Burnout and AIDS care-related factors in HIV community clinical nurse specialists in the North of England

Burnout in Acquired Immune Deficiency Syndrome (AIDS) care nursing is well described in the literature from a hospital based perspective. No studies into the effects of AIDS care and burnout have been carried out within the community setting. A two-stage, mixed method study was carried out. In Stage one 30 Clinical Nurse Specialists in human immunodeficiency virus (HIV)/AIDS from the North of England completed the Maslach Burnout Inventory (MBI) and the AIDS Impact Scale. For Stage two five practitioners were selected randomly for semi-structured interview. Burnout morbidity was significant. Sixty-six per cent of informants scored as moderate or high burnout cases on the emotional Exhaustion and Personal Accomplishment subscales of the MBI. Only three per cent scored as cases on the depersonalization subscale. Links between the close involvement of practitioners with clients, death of clients, isolation, stigma and discrimination and the availability of support and supervision were identified as significant factors in AIDS care within this population that contributed to stress and burnout. Paradoxically, informants found the close relationships with clients, the autonomy of isolation and the exclusive nature of AIDS care positive aspects of their practice. The role of support and supervision in facilitating the continuance of a close empathic and therapeutic relationship and the prevention of an over-involved, isolated and stressful relationship is proposed as a way forward.     

The practice of community caregivers in a home-based HIV/AIDS project in South Africa

The aim of this study was to describe the practice of community caregivers in a home-based AIDS care project at seven sites in South Africa. The community caregivers felt positive about the contribution they made, but found it difficult to cope with the poverty and complexity of problems they were faced with. They visited each client an average of five times per month, and their care usually involved counselling and informing, symptom control, psychosocial support and welfare assistance. The caregivers worked in close collaboration with the South African Hospice Association and clinic staff, and each site developed a work pattern suitable to its resources.     

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

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.     

The HIV/AIDS Epidemic in Malawi

In Africa south of the Sahara desert, nearly 21 million people are living with HIV/AIDS. In 13 countries in the region at least 10% of all adults are infected with HIV/AIDS and the prevalence rates in many capital cities are 35% or more. Botswana and Zimbabwe have reached a prevalence rate of 25%, or one out of every four adults in the country is infected. ¹³ And in nearby Malawi, the prevalence rate is 15% among adults and increasing daily. The Malawi Government recognizes HIV/AIDS as a serious public health and socioeconomic problem requiring multisectoral involvement. Below is an overview of the epidemic's magnitude, the cultural practices facilitating its proliferation and how nurses are joining the country's community mobilization strategy.     

程序化健康教育对门诊HIV感染者／AIDS患者的影响

目的探讨程序化健康教育对门诊艾滋病病毒（HIV）感染者／艾滋病（AIDS）患者的影响。方法以120例门诊HIV感染者／AIDS患者为研究对象,随机分为实验组和对照组。对照组只接受医院门诊常规健康教育;实验组在常规健康教育的基础上,接受本研究专门设计的系统健康教育,干预3个月,用问卷调查分别对两组患者进行测试。结果接受程序化健康教育的患者艾滋病相关知识水平和对健康指导依从性显著高于对照组（P〈0．05）,心理健康水平优于对照组。结论本研究设计的程序化健康教育能有效促进门诊HIV感染者／AIDS患者的身心健康,对降低艾滋病流行和蔓延,控制疾病的发展,延长患者生命和提高患者的生存质量具有重要意义。     

People with HIV/AIDS: who cares?

People with HIV/AIDS: who cares? Studies have shown that some nurses, doctors and other carers have negative attitudes towards people with human immune deficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Some cope by avoiding working with such patients, while others just do the best they can. But does it matter? This paper describes a review of the literature on the impact of attitudes to care and the barriers affecting the quality of care for people with HIV/AIDS by professional health care workers and other carers. Most of the reports identified were based on attitude scales, mostly unique and often unvalidated. Attitudes of health care workers based in the community, and ‘house keeping’ staff such as porters, receptionists, etc., have been neglected areas of research. There is also little information about the culture of organizations and the attitudes of individuals with HIV/AIDS to care. Only three references were found in which both patients’ and carers’ attitudes to each other were considered and none of these looked at negative feelings and their impact. There is scope therefore to investigate the attitudes of patients and carers towards each other and how this can effect the quality of care. It is anticipated that the benefits of such investigations could lead to the development of educational strategies designed to improve the quality of patient care.     

HIV/AIDS人员的心理特征及人文关怀

HIV/AIDS人员作为一个特殊的社会群体,普遍存在负性心理反应,并引发一系列社会问题,在护理这些人员的过程中,应针对他们的心理特点给予人文关怀,改善其身心健康状况。     

Unhealthy substance-use behaviors as symptom-related self-care in persons with HIV/AIDS

Unhealthy substance-use behaviors, including a heavy alcohol intake, illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage their disease-related symptoms. This study, based on data from a larger randomized controlled trial of an HIV/AIDS symptom management manual, examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms. The mean age of the sample (n = 775) was 42.8 years and 38.5% of the sample was female. The mean number of years living with HIV was 9.1 years. The specific self-reported unhealthy substance-use behaviors were the use of marijuana, cigarettes, a large amount of alcohol, and illicit drugs. A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance-use behaviors, including amphetamine and injection drug use, heavy alcohol use, cigarette smoking, and marijuana use. The implications for clinical practice include the assessment of self-care behaviors, screening for substance abuse, and education of persons regarding the self-management of HIV.     

Attitudes of university students towards HIV/AIDS

The purpose of this study was to assess, in one university in Finland, students' attitudes and feelings towards HIV/AIDS while they were studying for their first year at the University of Oulu. This study is part of a larger research project concerning HIV/AIDS in the Department of Nursing at the University of Oulu. The results can be used in planning and implementing health education for young people. The data were collected by using a questionnaire with both structured and open-ended questions. The study group consisted of 245 students who had started their studies in the autumn of 1993. The data were analysed by using cross tabulation (chi-square test) and inductively by content analysis. The most important source of knowledge concerning HIV/AIDS was television (84%) and 30% of the students had obtained their knowledge from a school nurse. Even when there was a lot of knowledge available to the students, they estimated their knowledge as insufficient and defined HIV more correctly than AIDS. Knowledge did not increase the use of safe sex but limited sexual behaviour. Religion had an importance for sexual behaviour. Female students were more sexually active than male students. The feelings towards HIV/AIDS were more often negative than positive or neutral and the students felt stronger negative feelings towards AIDS than HIV. The negative feelings were often based on fear. The differences between the faculties were minimal.     

湖北省HIV感染者/AIDS病人的知觉压力及压力源的调查

[目的]了解湖北省人类免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)病人的心理压力水平,探究导致压力产生的压力源,为有效心理干预提供理论依据。[方法]采用方便抽样法对我省95例HIV感染者/AIDS病人进行调查。调查问卷由中文知觉压力量表、中文AIDS病人的症状体征量表和修订版AIDS病人压力源量表组成。[结果]HIV感染者/AIDS病人的知觉压力总分为25.90分±8.58分,女性病人压力水平高于男性病人(P<0.01)。身体症状体征、经济问题及性别是知觉压力的预测因子。[结论]HIV感染者/AIDS病人处在较高压力水平;身体症状严重、遭遇经济问题以及女性病人更容易产生压力感。     

HIV/AIDS肺部感染的影像学表现

目的 探讨HIV／AIDS合并肺部感染的X线及CT表现。方法 收集临床确证的HIV／AIDS病人中有胸部影像异常者10例,所有病例均有胸部X线及CT照片。结果 肺结核表现为肺内斑片、大片影,纵隔淋巴结肿大及肺外淋巴结肿大。军团菌肺炎为大片状影像,卡氏囊虫肺炎为弥漫性浸润及间质异常影像。结论 肺结核、卡氏肺囊虫及革兰阴性杆菌肺炎是HIV／AIDS的较常见的机会感染。HIV／AIDS病人肺内出现斑片、大片和弥漫病变,或有关淋巴结肿大时应考虑到这些疾病的可能。     

Sociocultural factors influencing HIV/AIDS caregiving in Addis Ababa, Ethiopia

The sociocultural factors that influence care and caregiving vary from place to place, with both beneficial and harmful effects on the health of the caregivers. Therefore, this article presents the cultural and social structural factors that influence care and caregiving from the perspectives of the family caregivers of people living with HIV/AIDS in Addis Ababa, Ethiopia. Using semistructured interviews and participant observation, a purposive sample of six key participants and 12 general participants were interviewed in their home between December 2005 and January 2006. Four important sociocultural factors that influence care and caregiving have been identified: religious beliefs, economic issues, education, and social stigma and discrimination. The findings of our study underscore the importance of understanding the cultural and social structural factors that influence care and caregiving from the perspectives of family caregivers in order to provide culturally congruent care to those in need.     

HIV/AIDS stigma among older PLWHA in south rural China

Stigma is a common problem among people living with HIV/AIDS (PLWHA). However, little is known about HIV/AIDS‐related stigma in older PLWHA over the age of 50. This study described the stigma of HIV/AIDS and its factors based on 120 PLWHA aged 50 or older in an area of high HIV prevalence in south rural China. Each participant completed a face‐to‐face questionnaire that collected information on demographic characteristics, AIDS‐related events and experience of HIV/AIDS‐related stigma. Finally, only 18.1% reported experiencing external stigma compared with 64.3% feeling internal stigma. Regression analysis indicated that social support and health status were the two variables that were significantly predictive of both external and internal stigma. Whatever, the more support were received from family members by PLWHA, the less external stigma was perceived. Negative marital situation was also related to external stigma. Reducing HIV/AIDS stigma requires a supportive environment, positive attitude and correct knowledge of AIDS. Health workers and policy makers should take practical approaches to reduce prejudice.     

河南省204例HIV/AIDS患者的临床和治疗概况

目的：报道河南省204例人类免疫缺陷病毒－1（HIV－1）感染和艾滋病（AIDS）患的临床表现和治疗概况，为进一步计划HIV／AIDS的综合防治措施提供依据。方法：分析自1998年2月至2001年7月收治的204例HIV／AIDS患的一般情况、流行病学资料、临床表现、治疗情况。结果：感染多为青壮年，感染途径以经血液感染为主，但性接触传播和母婴传播亦相继出现。有症状、无症状组中的平均病毒载量和CD4、CD8 T细胞计数及CD4／CD8比例呈现明显差别。结论：HIV感染的传播途径非常明确，因而其传播是完全可以预防的。早期预防，早期诊断，加强治疗，实行综合防治措施，有助于控制HIV感染的流行。     

贫困地区农村HIV/AIDS综合预防管理及健康教育的模式研究

目的 探讨综合预防管理及健康教育网络模式对贫困地区农村居民艾滋病知识、态度及行为的影响.方法 采用类实验性研究,建立由县、乡、村、家庭4级网络为纵向结构,不同人群为横向结构,家庭为基本单位,妇女及青少年为重点人群的HIV/AIDS综合预防管理及健康教育网络模式,进行为期1年的干预.应用艾滋病知识、态度及行为问卷进行干预...     

A comparative study of substance use before and after establishing HIV infection status among people living with HIV/AIDS

Objective: To determine if significant differences exist in substance use among people living with HIV/AIDS (PLWHA) before and after establishing their HIV infection status.

Method: The study participants are HIV positive clients of a community based HIV/AIDS outreach facility located in Montgomery, Alabama. The questionnaire includes demographics, substance use and risky sexual behaviors pertaining to HIV transmission. Each participant completed an anonymous questionnaire. A total of 341 questionnaires were distributed and 326 were fully completed and returned, representing a response rate of 96%.

Results: Findings revealed a statistically significant difference in alcohol consumption before sex among PLWHA before and after establishing their HIV infection status (p = .001). No significant differences were observed among participants who reported as having used drugs intravenously (p = .89), and among those sharing the same syringe/needle with another person (p = .87) before and after establishing their HIV infection status.

Conclusion: There is continued substance use and alcohol consumption before sex among PLWHA after establishing their HIV status despite clear evidence of such risky behaviors that could lead to an increase in exposure to HIV.     

Preliminary evidence of an adolescent HIV/AIDS peer education program

Adolescent peer education has been found to be an effective method to improve adolescents' knowledge and positive health behaviors. The purpose of this study was to determine the extent to which a peer education program was effective in changing adolescents' HIV/AIDS knowledge, risk behavior intentions, and confidence to engage in safe sex. The results showed that there was a significant difference in HIV knowledge between the peer education group and the traditionally educated group, with the peer group demonstrating greater knowledge. There was no significant difference in confidence to engage in safe sex between the two groups, but students in the intervention group were more likely to engage in safe sex than students in the traditionally educated group. Nurses can provide leadership in the development, implementation, and evaluation of peer education in adolescent health.