/AIDS patients were recorded.then measured by symptom check list(SCL-90),self-rating depression scale(SDS)and serf-rating anxiety Scale(SAS).Results 77 cases(75.49%)had different degrees of psychological problems.Other than hostility.the scores of somatization,compulsion,relationship,depression,anxiety,terror,paranoia and psychosis were obviously abnormal compared to normal model.The occurrence rates of depression and anxiety were 67.65%(69/102) and 43.13% (44/102),respectively.Conclusions Most HIV/AIDS patients are in an obviouslv ahnormal psychological statue.The occurrence rates of depression and anxiety are high.According to the patients'negative emotion,the pertinent psychological intervention and nursing strategy for HIV/AIDS patients are suggested to improve patient's psychological statue.It should be necessary for improving patient's living qualities.

  1. Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme

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    Nomafrench Mbombo

    2012-11-01

    Full Text Available South Africa (SA has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT. However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we describedteaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg’s competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.

  2. Integrating Prevention of Mother to Child HIV Transmission competencies into the nursing curriculum: Methodological lessons from a university-based undergraduate programme

    Directory of Open Access Journals (Sweden)

    Nomafrench Mbombo

    2012-05-01

    Full Text Available South Africa (SA has the highest number of women infected with HIV and AIDS during pregnancy, which results in more than 70 000 infected babies being born each year AIDS is the major contributor to maternal and child morbidities and mortalities in the country. To combat this, the SA government has developed a national policy to prevent mother-to-child HIV transmission (PMTCT. However, for effective implementation of this policy, there is a dire need for a competent, skilled health worker to render the service. In response to this, the School of Nursing at the University of the Western Cape has integrated PMTCT competencies into the undergraduate Bachelor of Nursing Science curriculum. In this paper, we described teaching and learning approaches used to integrate PMTCT competencies, including the skills laboratory methodology and case-based learning, as well as a portfolio of evidence assessment tool. A quantitative descriptive design was used to analyse data collected from students in regard to assessment of PMTCT competencies achieved. The study used the conceptual framework of Lenburg’s competency outcomes and performance assessment model, which focuses on competency development and assessment in a clinical environment. HIV competencies, including PMTCT, should be integrated both theoretically and at service delivery into other nursing and midwifery competencies, including assessment strategies. Provincial policies in provision of antiretrovirals by nurses and midwives become barriers to successful implementation of PMTCT, resulting in limited learning opportunities for students to practice PMTCT competencies. Further research is required to assess an attribute, affect, which is another prong for competencies.

  3. Perspectives and Practice of HIV Disclosure to Children and Adolescents by Healthcare Providers and Caregivers in Sub-Saharan Africa: A Systematic Review

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    Oluyemisi Aderomilehin

    2016-08-01

    Full Text Available Background: Sub-Saharan Africa has the highest prevalence of HIV globally, and this is due to persistent new HIV infections and decline in HIV/AIDS-related mortality from improved access to antiretroviral therapy. There is a limited body of work on perspectives of healthcare providers concerning disclosing outcomes of HIV investigations to children and adolescents in Sub-Saharan Africa. Most studies are country-specific, indicating a need for a regional scope. Objective: To review the current literature on the perspectives of healthcare providers and caregivers of children and adolescents on age group-specific and culture-sensitive HIV disclosure practice. Methods: Electronic database search in PubMed, Google scholar and the University of South Florida (USF Library Discovery Tool (January 2006 up to February 2016. Further internet search was conducted using the Journal Author Name Estimator (JANE search engine and extracting bibliographies of relevant articles. Search terms included ‘disclosure*’, ‘HIV guidelines’, ‘Sub-Saharan Africa’, ‘clinical staff’, ‘ART’, ‘antiretroviral adherence’, ‘People living with HIV’, ‘pediatric HIV’, ‘HIV’, ‘AIDS’, ‘healthcare provider’ (HCP, ‘caregiver’, ‘adolescent’, ‘primary care physicians’, ‘nurses’, ‘patients’. Only studies related to HIV/AIDS disclosure, healthcare providers, caregivers that clearly described perspectives and interactions during disclosure of HIV/AIDS sero-status to affected children and adolescents were included. Independent extraction of articles was conducted by reviewers using predefined criteria. Nineteen articles met inclusion criteria. Most studies were convenience samples consisting of combinations of children, adolescents, HCPs and caregivers. Key findings were categorized into disclosure types, prevalence, facilitators, timing, process, persons best to disclose, disclosure setting, barriers and outcomes of disclosure

  4. A assistência de enfermagem aos portadores de HIV/Aids no vislumbrar da sua epidemia em Ribeirão Preto: relato de experiÊncia de uma equipe de enfermagem The nursing assistance of HIV/Aids messenger in the glimpse of the epidemic in Ribeirão Preto city: experience report of a nursing team

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    Therezinha J.O. Resuto

    2000-09-01

    Full Text Available Trata-se de um relato de experiência vivenciada por uma equipe de enfermagem de uma Unidade de Internação, de um hospi tal geral do interior paulista, ao planejar e prestar assistência de enfermagem ao portador do HIV/Aids, no início da epidemia, em 1985.This is a report about the experience faced by a nursing team from public hospital in São Paulo city, that took care of HIV/Aids patients in the beginning of the epidemic in 1985.

  5. A survey of a HBCU's senior year nursing students' perception of the HIV/AIDS phenomenon: a follow-up study.

    Science.gov (United States)

    Adepoju, Joseph A; Watkins, Mary P; Richardson, Agnes

    2009-12-01

    This study was a follow-up to a previous study that was done among first semester nursing college students at a historically Black college and university in northeastern United States. The original intent was to ascertain their perceptions and knowledge of various aspects of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) phenomenon. It involved an anonymous survey questionnaire featuring yes and no answers, a Likert scale, and qualitative response questions concerning prevention behavior. Respondents were asked whether HIV/AIDS could make an individual "sick enough to die", whether they thought that wearing a condom would diminish their feeling during the sexual experience, and whether they would insist their partners use a condom. The original study consisted of 68 students. The follow-up study,four years later, consisted of the 20 remaining nursing students from the original cohort and was undertaken with the intent to appraise their knowledge level and to ascertain whether their attitudes towards the use of condoms as a way to prevent HIV/AIDS and STDs had changed. Findings from this follow-up study indicated that educational attainment of the respondents did not translate into a change in attitudes about responsible sexual behavior. Further findings may suggest that intensive HIV/AIDS education begin at an earlier phase in a students'education. Along with the basics of HIV/AIDS education, students need to learn to be respectful of each others' health and wellbeing. It is essential that a nurturing and protective environment exist so that young women are not afraid of the consequences related to asking partners to wear condoms during sexual encounters.

  6. TO ASSESS EFFECTIVENESS OF PLAN TEACHING PROGRAMME ON NATIONAL ACCREDITATION BOARD FOR HOSPITALS AND HEALTH CARE PROVIDERS (NABH GUIDELINES AMONG NEWLY RECRUITED STAFF NURSES AT KRISHNA HOSPITAL, KARAD

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    Kavita Sanjay

    2015-12-01

    Full Text Available The continual improvement of service quality in healthcare units has become a prime consideration to ensure patient satisfaction across the world in the modern economic scenario. In India, health sector is one of the largest and fastest growing sector in which both the private and government care providers and hospitals put much emphasis on quality improvement and patient satisfaction. National Accreditation Board of Hospitals and Healthcare Providers (NABH along with Quality Council of India provided the criteria based on which quality standard of hospitals is determined. The study was conducted on 51 newly recruited staff nurses at Krishna Hospital, Karad. An evaluator survey approach was considered. Study design was used one group pre-test, post-test design. Purposive sampling technique was used. RESULTS The study was conducted on 51 newly recruited staff nurses at Krishna Hospital, Karad. An evaluator survey approach was considered. Study design was used one group pre-test, post-test design. Purposive sampling technique was used. CONCLUSION Study concludes majority of newly recruited nursing staff having 19.38% average knowledge and 17.85% having average practice towards NABH guidelines. Knowledge and practice score of newly recruited nursing staff between the pre-test and post-test was highly significant. OBJECTIVES 1 To assess newly recruited staff nurses knowledge and practice towards NABH guidelines. 2 To find an association of knowledge and practice between pre-test and post-test of PTP programme on NABH guidelines.

  7. Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV.

    Science.gov (United States)

    Chen, Wei-Ti; Wantland, Dean; Reid, Paula; Corless, Inge B; Eller, Lucille S; Iipinge, Scholastika; Holzemer, William L; Nokes, Kathleen; Sefcik, Elizbeth; Rivero-Mendez, Marta; Voss, Joachim; Nicholas, Patrice; Phillips, J Craig; Brion, John M; Rose, Caro Dawson; Portillo, Carmen J; Kirksey, Kenn; Sullivan, Kathleen M; Johnson, Mallory O; Tyer-Viola, Lynda; Webel, Allison R

    2013-11-01

    The engagement of patients with their health care providers (HCP) improves patients' quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client's choices, and management of client concerns. This study compares country-level differences in patients' engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p self-efficacy for adherence (t = -5.22, p self-esteem ratings (t = 2.67, p self-reported symptoms (t = 3.25, p manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL.

  8. Response rates for providing a blood specimen for HIV testing in a population-based survey of young adults in Zimbabwe

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    Dube Hazel M

    2007-07-01

    Full Text Available Abstract Background To determine differences among persons who provided blood specimens for HIV testing compared with those who did not among those interviewed for the population-based Zimbabwe Young Adult Survey (YAS. Methods Chi-square analysis of weighted data to compare demographic and behavioral data of persons interviewed who provided specimens for anonymous testing with those who did not. Prevalence estimation to determine the impact if persons not providing specimens had higher prevalence rates than those who did. Results Comparing those who provided specimens with those who did not, there was no significant difference by age, residence, education, marital status, perceived risk, sexual experience or number of sex partners for women. A significant difference by sexual experience was found for men. Prevalence estimates did not change substantially when prevalence was assumed to be two times higher for persons not providing specimens. Conclusion When comparing persons who provided specimens for HIV testing with those who did not, few significant differences were found. If those who did not provide specimens had prevalence rates twice that of those who did, overall prevalence would not be substantially affected. Refusal to provide blood specimens does not appear to have contributed to an underestimation of HIV prevalence.

  9. The Challenges of Providing Postpartum Education in Dar es Salaam, Tanzania: Narratives of Nurse-Midwives and Obstetricians.

    Science.gov (United States)

    Mselle, Lilian Teddy; Aston, Megan; Kohi, Thecla W; Mbekenga, Columba; Macdonald, Danielle; White, Maureen; Price, Sheri; Tomblin Murphy, Gail; O'Hearn, Shawna; Jefferies, Keisha

    2017-10-01

    Postpartum education can save lives of mothers and babies in developing countries, and the World Health Organization recommends all mothers receive three postpartum consultations. More information is needed to better understand how postpartum education is delivered and ultimately improves postpartum health outcomes. The purpose of this qualitative study was to examine how postpartum care was delivered in three postnatal hospital clinics in Dar es Salaam, Tanzania. Semistructured interviews with 10 nurse-midwives and three obstetricians were conducted. Feminist poststructuralism guided the research process. Postpartum education was seen to be an urgent matter; there was a lack of supportive resources and infrastructure in the hospital clinics, and nurse-midwives and obstetricians had to negotiate conflicting health and traditional discourses using various strategies. Nurse-midwives and obstetricians are well positioned to deliver life-saving postpartum education; however, improvements are required including increased number of nurse-midwives and obstetricians.

  10. The South African triage scale (adult version) provides valid acuity ratings when used by doctors and enrolled nursing assistants

    OpenAIRE

    Michèle Twomey; Lee A. Wallis; Mary Lou Thompson; Myers, Jonathan E

    2012-01-01

    Objective: To estimate the validity of triage ratings by South African nurses and doctors with training and practical experience using the South African Triage Scale. Methods: Five emergency physicians and 10 enrolled nursing assistants, who had been trained in the use of the South African Triage Scale, were selected via convenience sampling to retrospectively triage adult emergency centre vignettes. Participants independently assigned triage ratings to 100 written vignettes unaware of the...

  11. Development of internalized and personal stigma among patients with and without HIV infection and occupational stigma among health care providers in Southern China

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    Li J

    2016-11-01

    Full Text Available Jing Li,1,2,* Sawitri Assanangkornchai,1,* Lin Lu,3 Manhong Jia,3,* Edward B McNeil,1,* Jing You,4,* Virasakdi Chongsuvivatwong1,* 1Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand; 2School of Public Health, Kunming Medical University, 3Yunnan Center for Disease Prevention and Control, 4Infectious Diseases Department, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, People’s Republic of China *These authors contributed equally to this work Background: HIV/AIDS-related stigma is a major barrier of access to care for those infected with HIV. The aim of this study was to examine, validate, and adapt measuring scales of internalized, personal, and occupational stigma developed in Africa into a Chinese context. Methods: A cross-sectional study was conducted from January to September 2015 in Kunming, People’s Republic of China. Various scales were constructed on the basis of the previous studies with modifications by experts using exploratory and confirmatory factor analyses (EFA + CFA. Validation of the new scales was done using multiple linear regression models and hypothesis testing of the factorial structure invariance. Results: The numbers of subjects recruited for the development/validation samples were 696/667 HIV-positive patients, 699/667 non-HIV patients, and 157/155 health care providers. EFA revealed a two-factor solution for internalized and personal stigma scales (guilt/blaming and being refused/refusing service, which were confirmed by CFA with reliability coefficients (r of 0.869 and 0.853, respectively. The occupational stigma scale was found to have a three-factor structure (blaming, professionalism, and egalitarianism with a reliability coefficient (r of 0.839. Higher correlations of factors in the HIV patients (r=0.537 and non-HIV patients (r=0.703 were observed in contrast to low-level correlations (r=0.231, 0.286, and 0.266 among factors

  12. Tingkat Pengetahuan Ibu Hamil tentang HIV/AIDS dengan Perilaku Pemeriksaan Test PITC (Provider Initiated Test and Counselling di Puskesmas Sleman Yogyakarta

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    Annisaa’ Nurmasari

    2015-03-01

    Full Text Available HIV infection in pregnant women can threaten the life of the mother and the mother can transmit the virus to their babies. Sleman PHC registered 2 people including one pregnant woman and one women of childbearing age in the year of 2014. Incidence of pregnant women suffering from HIV-AIDS in 2014 is 1 patients and detected from PITC test results for 7 weeks in a row is 1 patient. And in January year of 2015 found 1 patient with 3 times test and the results was positive. The purpose of this study was to determine relationship between Knowledge Level of Pregnant women about HIV/AIDS and Behaviour of PITC (Provider Initiated Test and Counselling test. This study was a quantitative analysis of correlation with cross-sectional design. The population of this study were all pregnant women checkups at the health center in Yogyakarta Sleman. The sampling technique was used accidental sampling study which consisted of 72 respondents. The analysis used univariate and bivariate. The results showed that most respondents aged 20-35 (72.2%, senior high school education (47.2% and work as a housewife (IRT (38.9%. Most respondents have good knowledge about HIV/AIDS were 50 respondents (69.4%. Most respondents perform checks PITC were 71 respondents (98.6%. There was no relationship between knowledge level of pregnant women about HIV/AIDS and Behaviour of PITC (p-value=0.243>0.005. In Conclusion, There was no relationship between knowledge level of pregnant women about HIV/AIDS and Behaviour of PITC in Sleman, Yogyakarta.

  13. "I don't know if this is right … but this is what I'm offering": healthcare provider knowledge, practice, and attitudes towards safer conception for HIV-affected couples in the context of Southern African guidelines.

    Science.gov (United States)

    West, Nora; Schwartz, Sheree; Phofa, Rebecca; Yende, Nompumelelo; Bassett, Jean; Sanne, Ian; Van Rie, Annelies

    2016-01-01

    The 2011 guidelines for safer conception for HIV-affected individuals and couples were adopted by the South African Department of Health in December 2012. We assessed implementation gaps and facilitators and barriers to delivering safer conception services through examining patient and healthcare provider (HCP) experiences. At Witkoppen Health and Welfare Centre, a primary care clinic in Johannesburg, we conducted in-depth interviews (IDIs) with nine HCPs (doctors, nurses, and counselors) and IDIs and focus group discussions with 42 HIV-affected men and women interested in having a child. Data were analyzed using a grounded theory approach. HCPs were supportive of fertility intentions of HIV-affected couples and demonstrated some knowledge of safer conception methods, especially ART initiation to suppress viral load in infected partners. Unfortunately, HCPs did not follow the key recommendation that HCPs initiate conversations on fertility intentions with HIV-affected men and women. Providers and clients reported that conversations about conception only occur when client-initiated, placing the onus on HIV-affected individuals. Important barriers underlying this were the misconception held by some HCPs that uninfected partners in serodiscordant partnerships are "latently" infected and the desire by most HCPs to protect or control knowledge around fertility and safer conception methods out of concern over what clients will do with this knowledge before they are virally suppressed or ready to conceive. Almost all participants who had conceived or attempted conception did so without safer conception methods knowledge. HCP concern over conception readiness, perception of what clients will do with safer conception knowledge, and gaps in safer conception knowledge prevent HCPs from initiating conversations with HIV-affected patients on the issue of childbearing. Examining these findings in the context of existing South African guidelines illuminates areas that need to be

  14. Interleukin-8-mediated heterologous receptor internalization provides resistance to HIV-1 infectivity. Role of signal strength and receptor desensitization.

    Science.gov (United States)

    Richardson, Ricardo M; Tokunaga, Kenzo; Marjoram, Robin; Sata, Tetsutaro; Snyderman, Ralph

    2003-05-02

    Human immunodeficiency virus type 1 (HIV-1) entry into CD4(+) cells requires the chemokine receptors CCR5 or CXCR4 as co-fusion receptors. We have previously demonstrated that chemokine receptors are capable of cross-regulating the functions of each other and, thus, affecting cellular responsiveness at the site of infection. To investigate the effects of chemokine receptor cross-regulation in HIV-1 infection, monocytes and MAGIC5 and rat basophilic leukemia (RBL-2H3) cell lines co-expressing the interleukin-8 (IL-8 or CXCL8) receptor CXCR1 and either CCR5 (ACCR5) or CXCR4 (ACXCR4) were generated. IL-8 activation of CXCR1, but not the IL-8 receptor CXCR2, cross-phosphorylated CCR5 and CXCR4 and cross-desensitized their responsiveness to RANTES (regulated on activation normal T cell expressed and secreted) (CCL5) and stromal derived factor (SDF-1 or CXCL12), respectively. CXCR1 activation internalized CCR5 but not CXCR4 despite cross-phosphorylation of both. IL-8 pretreatment also inhibited CCR5- but not CXCR4-mediated virus entry into MAGIC5 cells. A tail-deleted mutant of CXCR1, DeltaCXCR1, produced greater signals upon activation (Ca(2+) mobilization and phosphoinositide hydrolysis) and cross-internalized CXCR4, inhibiting HIV-1 entry. The protein kinase C inhibitor staurosporine prevented phosphorylation and internalization of the receptors by CXCR1 activation. Taken together, these results indicate that chemokine receptor-mediated HIV-1 cell infection is blocked by receptor internalization but not desensitization alone. Thus, activation of chemokine receptors unrelated to CCR5 and CXCR4 may play a cross-regulatory role in the infection and propagation of HIV-1. Since DeltaCXCR1, but not CXCR1, cross-internalized and cross-inhibited HIV-1 infection to CXCR4, the data indicate the importance of the signal strength of a receptor and, as a consequence, protein kinase C activation in the suppression of HIV-1 infection by cross-receptor-mediated internalization.

  15. Knowledge, Beliefs and Practices Regarding Antiretroviral Medications for HIV Prevention: Results from a Survey of Healthcare Providers in New England.

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    Douglas S Krakower

    Full Text Available Antiretroviral treatment for HIV-infection before immunologic decline (early ART and pre-exposure chemoprophylaxis (PrEP can prevent HIV transmission, but routine adoption of these practices by clinicians has been limited.Between September and December 2013, healthcare practitioners affiliated with a regional AIDS Education and Training Center in New England were invited to complete online surveys assessing knowledge, beliefs and practices regarding early ART and PrEP. Multivariable models were utilized to determine characteristics associated with prescribing intentions and practices.Surveys were completed by 184 practitioners. Respondent median age was 44 years, 58% were female, and 82% were white. Among ART-prescribing clinicians (61% of the entire sample, 64% were aware that HIV treatment guidelines from the Department of Health and Human Services recommended early ART, and 69% indicated they would prescribe ART to all HIV-infected patients irrespective of immunologic status. However, 77% of ART-prescribing clinicians would defer ART for patients not ready to initiate treatment. Three-fourths of all respondents were aware of guidance from the U.S. Centers for Disease Control and Prevention recommending PrEP provision, 19% had prescribed PrEP, and 58% of clinicians who had not prescribed PrEP anticipated future prescribing. Practitioners expressed theoretical concerns and perceived practical barriers to prescribing early ART and PrEP. Clinicians with higher percentages of HIV-infected patients (aOR 1.16 per 10% increase in proportion of patients with HIV-infection, 95% CI 1.01-1.34 and infectious diseases specialists (versus primary care physicians; aOR 3.32, 95% CI 0.98-11.2 were more likely to report intentions to prescribe early ART. Higher percentage of HIV-infected patients was also associated with having prescribed PrEP (aOR 1.19, 95% CI 1.06-1.34, whereas female gender (aOR 0.26, 95% CI 0.10-0.71 was associated with having not

  16. Curcumin-loaded apotransferrin nanoparticles provide efficient cellular uptake and effectively inhibit HIV-1 replication in vitro.

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    Upendhar Gandapu

    Full Text Available BACKGROUND: Curcumin (diferuloylmethane shows significant activity across a wide spectrum of conditions, but its usefulness is rather limited because of its low bioavailability. Use of nanoparticle formulations to enhance curcumin bioavailability is an emerging area of research. METHODOLOGY/PRINCIPAL FINDINGS: In the present study, curcumin-loaded apotransferrin nanoparticles (nano-curcumin prepared by sol-oil chemistry and were characterized by electron and atomic force microscopy. Confocal studies and fluorimetric analysis revealed that these particles enter T cells through transferrin-mediated endocytosis. Nano-curcumin releases significant quantities of drug gradually over a fairly long period, ∼50% of curcumin still remaining at 6 h of time. In contrast, intracellular soluble curcumin (sol-curcumin reaches a maximum at 2 h followed by its complete elimination by 4 h. While sol-curcumin (GI(50 = 15.6 µM is twice more toxic than nano-curcumin (GI(50 = 32.5 µM, nano-curcumin (IC(50<1.75 µM shows a higher anti-HIV activity compared to sol-curcumin (IC(50 = 5.1 µM. Studies in vitro showed that nano-curcumin prominently inhibited the HIV-1 induced expression of Topo II α, IL-1β and COX-2, an effect not seen with sol-curcumin. Nano-curcumin did not affect the expression of Topoisomerase II β and TNF α. This point out that nano-curcumin affects the HIV-1 induced inflammatory responses through pathways downstream or independent of TNF α. Furthermore, nano-curcumin completely blocks the synthesis of viral cDNA in the gag region suggesting that the nano-curcumin mediated inhibition of HIV-1 replication is targeted to viral cDNA synthesis. CONCLUSION: Curcumin-loaded apotransferrin nanoparticles are highly efficacious inhibitors of HIV-1 replication in vitro and promise a high potential for clinical usefulness.

  17. Comparison of expert modeling versus voice-over PowerPoint lecture and presimulation readings on novice nurses' competence of providing care to multiple patients.

    Science.gov (United States)

    Franklin, Ashley E; Sideras, Stephanie; Gubrud-Howe, Paula; Lee, Christopher S

    2014-11-01

    Due to today's complex needs of hospitalized patients, nurses' competence and strategies to improve competence are of growing importance. Simulation is commonly used to influence competence, but little evidence exists for comparing how presimulation assignments influence competence. A randomized control trial was used to compare the efficacy of three simulation preparation methods (expert modeling/intervention, voice-over PowerPoint/active control, and reading assignments/passive control) on improving competence for providing care to multiple patients among senior undergraduate novice nurses. Competence was measured at two time points (baseline and following a 5-week intervention) by two blinded raters using the Creighton Simulation Evaluation Instrument. Twenty novice nurses participated in the trial. No significant differences were noted in raw improvements in competence among the three groups, but the expert modeling (Cohen's d=0.413) and voice-over PowerPoint methods (Cohen's d=0.226) resulted in greater improvements in competence, compared with the passive control.

  18. Adverse psychosocial consequences: Compassion fatigue, burnout and vicarious traumatization: Are nurses who provide palliative and hematological cancer care vulnerable?

    Directory of Open Access Journals (Sweden)

    Brenda M Sabo

    2008-01-01

    Full Text Available The work environment significantly affects the physical, psychological, emotional and/or spiritual wellbeing of individuals is unquestionable. Adverse effects have been noted among healthcare professionals working with clients experiencing pain and suffering often associated with cancer, palliative or end-of-life care; however, little is known about how or in which manner the nurse-patient-family relationship may affect the psychosocial health and wellbeing of nurses working in these areas. Three concepts have been highlighted as most frequently associated with the adverse consequences of caring work: these are compassion fatigue (secondary traumatic stress, burnout and vicarious traumatization. The following discussion investigates these concepts and their implications on palliative and hematological cancer nursing practice.

  19. [Competency to provide cross-cultural nursing care for people with disability: a self-assessment instrument].

    Science.gov (United States)

    Pagliuca, Lorita Marlena Freitag; Maia, Evanira Rodrigues

    2012-01-01

    This study addresses the Cross-Cultural Nursing Theory, which develops foundations for care delivery, as the essence of nursing work, based on anthropology, which supports and explains culture and care aspects. This reflexive study was based on the Theory Analysis method to study the concepts aimed at constructing a Self-Assessment Instrument of Competencies for Cross-Cultural Care to Disabled People. After analyzing the main concepts, Culturally Competent Care and Cultural Communication, were analyzed, as well as the sub-concepts: assessment, values, bio-cultural diversity, skill, knowledge, identity, code and cultural empathy. The analysis cycle of cultural values supporting self-assessment was summarized. The Self-Assessment Instrument of Competencies for Cross-Cultural Nursing Care to Disabled People was constructed, specifically deafness, blindness or low sight, physical impairment and mental impairment, regarding greeting, accepting, helping, knowing and advocating. It is concluded that the theory joins characteristics for care delivery to disabled people.

  20. 社区护士执行社区护理服务水平的现状研究%Study on Present Situation of Nursing Services Provided by Community Health Nurses

    Institute of Scientific and Technical Information of China (English)

    郭玲; 刘素珍

    2012-01-01

    目的 了解武侯区社区护士执行社区护理服务水平的现状,为规范社区护理服务内容及有针对性地提高社区护士的工作应对能力提供依据.方法 采用世界卫生组织在我国开展的"中国医疗卫生体制改革背景下的社区护理发展"项目提供的对武侯区社区护士执行社区护理服务的现状进行普查.结果 参与护理技术性服务的护士比例最大(91.5%),参与妇幼青少年健康保健服务者比例最小(69.3%).社区护士执行社区护理服务难度最大的是健康教育类别的服务,得分为(3.62±0.73)分;难度最小的是护理技术性服务,得分为(4.15±0.58)分.不同聘用类型和工作经历的社区护士其服务难易度间差异有统计学意义(P<0.05).结论 社区护士执行的社区护理服务内容及类别有限,执行服务也有一定难度,因此应拓展和深化社区护理服务,特别是有针对性地加强社区护士胜任公共卫生护理服务能力和基本专科技能的培养.%Objective To learn the nursing services provided by community health nurses in Wuhou District. Methods A cross - sectional survey was conducted in Wuhou district focusing on the community nursing services. The questionnaire was adapted from the research project " Development of Community Health Nursing during Healthcare Reform" hosted by the Ministry of Health of China and WHO. Results " Technical nursing service" was the largest service category ( 91. 5% ) provided by the community health nurses, whereas " maternal and adolescent health care services" was the smallest category ( 69. 3% ). Among the dimensions of service, " Health education" , with a score of ( 3. 62 ± 0. 73 ), was the most difficult service for community health nurses. " Technical nursing service" was the least difficult service, with a score of ( 4. 15 ±0. 58 ). The nurses with different training background and working experiences had significantly different opinions on the difficulty of

  1. Frontline Health Service Providers' Perspectives on HIV Vaccine Trials among Female Sex Workers and Men Who Have Sex with Men in Karnataka, South India.

    Directory of Open Access Journals (Sweden)

    Satyanarayana Ramanaik

    Full Text Available Little qualitative research is available on the role of frontline health service providers (FHSPs in the implementation of clinical trials, particularly in developing countries. This paper presents findings from a qualitative study about the perspectives of FHSPs on future HIV vaccine trials involving female sex workers (FSWs and men who have sex with men (MSM in three districts of Karnataka, India. In particular, we explore FHSPs' knowledge of and views on clinical trials in general, and examine their potential willingness to play a role if such trials were introduced or implemented in the region.A field team of four researchers from Karnataka-two of whom self-identified with FSW or MSM communities ("community researchers" and two with backgrounds in social work-conducted in-depth interviews with FHSPs. Including community researchers in the study helped to build rapport with FSW and MSM participants and facilitate in-depth discussions. A coding scheme for transcribed and translated data was developed using a framework analysis approach. Data was then analysed thematically using a combination of a priori and emergent codes.Over half of FHSPs demonstrated limited knowledge or understanding of clinical trials. Despite reported skepticism around the testing of HIV vaccines in developing countries and concerns around potential side effects, most FHSPs strongly advocated for the implementation of HIV vaccine clinical trials in Karnataka. Further, most FHSPs expressed their willingness to be involved in future HIV vaccine clinical trials in varying capacities.Given that FHSPs are often directly involved in the promotion of health and well-being of FSWs and MSM, they are well-positioned to play leadership, ethical, and communicative roles in future HIV vaccine trials. However, our findings reveal a lack of awareness of clinical trials among FHSP participants, suggesting an important area for capacity building and staff development before viable and

  2. The relationship of professional self-concept and job satisfaction among the HIV/AIDS department nurses%艾滋病科护士专业自我概念与工作满意度相关性研究

    Institute of Scientific and Technical Information of China (English)

    刘聪; 胡爱玲; 李俊彬; 农菲; 钟燕萍; 颜婵; 李义青; 徐国红; 杨莉

    2015-01-01

    目的:探讨艾滋病科护士专业自我概念与工作满意度的关系,为提高艾滋病科护士专业自我概念和工作满意度提供理论依据。方法:采用护理专业自我概念量表(PSCNI)、护士工作满意度量表(MMSS)对广东省6家艾滋病定点医院的188名护士进行问卷调查。结果:艾滋病科护士专业自我概念总分为(83.36±10.69)分,工作满意度总分为(94.39±15.54)分;工作满意度与专业自我概念的管理能力、专业技能、灵活性、满意度呈显著正相关(P<0.01),与专业自我概念的沟通能力无相关性。结论:艾滋病科护士的专业自我概念水平和工作满意度较高。专业自我概念中管理能力、专业技能、灵活性、满意度是工作满意度的影响因素。医院应培养护士积极的专业自我概念,从而提高护士工作满意度,发挥护士工作积极性和创造性,促进艾滋病护理专业的发展。%Objective:To explore the relationship between professional self-concept and job satisfaction among the HIV/AIDS department nurses, and to provide the references for improving HIV/AIDS department nurses' professional self-concept and job satisfaction. Methods:A total of 188 nurses working in the HIV/AIDS department from 6 designated AIDS hospitals in Guangdong province were recruited and investigated by Professional Self-Concept of Nurses Instrument (PSCNI) and McCloskey-Mueller Satisfaction Scale (MMSS). Results:The mean scores of professional self-concept and job satisfaction among HIV/AIDS department nurses were (83.36±10.69) and (94.39±15.54), respectively. Job satisfaction has significantly positive relationship with management ability, professional skills, lfexibility and degree of satisfaction of professional self-concept (P<0.01) and had no statistical relationship with the communicating skill of professional self-concept. Conclusion:The HIV/AIDS department nurses have positive

  3. Providing HIV results via SMS one day after testing: more popular than rapid point-of-care tests.

    Science.gov (United States)

    Davies, Stephen C; Koh, Andrew; Lindsay, Heather E; Fulton, Richard B; Fernando, Suran L

    2017-06-01

    An inner Sydney sexual health service introduced the option to gay and bisexual men of receiving a negative HIV result by SMS to mobile phone one business day after venipuncture (rapid SMS). Men could also choose one of the other options: a point-of-care-test (POCT), by phone, or in-person (clinicians could also require in-person). We followed-up patients choosing the rapid SMS method to ascertain their satisfaction. During 12 months, 473 men had 591 HIV tests. Of these tests, 5.4% were POCTs, 9.1% were in-person, 24% were by phone, and 62% were rapid SMS. HIV POCTs declined from being 22% of result methods in the pre-study period to 5.4% during the rapid SMS intervention period (odds ratio 0.20, 95% CI 0.13-0.32, P rapid SMS result rather than having another POCT. The higher accuracy of conventional serology was commonly expressed as the reason for choosing rapid SMS for results.

  4. Quality of antenatal care provided by nurse midwives in an Urban health centre with regard to low-risk antenatal mothers

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    Ruby Angeline Pricilla

    2017-01-01

    Full Text Available Background:India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO. Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care.

  5. Factors affecting acceptance of provider-initiated HIV testing and counseling services among outpatient clients in selected health facilities in Harar Town, Eastern Ethiopia

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    Abdurahman S

    2015-05-01

    Full Text Available Sami Abdurahman,1 Berhanu Seyoum,2 Lemessa Oljira,2 Fitsum Weldegebreal2 1Harari Regional Health Bureau, 2Haramaya University, College of Health and Medical Sciences, Harar, Ethiopia Purpose: To improve the slow uptake of HIV counseling and testing, the World Health Organization (WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS have developed draft guidelines on provider-initiated testing and counseling (PITC. Both in low- and high-income countries, mainly from outpatient clinics and tuberculosis settings, indicates that the direct offer of HIV testing by health providers can result in significant improvements in test uptake. In Ethiopia, there were limited numbers of studies conducted regarding PITC in outpatient clinics. Therefore, in this study, we have assessed the factors affecting the acceptance of PITC among outpatient clients in selected health facilities in Harar, Harari Region State, Ethiopia. Materials and methods: Institutional-based, cross-sectional quantitative and qualitative studies were conducted from February 12–30, 2011 in selected health facilities in Harar town, Harari Region State, Ethiopia. The study participants were recruited from the selected health facilities of Harar using a systematic random sampling technique. The collected data were double entered into a data entry file using Epi Info version 3.5.1. The data were transferred to SPSS software version 16 and analyzed according to the different variables. Results: A total of 362 (70.6% clients accepted PITC, and only 39.4% of clients had heard of PITC in the outpatient department service. Age, occupation, marital status, anyone who wanted to check their HIV status, and the importance of PITC were the variables that showed significant associations with the acceptance of PITC upon bivariate and multivariate analyses. The main reasons given for not accepting the tests were self-trust, not being at risk for HIV, not being ready, needing to consult their

  6. Attitude of Health-Care Workers to HIV/

    African Journals Online (AJOL)

    respectively among trained nurses and auxiliary nurses were unaware that HIV could be ... KEY WORDs: HIV/AIDS, health care workers, knowledge, attitude, discrimination, stigmatigation ..... infection prevention measures with emphasis on.

  7. "That is why I stopped the ART": Patients' & providers' perspectives on barriers to and enablers of HIV treatment adherence in a South African workplace programme

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    Kielmann Karina

    2008-02-01

    Full Text Available Abstract Background As ART programmes in African settings expand beyond the pilot stages, adherence to treatment may become an increasing challenge. This qualitative study examines potential barriers to, and facilitators of, adherence to ART in a workplace programme in South Africa. Methods We conducted key informant interviews with 12 participants: six ART patients, five health service providers (HSPs and one human resources manager. Results The main reported barriers were denial of existence of HIV or of one's own positive status, use of traditional medicines, speaking a different language from the HSP, alcohol use, being away from home, perceived severity of side-effects, feeling better on treatment and long waiting times at the clinic. The key facilitators were social support, belief in the value of treatment, belief in the importance of one's own life to the survival of one's family, and the ability to fit ART into daily life schedules. Conclusion Given the reported uncertainty about the existence of HIV disease and the use of traditional medicines while on ART, despite a programme emphasising ART counselling, there is a need to find effective ways to support adherence to ART even if the individual does not accept biomedical concepts of HIV disease or decides to use traditional medicines. Additionally, providers should identify ways to minimize barriers in communication with patients with whom they have no common language. Finally, dissatisfaction with clinical services, due to long waiting times, should be addressed.

  8. Provider-related barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs) and hospitals.

    Science.gov (United States)

    Bogart, Laura M; Howerton, Devery; Lange, James; Setodji, Claude Messan; Becker, Kirsten; Klein, David J; Asch, Steven M

    2010-06-01

    We examined provider-reported barriers to rapid HIV testing in U.S. urban non-profit community clinics, community-based organizations (CBOs), and hospitals. 12 primary metropolitan statistical areas (PMSAs; three per region) were sampled randomly, with sampling weights proportional to AIDS case reports. Across PMSAs, all 671 hospitals and a random sample of 738 clinics/CBOs were telephoned for a survey on rapid HIV test availability. Of the 671 hospitals, 172 hospitals were randomly selected for barriers questions, for which 158 laboratory and 136 department staff were eligible and interviewed in 2005. Of the 738 clinics/CBOs, 276 were randomly selected for barriers questions, 206 were reached, and 118 were eligible and interviewed in 2005-2006. In multivariate models, barriers regarding translation of administrative/quality assurance policies into practice were significantly associated with rapid HIV testing availability. For greater rapid testing diffusion, policies are needed to reduce administrative barriers and provide quality assurance training to non-laboratory staff.

  9. The South African triage scale (adult version provides valid acuity ratings when used by doctors and enrolled nursing assistants

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    Michèle Twomey

    2012-03-01

    Conclusion: The results of this study fall within the accepted range of over-/under-triage and indicate that the South African Triage Scale is valid when used by emergency physicians and nurses to triage emergency centre vignettes under South African conditions. Further research into appropriate reference ranges for extent of over-/under-triage and over-/under-prediction within each acuity level is recommended.

  10. A study of the lived experiences of registered nurses who have provided end-of-life care within an intensive care unit.

    Science.gov (United States)

    Holms, Natalie; Milligan, Stuart; Kydd, Angela

    2014-11-01

    End-of-life care (EOLC) in the intensive care unit (ICU) has received little attention in the literature in comparison to the considerable amount of existing literature available on EOLC in other areas of nursing. The ethos of the ICU is to preserve life, but as many patients die in this environment, EOLC should be an integral part of the ICU nurse's role. This qualitative study explored the experiences of ICU nurses who had provided EOLC to patients and their families. Participants were purposively recruited within one local ICU (n=5). A semi-structured interview format was used to guide in-depth interviews. The themes identified from the interview analysis were; use of integrated care systems, communication, the environment, education and training, staff distress. The findings suggest that ICU nurses do not feel adequately prepared to give proficient EOLC. Those who felt more confident in EOLC had learned what to do over time. Appropriate training, support and improved communication between staff, patients and families is necessary for good EOLC in ICUs.

  11. Providers' perspectives on male involvement in family planning in the context of a cluster-randomized controlled trial evaluating integrating family planning into HIV care in Nyanza Province, Kenya.

    Science.gov (United States)

    Tao, Amy R; Onono, Maricianah; Baum, Sarah; Grossman, Daniel; Steinfeld, Rachel; Cohen, Craig R; Bukusi, Elizabeth A; Newmann, Sara J

    2015-01-01

    Integration of family planning (FP) services into HIV care and increasing male partner involvement in FP are being explored as strategies to reduce unmet need for contraception. Providers' views can give valuable insight into current FP care. We evaluated the perspectives of HIV care providers working at HIV clinics in Nyanza Province, Kenya, on male partner involvement in FP. This qualitative study was part of a cluster-randomized controlled trial evaluating the impact of integrating FP into HIV services on contraceptive prevalence among HIV-positive patients in Nyanza Province, Kenya. Thirty individual interviews were conducted among health-care workers at 11 HIV care facilities in Nyanza Province, Kenya. Interviews were conducted from integrated and control sites one year after implementation of FP/HIV integration. Data were transcribed and analyzed using grounded theory methods and ATLAS-ti. Providers supported male partner inclusion when choosing FP and emphasized that decisions should be made collaboratively. Providers believed that men have traditionally played a prohibitive role in FP but identified several benefits to partner involvement in FP decision-making including: reducing relationship conflicts, improving FP knowledge and contraceptive continuation, and increasing partner cohesion. Providers suggested that integrated FP/HIV services facilitate male partner involvement in FP decision-making since HIV-positive men are already established patients in HIV clinics. Some providers stated that women had a right to choose and start FP alone if their partners did not agree with using FP. Integrated FP services may be a useful strategy to help increase male participation to reduce the unmet FP need in sub-Saharan Africa. It is important to determine effective ways to engage male partners in FP, without impinging upon women's autonomy and reproductive rights.

  12. O HIV e o trabalhador de enfermagem frente ao acidente com material perfurocortante El VIH y el trabajador de enfermería frente a accidentes con material punzocortante HIV and the nursing professional in face of needlestick accidents

    Directory of Open Access Journals (Sweden)

    Mariana Vieira

    2008-12-01

    rea de trabajo, pues el número de casos con VIH esta en aumento.The goal of this study was to identify the scientific production about work-related needlestick accidents among nursing professionals involving HIV-contaminated biological material, as well as to characterize the pre-existing factors to such accidents, such as procedures occurring after the exposure to potentially HIV-contaminated needlestick material. This is a literature review, whose bibliographic search for keywords was carried out within the LILACS databases from the year 2000 onward. This study confirms that pre-existing factors for the occurrence of work-related needlestick accidents are related to work conditions as much as to individual conditions. In face of these accidents, the nursing workers need to know the conducts concerning post-exposure to potentially HIV-contaminated needlestick material. We conclude that the adoption of standardized precautions when working in healthcare is a fundamental condition for worker safety, independently of their area of expertise, given the increasing number of HIV cases.

  13. International collaboration to enhance the fight against HIV/AIDS: Report of a consultative meeting between the University of Buea in Cameroon and the Goldfarb School of Nursing in the USA

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    Dickson S. Nsagha

    2011-09-01

    Full Text Available HIV/AIDS is a major public health pandemic affecting the development, survival and life of young people both in Cameroon and the USA. Youths are more adaptive to change and less hindered by prejudice than adults. Student-to-student peer mentoring is a non-formal way for students to learn new life skills and different cross-cultural values. We report on a two-day consultative meeting on developing international collaboration for the fight against HIV/AIDS between Cameroonian and USA nursing students. We used adult learning approaches consisting of presentations, discussions, questions and answer sessions, role plays and demonstrations. Deliberations and resolutions from the consultative meeting enabled the Vice-Chancellor of the University of Buea to sign a memorandum of understanding with the Goldfarb School of Nursing in the USA on HIV/AIDS international collaboration paving the way forward for more developmental health projects in this domain.

  14. Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient-Provider Communication in the START Study.

    Science.gov (United States)

    Hirsch-Moverman, Yael; Daftary, Amrita; Yuengling, Katharine A; Saito, Suzue; Ntoane, Moeketsi; Frederix, Koen; Maama, Llang B; Howard, Andrea A

    2017-01-01

    mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers. Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data. From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers. The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.

  15. Truth-telling to the patient, family, and the sexual partner: a rights approach to the role of healthcare providers in adult HIV disclosure in China.

    Science.gov (United States)

    Nie, Jing-Bao; Walker, Simon Thomas; Qiao, Shan; Li, Xiaoming; Tucker, Joseph D

    2015-01-01

    Patients' rights are central in today's legislation and social policies related to health care, including HIV care, in not only Western countries but around the world. However, given obvious socio-cultural differences it is often asked how or to what extent patients' rights should be respected in non-Western societies such as China. In this paper, it is argued that the patients' rights framework is compatible with Chinese culture, and that from the perspective of contemporary patient rights healthcare providers have a duty to disclose truthfully the diagnosis and prognosis to their patients, that the Chinese cultural practice of involving families in care should - with consent from the patient - be promoted out of respect for patients' rights and well-being, and that healthcare providers should be prepared to address the issue of disclosing a patient's HIV status to sexual partner(s). Legally, the provider should be permitted to disclose without consent from the patient but not obliged to in all cases. The decision to do this should be taken with trained sensitivity to a range of ethically relevant considerations. Post-disclosure counseling or psychological support should be in place to address the concerns of potentially adverse consequences of provider-initiated disclosure and to maximize the psychosocial and medical benefits of the disclosure. There is an urgent need for healthcare providers to receive training in ethics and disclosure skills. This paper concludes also with some suggestions for improving the centerpiece Chinese legislation, State Council's "Regulations on AIDS Prevention and Control" (2006), to further safeguard the rights and well-being of HIV patients.

  16. Catching the missing million: experiences in enhancing TB & DR-TB detection by providing upfront Xpert MTB/RIF testing for people living with HIV in India.

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    Neeraj Raizada

    Full Text Available A critical challenge in providing TB care to People Living with HIV (PLHIV is establishing an accurate bacteriological diagnosis. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents results from PLHIV taking part in a large demonstration study across India wherein upfront Xpert MTB/RIF testing was offered to all presumptive PTB cases in public health facilities.The study covered a population of 8.8 million across 18 sub-district level tuberculosis units (TU, with one Xpert MTB/RIF platform established at each TU. All HIV-infected patients suspected of TB (both TB and Drug Resistant TB (DR-TB accessing public health facilities in study area were prospectively enrolled and provided upfront Xpert MTB/RIF testing.2,787 HIV-infected presumptive pulmonary TB cases were enrolled and 867 (31.1%, 95% Confidence Interval (CI 29.4‒32.8 HIV-infected TB cases were diagnosed under the study. Overall 27.6% (CI 25.9-29.3 of HIV-infected presumptive PTB cases were positive by Xpert MTB/RIF, compared with 12.9% (CI 11.6-14.1 who had positive sputum smears. Upfront Xpert MTB/RIF testing of presumptive PTB and DR-TB cases resulted in diagnosis of 73 (9.5%, CI 7.6‒11.8 and 16 (11.2%, CI 6.7‒17.1 rifampicin resistance cases, respectively. Positive predictive value (PPV for rifampicin resistance detection was high 97.7% (CI 89.3‒99.8, with no significant difference with or without prior history of TB treatment.The study results strongly demonstrate limitations of using smear microscopy for TB diagnosis in PLHIV, leading to low TB and DR-TB detection which can potentially lead to either delayed or sub-optimal TB treatment. Our findings demonstrate the usefulness and feasibility of addressing this diagnostic gap with upfront of Xpert MTB/RIF testing, leading to overall strengthening of care and support package for PLHIV.

  17. A critical subset model provides a conceptual basis for the high antiviral activity of major HIV drugs.

    Science.gov (United States)

    Shen, Lin; Rabi, S Alireza; Sedaghat, Ahmad R; Shan, Liang; Lai, Jun; Xing, Sifei; Siliciano, Robert F

    2011-07-13

    Control of HIV-1 replication was first achieved with regimens that included a nonnucleoside reverse transcriptase inhibitor (NNRTI) or a protease inhibitor (PI); however, an explanation for the high antiviral activity of these drugs has been lacking. Indeed, conventional pharmacodynamic measures like IC(50) (drug concentration causing 50% inhibition) do not differentiate NNRTIs and PIs from less active nucleoside reverse transcriptase inhibitors (NRTIs). Drug inhibitory potential depends on the slope of the dose-response curve (m), which represents how inhibition increases as a function of increasing drug concentration and is related to the Hill coefficient, a measure of intramolecular cooperativity in ligand binding to a multivalent receptor. Although NNRTIs and PIs bind univalent targets, they unexpectedly exhibit cooperative dose-response curves (m > 1). We show that this cooperative inhibition can be explained by a model in which infectivity requires participation of multiple copies of a drug target in an individual life cycle stage. A critical subset of these target molecules must be in the unbound state. Consistent with experimental observations, this model predicts m > 1 for NNRTIs and PIs and m = 1 in situations where a single drug target/virus mediates a step in the life cycle, as is the case with NRTIs and integrase strand transfer inhibitors. This model was tested experimentally by modulating the number of functional drug targets per virus, and dose-response curves for modulated virus populations fit model predictions. This model explains the high antiviral activity of two drug classes important for successful HIV-1 treatment and defines a characteristic of good targets for antiviral drugs in general, namely, intermolecular cooperativity.

  18. The experiences of clients and healthcare providers regarding the provision of reproductive health services including the prevention of HIV and AIDS in an informal settlement in Tshwane

    Directory of Open Access Journals (Sweden)

    M.L.S. Mataboge

    2016-12-01

    Full Text Available Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV and to acquired immunodeficiency syndrome (AIDS than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.

  19. Nursing agency: the link between practical nursing science and nursing practice.

    Science.gov (United States)

    Banfield, Barbara E

    2011-01-01

    The relationship of nursing science and nursing practice has been the topic of numerous discussions over the past decades. According to Orem, nursing science is a practical science, meaning that knowledge is developed for the sake of nursing practice. Within Orem's self-care deficit nursing theory, the concept of nursing agency links nursing science and nursing practice. Nursing agency refers to the power or ability of the nurse to design and produce systems of care. The relationship of practical nursing science, nursing practice, and nursing agency is examined in this article. Suggestions for further work related to nursing agency are provided.

  20. The impact on nurses and nurse managers of introducing PEPFAR clinical services in urban government clinics in Uganda

    Directory of Open Access Journals (Sweden)

    Kyegombe Nambusi

    2011-03-01

    Full Text Available Abstract Background Improving provider performance is central to strengthening health services in developing countries. Because of critical shortages of physicians, many clinics in sub-Saharan Africa are led by nurses. In addition to clinical skills, nurse managers need practical managerial skills and adequate resources to ensure procurement of essential supplies, quality assurance implementation, and productive work environment. Giving nurses more autonomy in their work empowers them in the workplace and has shown to create positive influence on work attitudes and behaviors. The Infectious Disease Institute, an affiliate of Makerere University College of Health Science, in an effort to expand the needed HIV services in the Ugandan capital, established a community-university partnership with the Ministry of Health to implement an innovative model to build capacity in HIV service delivery. This paper evaluates the impact on the nurses from this innovative program to provide more health care in six nurse managed Kampala City Council (KCC Clinics. Methods A mixed method approach was used. The descriptive study collected key informant interviews from the six nurse managers, and administered a questionnaire to 20 staff nurses between September and December 2009. Key themes were manually identified from the interviews, and the questionnaire data were analyzed using SPSS. Results Introducing new HIV services into six KCC clinics was positive for the nurses. They identified the project as successful because of perceived improved environment, increase in useful in-service training, new competence to manage patients and staff, improved physical infrastructure, provision of more direct patient care, motivation to improve the clinic because the project acted on their suggestions, and involvement in role expansion. All of these helped empower the nurses, improving quality of care and increasing job satisfaction. Conclusions This community-university HIV

  1. Knowledge Level and Attitude of Health Care Workers About HIV/AIDS

    Directory of Open Access Journals (Sweden)

    Ayse Ižnci

    2013-10-01

    Full Text Available Aim: In this study,it was aimed to investigate the level of knowledge and attitudes of healty care workers about HIV/AIDS. Material and Method: Data on knowledge and attitude of health care workers about HIV/AIDS was collected with a questionnaire. Results:This research was carried out on 230 health care workers (36 doctors, 194 nurses to investigate their knowledge and attidudes on HIV/AIDS. All of the participants knew that HIV/AIDS is an infectious disease,while 90.4 % of the participants stated that HIV/AIDS can be transmitted sexually.76.5 % of the participants stated they found their work risky for HIV/AIDS. Discussion:These findings have provided a data for educational programs designed for healty care workers. We belive that education programs for healty care workers will be effecive to control HIV/AIDS.

  2. A qualitative study of provider thoughts on implementing pre-exposure prophylaxis (PrEP in clinical settings to prevent HIV infection.

    Directory of Open Access Journals (Sweden)

    Emily A Arnold

    Full Text Available BACKGROUND: A recent clinical trial demonstrated that a daily dose tenofovir disoproxil fumarate and emtricitabrine (TDF-FTC can reduce HIV acquisition among men who have sex with men (MSM and transgender (TG women by 44%, and up to 90% if taken daily. We explored how medical and service providers understand research results and plan to develop clinical protocols to prescribe, support and monitor adherence for patients on PrEP in the United States. METHODS: Using referrals from our community collaborators and snowball sampling, we recruited 22 healthcare providers in San Francisco, Oakland, and Los Angeles for in-depth interviews from May-December 2011. The providers included primary care physicians seeing high numbers of MSM and TG women, HIV specialists, community health clinic providers, and public health officials. We analyzed interviews thematically to produce recommendations for setting policy around implementing PrEP. Interview topics included: assessing clinician impressions of PrEP and CDC guidance, considerations of cost, office capacity, dosing schedules, and following patients over time. RESULTS: Little or no demand for PrEP from patients was reported at the time of the interviews. Providers did not agree on the most appropriate patients for PrEP and believed that current models of care, which do not involve routine frequent office visits, were not well suited for prescribing PrEP. Providers detailed the need to build capacity and were concerned about monitoring side effects and adherence. PrEP was seen as potentially having impact on the epidemic but providers also noted that community education campaigns needed to be tailored to effectively reach specific vulnerable populations. CONCLUSIONS: While PrEP may be a novel and clinically compelling prevention intervention for MSM and TG women, it raises a number of important implementation challenges that would need to be addressed. Nonetheless, most providers expressed optimism that

  3. Can a sustainability and health scenario provide a realistic challenge to student nurses and provoke changes in practice? An evaluation of a training intervention.

    Science.gov (United States)

    Grose, J; Richardson, J

    2016-06-01

    Climate change and limited natural resources will impact on the sustainable supply and disposal of materials used in health care. Healthcare students need opportunities to reflect on the ecological footprint of health services to mitigate against negative effects on service delivery. In order to raise awareness of these issues, there is a need for evidence-based teaching tools which are relevant and meaningful to nursing practice. An evidence-based sustainability skills teaching session was delivered to 293 nursing students from child and adult health disciplines. Following the sessions, evaluation sheets were distributed to the participants, of which 290 responded. The majority of nurses valued both the delivery and the content of the training and some were motivated to complete further study. The evaluation provided valuable information on how to deliver sustainability education and important insights into where more information and support was needed in order to change practice. Embedding sustainability teaching in skill sessions appears to be a realistic way of informing and motivating learners to consider current and best practice. Following training, further evaluation of practice-based behaviour is needed.

  4. Integrating a Career Planning and Development Program into the Baccalaureate Nursing Curriculum: Part III. Impact on Faculty's Career Satisfaction and Confidence in Providing Student Career Coaching.

    Science.gov (United States)

    Waddell, Janice; Spalding, Karen; Navarro, Justine; Gaitana, Gianina

    2015-11-25

    As career satisfaction has been identified as a predictor of retention of nurses across all sectors, it is important that career satisfaction of both new and experienced nursing faculty is recognized in academic settings. A study of a curriculum-based career planning and development (CPD) program was conducted to determine the program's effects on participating students, new graduate nurses, and faculty. This third in a series of three papers reports on how the CPD intervention affected faculty participants' sense of career satisfaction and confidence in their role as career educators and coaches. Faculty who participated in the intervention CPD intervention group reported an increase in confidence in their ability to provide career coaching and education to students. They further indicated that their own career development served to enhance career satisfaction; an outcome identified as a predictor of faculty career satisfaction. Study results suggest that interventions such as the one described in this paper can have a potentially positive impact in other settings as well.

  5. Improvement in screening for sexually transmitted infections in HIV-positive patients following implementation of a nurse-led clinic.

    Science.gov (United States)

    Hamlyn, E; Barrett, S; Kelsey, J; Lockyer, S; Welz, T; Poulton, M

    2007-06-01

    The objective of this study was to assess changes in the uptake of sexually transmitted infection (STI) screening resulting from implementation of a specific STI clinic for HIV-positive patients. An audit of STI screening in HIV-positive patients was undertaken before and after the establishment of the clinic. Significant increases in the number of patients having a sexual health discussion and annual health screen were seen. High rates of positive results were found in all patient groups. National guidelines recommend regular STI screening for all HIV-positive patients. A specific clinic for HIV-positive patients is feasible and acceptable and may result in an increase in uptake of STI screening.

  6. Nursing: What's a Nurse Practitioner?

    Science.gov (United States)

    ... such as family practice or pediatrics. Pediatric and family practice NPs can provide regular health care for kids. Nurse practitioners (also referred to as advanced practice nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification in their ...

  7. Hormonal contraception and HIV/AIDS transmission: challenges for Zimbabwe’s reproductive health service providers in promoting informed contraception choices

    Directory of Open Access Journals (Sweden)

    Christopher Mafuva

    2013-10-01

    Full Text Available None-barrier methods are the most predominant contraceptive methods of choice among Zimbabwean women, with the contraceptive pill being the most popular. The spread of HIV/AIDS is most prevalent in sub-Saharan African countries, Zimbabwe included. The prevalent mode of transmission is unprotected heterosexual sex. Although Zimbabwe boasts of a high literacy rate some women may still be vulnerable like in other parts of the world, as they may not understand the role of the Zimbabwe National Family Planning Council (ZNFPC and other reproductive health service providers. This is because some women at risk may expose themselves to unprotected sex while they are on hormonal contraceptives. This paper seeks to infer into pros and cons of hormonal contraceptive use among Zimbabwean women. There is also need to discuss the effectiveness of providers (ZNFPC clinics and the Ministry of Health in educating women about the risk of HIV transmission, which may be associated with some non-barrier methods of contraception. An understanding of women’s attitudes towards the different forms of contraception is of paramount importance as is that of the factors that could contribute to women in different social settings resorting to uninformed contraceptive choices.

  8. Nurse practitioner perceptions of barriers and facilitators in providing health care for deaf American Sign Language users: A qualitative socio-ecological approach.

    Science.gov (United States)

    Pendergrass, Kathy M; Nemeth, Lynne; Newman, Susan D; Jenkins, Carolyn M; Jones, Elaine G

    2017-06-01

    Nurse practitioners (NPs), as well as all healthcare clinicians, have a legal and ethical responsibility to provide health care for deaf American Sign Language (ASL) users equal to that of other patients, including effective communication, autonomy, and confidentiality. However, very little is known about the feasibility to provide equitable health care. The purpose of this study was to examine NP perceptions of barriers and facilitators in providing health care for deaf ASL users. Semistructured interviews in a qualitative design using a socio-ecological model (SEM). Barriers were identified at all levels of the SEM. NPs preferred interpreters to facilitate the visit, but were unaware of their role in assuring effective communication is achieved. A professional sign language interpreter was considered a last resort when all other means of communication failed. Gesturing, note-writing, lip-reading, and use of a familial interpreter were all considered facilitators. Interventions are needed at all levels of the SEM. Resources are needed to provide awareness of deaf communication issues and legal requirements for caring for deaf signers for practicing and student NPs. Protocols need to be developed and present in all healthcare facilities for hiring interpreters as well as quick access to contact information for these interpreters. ©2017 American Association of Nurse Practitioners.

  9. Research based empathic knowledge for nursing: a translational strategy for disseminating phenomenological research findings to provide evidence for caring practice.

    Science.gov (United States)

    Galvin, Kathleen T; Todres, Les

    2011-04-01

    We are interested in the kind of knowledge that is particularly relevant to caring practice and the way in which qualitative research findings can serve such knowledge. As phenomenological researchers we have been engaged with the question of how findings from such research can be re-presented and expressed more aesthetically. Such a movement towards a more aesthetic phenomenology may serve the communicative concern to express phenomena relevant to caring practice in ways that appeal to the 'head, hand and heart'. The paper first offers some thoughts about the complex kind of knowledge relevant to caring that is not only technical or propositional, but actionable and aesthetically moving as well. We call this kind of knowledge 'embodied relational understanding'. Further, the paper outlines the development of one way of serving a more aesthetic phenomenology whereby research findings can be faithfully and evocatively translated into more empathically impactful expressions. We call this process 'embodied interpretation'. It is guided by an epistemological framework grounded in the philosophies of Gadamer and Gendlin. We finally illustrate the process with reference to the experience of living after Stroke, and consider the value of this translational process for nursing education and practice.

  10. Perceived Empathy of Service Providers Mediates the Association between Perceived Discrimination and Behavioral Intention to Take Up HIV Antibody Testing Again among Men Who Have Sex with Men

    OpenAIRE

    2015-01-01

    HIV antibody testing is a key measure of HIV prevention for men who have sex with men (MSM). The World Health Organization recommends sexually active and at-risk MSM to take up HIV antibody testing regularly. This study aimed to investigate the prevalence of behavioral intention to take up HIV antibody testing in the next six months among Hong Kong MSM who were ever-testers. An anonymous cross-sectional survey recruited 326 MSM who had taken up HIV antibody testing from gay-friendly venues an...

  11. "Conditional scholarships" for HIV/AIDS health workers: educating and retaining the workforce to provide antiretroviral treatment in sub-Saharan Africa.

    Science.gov (United States)

    Bärnighausen, Till; Bloom, David E

    2009-02-01

    Without large increases in the number of health workers to treat HIV/AIDS (HAHW) many countries in sub-Saharan Africa will be unable to achieve universal coverage with antiretroviral treatment (ART), leading to large numbers of avoidable deaths among people living with HIV/AIDS. We conduct a cost-benefit analysis of a health care education scholarship that is conditional on the recipient committing to work for several years after graduation delivering ART in sub-Saharan Africa. Such a scholarship could address two of the main reasons for the low numbers of health workers in sub-Saharan Africa: low education rates and high emigration rates. We use Markov Monte Carlo microsimulation to estimate the expected net present value (eNPV) of "conditional scholarships" in sub-Saharan Africa. The scholarships are highly eNPV-positive under a wide range of assumptions. Conditional scholarships for a HAHW team sufficient to provide ART for 500 patients have an eNPV of 1.24 million year-2000 US dollars, assuming that the scholarship recipients are in addition to the health workers who would have been educated without scholarships and that the scholarships reduce annual HAHW emigration probabilities from 15% to 5% for five years. The eNPV of the education effect of the scholarships is larger than eNPV of the migration effect. Policy makers should consider implementing "conditional scholarships" for HAHW, especially in countries where health worker education capacity is currently underutilized or can be rapidly expanded.

  12. Barriers and facilitators in providing oral health care to nursing home residents, from the perspective of care aides-a systematic review protocol.

    Science.gov (United States)

    Hoben, Matthias; Hu, Huimin; Xiong, Tianyuan; Kent, Angelle; Kobagi, Nadia; Yoon, Minn N

    2016-04-07

    Unregulated care aides provide up to 80 % of direct resident care in nursing homes. They have little formal training, manage high workloads, frequently experience responsive behaviours from residents, and are at high risk for burnout. This affects quality of resident care, including quality of oral health care. Poor quality of oral health care in nursing homes has severe consequences for residents and the health care system. Improving quality of oral health care requires tailoring interventions to identified barriers and facilitators if these interventions are to be effective. Identifying barriers and facilitators from the care aide's perspective is crucial. We will systematically search the databases MEDLINE, Embase, Evidence Based Reviews-Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science. We will include qualitative and quantitative research studies and systematic reviews published in English that assess barriers and facilitators, as perceived by care aides, to providing oral health care to nursing home residents. Two reviewers will independently screen studies for eligibility. We will also search by hand the contents of key journals, publications of key authors, and reference lists of all the studies included. Two reviewers will independently assess the methodological quality of the studies included using four validated checklists appropriate for different research designs. Discrepancies at any stage of review will be resolved by consensus. We will conduct a thematic analysis of barriers and facilitators using all studies included. If quantitative studies are sufficiently homogeneous, we will conduct random-effects meta-analyses of the associations of barriers and facilitators with each other, with care aide practices in resident oral health care, and with residents' oral health. If quantitative study results cannot be pooled, we will present a narrative synthesis of the results. Finally, we will compare quantitative findings to

  13. Gogo care and protection of vulnerable children in rural Malawi: changing responsibilities, capacity to provide, and implications for well-being in the era of HIV and AIDS.

    Science.gov (United States)

    Littrell, Megan; Murphy, Laura; Kumwenda, Moses; Macintyre, Kate

    2012-12-01

    The role of older women in the care and protection of vulnerable children in sub-Saharan Africa may be changing given increasing rates of orphanhood due to AIDS. Concern regarding their capacity to provide for children and implications for their health and well-being dominate the literature. However, studies have not yet examined the situation of older caregivers in comparison to their younger counterparts over time. In this study, panel data on 1,219 caregivers in rural Malawi between 2007 and 2009 is complemented by in-depth interview (N=62) and group discussion (N=4) data. Caregiver responsibilities, capacity to care for children, and implications for well-being are examined. Chi-square tests examine differences in these measures between older foster caregivers and younger foster caregivers, parents of orphans, and parents of non-orphans. Older women, in comparison with younger counterparts, are more stable as primary caregivers for orphans. Care by older women is particularly valued when younger family stability is threatened by burdens of orphan care. Qualitative data reveal many challenges that older caregivers face, most notably provision of food. However, survey data suggest that the capacity to provide food, schooling and other basic needs is similar among older and younger caregivers. Self-reported health status is generally poorer among older caregivers, however levels of emotional distress and social capital are similar among older and younger caregivers. Providing care for children in old age appears to entail a number of benefits. Older women committed to providing care and protection for children are important assets, particularly in the context of threats to child well-being due to HIV and AIDS. Bolstering older caregivers with material and social support to help sustain their key roles in fostering is a promising avenue for maintaining extended family responses to HIV and AIDS.

  14. Developing the HIV Workforce: The MATEC Clinician Scholars Program.

    Science.gov (United States)

    Boehler, Malinda; Schechtman, Barbara; Rivero, Ricardo; Jacob, Beth-Anne; Sherer, Renslow; Wagner, Cornelia; Alabduljabbar, Salma A; Linsk, Nathan L

    2016-01-01

    Engaging new clinical providers in the HIV workforce is a critical need due to rapidly evolving treatment paradigms, aging out of existing providers, and special population needs. The 1-year competency-based Clinician Scholar Program for minority-serving providers with limited HIV care experience was individually tailored for each provider (n = 74), mostly nurse practitioners, physicians, and clinical pharmacists. Baseline and endpoint self-assessments of clinical knowledge and skills showed significant improvements in all 11 targeted competencies, particularly in managing antiretroviral medications, screening and testing methods, incorporating prevention into HIV care, understanding risk reduction methods, and describing current care standards. Faculty mentor assessments also showed significant improvement in most competencies. Additional benefits included ongoing access to mentorship and training, plus sustained engagement in local and statewide HIV care networks. Our intensive mentoring program model is replicable in other AIDS Education and Training Centers and in other structured training programs.

  15. Symptom Status Predicts Patient Outcomes in Persons with HIV and Comorbid Liver Disease

    Directory of Open Access Journals (Sweden)

    Wendy A. Henderson

    2012-01-01

    Full Text Available Persons living with human immunodeficiency virus (HIV are living longer; therefore, they are more likely to suffer significant morbidity due to potentially treatable liver diseases. Clinical evidence suggests that the growing number of individuals living with HIV and liver disease may have a poorer health-related quality of life (HRQOL than persons living with HIV who do not have comorbid liver disease. Thus, this study examined the multiple components of HRQOL by testing Wilson and Cleary’s model in a sample of 532 individuals (305 persons with HIV and 227 persons living with HIV and liver disease using structural equation modeling. The model components include biological/physiological factors (HIV viral load, CD4 counts, symptom status (Beck Depression Inventory II and the Medical Outcomes Study HIV Health Survey (MOS-HIV mental function, functional status (missed appointments and MOS-HIV physical function, general health perceptions (perceived burden visual analogue scale and MOS-HIV health transition, and overall quality of life (QOL (Satisfaction with Life Scale and MOS-HIV overall QOL. The Wilson and Cleary model was found to be useful in linking clinical indicators to patient-related outcomes. The findings provide the foundation for development and future testing of targeted biobehavioral nursing interventions to improve HRQOL in persons living with HIV and liver disease.

  16. The impact of leadership hubs on the uptake of evidence-informed nursing practices and workplace policies for HIV care: a quasi-experimental study in Jamaica, Kenya, Uganda and South Africa.

    Science.gov (United States)

    Edwards, Nancy; Kaseje, Dan; Kahwa, Eulalia; Klopper, Hester C; Mill, Judy; Webber, June; Roelofs, Susan; Harrowing, Jean

    2016-08-03

    district improvements in workplace policies and quality assurance in Jamaica, but these were primarily due to a decline in scores in the control group. There were modest improvements in clinical practices, workplace policies and quality assurance in South Africa (pre-post) (clinical practices of self-pre 0.67 (95 % CI, 0.62, 0.72) versus post 0.78 (95 % CI, 0.73-0.82), p = 0.002; workplace policies-pre 0.82 (95 % CI, 0.70, 0.85) versus post 0.87 (95 % CI, 0.84, 0.90), p = 0.001; quality assurance-pre 0.72 (95 % CI, 0.67, 0.77) versus post 0.84 (95 % CI, 0.80, 0.88)). There were statistically significant improvements in scores for nurses stigmatising patients (Jamaica reports of not stigmatising-pre-post intervention 33.9 versus 62.4 %, pre-post control 54.7 versus 64.4 %, p = 0.002-and Kenya pre-post intervention 35 versus 51.6 %, pre-post control 34.2 versus 47.8 %, p = 0.006) and for nurses being stigmatised (Kenya reports of no stigmatisation-pre-post intervention 23 versus 37.3 %, pre-post control 15.4 versus 27 %, p = 0.004). Multivariate results for Kenya and Jamaica were non-significant. Twelve hubs were established; 11 were active at follow-up. Hub members (n = 34) reported significant improvements in their capacity to address care gaps. Leadership hubs, comprising nurses and other stakeholders committed to change and provided with capacity building can collectively identify issues and act on strategies that may improve practice and policy. Overall, hubs did not provide the necessary force to improve the uptake of evidence-informed HIV care in their districts. If hubs are to succeed, they must be integrated within district health authorities and become part of formal, legal organisations that can regularise and sustain them.

  17. True User Involvement by People Living With HIV is Possible: Description of a User-driven HIV Clinic in Norway.

    Science.gov (United States)

    Berg, Rigmor C; Gamst, Are; Said, Maryan; Aas, Kristin Bårdsen; Songe, Solveig Helene; Fangen, Kim; Rysstad, Ole

    2015-01-01

    The Greater Involvement of People Living with or Affected by HIV principle highlights the various contributions HIV-infected people can make in HIV program development and implementation. We present a unique example of how service users' involvement led to a complete organizational redesign of an outpatient HIV clinic in Southern Norway. We applied a user-driven, case study method, which showed that establishing a user board laid the foundation for the redesign process, as the board provided a clear infrastructure of user involvement and developed a set of user-defined targets for services. The main targets-optimal health, holistic care and treatment, and empowerment-were operationalized as a set of action points, such as establishing HIV nurse coordinators. While there is no single method for user involvement, we offer useful ideas that can help others develop an involvement project that is effective and sustainable.

  18. Research progress on risk factors and protect of occupational exposure to HIV in operating room nurses%手术室护士 HIV 职业暴露的危险因素及防护措施的研究进展1)

    Institute of Scientific and Technical Information of China (English)

    李源

    2014-01-01

    It reviewed the risk factors and protective measures of occupa-tional exposure to HIV occurred in operating room nurses in China in re-cent years.Its main influencing factors included the operating room nurses’ job characteristics,nurses ’mental and physical characteristics,operating procedures,the use of protective equipment as well as nonstandard post exposure treatment process.The main measures consisted of training for nurses,prevention for psychological and physiological factors of nurses, standardizing operation process,protesting measure and the right process to cope with risks.It points out that it can prevent and reduce risks in occu-pational exposure to HIV in operating room nurses to implement knowl-edge training,improve protection awareness and standard operating proce-dures.%本文综述近年来国内外对手术室护士发生人类免疫缺陷病毒(HIV)职业暴露的危险因素及防护措施,其主要影响因素包括手术室护士岗位的特点、护士心理和身体特征、操作流程、防护用品的使用、暴露后处理流程不规范。主要措施包括对护士培训、心理和生理因素的预防、规范操作流程、防护措施、暴露后正确处理流程。对护士实施知识培训、提高防护意识、规范操作流程等措施可有效预防并降低手术室护士发生 HIV 职业暴露的风险。

  19. How can information systems provide support to nurses' hand hygiene performance? Using gamification and indoor location to improve hand hygiene awareness and reduce hospital infections.

    Science.gov (United States)

    Marques, Rita; Gregório, João; Pinheiro, Fernando; Póvoa, Pedro; da Silva, Miguel Mira; Lapão, Luís Velez

    2017-01-31

    Hospital-acquired infections are still amongst the major problems health systems are facing. Their occurrence can lead to higher morbidity and mortality rates, increased length of hospital stay, and higher costs for both hospital and patients. Performing hand hygiene is a simple and inexpensive prevention measure, but healthcare workers' compliance with it is often far from ideal. To raise awareness regarding hand hygiene compliance, individual behaviour change and performance optimization, we aimed to develop a gamification solution that collects data and provides real-time feedback accurately in a fun and engaging way. A Design Science Research Methodology (DSRM) was used to conduct this work. DSRM is useful to study the link between research and professional practices by designing, implementing and evaluating artifacts that address a specific need. It follows a development cycle (or iteration) composed by six activities. Two work iterations were performed applying gamification components, each using a different indoor location technology. Preliminary experiments, simulations and field studies were performed in an Intensive Care Unit (ICU) of a Portuguese tertiary hospital. Nurses working on this ICU were in a focus group during the research, participating in several sessions across the implementation process. Nurses enjoyed the concept and considered that it allows for a unique opportunity to receive feedback regarding their performance. Tests performed on the indoor location technology applied in the first iteration regarding distances estimation presented an unacceptable lack of accuracy. Using a proximity-based technique, it was possible to identify the sequence of positions, but beacons presented an unstable behaviour. In the second work iteration, a different indoor location technology was explored but it did not work properly, so there was no chance of testing the solution as a whole (gamification application included). Combining automated monitoring

  20. Access to Healthcare, HIV/STI Testing, and Preferred Pre-Exposure Prophylaxis Providers among Men Who Have Sex with Men and Men Who Engage in Street-Based Sex Work in the US

    Science.gov (United States)

    Underhill, Kristen; Morrow, Kathleen M.; Colleran, Christopher M.; Holcomb, Richard; Operario, Don; Calabrese, Sarah K.; Galárraga, Omar; Mayer, Kenneth H.

    2014-01-01

    Background Pre-exposure prophylaxis (PrEP) is a promising strategy for HIV prevention among men who have sex with men (MSM) and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men’s healthcare and HIV testing experiences to inform PrEP implementation. Methods We conducted 8 focus groups (n = 38) in 2012 and 56 in-depth qualitative interviews in 2013–14 with male sex workers (MSWs) (n = 31) and other MSM (n = 25) in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers. Results MSWs primarily accessed care in emergency rooms (ERs), substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings. Conclusions PrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations. PMID:25386746

  1. Access to healthcare, HIV/STI testing, and preferred pre-exposure prophylaxis providers among men who have sex with men and men who engage in street-based sex work in the US.

    Directory of Open Access Journals (Sweden)

    Kristen Underhill

    Full Text Available Pre-exposure prophylaxis (PrEP is a promising strategy for HIV prevention among men who have sex with men (MSM and men who engage in sex work. But access will require routine HIV testing and contacts with healthcare providers. This study investigated men's healthcare and HIV testing experiences to inform PrEP implementation.We conducted 8 focus groups (n = 38 in 2012 and 56 in-depth qualitative interviews in 2013-14 with male sex workers (MSWs (n = 31 and other MSM (n = 25 in Providence, RI. MSWs primarily met clients in street-based sex work venues. Facilitators asked participants about access to healthcare and HIV/STI testing, healthcare needs, and preferred PrEP providers.MSWs primarily accessed care in emergency rooms (ERs, substance use clinics, correctional institutions, and walk-in clinics. Rates of HIV testing were high, but MSWs reported low access to other STI testing, low insurance coverage, and unmet healthcare needs including primary care, substance use treatment, and mental health services. MSM not engaging in sex work were more likely to report access to primary and specialist care. Rates of HIV testing among these MSM were slightly lower, but they reported more STI testing, more insurance coverage, and fewer unmet needs. Preferred PrEP providers for both groups included primary care physicians, infectious disease specialists, and psychiatrists. MSWs were also willing to access PrEP in substance use treatment and ER settings.PrEP outreach efforts for MSWs and other MSM should engage diverse providers in many settings, including mental health and substance use treatment, ERs, needle exchanges, correctional institutions, and HIV testing centers. Access to PrEP will require financial assistance, but can build on existing healthcare contacts for both populations.

  2. Prevalence of HIV infection and median CD4 counts among health ...

    African Journals Online (AJOL)

    Prevalence of HIV infection and median CD4 counts among health care workers in South Africa. ... Outcome measures. HIV prevalence and CD4 ... By occupation, prevalence was highest among student nurses (13.8%) and nurses (13.7%).

  3. Expectation and satisfaction of HIV/AIDS patients toward the pharmaceutical care provided at Gondar University Referral Hospital, Northwestern Ethiopia: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Abebe TB

    2016-10-01

    provided at Gondar University Referral Hospital was found to be low, while the overall respondents’ expectation from the pharmaceutical services were exceedingly high. The hospital should implement good dispensing practice systems in relation to the services and continuing professional development to professionals in order to improve the satisfaction of patients. Keywords: pharmaceutical care, Ethiopia, HIV/AIDS, antiretroviral therapy

  4. Development of Model Systematic Trilateral Approach to Provide Continuing Education for Nursing Home and Small Hospital Personnel. Final Report.

    Science.gov (United States)

    Schrader, Marvin A.; And Others

    The project was designed to determine the feasibility of having a vocational technical adult education (VTAE) district provide continuing education inservice training for health care facilities using videotape equipment so that employees could gain knowledge and skills without leaving the facility or having to involve time outside the normal…

  5. A systematic review of education for the prevention of HIV/AIDS among older adults.

    Science.gov (United States)

    Milaszewski, Dorota; Greto, Elise; Klochkov, Tanya; Fuller-Thomson, Esme

    2012-01-01

    Through a comprehensive literature search, the authors of this systematic review identified 21 articles focused on primary prevention of HIV/AIDS for adults aged 50 and over. Three major challenges to providing HIV/AIDS education for older adults include health professionals' ageism, older adults' reluctance to discuss sexuality, and their misconception of their HIV risk. Clinical guidelines for social workers, nurses, and physicians identified the importance of sharing information and assessing risk, considering cultural diversity, and devising creative delivery strategies. Three models of HIV/AIDS education include group education programs delivered by social workers or other health professionals, peer education models, and one-on-one early intervention models including HIV/AIDS testing. Additional outreach and research on HIV/AIDS prevention among older adults is needed.

  6. A model for HIV disclosure of a parent’s and/or a child’s illness

    Directory of Open Access Journals (Sweden)

    Grace Gachanja

    2016-02-01

    Full Text Available HIV prevalence in Kenya remains steady at 5.6% for adults 15 years and older, and 0.9% among children aged below 14 years. Parents and children are known to practice unprotected sex, which has implications for continued HIV spread within the country. Additionally, due to increased accessibility of antiretroviral therapy, more HIV-positive persons are living longer. Therefore, the need for HIV disclosure of a parent’s and/or a child’s HIV status within the country will continue for years to come. We conducted a qualitative phenomenological study to understand the entire process of disclosure from the time of initial HIV diagnosis of an index person within an HIV-affected family, to the time of full disclosure of a parent’s and/or a child’s HIV status to one or more HIV-positive, negative, or untested children within these households. Participants were purposively selected and included 16 HIV-positive parents, seven HIV-positive children, six healthcare professionals (physician, clinical officer, psychologist, registered nurse, social worker, and a peer educator, and five HIV-negative children. All participants underwent an in-depth individualized semistructured interview that was digitally recorded. Interviews were transcribed and analyzed in NVivo 8 using the modified Van Kaam method. Six themes emerged from the data indicating that factors such as HIV testing, living with HIV, evolution of disclosure, questions, emotions, benefits, and consequences of disclosure interact with each other and either impede or facilitate the HIV disclosure process. Kenya currently does not have guidelines for HIV disclosure of a parent’s and/or a child’s HIV status. HIV disclosure is a process that may result in poor outcomes in both parents and children. Therefore, understanding how these factors affect the disclosure process is key to achieving optimal disclosure outcomes in both parents and children. To this end, we propose an HIV disclosure model

  7. The impact of alcohol on HIV prevention and treatment for South Africans in primary healthcare

    Directory of Open Access Journals (Sweden)

    Michelle Schneider

    2014-02-01

    Full Text Available Background: Antiretroviral treatment (ART has substantially reduced morbidity and mortality for HIV patients. In South Africa, with the largest ART programme globally, attention is needed not only on the further expansion of ART coverage, but also on factors which undermine its effectiveness, such as alcohol use.Objective: Given the decentralised approach of nurse-initiated and -sustained ART in the South African primary health sector, it is important to document key aspects of alcohol use to be conveyed to HIV-positive individuals and those at risk for HIV.Method: This study comprised a narrative review of relevant literature.Results: Alcohol acts through both behavioural and physiological pathways to impact on the acquisition, further transmission and then progression of HIV disease. Besides links to risky sex, alcohol undermines the immune system, raising susceptibility to contracting and then countering HIV and other infections. There are important drug interactions between alcohol and ART, or therapies for opportunistic infections and other co-morbidities. Moreover, alcohol undermines adherence to the medication which is essential for effective ART.Conclusion: Primary healthcare clinic attendees need evidence-based information on the detrimental effects of alcohol consumption on HIV infection, which ensue throughout the clinical course of HIV. This spans the role of alcohol consumption as a risk factor for HIV infection, HIV replication in infected individuals, a person’s response to HIV infection and HIV treatment. Primary healthcare workers, especially nurses and HIV counsellors, require training in order to screen for and provide appropriate interventions for HIV-positive patients, those on treatment and treatment-naïve patients, who will benefit from reduced alcohol consumption or the cessation thereof.

  8. Ethical and legal issues on HIV testing, policy and the practice of dentistry.

    Science.gov (United States)

    Naidoo, Sudeshni; Vernillo, Anthony

    2012-12-01

    This paper is structured around the following: autonomy and consent, confidentiality, disclosure, knowledge of patient and provider HIV status, the right to choose whom to treat, testing for HIV and the importance of HIV policies in the workplace to guard against discrimination. The emergence of the HIV/AIDS pandemic has challenged traditional ethical values of the health care profession. These include the infectious nature of HIV, the social stigma of the disease and its ethical and legal dilemmas. This paper addresses some of the pertinent questions related to HIV infection and AIDS. The three broad principles of ethics, namely, autonomy, beneficence and justice, provide the basic framework on which this paper is based. Advances in the biotechnology of rapid oral fluid testing particularly in the detection of HIV antibodies from patients in the dental setting have raised additional ethical and legal considerations in the subsequent management of HIV infected patients to include disclosure of test results to the patient and proper referral to physicians or nurse practitioners. The oral health care worker must thus have a solid foundation in the application of bioethical principles. A clinical case scenario related to HIV testing in the dental setting is presented to illustrate how a lack of understanding and the wrongful application of ethical principles may lead to patient harm and legal liability. Given the increasing infection rate of HIV worldwide, polices must be upheld and revised as needed to protect healthcare providers, patients, and society generally against discrimination.

  9. Orchestrating care through the fast-track perspective: Orthopaedic nurses’ perceptions and experiences of providing individualised nursing care in older patients’ standardised fast-track programmes after total hip or knee replacement

    DEFF Research Database (Denmark)

    Bøttcher Berthelsen, Connie; Frederiksen, Kirsten

    2017-01-01

    The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised...... fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim...

  10. Integration of routine rapid HIV screening in an urban family planning clinic.

    Science.gov (United States)

    Criniti, Shannon M; Aaron, Erika; Hilley, Amy; Wolf, Sandra

    2011-01-01

    Family planning centers can play an important role in HIV screening, education, and risk-reduction counseling for women who are sexually active. This article describes how 1 urban Title X-funded family planning clinic transitioned from using a designated HIV counselor for targeted testing to a model that uses clinic staff to provide integrated, routine, nontargeted, rapid HIV testing as standard of care. Representative clinic staff members developed an integrated testing model that would work within the existing clinic flow. Education sessions were provided to all staff, signs promoting routine HIV testing were posted, and patient and clinician information materials were developed. A review of HIV testing documentation in medical charts was performed after the new model of routine, nontargeted, rapid HIV testing was integrated, to determine any changes in patient testing rates. A survey was given to all staff members 6 months after the transition to full integration of HIV testing to evaluate the systems change process. Two years after the transition, the rate of patients with an HIV test in the medical chart within the last 12 months increased 25.5%. The testing acceptance rate increased 17%. Sixteen HIV seropositive individuals were identified and linked into medical care. All surveyed clinic staff agreed that offering routine HIV screening to all patients is very important, and 78% rated the integration efforts as successful. Integrating routine HIV screening into a family planning clinic can be critical to identifying new HIV infections in women. This initiative demonstrated that routine, nontargeted, rapid HIV screening can be offered successfully as a standard of care in a high-volume, urban, reproductive health care setting. This description and evaluation of the process of changing the model of HIV testing in a clinic setting is useful for clinicians who are interested in expanding routine HIV testing in their clinics. © 2011 by the American College of

  11. "Conditional Scholarships" for HIV/AIDS Health Workers: Educating and Retaining the Workforce to Provide Antiretroviral Treatment in Sub-Saharan Africa. NBER Working Paper No. 13396

    Science.gov (United States)

    Barnighausen, Till; Bloom, David E.

    2007-01-01

    Without large increases in the number of health workers to treat HIV/AIDS (HAHW), most developing countries will be unable to achieve universal coverage with antiretroviral treatment (ART), leading to large numbers of potentially avoidable deaths among people living with HIV/AIDS. We use Markov Monte Carlo microsimulation to estimate the expected…

  12. Can biomedical and traditional health care providers work together? Zambian practitioners' experiences and attitudes towards collaboration in relation to STIs and HIV/AIDS care: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Höjer Bengt

    2006-07-01

    Full Text Available Abstract Background The World Health Organization's World health report 2006: Working together for health underscores the importance of human resources for health. The shortage of trained health professionals is among the main obstacles to strengthening low-income countries' health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs. The aim of this paper is to explore biomedical and traditional health practitioners' experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs and HIV/AIDS. Methods We conducted a cross-sectional study in two Zambian urban sites, using structured questionnaires. We interviewed 152 biomedical health practitioners (BHPs and 144 traditional health practitioners (THPs who reported attending to patients with STIs and HIV/AIDS. Results The study showed a very low level of experience of collaboration, predominated by BHPs training THPs (mostly traditional birth attendants on issues of safe delivery. Intersectoral contacts addressing STIs and HIV/AIDS care issues were less common. However, both groups of providers overwhelmingly acknowledged the potential role of THPs in the fight against HIV/AIDS. Obstacles to collaboration were identified at the policy level in terms of legislation and logistics. Lack of trust in THPs by individual BHPs was also found to inhibit collaboration. Nevertheless, as many as 40% of BHPs expressed an interest in working more closely with THPs. Conclusion There is indication that practitioners from both sectors seem willing to strengthen collaboration with each other. However

  13. Can biomedical and traditional health care providers work together? Zambian practitioners' experiences and attitudes towards collaboration in relation to STIs and HIV/AIDS care: a cross-sectional study.

    Science.gov (United States)

    Kaboru, Berthollet Bwira; Falkenberg, Torkel; Ndubani, Phillimon; Höjer, Bengt; Vongo, Rodwell; Brugha, Ruairi; Faxelid, Elisabeth

    2006-07-17

    The World Health Organization's World health report 2006: Working together for health underscores the importance of human resources for health. The shortage of trained health professionals is among the main obstacles to strengthening low-income countries' health systems and to scaling up HIV/AIDS control efforts. Traditional health practitioners are increasingly depicted as key resources to HIV/AIDS prevention and care. An appropriate and effective response to the HIV/AIDS crisis requires reconsideration of the collaboration between traditional and biomedical health providers (THPs and BHPs). The aim of this paper is to explore biomedical and traditional health practitioners' experiences of and attitudes towards collaboration and to identify obstacles and potential opportunities for them to collaborate regarding care for patients with sexually transmitted infections (STIs) and HIV/AIDS. We conducted a cross-sectional study in two Zambian urban sites, using structured questionnaires. We interviewed 152 biomedical health practitioners (BHPs) and 144 traditional health practitioners (THPs) who reported attending to patients with STIs and HIV/AIDS. The study showed a very low level of experience of collaboration, predominated by BHPs training THPs (mostly traditional birth attendants) on issues of safe delivery. Intersectoral contacts addressing STIs and HIV/AIDS care issues were less common. However, both groups of providers overwhelmingly acknowledged the potential role of THPs in the fight against HIV/AIDS. Obstacles to collaboration were identified at the policy level in terms of legislation and logistics. Lack of trust in THPs by individual BHPs was also found to inhibit collaboration. Nevertheless, as many as 40% of BHPs expressed an interest in working more closely with THPs. There is indication that practitioners from both sectors seem willing to strengthen collaboration with each other. However, there are missed opportunities. The lack of collaborative

  14. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... access to the latest, federally approved HIV/AIDS medical practice guidelines, HIV treatment and prevention clinical trials, and other research information for health care providers, researchers, people affected by HIV/AIDS, and the ...

  15. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... the latest, federally approved HIV/AIDS medical practice guidelines, HIV treatment and prevention clinical trials, and other research information for health care providers, researchers, people affected by HIV/AIDS, ...

  16. NGO-provided free HIV treatment and services in Burkina Faso: scarcity, therapeutic rationality and unfair process

    Directory of Open Access Journals (Sweden)

    Ridde Valéry

    2012-03-01

    Full Text Available Abstract Until 2010, Burkina Faso was an exception to the international trend of abolishing user fees for antiretroviral treatment (ART. Patients were still expected to pay 1,500F CFA (2 Euros per month for ART. Nevertheless, many non-governmental organizations (NGOs exempted patients from payment. The objective of this study was to investigate how NGOs selected the beneficiaries of payment exemptions for government-provided ART and rationed out complementary medical and psychosocial services. For this qualitative study, we conducted 13 individual interviews and three focus group discussions (n = 13 persons with program staff in nine NGOs (4,000 patients, two NGO coordinating structures and one national program. These encounters were recorded and transcribed, and their content was thematically analyzed. The results were presented to the NGOs for feedback. Results indicate that there are no concrete guidelines for identifying patients warranting payment exemptions. Formerly, ART was scarce in Burkina Faso and the primary criterion for treatment selection was clinical. Our results suggest that this scarcity, mediated by an approach we call sociotherapeutic rationality (i.e. maximization of clinical success, may have led to inequities in the provision of free ART. This approach may be detrimental to assuring equity since the most impoverished lack resources to pay for services that maximize clinical success (e.g. viral load that would increase their chances of being selected for treatment. However, once selected into treatment, attempts were made to ration-out complementary services more equitably. This study demonstrates the risks entailed by medication scarcity, which presents NGOs and health professionals with impossible choices that run counter to the philosophy of equity in access to treatment. Amid growing concerns of an international funding retreat for ART, it is important to learn from the past in order to better manage the potentially

  17. Nursing Revalidation

    OpenAIRE

    F. Cannon; McCutcheon, K.

    2016-01-01

    This article details the Nursing and Midwifery Council revalidation requirements essential for all registered nurses and midwives in the United Kingdom. Nursing revalidation is effective from April 2016 and is built on the pre-existing Post-registration education and practice. Unlike the previous process, revalidation provides a more robust system which is clearly linked to the Code and should assist towards the delivery of quality and safe effective care

  18. American Nurses Association Nursing World

    Science.gov (United States)

    ... ANA Staff Nurses Advanced Practice Nurses Nurse Managers Nursing Research Student Nurses Educators What is Nursing? NursingWorld About ... Online Course Alert! The Ins and Outs of Nursing Research 11/09/16 ANA Ready to Work with ...

  19. The INSTI HIV-1/HIV-2 antibody test: a review.

    Science.gov (United States)

    Singh, Ameeta E; Lee, Bonita; Fenton, Jayne; Preiksaitis, Jutta

    2013-05-01

    Rapid HIV tests have been widely adopted globally as an important component of HIV prevention and control programs. The INSTI™ HIV-1/HIV-2 antibody test is a second-generation HIV antibody test, available in most countries for use from whole blood, serum, and plasma. Available data on kit characteristics and current performance data on the INSTI™ HIV-1/HIV-2 antibody test are presented together with six other rapid point-of-care tests (RPOCTs) for HIV antibody. Few published data are available providing direct comparisons of INSTI™ with other RPOCTs for HIV antibody and standard laboratory-based HIV-1/HIV-2 antibody assays. Existing data showed that INSTI™ has comparable performance to other RPOCTs but detected seroconversion later than standard laboratory-based assays. The good performance of INSTI HIV-1/HIV-2 antibody test, its ease of use, the rapid availability of results (resource-limited settings.

  20. Examining the content of weight, nutrition and physical activity advices provided by Dutch practice nurses in primary care: analysis of videotaped consultations.

    Science.gov (United States)

    van Dillen, S M E; Noordman, J; van Dulmen, S; Hiddink, G J

    2014-01-01

    To examine the content of Dutch practice nurses' (PNs') advices about weight, nutrition and physical activity to overweight and obese patients. A 100 videotaped real-life PN consultations (The Netherlands, 2010/2011) with overweight or obese patients were selected. An observational checklist was developed to assess frequency and content. Personalization of advices was scored, as also the guidelines on which PNs based their advices. Content analysis was used to identify different categories of advices. About one quarter of advices concerned weight, over two-thirds nutrition and one-third physical activity. Lose weight, eat less fat and be more physically active in general were the main categories for each type of advice. Despite high clarity of advices, lower scores were found for specificity and personalization. Very few nutrition advices were provided in combination with physical activity advices. Weight advices often related to the patient's complaint. PNs seldom set a concrete weight goal. Although benefits of physical activity were discussed, often no practical advices were provided about how to achieve this. Integrated lifestyle advice was not common: advices about nutrition and physical activity were fragmented throughout the consultation. Obesity prevention needs more emphasis in PNs' educational programs.

  1. Humanizing infant milk formula to decrease postnatal HIV transmission.

    Science.gov (United States)

    Blais, David R; Altosaar, Illimar

    2007-09-01

    There are currently no safe methods for feeding babies born from the 16 million HIV-infected women living in resource-constrained countries. Breast milk can transmit HIV, and formula feeding can lead to gastrointestinal illnesses owing to unsanitary conditions and the composition of milk formulations. There is therefore a need to ensure that breast milk substitutes provide optimal health outcomes. Given that the immune properties of several breast milk proteins are known, transgenic food crops could facilitate inexpensive and safe reconstitution of the beneficial breast milk proteome in infant formulae, while keeping the HIV virus at bay. At least seven breast milk immune proteins have already been produced in food crops, and dozens more proteins could potentially be produced if fortified formula proves effective in nursing newborns born to HIV-infected mothers.

  2. Consulta de enfermagem no ambulatório de HIV/AIDS: a percepção dos usuários Consulta de enfermería en ambulatorio de VIH/SIDA: la percepción de los usuarios Nursing consultation in an HIV/AIDS outpatient clinic: patients' perception

    Directory of Open Access Journals (Sweden)

    Simara Moreira de Macêdo

    2012-09-01

    presentes en su enfermedad.The study aims to understand the patients' perception regarding the nursing consultation at an outpatient clinic for Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome (HIV / AIDS in the city of Fortaleza-CE (State of Ceará. This is an exploratory and descriptive qualitative approach. Data was collected through semi-structured interviews with fifteen patients of this institution and analyzed with the support of content analysis. The nursing consultation was reported by patients as a learning moment, focused on providing information. The trust and emotional support provided by the professional act as a support to the conflicts experienced by the patients, allowing the construction of a new perspective of the disease. We believe that the implementation of the nursing consultation in a dialogic perspective can provide a new meaning to the conflicts surrounding the patients' illness.

  3. Healthcare workers’ experiences of HIV testing in Tshwane, South Africa

    Directory of Open Access Journals (Sweden)

    Mamakwa S. Mataboge

    2014-02-01

    Full Text Available Background: In an era when antiretroviral (ARV therapy has become part of the Human Immunodeficiency Virus (HIV prevention strategy, early testing and introduction to ARVs iscritical for improving public health outcomes in general and, in particular, the lives of people living with HIV. South Africa has the highest number of people living with HIV as compared with the rest of the world. Initiated voluntary HIV counselling and testing and provider initiated counselling and testing (PICT are required in order to increase the uptake of HIV testing.Objectives: To explore and describe the experiences of healthcare workers who are themselves in need of HIV testing.Method: A descriptive, exploratory design was used. In-depth interviews were conducted with the 26 healthcare workers who were involved in HIV testing in the Tshwane district of South Africa. The participants were sampled purposively from two healthcare settings. A thematic framework was used for data analysis.Results: There was a complication with regard to PICT as healthcare workers felt they could not initiate HIV testing for themselves and or their work colleagues without their confidentiality being compromised. This was complicated further by both the perceived and actual fear of stigmatisation and discrimination. It was difficult for qualified staff to support and encourage the uptake of HIV testing by students nurses as this was seen, albeit incorrectly, as targeting the students in a negative manner.Conclusion: There is a need for accessible HIV testing policies for healthcare workers in order to increase access to HIV testing and prevent the progression of the disease

  4. California's "Bridge to Reform": identifying challenges and defining strategies for providers and policymakers implementing the Affordable Care Act in low-income HIV/AIDS care and treatment settings.

    Directory of Open Access Journals (Sweden)

    Patrick T Hazelton

    Full Text Available In preparation for full Affordable Care Act implementation, California has instituted two healthcare initiatives that provide comprehensive coverage for previously uninsured or underinsured individuals. For many people living with HIV, this has required transition either from the HIV-specific coverage of the Ryan White program to the more comprehensive coverage provided by the county-run Low-Income Health Programs or from Medicaid fee-for-service to Medicaid managed care. Patient advocates have expressed concern that these transitions may present implementation challenges that will need to be addressed if ambitious HIV prevention and treatment goals are to be achieved.30 semi-structured, in-depth interviews were conducted between October, 2012, and February, 2013, with policymakers and providers in 10 urban, suburban, and rural California counties. Interview topics included: continuity of patient care, capacity to handle payer source transitions, and preparations for healthcare reform implementation. Study team members reviewed interview transcripts to produce emergent themes, develop a codebook, build inter-rater reliability, and conduct analyses.Respondents supported the goals of the ACA, but reported clinic and policy-level challenges to maintaining patient continuity of care during the payer source transitions. They also identified strategies for addressing these challenges. Areas of focus included: gaps in communication to reach patients and develop partnerships between providers and policymakers, perceived inadequacy in new provider networks for delivering quality HIV care, the potential for clinics to become financially insolvent due to lower reimbursement rates, and increased administrative burdens for clinic staff and patients.California's new healthcare initiatives represent ambitious attempts to expand and improve health coverage for low-income individuals. The state's challenges in maintaining quality care and treatment for people

  5. Consulta de enfermagem ao paciente com HIV: perspectivas e desafios sob a ótica de enfermeiros Consulta de enfermería al paciente con VIH: perspectivas y desafíos bajo la perspectiva de enfermeros Nursing consultation for patient with HIV: perspectives and challenges from nurses'view

    Directory of Open Access Journals (Sweden)

    Simara Moreira de Macêdo

    2013-04-01

    Full Text Available Busca-se analisar como a consulta de enfermagem é desenvolvida por enfermeiros que atuam em Serviço Ambulatorial Especializado em HIV/AIDS no município de Fortaleza-CE. Estudo exploratório e descritivo, com abordagem qualitativa, que utilizou a análise de conteúdo como técnica de análise dos dados. Para realização da consulta de enfermagem, a escuta foi relatada pelos enfermeiros como o principal mecanismo que possibilita a construção de relação de empatia e confiança com o paciente, possibilitando a manifestação de dúvidas, temores e anseios. Possibilita também a propagação de informações e orientações acerca da patologia, assim como a convocação do sujeito para uma participação ativa no processo de cuidado, buscando conscientizá-lo acerca da importância da adesão ao tratamento medicamentoso. A consulta de enfermagem configura-se como um momento educativo oportuno para a troca de saberes e estreitamento de laços.El estudio objetivó analizar como la consulta de enfermería es percibida por las enfermeras de un ambulatorio especializado en VIH / SIDA en Fortaleza-CE. Estudio exploratorio y descriptivo, con abordaje cualitativo, en que se utilizó el Análisis de Contenido como técnica para análisis de los datos. Para llevar a cabo la consulta de enfermería, la escucha fue reportada por los enfermeros como el principal mecanismo, por les permitir construir una relación de confianza y empatía con el paciente, permitiendo la expresión de dudas, miedos y ansiedades. Además, permite la difusión de informaciones y orientaciones sobre la patología, así como la convocatoria del sujeto a una participación activa en el proceso de atención, en la búsqueda por educarlo acerca de la importancia de la adherencia al tratamiento farmacológico. La consulta de enfermería es un momento educativo oportuno para el intercambio de conocimientos y vínculos.The study aims to examine how the nursing consultation is

  6. Providing ART to HIV Seropositive Persons who use Drugs: Progress in New York City, Prospects for “Ending the Epidemic”

    Science.gov (United States)

    Des Jarlais, Don C.; Arasteh, Kamyar; McKnight, Courtney; Feelemyer, Jonathan; Hagan, Holly; Cooper, Hannah L.F.; Campbell, Aimee N. C.; Tross, Susan; Perlman, David C.

    2015-01-01

    New York City has experienced the largest HIV epidemic among persons who use psychoactive drugs. We examined progress in placing HIV seropositive persons who inject drugs (PWID) and HIV seropositive non-injecting drug users (NIDU) onto antiretroviral treatment (ART) in New York City over the last 15 years. We recruited 3511 PWID and 3543 NIDU from persons voluntarily entering drug detoxification and methadone maintenance treatment programs in New York City from 2001 to 2014. HIV prevalence declined significantly among both PWID and NIDU. The percentage who reported receiving ART increased significantly, from approximately 50% (2001-2005) to approximately 75% (2012-2014). There were no racial/ethnic disparities in the percentages of HIV seropositive persons who were on ART. Continued improvement in ART uptake and TasP and maintenance of other prevention and care services should lead to an “End of the AIDS Epidemic” for persons who use heroin and cocaine in the New York City. PMID:25731661

  7. 团体咨询在缓解艾滋病科护士工作压力中的作用%Role of Group Counseling in Alleviating Job Pressure for HIV/AIDS Nurses

    Institute of Scientific and Technical Information of China (English)

    唐素荣; 石柳春; 梁桂月

    2013-01-01

    Objective To investigate the role of group counseling in alleviating the job pressure for HIV/ AIDS nurses. Methods Using convenience sampling, 2 AIDS nursing groups in the hospital were enrolled into the study and divided into control group with the routine nursing and intervention group with monthly group counseling for 1 year. The nurse stress scale and attitude survey scale of nurses' attitude towards AIDS patient were used to evaluate each group of nurses separately. Results Significant differences were detected on the scores of nursing pressure scale and attitude survey scale of nurses' attitude towards AIDS (except for fear of occupational exposure) in the intervention group before and after the intervention and between the intervention group and the control group after the intervention(P<0. 05 or P<0.01). Conclusion Application of group counseling technology in education activities can alleviate the job pressure on AIDS nurses and change nurse's attitudes towards AIDS patients, thereby improving the quality of care.%目的 探讨团体咨询在缓解艾滋病(acquired immune deficiency syndrome,AIDS)科护士工作压力中的作用.方法 方便性抽样选取广西壮族自治区龙潭医院AIDS科中的2个护理组,一组设为常规对照组,另一组设为干预组.干预组每月运用团体咨询技术开展1次AIDS教育活动,运行1年.分别于干预前后,采用护士压力源量表和护士对AIDS患者的态度调查简表对两组护士进行测评.结果 干预组护士干预前后以及干预后与对照组比较,护士压力评分及对AIDS患者的态度(除害怕职业暴露方面外)的差异均有统计学意义(P<0.05或P<0.01).结论 运用团体咨询技术开展教育活动,能减轻AIDS科护士的工作压力,改变其对AIDS患者的态度,从而提高护理质量.

  8. Therapeutic HIV Peptide Vaccine

    DEFF Research Database (Denmark)

    Fomsgaard, Anders

    2015-01-01

    Therapeutic vaccines aim to control chronic HIV infection and eliminate the need for lifelong antiretroviral therapy (ART). Therapeutic HIV vaccine is being pursued as part of a functional cure for HIV/AIDS. We have outlined a basic protocol for inducing new T cell immunity during chronic HIV-1...... infection directed to subdominant conserved HIV-1 epitopes restricted to frequent HLA supertypes. The rationale for selecting HIV peptides and adjuvants are provided. Peptide subunit vaccines are regarded as safe due to the simplicity, quality, purity, and low toxicity. The caveat is reduced immunogenicity...

  9. National Nursing Home Survey

    Science.gov (United States)

    The National Nursing Home Survey provides includes characteristics such as size of nursing home facilities, ownership, Medicare/Medicaid certification, occupancy rate, number of days of care provided, and expenses.

  10. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses quality...

  11. Nursing Home Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — This Nursing Home Quality Initiative (NHQI) website provides consumer and provider information regarding the quality of care in nursing homes. NHQI discusses...

  12. Assembling different antennas of the gp120 high mannose-type glycans on gold nanoparticles provides superior binding to the anti-HIV antibody 2G12 than the individual antennas.

    Science.gov (United States)

    Chiodo, Fabrizio; Enríquez-Navas, Pedro M; Angulo, Jesús; Marradi, Marco; Penadés, Soledad

    2015-03-20

    In order to re-build Man9GlcNAc2 clusters of the HIV gp120 glycoprotein, ∼2 nm gold glyconanoparticles (GNPs) were coated with the synthetic partial structures of Man9, the tetramannoside Manα1-2Manα1-2Manα1-3Manα1- and the pentamannoside Manα1-2Manα1-3[Manα1-2Manα1-6]Manα1-. Their interactions with the anti-HIV broadly neutralizing antibody 2G12 were studied by surface plasmon resonance (SPR)-based biosensors and saturation transfer difference (STD)-NMR spectroscopy. A synergistic effect of the tetra- and pentamannosides multimerized on a same GNP was observed. The assembly of these antennas of the gp120 high-mannose type glycan on GNPs provided superior binding to the anti-HIV antibody 2G12 with respect to GNPs carrying only the individual oligomannosides. The results presented in this work provide new molecular information on the interactions between clusters of oligomannosides and 2G12 that could help in the design of a carbohydrate-based vaccine against HIV.

  13. Clinical mentorship of nurse initiated antiretroviral therapy in Khayelitsha, South Africa: a quality of care assessment.

    Directory of Open Access Journals (Sweden)

    Ann Green

    Full Text Available INTRODUCTION: To combat the AIDS epidemic and increase HIV treatment access, the South African government implemented a nurse-based, doctor-supported model of care that decentralizes administration of antiretroviral treatment (ART for HIV positive patients through nurse initiated and managed ART. Médecins Sans Frontières (MSF implemented a mentorship programme to ensure successful task-shifting, subsequently assessing the quality of clinical care provided by nurses. METHODS: A before-after cross-sectional study was conducted on nurses completing the mentorship programme in Khayelitsha, South Africa, from February 2011-September 2012. Routine clinical data from 229 patient folders and 21 self-assessment questionnaires was collected to determine the number of patients initiated on ART by nurses; quality of ART management before-after mentorship; patient characteristics for doctor and nurse ART initiations; and nurse self-assessments after mentorship. RESULTS: Twenty one nurses were authorized by one nurse mentor with one part-time medical officer's support, resulting in nurses initiating 77% of ART eligible patients. Improvements in ART management were found for drawing required bloods (91% vs 99%, p = 0.03, assessing adherence (50% vs 78%, p<0.001 and WHO staging (63% vs 91%, p<0.001. Nurse ART initiation indicators were successfully completed at 95-100% for 11 of 16 indicators: clinical presentation; patient weight; baseline blood work (CD4, creatinine, haemoglobin; STI screening; WHO stage, correlating medical history; medications prescribed appropriately; ART start date; and documented return date. Doctors initiated more patients with TB/HIV co-infection and WHO Stage 3 and 4 disease than nurses. Nurse confidence improved for managing HIV-infected children and pregnant women, blood result interpretation and long-term side effects. CONCLUSIONS: Implementation of a clinical mentorship programme in Khayelitsha led to nurse initiation of a

  14. Treatment for HIV

    Science.gov (United States)

    ... Policies and Reports Provider Education Provider Education Home HIV Meds Updates Online Courses (CME) Case Studies Journal Articles Glossary Quick References Quick References Home Guidelines Integrated ...

  15. Drugs, Alcohol and HIV

    Science.gov (United States)

    ... Policies and Reports Provider Education Provider Education Home HIV Meds Updates Online Courses (CME) Case Studies Journal Articles Glossary Quick References Quick References Home Guidelines Integrated ...

  16. Mental Health and HIV

    Science.gov (United States)

    ... Policies and Reports Provider Education Provider Education Home HIV Meds Updates Online Courses (CME) Case Studies Journal Articles Glossary Quick References Quick References Home Guidelines Integrated ...

  17. 需要层次论在艾滋病病人家庭护理中的应用%Application of Maslows hierarchv need theory in home nursing care of people living with HIV/AIDS

    Institute of Scientific and Technical Information of China (English)

    颜余竹; 周颖清

    2011-01-01

    目的 探讨马斯洛需要层次论在艾滋病患者家庭护理中的应用.方法 按照马斯洛需要层次论,为艾滋病患者提供身心整体护理.结果 采用了“生理的需要、安全的需要、爱与归属的需要、自尊的需要及自我实现的需要”5个层次的护理措施,满足了患者的基本需要,提高了生活质量.结论 运用马斯洛需要层次论对艾滋病患者进行家庭护理,可以节约社会资源,减少社会开支,值得推广.%Objective To evaluate the application of Maslow's hierarchy need theory in the practice of home nursing care of people living with HIV/ AIDS(PLWHA). Methods According to Maslow's hierarchy need theory .holistic nursing care was given to PLWHA . Results Five levels of nursing care .namely psychological need, safety need,love need, self esteem need, and self value , were applied to meet the basic needs of patients and improve their quality of life. Conclusion The use of Maslow's hierarchy need theory in the practice of home nursing care of people living with HIV/AIDS, can save social resources and reduce social spending, and is worth promoting.

  18. Health-seeking behaviour of people living with HIV/AIDS and their satisfaction with health services provided at a tertiary care hospital, Karachi, Pakistan.

    Science.gov (United States)

    Bhutto, Abdul-Qadir; Nisar, Nighat

    2017-02-21

    Appropriate health-seeking behaviour is important as it allows prompt treatment for a condition and this can reduce complications and improve quality of life. This study aimed to assess the health-seeking behaviour and satisfaction with health care services of people living with HIV/AIDS attending the HIV/AIDS clinic of the Civil Hospital in Karachi. A total of 182 patients were interviewed using a pretested semi-structured questionnaire. Mean age of the participants was 32.31 (SD 7.91) years, 76.9% were male, 81.3% had no education and 75.8% were employed. Only 23.6% showed positive health-seeking behaviour and 57.7% were satisfied with the health care services. In logistic regression analysis, the cost of treatment per visit < US$ 5 and duration of HIV infection < 2 years were significantly associated with health-seeking behaviour. Efforts are needed to improve the health-seeking behaviour of people living with HIV/AIDS at the clinic and the health services offered.

  19. Do nursing homes for older people have the support they need to provide end-of-life care? A mixed methods enquiry in England

    Science.gov (United States)

    Seymour, Jane E; Kumar, Arun; Froggatt, Katherine

    2011-01-01

    Nursing homes are a common site of death, but older residents receive variable quality of end-of-life care. We used a mixed methods design to identify external influences on the quality of end-of-life care in nursing homes. Two qualitative case studies were conducted and a postal survey of 180 nursing homes surrounding the case study sites. In the case studies, qualitative interviews were held with seven members of nursing home staff and 10 external staff. Problems in accessing support for end-of-life care reported in the survey included variable support by general practitioners (GPs), reluctance among GPs to prescribe appropriate medication, lack of support from other agencies, lack of out of hours support, cost of syringe drivers and lack of access to training. Most care homes were implementing a care pathway. Those that were not rated their end-of-life care as in need of improvement or as average. The case studies suggest that critical factors in improving end-of-life care in nursing homes include developing clinical leadership, developing relationships with GPs, the support of ‘key’ external advocates and leverage of additional resources by adoption of care pathway tools. PMID:21282349

  20. Advanced care nurse practitioners can safely provide sole resident cover for level three patients: impact on outcomes, cost and work patterns in a cardiac surgery programme.

    Science.gov (United States)

    Skinner, Henry; Skoyles, Julian; Redfearn, Sue; Jutley, Raj; Mitchell, Ian; Richens, David

    2013-01-01

    There are significant pressures on resident medical rotas on intensive care. We have evaluated the safety and feasibility of nurse practitioners (NPs) delivering first-line care on an intensive care unit with all doctors becoming non-resident. Previously, resident doctors on a 1:8 full-shift rota supported by NPs delivered first-line care to patients after cardiac surgery. Subsequently, junior doctors changed to a 1:5 non-resident rota and NPs onto a 1:7 full-shift rota provided first-line care. A single centre before-and-after service evaluation on cardiac intensive care. mortality rates, surgical trainee attendance in theatre and cost before and after the change. After-hour calls by NPs to doctors and subsequent actions were also audited after the change. The overall mortality rates in the 12 months before the change were 2.8 and 2.2% in the 12 months after (P = 0.43). The median [range] logistic EuroSCORE was 5.3 [0.9-84] before and 5.0 [0.9-85] after the change (P = 0.16). After accounting for the risk profile, the odds ratio for death after the change relative to before was 0.83, 95% confidence interval 0.41-1.69. Before the change, a surgical trainee attended theatre 467 of 702 (68%) cases. This increased to 539 of 677 (80%) cases after the change (P cardiac intensive care. Training opportunities for junior surgeons increased and costs were reduced.

  1. Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic

    Directory of Open Access Journals (Sweden)

    Vance D

    2011-05-01

    Full Text Available David E Vance1, Mark Brennan2, Comfort Enah1, Glenda L Smith1, Jaspreet Kaur31School of Nursing, University of Alabama at Birmingham (UAB, Birmingham, AL, USA; 2New York University College of Nursing, AIDS Community Research Initiative of America, New York, NY, USA; 3Department of Psychology and Edward R. Roybal Center for Translational Research in Aging and Mobility, University of Alabama at Birmingham (UAB, Birmingham, AL, USAAbstract: By 2015, approximately half of adults with HIV in the United States will be 50 and older. The demographic changes in this population due to successful treatment represent a unique challenge, not only in assisting these individuals to cope with their illness, but also in helping them to age successfully with this disease. Religious involvement and spirituality have been observed to promote successful aging in the general population and help those with HIV cope with their disease, yet little is known about how these resources may affect aging with HIV. Also, inherent barriers such as HIV stigma and ageism may prevent people from benefitting from religious and spiritual sources of solace as they age with HIV. In this paper, we present a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided.Keywords: HIV, aging, spirituality, religion, stigma, coping, successful aging

  2. The costs of providing antiretroviral therapy services to HIV-infected individuals presenting with advanced HIV disease at public health centres in Dar es Salaam, Tanzania: Findings from a randomised trial evaluating different health care strategies

    Science.gov (United States)

    Kimaro, Godfather Dickson; Mfinanga, Sayoki; Simms, Victoria; Kivuyo, Sokoine; Bottomley, Christian; Hawkins, Neil; Harrison, Thomas S.; Jaffar, Shabbar; Guinness, Lorna

    2017-01-01

    Background Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on health service resources used by patients and their associated costs within antiretroviral (ART) programmes in Africa. Material and methods The study was nested within a large trial, which evaluated screening for cryptococcal meningitis and tuberculosis and a short initial period of home-based adherence support for patients initiating ART with advanced HIV disease in Tanzania and Zambia. The economic evaluation was done in Tanzania alone. We estimated costs of providing routine ART services from the health service provider's perspective using a micro-costing approach. Incremental costs for the different novel components of service delivery were also estimated. All costs were converted into US dollars (US$) and based on 2012 prices. Results Of 870 individuals enrolled in Tanzania, 434 were enrolled in the intervention arm and 436 in the standard care/control arm. Overall, the median (IQR) age and CD4 cell count at enrolment were 38 [31, 44] years and 52 [20, 89] cells/mm3, respectively. The mean per patient costs over the first three months and over a one year period of follow up following ART initiation in the standard care arm were US$ 107 (95%CI 101–112) and US$ 265 (95%CI 254–275) respectively. ART drugs, clinic visits and hospital admission constituted 50%, 19%, and 19% of the total cost per patient year, while diagnostic tests and non-ART drugs (co-trimoxazole) accounted for 10% and 2% of total per patient year costs. The incremental costs of the intervention to the health service over the first three months was US$ 59 (p<0.001; 95%CI 52–67) and over a one year period was US$ 67(p<0.001; 95%CI 50–83). This is equivalent to an increase of 55% (95%CI 51%–59%) in the mean cost of care over the first three months, and 25% (95%CI 20%–30%) increase over one year of follow up. PMID:28234969

  3. Nursing Professionalism, Self-Efficacy and Nurse Parent Partnership in Pediatric Nurses

    National Research Council Canada - National Science Library

    Cho, Eun-Ju; Bang, Kyung-Sook

    2013-01-01

    To provide basic data to improve the practice environment of pediatric nurses by identifying their recognition of nursing professionalism and self-efficacy, and to examine the pediatric nurse parent partnership...

  4. Nursing: Registered Nurses

    Science.gov (United States)

    ... a diploma from an approved nursing program. Registered nurses also must be licensed. Education In all nursing education programs, students take courses in anatomy, physiology, microbiology, chemistry, nutrition, psychology, and other social and ...

  5. Managing occupational HIV exposures: a Canadian study.

    Science.gov (United States)

    Reutter, L I; Northcott, H C

    1995-10-01

    The findings reported in this paper are part of a larger study that explored how nurses cope with the risk of acquiring HIV infection while caring for persons with AIDS (PWAs). The data were collected through in-depth interviews with 13 nurses who cared for PWAs in a large Western Canadian hospital. Seven of these nurses perceived that they had been exposed to HIV-infected blood or body fluids. This paper describes how these seven nurses coped with actual exposures to HIV-infected blood or body fluids. Data were analyzed using the methodology of grounded theory. Nurses' coping efforts after exposure were grouped into four categories: minimizing the effect of exposures, reducing a sense of vulnerability, selective disclosure to others, and assigning meaning. Nurses minimized the physical effects of exposure through measures such as 'bleeding' the needlestick injury and immersing the affected area in bleach solution. Nurses reduced their sense of vulnerability by assessing the possibility of harm, avoiding situations that aroused fear, and confronting the decision for HIV testing. Nurses limited their disclosures to co-workers to avoid rejection and to preserve professional self-esteem. Disclousre to significant others was influenced primarily by the support nurses perceived they would receive. Finally, nurses attempted to assign meaning to the exposure by determining why the event occurred and by evaluating the implications it has had on their lives. The article concludes with implications for nursing practice.

  6. Naturalistic nursing.

    Science.gov (United States)

    Hussey, Trevor

    2011-01-01

    Where nurse education aims to provide an overarching intellectual framework, this paper argues that it should be the framework of naturalism. After an exposition of the chief features of naturalism and its relationship to science and morality, the paper describes naturalistic nursing, contrasting it with some other perspectives. There follows a defence of naturalism and naturalistic nursing against several objections, including those concerning spirituality, religion, meaning, morality, and alternative sources of knowledge. The paper ends with some of the advantages of the naturalistic approach.

  7. Examining the content of weight, nutrition and physical activity advices provided by Dutch practice nurses in primary care: analysis of videotaped consultations

    NARCIS (Netherlands)

    Dillen, S.M. van; Noordman, J.; Dulmen, S. van; Hiddink, G.J.

    2014-01-01

    BACKGROUND/OBJECTIVE: To examine the content of Dutch practice nurses' (PNs') advices about weight, nutrition and physical activity to overweight and obese patients. SUBJECTS/METHODS: A 100 videotaped real-life PN consultations (The Netherlands, 2010/2011) with overweight or obese patients were

  8. CCR5 Disruption in Induced Pluripotent Stem Cells Using CRISPR/Cas9 Provides Selective Resistance of Immune Cells to CCR5-tropic HIV-1 Virus.

    Science.gov (United States)

    Kang, HyunJun; Minder, Petra; Park, Mi Ae; Mesquitta, Walatta-Tseyon; Torbett, Bruce E; Slukvin, Igor I

    2015-12-15

    The chemokine (C-C motif) receptor 5 (CCR5) serves as an HIV-1 co-receptor and is essential for cell infection with CCR5-tropic viruses. Loss of functional receptor protects against HIV infection. Here, we report the successful targeting of CCR5 in GFP-marked human induced pluripotent stem cells (iPSCs) using CRISPR/Cas9 with single and dual guide RNAs (gRNAs). Following CRISPER/Cas9-mediated gene editing using a single gRNA, 12.5% of cell colonies demonstrated CCR5 editing, of which 22.2% showed biallelic editing as determined by a Surveyor nuclease assay and direct sequencing. The use of dual gRNAs significantly increased the efficacy of CCR5 editing to 27% with a biallelic gene alteration frequency of 41%. To ensure the homogeneity of gene editing within cells, we used single cell sorting to establish clonal iPSC lines. Single cell-derived iPSC lines with homozygous CCR5 mutations displayed the typical characteristics of pluripotent stem cells and differentiated efficiently into hematopoietic cells, including macrophages. Although macrophages from both wild-type and CCR5-edited iPSCs supported CXCR4-tropic virus replication, macrophages from CCR5-edited iPSCs were uniquely resistant to CCR5-tropic virus challenge. This study demonstrates the feasibility of applying iPSC technology for the study of the role of CCR5 in HIV infection in vitro, and generation of HIV-resistant cells for potential therapeutic applications.

  9. HIV Transmission

    Science.gov (United States)

    ... Abroad Treatment Basic Statistics Get Tested Find an HIV testing site near you. Enter ZIP code or city Follow HIV/AIDS CDC HIV CDC HIV/AIDS See RSS | ... on HIV Syndicated Content Website Feedback HIV/AIDS HIV Transmission Language: English (US) Español (Spanish) Recommend ...

  10. Prevention-of-Mother-To-Child-Transmission of HIV Services in Sub-Saharan Africa: A Qualitative Analysis of Healthcare Providers and Clients Challenges in Ghana

    Directory of Open Access Journals (Sweden)

    Amos Kankponang Laar, PhD

    2014-09-01

    Full Text Available Background: Developed by the World Health Organization (WHO and partners, the correct adaptation and implementation of the global guidelines on prevention of mother-to-child transmission (PMTCT of HIV is critical. This study explored the challenges that health workers face implementing WHO’s PMTCT guidelines, and the experiences of HIV-positive clients receiving these services. Methods: We interacted with 14 health professionals, and 16 PMTCT clients through in-depth interviews. Four of seven PMTCT sites within the Accra Metropolis were purposively included. Interviews were tape-recorded, transcribed, analyzed, and then sorted into themes. Results: Health workers had challenges translating PMTCT guidelines into useful messages for their clients. Their counselling was often prescriptive. Counselors identified inadequate in-service training as a key reason for their outdated and inconsistent messages. HIV-positive clients exhibited general knowledge about the importance of doing exclusive breast-feeding for the first six months of life. Clients had confidence in antiretroviral for PMTCT. However, deeply rooted socio-cultural practices and the attitudes of counselors remain challenges to clients. Conclusions and Global Health Implications: Counselors require refresher training which addresses, among other things, long-held socio-cultural practices. Publicizing these challenges will prod policy makers and program implementers to develop strategies that address the challenges both locally and globally.

  11. Assistência de enfermagem a um paciente infartado portador de HIV, baseada na teoria do autocuidado: estudo de caso La asistencia de enfermería a un paciente infartado portador de vih, basado en la teoría del autocuidado: estudio de caso The nursing assistance to patient myocardio infarction with hiv, based on the theory of to be careful: case study

    Directory of Open Access Journals (Sweden)

    Gabriela Silvestre de Lima

    2007-12-01

    the treatment of the patients with HIV is the possible increase of the cardiovascular risk in patients using inhibiting of proteasis. METHODS: Being thus, we objectify to apply the Systematization of the Assistance of Nursing (SAN to a carrying of HIV and glutted patient. School is about a study of case carried through in a hospital located in the region metropolitan of São Paulo, in November of 2003, using the SAE and considering of diagnostics of nursing on the basis of taxonomy NANDA II(1 as well as the related interventions of nursing. RESULTS: The main identified disgnostic of nursing had been: Risk for inefficacious control of the therapeutical regimen, anxiety, perfusion to tissular cardiac modified, physical mobility harmed, modified protection, risk for infection, among others. CONCLUSION: The study it showed the importance of the SAE and the decision of the patient in engaging itself in the careful one in order to provide an improvement in the standard of reply of the sick person to the illness.

  12. Adaptation and validation of the Evidence-Based Practice Belief and Implementation scales for French-speaking Swiss nurses and allied healthcare providers.

    Science.gov (United States)

    Verloo, Henk; Desmedt, Mario; Morin, Diane

    2017-09-01

    To evaluate two psychometric properties of the French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales, namely their internal consistency and construct validity. The Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales developed by Melnyk et al. are recognised as valid, reliable instruments in English. However, no psychometric validation for their French versions existed. Secondary analysis of a cross sectional survey. Source data came from a cross-sectional descriptive study sample of 382 nurses and other allied healthcare providers. Cronbach's alpha was used to evaluate internal consistency, and principal axis factor analysis and varimax rotation were computed to determine construct validity. The French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales showed excellent reliability, with Cronbach's alphas close to the scores established by Melnyk et al.'s original versions. Principal axis factor analysis showed medium-to-high factor loading scores without obtaining collinearity. Principal axis factor analysis with varimax rotation of the 16-item Evidence-Based Practice Beliefs scale resulted in a four-factor loading structure. Principal axis factor analysis with varimax rotation of the 17-item Evidence-Based Practice Implementation scale revealed a two-factor loading structure. Further research should attempt to understand why the French Evidence-Based Practice Implementation scale showed a two-factor loading structure but Melnyk et al.'s original has only one. The French versions of the Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales can both be considered valid and reliable instruments for measuring Evidence-Based Practice beliefs and implementation. The results suggest that the French Evidence-Based Practice Beliefs and Evidence-Based Practice Implementation scales are valid and reliable and can therefore be used to

  13. Benefits of task-shifting HIV care to nurses in terms of health-related quality of life in patients initiating antiretroviral therapy in rural district hospitals in Cameroon [Stratall Agence Nationale de Recherche sur le SIDA (ANRS) 12110/Ensemble pour une Solidarité Thérapeutique Hospitalière en Réseau (ESTHER) substudy].

    Science.gov (United States)

    Suzan-Monti, M; Blanche, J; Boyer, S; Kouanfack, C; Delaporte, E; Bonono, R-C; Carrieri, P M; Protopopescu, C; Laurent, C; Spire, B

    2015-05-01

    The World Health Organization (WHO) recommends task-shifting HIV care to nurses in low-resource settings with limited numbers of physicians. However, the effect of such task-shifting on the health-related quality of life (HRQL) of people living with HIV (PLHIV) has seldom been evaluated. We aimed to investigate the effect of task-shifting HIV care to nurses on HRQL outcomes in PLHIV initiating antiretroviral therapy (ART) in rural district hospitals in Cameroon. Outcomes in PLHIV were longitudinally collected in the 2006-2010 Stratall trial. PLHIV were followed up for 24 months by nurses and/or physicians. Six HRQL dimensions were assessed during face-to-face interviews using the WHO Quality of Life (WHOQOL)-HIV BREF scale: physical health; psychological health; independence level; social relationships; environment; and spirituality/religion/personal beliefs. The degree of task-shifting was estimated using a consultant ratio (i.e. the ratio of nurse-led to physician-led visits). The effect of task-shifting and other potential correlates on HRQL dimensions was explored using a Heckman two-stage approach based on linear mixed models to adjust for the potential bias caused by missing data in the outcomes. Of 1424 visits in 440 PLHIV (70.5% female; median age 36 years; median CD4 count 188 cells/μL at enrolment), 423 (29.7%) were task-shifted to nurses. After multiple adjustment, task-shifting was associated with higher HRQL level for four dimensions: physical health [coefficient 0.7; 95% confidence interval (CI) 0.1-1.2; P = 0.01], psychological health (coefficient 0.5; 95% CI 0.0-1.0; P = 0.05), independence level (coefficient 0.6; 95% CI 0.1-1.1; P = 0.01) and environment (coefficient 0.6; 95% CI 0.1-1.0; P = 0.02). Task-shifting HIV care to nurses benefits the HRQL of PLHIV. Together with the previously demonstrated comparable clinical effectiveness of physician-based and nurse-based models of HIV care, our results support the WHO recommendation

  14. Results of provider-initiated HIV testing and counselling in health facility in Nanshan District of Shenzhen%深圳市医务人员艾滋病检测咨询效果分析

    Institute of Scientific and Technical Information of China (English)

    罗珍胄; 李岚; 李真; 袁军; 杨祖庆; 周国茂; 田丽闪

    2012-01-01

    Objective To evaluate the results of provider-initiated HIV testing and counselling (PITC) by medical workers in Nanshan District of Shenzhen. Methods Based on the technical guideline of provider-initiated HIV testing and counselling (PITC), health providers offered PITC services to all patients. The information of counselling and testing obtained from the clinics were statistically analyzed and evaluated. Results A total of 74 076 (11.2%)patients were provided with PITC services,and 47.0% (34784/74076)of them accepted HIV testing,the HIV testing rate was 5.2%. Of those tested, 11 were identified as HIV positives, with a positive rate of 0.32‰. Compared with the baseline, the rate of patients offered information about HIV testing and HIV testing rate were significantly higher (P<0.05). And they were significant different within the different types of health facility and the different types of clinical departments (P<0.001), Conclusion The provider-initiated HIV testing and counselling carried out in Nanshan District is,to a certain extent, fruitful and the practice be further promoted in sexual outpatient departments.%目的 对医疗机构医务人员主动提供艾滋病检测咨询(PITC)项目工作情况进行评价,以期为PITC服务的广范推广提供依据.方法 按照PITC工作指南,在项目科室对就诊者主动提供艾滋病检测和咨询(PITC)服务,并对咨询和检测相关数据进行统计分析和评价.结果 共对74 076名就诊者提供了艾滋病检测和咨询(PITC)服务,提供信息率为112%,其中47.0%(34 784/74 076)就诊者接受了HIV检测,HIV检测率为5.2%,检出阳性者11例,阳性率检出率为0.32%;与基线相比较,提供HIV检测信息率、HIV检测率均显著提高(x2=1456.96,P<0.001;x2=6.33,P<0.05).不同类型医疗机构之间以及不同科室之间医务人员主动提供HIV检测信息率、HIV检测率的差异具有统计学意义(x2=316124,P<0.001; x2=1809.46,P<0.001).结论 PITC

  15. Modernization of Nursing Education and Nurse' It Competence

    OpenAIRE

    Šakalytė, Danguolė

    2015-01-01

    The use of technology in nursing is not new; in fact, nurses have become proficient in utilizing and adapting complex technology into caring nursing practice. Since nurses are the largest group of health care providers, discipline-specific competencies in the use of ICT and other technologies are imperative. This realization has catalyzed the steady development of nursing informatics. Nursing schools demonstrate use of recognized approaches to teaching and learning in their programs, includin...

  16. Nurse task shifting for antiretroviral treatment services in Namibia: implementation research to move evidence into action.

    Directory of Open Access Journals (Sweden)

    Gabrielle O'Malley

    Full Text Available BACKGROUND: Evidence from several sub-Saharan countries support nurse-initiated antiretroviral treatment as a feasible alternative to doctor-led models characteristic of early responses to the HIV epidemic. However, service delivery models shown to be effective in one country may not be readily adopted in another. This study used an implementation research approach to assist policy makers and other stakeholders to assess the acceptability and feasibility of task shifting in the Namibian context. METHODS: The Namibian Ministry of Health and Social Services implemented a Task Shifting Demonstration Project (TSDP at 9 sites at different levels of the health system. Six months after implementation, a mixed methods evaluation was conducted. Seventy semi-structured interviews were conducted with patients, managers, doctors and nurses directly involved with the TSDP. Physician-evaluators observed and compared health service provision between doctors and nurses for 40 patients (80 observations, documenting performance in agreement with the national guidelines on 13 clinical care indicators. RESULTS: Doctors, nurses, and patients interviewed believed task shifting would improve access to and quality of HIV services. Doctors and nurses both reported an increase in nurses' skills as a result of the project. Observation data showed doctors and nurses were in considerable agreement (>80% with each other on all dimensions of HIV care and ≥90% on eight dimensions. To ensure success of national scale-up of the task shifting model, challenges involving infrastructure, on-going mentoring, and nursing scope of practice should be anticipated and addressed. CONCLUSION: In combination with findings from other studies in the region, data from the TSDP provided critical and timely information to the Namibian Ministry of Health and Social Services, thus helping to move evidence into action. Small-scale implementation research projects enable stakeholders to learn by

  17. HIV Vaccination, is Breakthrough Underway?

    Science.gov (United States)

    Lu, Da-Yong; Wu, Hong-Ying; Lu, Ting-Ren; Xu, Bin; Ding, Jian

    2016-01-01

    After long defeats-almost no marked breakthrough in HIV vaccination campaign has been observed during the past two decades, and we still have not lost our faiths for the development of highly effective and low risk HIV vaccines. Many effective vaccines have been discovered and will certainly enter into the markets within the next 5 to 10 years. In order to promote HIV vaccine developments and clinical HIV therapeutic improvements, this perspective addresses the good and bad sides of currently available HIV vaccines, discusses many subjects of medical significance and finally provides up-to-date information in the field of HIV studies, in particular regarding vaccine developments and HIV pathogenesis.

  18. Conhecimento em HIV/AIDS de 1998 a 2005: estudos publicados em períodicos de Enfermagem Conocimiento en HIV/SIDA de 1998 a 2005: estudios publicados en Periódicos de Enfermería Knowledge in HIV/AIDS from 1998 to 2005: studies published in Nursing Periodicals

    Directory of Open Access Journals (Sweden)

    Maria Alix Leite Araújo

    2006-04-01

    Full Text Available A pesquisa em enfermagem contribui para o fortalecimento da profissão e para a elaboração de um corpo de conhecimentos especializados, específicos e atualizados, buscando torná-la de relevância social. Deve ser analisada visando refletir sobre o conhecimento de maneira a torná-lo mais adequado. Teve-se por objetivo analisar pesquisas publicadas em seis periódicos de enfermagem Qualis internacional no período de 1998 a 2005. Foram encontrados 40 estudos, realizados predominantemente na Região Sudeste, derivados de teses e dissertações e de autoria de docentes. A temática privilegiada foi a vivência e convivência dos portadores de HIV/AIDS. Conclui-se pela necessidade de expansão da abrangência das pesquisas, buscando atender as exigências da área.La investigación en enfermería contribuye para el fortalecimiento de la profesión y para la elaboración de un cuerpo de conocimientos especializados, específicos y actualizados, buscando tornala de importancia social. Debe ser analizada con vistas a reflexionar el conocimiento para tornarlo más adecuado. Se tuvo por objetivo analisar investigaciones publicadas en seis periódicos de enfermería internacional, en el período de 1998 a 2005. Fueron encontrados 40 estudios, realizados predominantemente en la región sureste, derivados de tesis y disertaciones de autoría de docentes. La temática privilegiada fué experiencia y convivencia de los portadores de VIH/SIDA. Se concluye por la necesidad de expansión de la abrangencia de las investigaciones, buscanco atender a los requisitos del área.The research in nursing contributes for the profession strengthening and for the elaboration of specialized, specific and updated knowledge body, turning it to social relevance. It must be analyzed to ponder about knowledge in a way to make it more suitable. The goal was to analyze researches published in six nursing periodicals - Qualis International - from 1998 to 2005. 40 studies were

  19. Good nurse, bad nurse....

    Science.gov (United States)

    Alavi, C; Cattoni, J

    1995-02-01

    The construction of the nursing subject is discussed. The paper takes a historical perspective, arguing that the range of speaking positions available to the nurse is limited by gender, class and education. It evaluates the position of nursing in the university, showing how this also has propensity to limit the development of the nursing profession.

  20. Phylogenetic analysis provides evidence of interactions between Italian heterosexual and South American homosexual males as the main source of national HIV-1 subtype C epidemics.

    Science.gov (United States)

    Lai, Alessia; Bozzi, Giorgio; Franzetti, Marco; Binda, Francesca; Simonetti, Francesco R; Micheli, Valeria; Meraviglia, Paola; Corsi, Paola; Bagnarelli, Patrizia; De Luca, Andrea; Ciccozzi, Massimo; Zehender, Gianguglielmo; Zazzi, Maurizio; Balotta, Claudia

    2014-05-01

    The HIV-1 clade C is prevalent worldwide and spread from Africa to South East Asia and South America early in the course of the epidemic. As a consequence of migration waves about 13% of the Italian HIV-1 epidemic is sustained by this clade. Two hundred fifty-four C pol sequences from the Italian ARCA database collected during 1997-2011 were analyzed. Epidemiological networks and geographical fluxes were identified through phylogeny using Bayesian approaches. Patients' country of origin was Italy, Africa, South America, and South East Asia for 44.9%, 23.6%, 4.7%, and 1.6%, respectively. Heterosexuals and men having sex with men accounted for 83.2% and 16.8%, respectively. Modality of infection was distributed differently: heterosexuals were largely prevalent among Italians (84.1%) and Africans (95.3%), while men having sex with men predominated among South Americans (66.7%). Eight significant clusters encompassing 111 patients (43.7%) were identified. Comparison between clustering and non-clustering patients indicated significant differences in country of origin, modality of infection and gender. Men having sex with men were associated to a higher probability to be included in networks (70% for men having sex with men vs. 30.3% for heterosexuals). Phylogeography highlighted two significant groups. One contained Indian strains and the second encompassed South Americans and almost all Italian strains. Phylogeography indicated that the spread of C subtype among Italians is related to South American variant. Although Italian patients mainly reported themselves as heterosexuals, homo-bisexual contacts were likely their source of infection. Phylogenetic monitoring is warranted to guide public health interventions aimed at controlling HIV infection.

  1. Estratégias de implementação do processo de enfermagem para uma pessoa infectada pelo HIV Estrategias de implementación del proceso de enfermería para una persona infectada por el HIV Implementations strategies of nursing processes for an HIV-positive client

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    Cristina Arreguy Sena

    2001-01-01

    Full Text Available Buscando valorizar a utilização de estratégias como os métodos de ensino e de aprendizagem, a técnica de relaxamento e o "coping é relatado um estudo de caso de uma pessoa infectada pelo HIV e portadora da Síndrome da Imunodeficiência Adquirida (AIDS que se encontra hospitalizada. Adotou-se, como referencial teórico, o modelo conceptual de Dorothéia Orem (OREM, 1985, a proposta de Risner para a condução do raciocínio diagnóstico e a Uniformização do Diagnóstico de Enfermagem proposta pela NANDA (NANDA, 1996. Dos diagnósticos identificados foram selecionados três para exemplificar as fases de planejamento, implementação e avaliação do processo.Buscando valorizar la utilización de estrategias como los métodos de enseñanza y aprendizaje, la técnica de relajación y el "coping", es relatado un estudio de caso de una persona infectada por el HIV y portadora del Síndrome de Inmunodeficiencia Adquirida (SIDA que se encuentra hospitalizada. Se adoptó como referencial teórico el Modelo Conceptual de Dorothea Orem (OREM, 1985, la propuesta de Risner para la conducción del raciocinio diagnostico y la uniformidad en el Diagnostico de Enfermería propuesta por la NANDA (NANDA, 1996. De los diagnósticos identificados fueron seleccionados tres para ejemplificar las fases de planeación, implementación y evaluación del proceso.Aiming at valuing the use of strategies such as teaching and learning methods, the relaxation technique and coping are described in a case study concerning a hospitalized HIV-positive person presenting the Acquired Immuno-Defficiency Syndrome (AIDS. The Conceptual Model proposed by Dorothéia Orem (OREM, 1985, Risner's proposal for the conduction of diagnostic thinking and the Nursing Diagnostic Unifying System proposed by NANDA (NANDA, 1996 were use as theoretical framework. Among the identified diagnoses, three were selected in order to exemplify the planning, implementation and process evaluation

  2. Perspectives on nursing knowledge.

    Science.gov (United States)

    Takahashi, T

    1992-01-01

    On May 19, 1991, in Tokyo, Japan, four nurse theorists participated in a panel discussion at Discovery International, Inc.'s Biennial Nurse Theorist Conference. The participants were Imogene M. King, Hildegard E. Peplau, Rosemarie Rizzo Parse, and Martha E. Rogers. The goal of the conference was to present the latest views on nursing knowledge of these nurse leaders. The panel discussion provided the nurse theorists with an opportunity to engage in dialogue regarding issues of concern to the audience. The panel moderator was Hiroko Minami of St. Luke's College of Nursing in Tokyo.

  3. Challenges in Providing Treatment and Care for Viral Hepatitis among Individuals Co-Infected with HIV in Resource-Limited Settings

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    Wirach Maek-a-Nantawat

    2012-01-01

    Full Text Available Hepatitis B and C infections are prevalent among HIV-infected individuals with different epidemiologic profiles, modes of transmission, natural histories, and treatments. Southeast Asian countries are classified as “highly prevalent zones,” with a rate of hepatitis B and C coinfection in people living with HIV/AIDS of approximately 3.2–11%. Majority of hepatitis B coinfection is of genotype C. Most of the patients infected with hepatitis C in Thailand have genotype 3 which is significantly related to intravenous drug use whereas, in Vietnam, it is genotype 6. The options for antiretroviral drugs are limited and rely on global funds and research facilities. Only HBV treatment is available for free through the national health scheme. Screening tests for HBV and HCV prior to commencing antiretroviral treatment are low. Insufficient concern on hepatitis-virus-related liver malignancy and long-term hepatic morbidities is noted. Cost-effective HCV treatment can be incorporated into the national health program for those who need it by utilizing data obtained from clinical research studies. For example, patients infected with HCV genotype 2/3 with a certain IL-28B polymorphism can be treated with a shorter course of interferon and ribavirin which can also help reduce costs.

  4. Health Services Use and HIV Prevalence Among Migrant and National Female Sex Workers in Portugal: Are We Providing the Services Needed?

    Science.gov (United States)

    Dias, Sónia; Gama, Ana; Pingarilho, Marta; Simões, Daniel; Mendão, Luís

    2017-08-01

    This cross-sectional bio-behavioral survey conducted with 853 female sex workers (FSW) aimed to examine differences in use of HIV health services, testing and prevalence among migrant and national FSW. A quarter of undocumented FSW had never used National Health Service (NHS) and 15 % never tested for HIV, significantly more than nationals (p VIH, test y prevalencia entre TS migrantes y nacionales. Un cuarto de las TS indocumentadas nunca utilizaron el Servicio Nacional de Salud (SNS) y el 15 % nunca fueron testadas respecto al VIH, porcentajes significativamente superiores a las observadas para las nacionales (p VIH fue auto reportada por 11.9 % de las nacionales, 1.8 % de las migrantes documentadas y 0.8 % de las indocumentadas (p VIH fue reactivo para un 13.6 % de las indocumentadas, 8.0 % de las nacionales y 2.3 % de las documentadas. Una proporción mayor de migrantes desconocía su serostatus positivo en comparación con las nacionales. El test del VIH fue menos frecuente entre las indocumentadas, quien nunca utilizó el SNS y quien no sabía dónde recurrir si sospechaba estar infectada por el VIH. Promover un diagnóstico precoz en conexión con los cuidados en TS migrantes debe ser respaldado mientras se desarrollan servicios de salud mejor adaptados a sus necesidades.

  5. The effect of engaging unpaid informal providers on case detection and treatment initiation rates for TB and HIV in rural Malawi (Triage Plus): A cluster randomised health system intervention trial.

    Science.gov (United States)

    Bello, George; Faragher, Brian; Sanudi, Lifah; Namakhoma, Ireen; Banda, Hastings; Malmborg, Rasmus; Thomson, Rachael; Squire, S Bertel

    2017-01-01

    The poor face barriers in accessing services for tuberculosis (TB) and Human Immuno-deficiency Virus (HIV) disease. A cluster randomised trial was conducted to investigate the effectiveness of engaging unpaid informal providers (IPs) to promote access in a rural district. The intervention consisted of training unpaid IPs in TB and HIV disease recognition, sputum specimen collection, appropriate referrals, and raising community awareness. In total, six clusters were defined in the study areas. Through a pair-matched cluster randomization process, three clusters (average cluster population = 200,714) were allocated to receive the intervention in the Early arm. Eleven months later the intervention was rolled out to the remaining three clusters (average cluster population = 209,564)-the Delayed arm. Treatment initiation rates for TB and Anti-Retroviral Therapy (ART) were the primary outcome measures. Secondary outcome measures included testing rates for TB and HIV. We report the results of the comparisons between the Early and Delayed arms over the 23 month trial period. Data were obtained from patient registers. Poisson regression models with robust standard errors were used to express the effectiveness of the intervention as incidence rate ratios (IRR). The Early and Delayed clusters were well matched in terms of baseline monthly mean counts and incidence rate ratios for TB and ART treatment initiation. However there were fewer testing and treatment initiation facilities in the Early clusters (TB treatment n = 2, TB testing n = 7, ART initiation n = 3, HIV testing n = 20) than in the Delayed clusters (TB treatment n = 4, TB testing n = 9, ART initiation n = 6, HIV testing n = 18). Overall there were more HIV testing and treatment centres than TB testing and treatment centres. The IRR was 1.18 (95% CI: 0.903-1.533; p = 0.112) for TB treatment initiation and 1.347 (CI:1.00-1.694; p = 0.049) for ART initiation in the first 12 months and the IRR were 0.552 (95% CI:0

  6. Strategies to improve HIV treatment adherence in developed countries: clinical management at the individual level

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    Enriquez M

    2011-05-01

    Full Text Available Maithe Enriquez¹, David S McKinsey²¹School of Nursing, University of Missouri-Kansas City and Division of Infectious Diseases, Truman Medical Center Hospital Hill, ²School of Medicine, Division of Infectious Diseases, University of Kansas and Division of Infectious Diseases, Research Medical Center, Kansas City, MO, USAAbstract: Remarkable advances in the treatment of human immunodeficiency virus (HIV disease have been blunted by widespread suboptimal adherence (ie, nonadherence, which has emerged as a major barrier to achieving the primary goal of antiretroviral (ARV therapy: suppression of HIV viral load. Nonsuppressed HIV viral load is associated with drug resistance, increased morbidity and mortality, and a higher risk of person-to-person HIV transmission. For HIV-infected individuals who are failing HIV treatment due to nonadherence, becoming adherent is a life-saving behavior change. However, overcoming nonadherence is one of the most daunting challenges in the successful management of HIV disease. The purpose of this paper is to provide clinicians with a better understanding of nonadherence to ARV treatment and to review the various factors that have been associated with either adherence or nonadherence. Strategies are presented that may help the nonadherent individual become ready to take HIV medications as prescribed.Keywords: noncompliance, treatment failure, AIDS

  7. Stigma towards People Living on HIV/AIDS and Associated Factors among Nurses’ Working in Amhara Region Referral Hospitals, Northwest Ethiopia: A Cross-Sectional Study

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    Mohammed Hassen Salih

    2017-01-01

    Full Text Available Introduction. HIV/AIDS-related stigma occurs in the world towards people living with HIV/AIDS in a different form. Stigma among nurses in health care setting is one of the main challenges towards the prevention and management of HIV/AIDS in developing countries. It is one of the main reasons keeping patients from seeking health care service. Therefore assessing the magnitude of stigma and associated factors towards people living on HIV/AIDS among nurses is of paramount importance for the quality of nursing care as well as service utilization. Methods. An institutional based cross-sectional study was conducted in March 2013. Pretested and structured questionnaire via self-administration was used in the tool of HIV/AIDS Stigma Instrument-Nurse (HASI-N. Data were entered using EPI info version 3.5.3 and transferred to SPSS version 20 for further analysis. Descriptive statistics were conducted to summarize the sample characteristics. A backward stepwise logistic regression model was fitted and adjusted odds ratio with 95% confidence interval was calculated to identify associated factors. Results. A total of 386 nurses participated yielding a response rate of 97.2%. Nearly two-thirds (64.5% of them have shown stigma towards people living with HIV/AIDS in the health institution. Qualification level of diploma or certificate, lack of training, experiences of <06 years, low HIV patient caseload seen in the last six months, and the absence of guidelines/protocols about HIV/AIDS in their health institution were associated factors for stigma. Conclusions. The findings of this research showed high magnitude of stigma towards people living with HIV/AIDS among nurses. For stigma to be decreased nurses need to update their knowledge through training and experience sharing with senior staff. And it is crucial that the Ethiopian Ministry of Health, Amhara Regional Health Bureau, and the two hospitals work for decreasing stigma by creating educational development

  8. Viewpoint: use of King's conceptual system, nursing informatics, and nursing classification systems for global communication.

    Science.gov (United States)

    Killeen, Mary B; King, Imogene M

    2007-01-01

    To propose a common nursing language for communication among members of the nursing community worldwide. The Taxonomy of Nursing Practice, nursing informatics literature, King's Theory of Goal Attainment applied to the nursing process. Several milestones in nursing in the 20th century indicated the need for a universal language for nursing. The nursing process provides a method for synthesis of nursing data, information, and knowledge and is congruent with Imogene King's Theory of Goal Attainment. The authors advocate for a common nursing language (nursing classification and terminology systems) that would unify nurses worldwide. Supported by nursing theory and technology, global communication would be enhanced for nurses and the interdisciplinary teams of which they are a part. Use of Imogene King's Conceptual System and Theory of Goal Attainment and the nursing specialty of Nursing Informatics are examples of nursing theory and technology to frame global communication.

  9. Enfoque bioético de los pacientes portadores del VIH, y de médicos y enfermeros de la atención secundaria sobre el VIH/SIDA Bioethical approach of HIV-patients and of secondary care physicians and nurses on the HIV/AIDS

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    Germán Brito Sosa

    2011-06-01

    ún los 3 grupos encuestados. Los principios de la bioética no se cumplen adecuadamente en parte de las situaciones creadas por el VIH/SIDA.Introduction: the bioethics is a concept very used in the medical and scientific practice and as a novel discipline of only 40 years it represents a challenge to face the fearsome pandemic of HIV/AIDS due to its transmission route and the diversity of related problems. Objective: to analyze the knowledges and bioethical assessment of physicians and nursing staff of the "Julio Trigo López" hospital and the patient carriers of HIV with ambulatory treatment on HIV/AIDS consequences. Methods: a prospective, longitudinal, descriptive and observational study was conducted. A original survey designed by authors was applied and validated in the "Santiago de las Vegas" sanatorium to measure the general knowledges on HIV/AIDS and the bioethics features related to problems caused by this affection. Survey was applied in 300 persons aged over 15, from them 100 are physicians from the "Julio Trigo López" hospital, 100 nurses of that institution and 100 patients carriers of HIV with ambulatory treatment in La Habana. Surveys were fill in between January and December, 2006 in an anonymous way and directed by the physician to the three groups. Results: the 87 % of the three groups propose the there is a great possibility to acquire the HIV/AIDS when a sexual transmission infection has been present. The 100 % of the I group and the 90 % of the II group know that a HIV carrier may to transmit the disease. The 67 % of physicians, the 44 % of nursing staff and the 100 % of patient carriers of HIV consider that the population must not to know who the HIV/AIDS patients affected are. Conclusions: there is a good knowledge of HIV-AIDS by the person polled, although this is not the case in low percentage of nursing staff. There is discrimination with HIV carriers and of AIDS according the three polled groups. The principles of bioethics are not

  10. Expectativas de pacientes com HIV/AIDS hospitalizados, quanto à assistência de enfermagem Expectaciones de pacientes hospitalizados con HIV/AIDS cuanto a la atención de enfermería Expectations of hospitalized patients with HIV/AIDS regarding nursing care

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    Juliana Palhano da Costa

    2006-04-01

    ón.This study aimed at verifying the expectations of patients with HIV serum-positive patients, regarding to nursing care. This is a study with qualitative approach developed in the inpatient unit of a state public hospital in the municipal district of Fortaleza-CE. Data were collected in the period of September to October of 2003 through semi-structured interview, applied to 12 patients, randomly selected among the patients with diagnosis of HIV/AIDS. For data analysis it was used the Collective Subject's Speech (DSC through emission of central ideas and/or key-expression. It was conclude that the patients expectations are for a more human care, more attention, contact verbal, more affectivity of the nursing team, a qualified and worthy attention. Besides their needs they should be informed daily about the vulnerabilities that they are submitted during the hospitalization.

  11. Costs of Rapid HIV Screening in an Urban Emergency Department and a Nearby County Jail in the Southeastern United States.

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    Anne C Spaulding

    Full Text Available Emergency departments and jails provide medical services to persons at risk for HIV infection and are recommended venues for HIV screening. Our main objective in this study was to analyze the cost per new HIV diagnosis associated with the HIV screening program in these two venues. The emergency department's parallel testing program was conducted at Grady Memorial Hospital in Atlanta, Georgia starting in 2008; the jail's integrated testing program began at the Fulton County (GA Jail in 2011. The two sites, four miles apart from one another, employed the same rapid HIV test. Ascertainment that cases were new differed by site; only the jail systematically checked identities against health department HIV registries. The program in the emergency department used dedicated HIV test counselors and made 242 diagnoses over a 40-month period at a cost of $2,981 per diagnosis. The jail program used staff nurses, and found 41 new HIV cases over 10.5 months at a cost of $6,688 per new diagnosis. Differences in methods for ascertainment of new diagnoses, previously undiagnosed HIV sero-positivity, and methodologies used for assessing program costs prevent concluding that one program was more economical than the other. Nonetheless, our findings show that testing in both venues yielded many new diagnoses, with the costs within the range reported in the literature.

  12. Nursing as textually mediated reality.

    Science.gov (United States)

    Cheek, J; Rudge, T

    1994-11-01

    Nursing and nursing practice both construct and are in turn constructed by the context in which they operate. Texts plays a central part in that construction. As such, nursing and nursing practice can be considered to represent a reality that is textually mediated. This paper explores the notion of nursing as a textually mediated reality and offers the reader the possibility of engaging in reflection on what implications this has for nursing and their own nursing practice. The analyses provided draw on aspects of the work of both Foucault and Derrida. Foucault's notion of discourse provides a vehicle for the exploration of nursing as textually mediated, as does Derrida's concept of binary oppositions. The paper thus illustrates some of the possibilities afforded nursing by poststructural analyses. In particular it does this by exploring one of the central textual constructions, impacting on the way that nursing and nursing practice are conceptualized, the mind/body binary opposition.

  13. The making of a nurse entrepreneur.

    Science.gov (United States)

    Porter-O'Grady, T

    1998-03-01

    Nursing provides many opportunities for professional and career advancement. The entrepreneurial pathway is especially benefited by a nursing background. Focusing on the opportunities that nursing provides for the entrepreneur opens almost any door in health care.

  14. Tautomerism provides a molecular explanation for the mutagenic properties of the anti-HIV nucleoside 5-aza-5,6-dihydro-2'-deoxycytidine.

    Science.gov (United States)

    Li, Deyu; Fedeles, Bogdan I; Singh, Vipender; Peng, Chunte Sam; Silvestre, Katherine J; Simi, Allison K; Simpson, Jeffrey H; Tokmakoff, Andrei; Essigmann, John M

    2014-08-12

    Viral lethal mutagenesis is a strategy whereby the innate immune system or mutagenic pool nucleotides increase the error rate of viral replication above the error catastrophe limit. Lethal mutagenesis has been proposed as a mechanism for several antiviral compounds, including the drug candidate 5-aza-5,6-dihydro-2'-deoxycytidine (KP1212), which causes A-to-G and G-to-A mutations in the HIV genome, both in tissue culture and in HIV positive patients undergoing KP1212 monotherapy. This work explored the molecular mechanism(s) underlying the mutagenicity of KP1212, and specifically whether tautomerism, a previously proposed hypothesis, could explain the biological consequences of this nucleoside analog. Establishing tautomerism of nucleic acid bases under physiological conditions has been challenging because of the lack of sensitive methods. This study investigated tautomerism using an array of spectroscopic, theoretical, and chemical biology approaches. Variable temperature NMR and 2D infrared spectroscopic methods demonstrated that KP1212 existed as a broad ensemble of interconverting tautomers, among which enolic forms dominated. The mutagenic properties of KP1212 were determined empirically by in vitro and in vivo replication of a single-stranded vector containing a single KP1212. It was found that KP1212 paired with both A (10%) and G (90%), which is in accord with clinical observations. Moreover, this mutation frequency is sufficient for pushing a viral population over its error catastrophe limit, as observed before in cell culture studies. Finally, a model is proposed that correlates the mutagenicity of KP1212 with its tautomeric distribution in solution.

  15. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... people affected by HIV/AIDS, and the general public. U.S. National Library of Medicine HIV/AIDS Information : Specialized Information Services. VA National HIV/AIDS : This site provides information both for health care providers and for Veterans and the ... Public Service Announcements Jack & Jill : Campaign launch, ...

  16. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... HIV patients who do not abuse drugs. In animal studies, methamphetamine has been shown to increase the ... clinical trials, and other research information for health care providers, researchers, people affected by HIV/AIDS, and ...

  17. Drugs + HIV, Learn the Link

    Medline Plus

    Full Text Available ... or decrease symptoms of illness. To learn about current statistics of HIV in the United States, please ... programs also serve an important role in providing current information on HIV/AIDS and related diseases, counseling ...

  18. Nursing around the world: a perspective on growing concerns and the shortage of care

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    Vance DE

    2011-11-01

    Full Text Available David E VanceThe University of Alabama School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: Many of us think of nurses as people who provide direct care to us and our loved ones. And that is true. Images of a selfless person such as Florence Nightingale during the Crimean War running from one wounded soldier to another providing care inspires the imagination of what a nurse is and can be. Based on that image, a nurse is anyone who cares (and from a spiritual or philosophical perspective, that may be true. But nursing as a profession is so much more. nurse is someone with a very selective skill set that can only be developed and honed by intense training, education, and discipline while being used in a proscribed ethical manner. With such a combination of skills, ethics, and caring, nurses are the backbone of health care settings, tending to the individual needs of the patients; however, many nurses also function outside such traditional settings and perform numerous functions. Nurses are educators and provide data to the public designed to improve health literacy and promote physical and mental wellness. Nurses are computer and organizational specialists who provide hospitals and institutions with the technologies for keeping, maintaining, and analyzing records. Nurses are clergy, psychologists, and philosophers providing a direction and a moral compass in how to are for patients and each other. Nurses are researchers investigating everything from developing medication for Alzheimer's disease to improving crop yields to reduce hunger. Finally, nurses are advocates and leaders petitioning for justice and beneficence of all regardless of gender, age, race, religion, sexual orientation, and nationality; and as such, nursing is political and has a global impact. Nursing is global in nature and is facing global, as well as country specific, problems. The purpose of this editorial is to provide a brief overview of what

  19. 'Whose failure counts?' A critical reflection on definitions of failure for community health volunteers providing HIV self-testing in a community-based HIV/TB intervention study in urban Malawi.

    Science.gov (United States)

    Sambakunsi, Rodrick; Kumwenda, Moses; Choko, Augustine; Corbett, Elizabeth L; Desmond, Nicola Ann

    2015-12-01

    The category of community health worker applied within the context of health intervention trials has been promoted as a cost-effective approach to meeting study objectives across large populations, relying on the promotion of the concept of 'community belonging' to encourage altruistic volunteerism from community members to promote health. This community-based category of individuals is recruited to facilitate externally driven priorities defined by large research teams, outside of the target research environment. An externally defined intervention is then 'brought to' the community through locally recruited community volunteers who form a bridge between the researchers and participants. The specific role of these workers is context-driven and responsive to the needs of the intervention. This paper is based on the findings from an annual evaluation of community health worker performance employed as community counsellors to deliver semi-supervised HIV self-testing (HIVST) at community level of a large HIV/TB intervention trial conducted in urban Blantyre, Malawi. A performance evaluation was conducted to appraise individual service delivery and assess achievements in meeting pre-defined targets for uptake of HIVST with the aim of improving overall uptake of HIVST. Through an empirical 'evaluation of the evaluation' this paper critically reflects on the position of the community volunteer through the analytical lens of 'failure', exploring the tensions in communication and interpretation of intervention delivery between researchers and community volunteers and the differing perspectives on defining failure. It is concluded that community interventions should be developed in collaboration with the population and that information guiding success should be clearly defined.

  20. Self-care and HIV/aids patients: nursing care systematization El autocuidado y el portador de SIDA: sistematización de la atención de enfermería Autocuidado e o portador do HIV/aids: sitematização da assistência de enfermagem

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    Joselany Áfio Caetano

    2006-06-01

    Full Text Available This research aimed at systematizing nursing care to HIV/aids patients in view of Orem's Self-care Deficit Nursing Theory, using the convergent-care method and the Self-Care Nursing Process. Subjects were thirteen HIV/AIDS patients attended at a non-gove