Risk and obligation: Health professionals and the risk of AIDS

Abstract

This essay deals with the question of risk-taking by physicians and other health professionals when confronted with AIDS patients. The duty to take risks, and consequently to treat patients who have AIDS, is examined (a) from a historical perspective; (b) by considering fear and courage in the medical setting; (c) by considering views of community, justice, and the social contract; and (d) in light of notions of professionalism and obligation. It is concluded that health professionals have a historically grounded obligation to assume “reasonable” risks in dealing with such patients, that “reasonable” is defined by the community, and that this modifiable obligation emerges from views of community, justice, and professionalism.     

Risk and obligation: Health professionals and the risk of AIDS

This essay deals with the question of risk-taking by physicians and other health professionals when confronted with AIDS patients. The duty to take risks, and consequently to treat patients who have AIDS, is examined (a) from a historical perspective; (b) by considering fear and courage in the medical setting; (c) by considering views of community, justice, and the social contract; and (d) in light of notions of professionalism and obligation. It is concluded that health professionals have a historically grounded obligation to assume “reasonable” risks in dealing with such patients, that “reasonable” is defined by the community, and that this modifiable obligation emerges from views of community, justice, and professionalism.     

King's theory and its interface with the "Family Health" Program

This study of epistemological intention is about King's goal achievement theory and its contributions on knowledge and practicing for nurses who work in the "Family Health" Program (FHP), Brazil. The analysis component, based on the Meleis' Method of Theory Analysis concerning critical thought on the theory, was applied as well as reading and thoughts on FHP guidelines and proposals in order to verify the interface between the two paradigms in the study. The outcome of the study proves that the two approaching proposals are coherent. Such coherence drives authors to recommend the adoption of King's teachings concerning FHP practice for nursing to obtain greater and better results in its actions.     

Family and mental disease: the difficulty of living with differences

This study started from the reflections on the Psychiatric Care Reform and the desinstitutionalization process. The goal of this study is to identify the social representations built by the patients' relatives on the mental health-disease phenomenon. For analysis we have adopted the social representation referential through the Moscovici perspective. Eight relatives of the patients were interviewed. We have identified the mentioned relatives, considering those who are really different, as the center of their social representations. We have point out the importance of the mental health professionals to give careful considerations on their interventions, regarding to the knowledge emerged from the report of the patients' relatives.     

Family caregiving of persons living with HIV/AIDS in Thailand: caregiver burden, an outcome measure

The present paper provides an initial picture of HIV/AIDS-affected families. It is evident that families play a major role of support for HIV/AIDS patients in Thai society. Caregiver burden is one of the patient-related outcomes, which is the most common outcome measure in caregiver research. The demands on the family caregivers of these patients are enormous and need to be addressed. The determinants that are associated with caregiver burden such as caregiver characteristics, patient characteristics and social stigma are important for nurses to minimize the burden of care so that appropriate interventions can be developed for persons with HIV/AIDS and family members who share the work of managing their care at home.     

Aging and living with HIV/AIDS

With individuals either living longer with the disease or contracting it at a later stage in life, HIV/AIDS can no longer be regarded as just a young person's disease. In fact, people older than 50 will represent 50% of HIV/AIDS cases by 2015. The intersection of aging and HIV/AIDS is explored in this article through the use of an individual example highlighting typical age-related issues encountered in living with a chronic HIV infection and two of the more common comorbid conditions. Nursing implications for managing these conditions-depression and dyslipidemia-as well as other considerations for providing care to older adults with HIV/AIDS are addressed.     

Women living with type II diabetes: the intrusion of illness

This study is part of a larger research project which aimed to create an understanding of how people with type II diabetes incorporated chronic illness into their lives. We aimed to find wellness in the context of a chronic illness. The participatory action-orientated research (PAR) approach is consumer based and managed, and six women with diabetes and the research team met for eight two-hour sessions in August and September 1998. The objectives were to contribute to understanding of the health of adults who live with chronic illness by providing greater insight and understanding into the worlds of people who live with a chronic illness and allowing the voices of people with diabetes to be clearly heard in relation to their health. There was a wellness theme around taking time out, but considering the other dominant negative experiences, this study can only be considered as an attempt to find wellness in the context of chronic illness. The PAR process, built upon sharing, listening and reconstructing stories, worked toward the women being heard and having a voice for the first time. Listening and acting upon the voices of the women has implications for the practice of health care professionals.     

Risk and obligation: health professionals and the risk of AIDS.

This essay deals with the question of risk-taking by physicians and other health professionals when confronted with AIDS patients. The duty to take risks, and consequently to treat patients who have AIDS, is examined (a) from a historical perspective; (b) by considering fear and courage in the medical setting; (c) by considering views of community, justice, and the social contract; and (d) in light of notions of professionalism and obligation. It is concluded that health professionals have a historically grounded obligation to assume "reasonable" risks in dealing with such patients, that "reasonable" is defined by the community, and that this modifiable obligation emerges from views of community, justice, and professionalism.     

A Lifestyle Intervention Program to Improve Knowledge and Health Behaviors in Women

ObjectiveTo improve health knowledge, facilitate healthy behaviors, and provide social support for a high-risk population of women by implementing a culturally tailored, gender-specific lifestyle intervention program.DesignEvidence-based practice project.Setting/Local ProblemA Chicago neighborhood in Cook County, Illinois, where there are increased rates of diabetes, heart disease, cancer, stroke, hypertension, obesity, preterm birth, and violent crime.ParticipantsFemale residents of the community, ages 19 to 45 years; 12 participants registered for the program, and 11 participants completed the entire 2-month program.Interventions/MeasurementsThe BE WISE Lifestyle Intervention, a culturally tailored, gender-specific behavior change curriculum, was used for this project. An interprofessional team was used to enhance participant experience, and neighborhood collaborations were established to create sustainability of efforts. Pre- and postintervention measures of diet, physical activity, social support, and knowledge acquisition were used to evaluate outcomes.ResultsImprovement was noted for knowledge in most of the content areas, as well as for dietary and physical activity behaviors. All participants rated the program highly and responded positively to the social support experienced in the group.ConclusionCulturally tailored lifestyle interventions can be effective in improving knowledge and encouraging behavior change, especially when delivered in group settings to enhance social support. Community-level collaborations enhance interventions by providing local support and resources for participants. Because behavior change takes time, follow-up at the 6-month and 1-year intervals is recommended to determine longer-term outcomes.     

Women and AIDS: sociopolitical issues.

HIV infection and AIDS in women will continue without adequate diagnosis and treatment as long as women are not treated as full partners in society. Until issues related to women and their place in society are considered within the sociopolitical context, women who are at risk for HIV infection, those infected with the HIV virus, and those with AIDS will continue to receive inadequate attention. The National Center for Nursing's National Action Agenda, Nursing and the HIV Epidemic, provides some direction for addressing these issues and those that relate to practice, education, research, and health policy. It is incumbent on nurse researchers to conduct research related to the critical issues associated with HIV infection and AIDS in women, disseminate the findings of that research, and use those findings to inform and move health policy in this area forward. It is equally important to understand the issues that affect women--ethnic considerations, sexual practices, IV drug use--within the context or present political climate of our society. That climate allowed an NIH study that could identify risky sexual behaviors of adolescent and adult subjects who consent to participate in such a study to be called to a halt--not because of concerns about the study design or the scientific rigor of the study, but because of an elected official's fear that asking such questions will encourage these behaviors and his personal belief that such issues should not be discussed in polite society. These issues must be brought forward, acknowledged, and discussed if they are to be dealt with effectively. Otherwise, the relentless course of AIDS will continue.(ABSTRACT TRUNCATED AT 250 WORDS)