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AIDS and Behavior - Adolescents and young adults (AYA; 13–24 years-old) comprise 22% of new HIV infections in the United States (US), most of whom live in the South. We used the...  相似文献   
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AIDS and Behavior - Adherence to care and antiretroviral therapy is challenging, especially for people living with HIV (PLWH) with additional co-occurring risk factors. Case management...  相似文献   
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Chronic pain and substance use can strain the supportive relationships of persons with serious chronic illness, which may increase the likelihood of receiving negative, rather than positive, social support from informal caregivers and social network members. To our knowledge, this is the first study to longitudinally examine the effects of chronic pain and substance use on negative social support. The sample (N?=?383) comprised disadvantaged, primarily African-American, persons living with HIV/AIDS with a history of injection drug use, 32.4% of whom reported frequent or constant pain in the prior 6 months. Using factor analysis and structural equation modeling, current substance use and greater levels of chronic pain positively predicted negative social support 12 months later, after controlling for baseline negative support, viral load, age and sex. We also found a significant interaction effect such that among those not using substances, there was a significant positive association between pain and negative support, but no such association among those currently using substances. The findings emphasize the importance of treatment of chronic pain and substance use in the supportive functioning of social networks of a disadvantaged population with serious chronic conditions and persistent health disparities.  相似文献   
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Quality of Life Research - Persons living with HIV (PLWH) are living into old age with more complex care needs that non-PLWH. Promoting quality of life should include advance care planning (ACP)...  相似文献   
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Background

Recent healthcare mandates require availability of accessible medical exam equipment, which may reduce barriers to care for patients with disabilities (PWD). However, more research is needed to explore healthcare provider views on implementation and routine use of accessible equipment.

Objective

This study qualitatively explored healthcare provider perceptions of: (1) daily use of accessible medical examination tables with PWD; and (2) recommendations for addressing challenges to using this equipment.

Methods

Qualitative interviews and focus groups were conducted with physicians, nurse practitioners and registered nurses at a clinic where accessible examination tables were recently implemented in all clinic rooms. Data were coded and thematically analyzed by two researchers trained in qualitative methods.

Results

A total of 17 providers participated in focus groups or interviews. Participants were mostly female (82%; N = 14), and registered nurses (47%; N = 8), but also included nurse practitioners (29.4%; N = 5), and physicians (23%; N = 4). Common themes were: (1) Ease of use and functionality of tables; and (2) Challenges with use and available training. Overall, providers reported satisfaction with the tables' ability to accommodate patients who are PWD, although they expressed challenges with functionally using the tables with specific populations, such as pediatric patients.

Conclusions

Healthcare organizations seeking to implement height-adjustable tables should account for structural requirements of the height-adjustable tables (e.g. accommodating clearance needed when planning room sizes). Practical recommendations and policies for integrating height-adjustable tables into routine clinical care are needed to ensure equitable care for PWD.  相似文献   
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