Nurse training needs in AIDS counselling.

Twenty-one people involved in AIDS counselling or nurse education on AIDS were interviewed using a semi-structured process involving key questions. The interviews were transcribed directly onto a lap-top computer, then entered into a free-form database computer program for analysis. The findings, although non-generalisable, indicate that counselling is seen as a necessary part of the support services offered to people with HIV or AIDS, but is not necessarily a task suitable for nurses. AIDS counsellors were identified as the main source of psychosocial help for people with HIV or AIDS, whose main concerns were perceived as being fear of stigmatisation, poor health and dying. The issues of whether or not to train nurses as AIDS counsellors, and how to train them, require further study.     

Counselling of patients with HIV-related diseases: what is the role of the nurse?

• ? The need for counselling of patients with HIV-related diseases has been clearly demonstrated in the literature.
• ? This study aimed to elicit nurses', perception of their role in such counselling.
• ? Nurses did not have a uniform understanding of the term ‘counselling’, viewing it mostly as ‘information-giving’, however listening skills and allowing the person to deal with their own problems and fears were also central issues.
• ? The doctor was seen as the most important health professional when it comes to counselling of AIDS patients. The nurse is viewed as a ‘number two’, surprisingly perceived as more important than priests, psychologists and social workers, despite being thought of as not being well trained and consequently not having the necessary skills for counselling interventions.
• ? As a result, there was a clear need and wish for more general education on AIDS and counselling issues.

     

Daily living problems of people with haemophilia and HIV infection: implications for counselling

The advent of AIDS not only signifies the emergence of a new disease that affects hitherto healthy members of the general population but also highlights many unresolved problems of people with haemophilia, a life-long genetic disorder of blood clotting. Although HIV infection and the threat of AIDS has been a tragedy for people with haemophilia, the reported study shows that in spite of recent technological advancement in treatment, problems caused by haemophilia as such are still devastating for some severely affected patients. The ability of people with haemophilia to cope with their daily living problems such as chronic and acute pain, stress in the family, difficulties with unemployment and social relationships affects their response to HIV/AIDS. These facts have important implications for their rehabilitation and counselling and raise questions about coping with HIV/AIDS for other risk groups.     

Enabling overweight children to improve their food and exercise habits - school nurses' counselling in multilingual settings

Aims and objectives. The study aimed at analysing school nurses' counselling of overweight and obese children in settings with many immigrants, focusing on content concerning food and physical activity and how this was communicated. Background. For people with a predisposition for overweight, the weight control process requires cognitive skills. School nurses' counselling of overweight children has the potential to support this process by enabling personal resources in the children and their families. However, there is uncertainty among nurses about how to conduct supportive counselling. Design. An explorative design was used when collecting and analysing data. Method. Twenty-two counselling sessions between eight school nurses and 20 overweight children were audio-recorded and analysed using qualitative content analysis. Most of the participating schools represented areas with low socioeconomic status and a high proportion of immigrants and refugees. Results. Less adequate skills in enabling resources in the children and their parents were observed. Concurrently, school nurses provided inadequate explanations about food and physical activity. Topics related to general nutrition models were frequently communicated as general advice instead of individually tailored counselling. Counselling families with other languages and food cultures than the traditional Swedish created additional difficulties. Conclusions. Improved nutritional knowledge for nurses may enhance their skills in enabling children's and families' resources. School nurses should be provided with opportunities to cooperate with other professions in counteracting overweight. Relevance to clinical practice. Our findings demonstrate a relationship between content skills and person-centeredness in the counselling. This highlights the importance of inter-professional collaboration to ensure a high quality of lifestyle counselling. School health authorities should give high priority to facilitating school nurses' evidence-based continuing education.     

HIV infection and community nursing staff in Scotland--1. Experience, practice and education

To assess the effects of human immunodeficiency virus (HIV) for the work of community nursing staff, and to find out how community staff regard their contribution to the prevention of HIV infection, the care of people with AIDS and their preparation for this role was ascertained in a postal survey of one in five field staff carried out in Scotland. The 1,205 respondents represent an 85% response rate. While only 3% of respondents had experience of patients with AIDS, 11% had been involved with known asymptomatic HIV infection and 30% had encountered those they considered to be at high risk of infection. While the workload generated by HIV-infected patients for individual nurses at this time was small, there were variations in the proportions of staff involved according to type of staff and employing health board. Only one-fifth of those who had encountered HIV-positive patients had offered them health education, and fewer had referred patients to their general practitioners or offered counselling. However, community nursing staff do consider that they have a role to play in health education, counselling and terminal care, but feel ill equipped to carry out this role. There is an urgent need for policies which clearly specify the roles that community nursing staff should be playing and for in-service education programmes which assist them to draw on the knowledge and skills that they have to enable them to apply them to help patients with HIV infection.     

HIV infection and AIDS in England: the experience, knowledge and intentions of community nursing staff

A postal survey of 5243 community nursing staff throughout England sought information about their experience, education, knowledge, confidence and beliefs in relation to the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS). A response rate of 74% was obtained. While experience of patients positive for HIV antibody or with AIDS was limited, one-third of community nursing staff had encountered patients worried about HIV infection. However, most lacked confidence to provide health education, counselling and terminal care. A quarter felt that they should have the right to refuse to care for patients with AIDS, while 85% were concerned about their lack of experience. In order to play an effective role in the prevention and management of HIV infection, community nursing staff need to be assisted in making links between knowledge they already possess and its application to HIV infection, and in developing and practising skills.     

Teaching Rwandan Families to Care for People with AIDS at Home

AIDS causes disabling symptoms during its chronic and terminal phases. Families throughout the world, whether related to the patient by blood or affection, provide most of the personal care for him or her at home during these phases. Whether the family has access to advanced medical care or not, they can be taught simple comfort measures and nursing care skills that will improve the well-being of the patient. In Rwanda, a small country in east-central Africa, Red Cross volunteers were trained to teach these skills. The volunteers then returned to their villages to help local families. Six months later, 24 of these families were interviewed about the impact of the volunteers’ visits. Families indicated they had benefited from being taught the caregiving skills. They also appreciated the emotional support attendant to the volunteers’ visits. In summary, the training course enabled volunteers both to enhance family nursing care skills and to provide emotional support to families caring for people with AIDS at home. This training can also be used by volunteers to assist families caring for members ill with other endemic chronic infectious diseases.     

艾滋病的护理策略

艾滋病（acquired immunede ficiency syndrome，AIDS）是由人类免疫缺陷病毒（human immunodeficiency virus，HIV）引起，是一种慢性、进行性、致死性传染病。护理人员与艾滋病患者几乎是零距离接触，与他们一样要面对来自社会、家庭、朋友、亲人等各方面的压力，这就要求护理人员具有良好的职业素质、个人素质和丰富的专业知识及相关知识。本文从对护理人员的要求、培训及如何从各方面护理艾滋病患者阐述了自己的观点。     

Living with disability: part 2. The child/family/nurse relationship

This second part of a series of three CPD articles examines the relationship between children and young people with disabilities, their families and professionals by discussing the concept of 'therapeutic use of self'. The core skills that support this therapeutic intervention are: understanding the self and how we deal with our own emotions; managing our attitudes and beliefs; entering the experience of others (empathy); using reflective techniques to develop sensitivity; listening, speaking, supportive and counselling skills.     

A descriptive qualitative review of the barriers relating to breast-feeding counselling

The purpose of this review was to describe barriers in breast-feeding counselling considering it from the viewpoint of health professionals. CINAHL, MEDLINE and Cochrane databases were searched from 1950 to 2008. In total, 40 scientific research articles in English, Swedish or Finnish related to breast-feeding counselling were included and analysed using thematic analysis. The quality of the studies was also assessed. The main barriers were deficits in knowledge, resources, counselling skills and the counsellor's negative attitude. Conflicting advice, lack of guidelines, sufficiency of counselling and perceiving of the personal education needs were examples of the indicated barriers. The most commonly described barriers in breast-feeding counselling were limitations in breast-feeding knowledge. Developing of the measurements to assess the barriers in breast-feeding counselling is needed.     

Time to talk: counselling for people with dysphasia

In this small-scale qualitative study, 20 dysphasic people, including some with severe language impairments, were offered up to 20 sessions of individual counselling. The trained counsellors were a speech and language therapist and a teacher who had personal experience of dysphasia. The paper describes how the service was set up, and how it was evaluated through the use of interviews before, during and after the process of counselling. In general, participants valued the service and a number of positive outcomes were described. Negative reactions were largely due to problems with the setting, timing and organization of the counselling and to the presence of social problems which could not be addressed through counselling. A number of recommendations for setting up a counselling service for people with dysphasia can be drawn from this study. These are discussed in this paper, together with the issues arising from the collaboration between dysphasic and non-dysphasic researchers.     

Counselling as part of the nursing fabric: where is the evidence? A phenomenological study using 'reflection on actions' as a tool for framing the 'lived counselling experiences of nurses'

Anecdotal claims are often made that counselling has become part of the nursing fabric. While there is a plethora of literary comments on the subject, there is hardly any concrete evidence to demonstrate how nurses use counselling skills as part of their work. 'Evidence-based care' requires nurses to produce evidence or research in order to enhance nursing care. This study is an attempt to illuminate the counselling phenomenon as it applies to present-day nursing. Guided reflection-on-actions was used as a tool for framing the 'lived counselling experience' of six qualified nurses who have recently completed a counselling and health module as part of a BSc in Health Studies. The findings suggest the existence of a paradigm shift in the direction of a closer alignment between counselling skills as applied by nurses and counselling as a healing culture. It supports the notion that there is a distinction between using counselling skills and counselling practice per se. It also concludes that within the context of nursing, what patients require is exploration and/or resolution of focal problems and not 'personality fine-tuning' as might be the case in counselling in general. When called upon to 'dispense counselling skills', nurses are adept at combining this with other nursing activities being performed at the time.     

Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review

Title.  Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review.
Aim. This paper is a report of a literature review conducted to examine current research studies into attitudes of nursing students towards caring for people with HIV/AIDS and to identify factors that influenced those attitudes to inform current nursing practice and to develop nursing education regarding care provided to people with HIV/AIDS.
Background. Attitudes of nurses towards people living with HIV/AIDS have long been scrutinized. Studies show that some nurses have negative attitudes and are reluctant to provide care to people with HIV/AIDS, resulting in poorer quality nursing support being provided. Attitudes of nursing students towards caring for people with HIV/AIDS is thus of vital importance since they become the future practising nurses.
Data sources.  Eight electronic data bases were searched from 1996–2008.
Review methods.  Criteria used for study selection were: attitudes of nursing students towards caring for people with HIV/AIDS, primary research studies, published in English language in peer reviewed journals from 1996 to June 2008. Sixteen studies were identified for inclusion in this thematic review.
Results.  The following themes were identified: education and knowledge of HIV/AIDS; fear of contracting HIV/AIDS; reluctance to care for people with HIV/AIDS; homophobia; and stigma associated with HIV/AIDS.
Conclusion. There is reluctance on the part of some nursing students in specific regions of the world to provide care for people with HIV/AIDS. Educational programmes based on research evidence must play a leading role in developing strategies to help nursing students understand and overcome such attitudes.     

Counselling and mental health nursing: a qualitative study

The author draws upon his experience of training, practising and teaching both counselling and mental health nursing in order to examine the relevance of counselling skills training to mental health nurses. The qualitative study reported in this paper elicits the feelings and thoughts of five mental health nurses about their attitude towards individual counselling work with mental health clients. It is asserted that newly qualified mental health nurses may feel inadequately prepared for this aspect of their work and they may also feel inadequately supported. Additional counselling training may help equip mental health nurses for the skills they need to work within the therapeutic relationship. By not providing adequate counselling skills training, mental health nurse educators may contribute to a cycle of incompetence. Training methods are identified that may enhance nurse training and help promote competence and confidence for the newly qualified nurse.     

The health needs of gay men: a discussion of the literature and implications for nursing

Although there is a general dearth of nursing literature on health issues specific to gay (homosexual) men, the literature reviewed shows that gay men have particular concerns related to anti-homosexual feelings anticipated and experienced from health professionals The effects of homophobia in wider society may cause high levels of emotional distress in some gay men, which is associated with a higher incidence of substance misuse, parasuicide, bipolar psychiatric disorders and depression Gay men also have specific needs with regard to general medical problems, including hepatitis, HIV infection and some other sexually transmitted diseases Gay men may also present to health services for a wide range of general medical, surgical and mental health problems Some specific health needs are discussed general health, sexual health and bereavement counselling These issues may affect individuals differently through various stages in the lifespan, and nurses should be cognizant of them during their assessment of client needs Minimum counselling skills, together with appropriate training about gay issues, are required if nurses are to deal effectively with clients'needs     

培训培训者模式在护理人员艾滋病知识培训中的应用

目的探讨培训培训者模式在新疆5个艾滋病重点地区护理人员艾滋病知识、态度、行为培训中的实践效果。方法首先对培训者进行艾滋病相关知识培训,然后由这些培训者对本地区医院的护理人员进行培训。结果培训后,接受培训者及一般护理人员的艾滋病相关知识、态度、行为等得分较培训前均有显著提高,差异具有统计学意义（P〈0．01）。结论培训培训者模式可以有效提高护理人员的艾滋病知识和应对能力。     

Motivators and barriers to exercise among adults with a high risk of type 2 diabetes – a qualitative study

Scand J Caring Sci; 2011; 25; 62–69
Motivators and barriers to exercise among adults with a high risk of type 2 diabetes – a qualitative study Purpose: Type 2 diabetes (T2D) can be prevented through lifestyle changes. Regular exercise for more than 4 hours per week, combined with weight loss and changes in dietary habits reduces the incidence of T2D. The aim of this study was to describe motivators and barriers to exercise among adults with a high risk of T2D. Methods: Altogether, 74 subjects participated in a study on the Effectiveness and Feasibility of Activating Counseling Methods and Videoconferences in Dietary Group Counseling of Subjects with high risk of T2D. The qualitative data were gathered from video‐recorded group counselling sessions and were analysed using content analysis. Results: Enjoyment from exercise, social relationships related to exercise, encouragement from others, benefits to health, and the aim of weight control motivated subjects to exercise. The wish to join people with an active lifestyle, admiration of active friends and willingness to serve as an example for children reflected why exercise was an important value in life. The barriers to exercise were weather/season, health problems, lack of time, work‐related factors and lack of interest. Conclusions: Adults with high risk of T2D experienced many individually meaningful motivators. They experienced few barriers to exercise and highlighted the motivators. Thus, we present that they had a positive attitude towards increasing exercise during participation to counselling. The results can be used when developing counselling methods because they provide concrete content for counselling discussion such as importance of work‐related factors, family exercise, time management skills and social support for regular exercise.     

性病门诊艾滋病自愿咨询检测的实践与思考

目的通过性病门诊就诊者艾滋病自愿咨询检测（voluntary counselling and test,VCT）的临床资料探讨实行VCT的必要性和可行性。方法回顾性分析498例性病门诊就诊者艾滋病VCT的临床资料,包括咨询的主要原因、危险因素评估、艾滋病相关知识的认知情况及关心的主要问题等。结果为498例咨询者提供VCT服务,其中477例（95．9％）接受了艾滋病病毒（human immunodeficiency virus,HIV）抗体检测,9例（1．8％）初筛阳性;咨询主要原因：非婚性接触339例（66．5％）,自觉有艾滋病或其他性病症状187例（37．6％）,配偶性病感染史23例（4．6％）,拒绝报告原因15例（3％）,怀疑被室友传染4例（0．8％）;危险因素评估：合并其他性病感染201例（40．4％）,多性伴358例（71．9％）,肛交史66例（13．3％）,男男同性恋45例（9．0％）;大部分咨询者对艾滋病基本知识有所了解,对HIV三大传播途径的知晓率达到85％以上,但仍存在着不少误区;咨询者关心的问题有艾滋病的传播途径（98．2％）、预防知识（98．0％）、临床表现（73．3％）。结论性病门诊是艾滋病高危人群集中的场所,医护人员认真履行VCT服务,做好咨询者的健康教育、心理护理、行为干预等综合关怀工作,对艾滋病的防治具有重要意义。