HIV/AIDS and its impact on student nurses

This article describes components surrounding British nursing students' (n=138) knowledge base, attitudes towards HIV/AIDS, homophobia level, willingness to care for individuals with HIV/AIDS and attitudes to sexual risk behaviours. The data were collected by questionnaire and analysed by statistical methods. Out of the 33 knowledge questions, the mean value of correct answers was 22.2 (Min 13, Max 29, SD 3.27). Students who had taken care of people with AIDS and who were willing to take care of these people showed more positive attitudes to the disease and people with AIDS. Older age and reluctance to care for a person with AIDS were associated with a high level of homophobic attitudes. Students demonstrated a positive approach to carrying out general nursing tasks for a person with HIV/AIDS. Having been asked to care or having cared for a patient with HIV/AIDS, and being single were associated with a higher level of willingness to care for these patients. Female sex, older age and having children were associated with more cautious attitudes to sexual risk behaviours. The results underline the importance of providing education about HIV/AIDS and supporting student nurses who are afraid they might contract the disease in nursing tasks.     

HIV携带者及AIDS病人疲乏的研究进展

从HIV携带者和艾滋病(AIDS)病人相关疲乏的现状、测量工具、对病人的影响及疲乏的相关因素4个方面进行综述,以期引起相关部门对HIV携带者及AIDS病人疲乏的重视,并为今后进一步干预、研究和发展提供信息与方向.     

Pain and Palliative Care for People Living with HIV/AIDS in Asia

Millions of people living with HIV/AIDS (PLHA) in Asia need access to palliative care as part of a comprehensive response to their support needs. There are many causes of pain in HIV/AIDS, and its prevalence is as high if not higher than in cancer, but it is frequently undertreated. Access to adequate pain relief and palliative care is impeded by the barriers which face PLHA in Asia. These include few care and support services, lack of recognition and acknowledgement of pain in HIV/AIDS by health care professionals, widespread stigma and discrimination especially towards vulnerable groups such as injecting drug users, government regulatory mechanisms which make access to opioids even more difficult for the care services which have developed and a lack of understanding of or advocacy for pain relief and palliative care in the literature on HIV/AIDS care and support. During the growth of palliative care in Asia, there is opportunity for advocates of palliative care and care for PLHA to collaborate to influence national policy.     

Risk and Protective Factors for HIV Self-disclosure among Poor African-American Women Living with HIV/AIDS

African-American women with HIV are among the fastest growing populations with HIV. The psychosocial factors and beliefs/attitudes associated with disclosure and other un-safe sex practices are not fully understood in this population. A total of 158 HIV-positive women receiving primary care in an HIV clinic in Philadelphia who enrolled in a safe-sex intervention, completed a baseline questionnaire on their sexual activities with male partners and psychosocial factors that were potential protective/risk factors for unsafe sex. Women who were emotionally close and monogamous with their partner were most likely to disclose their HIV status and least likely to worry they had infected their partner. Women who were non-monogamous and who did not have an emotional connection to any of their partners were least likely to self-disclose. Partners were more likely to know each other's status when the woman felt she had a responsibility to talk about the importance of staying HIV-negative.     

Quality of life and living with HIV/AIDS in Cambodia.

This qualitative study was DESIGN: ability to maintain life functioning, describing QoL before getting sick and current hardships; isolation and the desire for connection with others, describing how perceived stigmatization, discrimination, and alienation affect QoL; anticipating the future, describing fears about future QoL; and reflection, describing the effect of vulnerable relationships and regrets on QoL. For the participants of this study, secrets and silence, selective disclosure, living in the present, and hopefulness were means of promoting achievement of QoL outcomes of being able to meet basic needs, having a sense of belonging, and having a safe and caring connection with others.     

Wasting and malnutrition in patients with HIV/AIDS

It is important for healthcare professionals caring for HIV-infected individuals to understand the relationship among nutrition, HIV infection, and the immune system. Progressive weight loss is a major component of the clinical syndrome in persons with HIV infection and AIDS. Weight loss occurs for a variety of reasons, which, when recognized, may be preventable or treatable. Malnutrition occurring with weight loss may adversely affect the function of the immune system and further impair the infected individual's ability to avoid or recover from infection. Nursing interventions in nutritional care, outlined in this article, can help these clients improve both the quantity and quality of their lives.     

个性化心理干预对HIV感染者/AIDS患者生活质量的影响

目的 探讨个性化心理干预对HIV感染者/AIDS患者生活质量的影响.方法 选取50例确诊HIV感染者/AIDS患者,随机分为对照组及观察组各25例,对照组给予常规的治疗及护理,观察组在此基础上根据SCL-90、SF-36量表测量心理健康及生活质量结果,分析其影响因素,制订计划并实施个性化的心理干预.出院3个月后评估测试SCL-90、SF-36评分,分析比较2组患者的心理健康及生活质量的情况.结果 干预前观察组与对照组心理健康及生活质量比较无差异,干预后2组心理健康及生活质量比较差异显著.结论 个性化的心理干预可提高患者生活质量.

Abstract：

Objective To investigate the influence of individual psychological intervention on quality of life of HIV infection / AIDS patients.Methods 50 cases diagnosed as HIV infection / AIDS were selected,randomly divided into the control group and the observation group with 25 cases in each group.The control group received routine treatment and care,while for the observation group,the psychological health and quality of life were measured with SCL-90,SF-36 scales,then personalized psychological intervention was implemented after analyzing the influencing factors.Three months after discharge,the assessment test was carried out using SCL-90 and SF-36 scales,then compared the quality of mental health and life situation of the two groups.Results Mental health and quality of life between the observation group and the control group before intervention was not statistically significant.After intervention,the comparison is statistically significant Conclusions Individualized psychological intervention can improve patients quality of life.     

艾滋病相关性耻辱和歧视对女性HIV／AIDS病人的影响

从有关耻辱和歧视定义、表现形式等方面对国内外有关艾滋病相关性耻辱和歧视进行了综述,提出了一些减轻女性艾滋病病毒（HIV）感染者／艾滋病（AIDs）病人耻辱和歧视的措施。     

The impact of PTSD on pain experience in persons with HIV/AIDS

Pain is a common and pervasive symptom for persons infected with the human immunodeficiency virus (HIV). Individuals with persistent pain are known to be at heightened risk for posttraumatic stress disorder (PTSD), an anxiety disorder that manifests itself following exposure to a traumatic event. Moreover, research suggests that patients with persistent pain who develop PTSD often experience greater pain intensity and pain-related disability than those who do not develop PTSD. The purpose of this study was to assess the relation of PTSD to pain intensity and pain-related interference in HIV-infected persons suffering from persistent pain. Study participants included 145 ambulatory persons living with HIV/AIDS (PWHAs) who were enrolled in a randomized clinical trial assessing the impact of a pain communication intervention. Participants completed a series of self-report measures including the Stressful Life Events Checklist (SLE), the Posttraumatic Stress Disorder Checklist-Civilian (PCL-C), the Mental Health Inventory (MHI), and the Brief Pain Inventory (BPI). On average, participants reported being exposed to 6.3 different types of trauma over the course of their lifetime, of which receiving an HIV diagnosis was rated as being among the most stressful. Over half (53.8%) merited a PTSD diagnosis according to the PCL-C. Those with PTSD reported having significantly higher pain intensity and greater pain-related interference in performance of daily activities (i.e., working, sleeping, walking ability and general activity), and affect (i.e., mood, relations with other people, enjoyment of life) over time than those who did not meet the diagnostic criteria. Possible explanations for these findings are discussed along with implications for clinical care.     

Stigma and Spiritual Well-being among People Living with HIV/AIDS in Southern Appalachia

The Appalachian South is disproportionately affected by HIV/AIDS. Partly due to the negative connotation that this disease carries in religiously conservative areas, HIV-related stigma remains a critical barrier to HIV care in the South. However, spirituality is a well-documented, effective coping mechanism among persons living with HIV/AIDS (PLWH). The purpose of this study was to examine the relationship between HIV-related stigma and spiritual well-being among a sample of PLWH (n = 216) in Appalachian counties of Tennessee and Alabama using the HIV Stigma Scale and the Spiritual Well-being Scale. Overall, disclosure of HIV status was the most highly reported stigma concern. Women reported higher levels of stigma and religious well-being than men. While existential well-being was negatively correlated with stigma, no significant overall correlation was found between religious well-being and stigma. Our findings reveal the importance of defining theology and differentiating between cultural religious conditioning and internalized beliefs.     

HIV感染者和艾滋病患者生活质量及其影响因素的研究现状

生活质量是一个多维概念[1].随着医学模式的转变,生活质量尤其是慢性病病人生活质量得到重视.因为它既能用来监测疾病,评估治疗对病人生理功能的作用,还能评价社会支持和关爱对患者心理方面的影响程度[2].     

综合护理干预对艾滋病患者HAART治疗依从性及生活质量的影响

目的:探讨综合护理干预对艾滋病患者HAART治疗依从性及生活质量的影响。方法:将122例艾滋病患者随机分为研究组和对照组各61例,对照组行一般的健康教育,研究组在此基础上采用综合护理干预措施。比较两组治疗依从性和生活质量。结果:干预4周后,研究组治疗依从性及生活质量均高于对照组(P0.05)。结论:综合护理干预能增强对艾滋病患者HAART治疗的依从性和提高患者生活质量,对提高HAART治疗效果具有重要的意义。     

The health-related quality of life of people living with HIV/AIDS

PURPOSE: The prevalence of people living with HIV/AIDS (PLWA) in South Africa is estimated to be approximately 14.2% of the total population. In the absence of anti-retroviral therapy, PLWA are likely to experience a steady decline in function, as their immune systems become increasingly compromised. However, there is limited information available to determine the potential role of rehabilitation interventions in the management of PLWA in a resource-poor community. SUBJECTS: Subjects were recruited from the population of beneficiaries of HIV/AIDS clinics run by Medecins Sans Frontières, which provides anti-retroviral therapy to PLWA within a resource poor community. The subjects, who were either in WHO Stage 3 or 4 of the disease and/or had a CD4 count of less than 200, were interviewed after enrolment on the anti-retroviral programme and before treatment was initiated. They were therefore not yet receiving anti-retroviral therapy. The control group consisted of a community sample randomly selected from the same area and who were in the same age range. METHODS: As all participants were Xhosa speaking, the Xhosa version of the EQ-5D measure of HRQoL was utilized. Analysis: The Mann-Whitney U-test was used to determine whether there was a difference in the rank ordering of responses to the five different domains of the EQ-5D and the Visual Analogue Scale of Health Status scores. RESULTS: There were 123 and 108 subjects in the experimental and control groups, respectively. In the domain of mobility 30.9% of the subjects reported some or severe problems, compared to 14.8% of the control group (p < 0.001). The corresponding figures for the other domains were: self-care 14.8% and 4.6% (p = 0.016), usual activity 31.7% and 10.2% (p < 0.001), pain/discomfort 69.1% and 33.3% (p < 0.001) and anxiety/depression 33.4% and 24.2% (p = 0.123) for the experimental and control groups respectively. PLWA reported a VAS score of 60.4 (SD 22.1), which was significantly lower than that of the community sample (80.13, SD 20.4, p < 0.001). CONCLUSION: Self-reporting indicates that Health Related Quality of Life is severely comprised in PLWA in Stages 3 and 4 and limitations in the four domains of mobility, usual activities, pain/discomfort and anxiety/depression constitute major problems for PLWA. There is an obvious need to provide a continuum of care, encompassing not only medical but also physical and mental rehabilitation services as well. In an area of high HIV prevalence, the provision of appropriate, multi-disciplinary health care services to PLWA presents a major challenge to the health services.