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.     

Undergraduate nursing student's attitudes towards caring for people with HIV/AIDS

The aim of this quantitative study was to determine the attitudes of Australian nursing students towards caring for people with HIV/AIDS. This research study was conducted among second year undergraduate nursing students at a university in South Australia, during August 2007. The survey tool consisted of six demographic questions and the AIDS Attitude Scale. This questionnaire was completed by 396 students, giving a response rate of 94.7%. The vast majority (95.7%) of students participating in this study demonstrated very positive attitudes towards caring for people with HIV/AIDS and only 4.3% demonstrated negative attitudes. No statistically significant differences were found in attitude score based on participants' age, gender, previous HIV/AIDS education, previous nursing experience or previous experience of caring for someone with HIV/AIDS. A statistically significant difference in AIDS attitude score was found in relation to participants' country/region of citizenship, with nursing students from China, East Asia, South East Asia, and Central Asia and Middle East having more negative attitudes than students from other countries/regions. As an increasing number of nursing students have been recruited to Australia from these countries/regions, nurse educators need to be aware of such differences when planning and delivering HIV/AIDS educational programs in tertiary institutions.     

Attitudes towards people with HIV/AIDS: entropy and health care ethics

Attitudes held by health care workers towards people with HIV and AIDS are on the whole negative, and numerous studies confirm the reality and complexity of this tendency. This paper will provide a related literature review, and identify four particular factors that go some way towards explaining the robustness of these attitudes. These are social, psychological, political and anthropological in nature. A model from classical physics will be used metaphorically to illustrate and articulate the apparent inevitability of this harmful process, and also a possible solution.     

Cultural encounters in reflective dialogue about nursing care: a qualitative study

Title.  Cultural encounters in reflective dialogue about nursing care: a qualitative study.
Aim.  This paper is a report of a study to explore how students developed reflective nursing practice through cultural encounters between students from Tanzania and Norway.
Background.  Nursing students need to develop cultural care competence to care for patients in a globalized world. One way to achieve this goal may be through international practice experience. Previous studies have shown that students visiting developing countries matured personally and intellectually more than those who experienced encounters between developed countries.
Method.  The study was exploratory, using qualitative data about nursing practice and cultural encounters experienced by nursing students from Tanzania and Norway. Data were collected through participatory observation, students' logs and focus group interviews in 2006.
Findings.  The encounter was characterized with an open attitude facilitating a good context for co-learning between the students. Three main themes were identified. The Norwegian students emphasized nurse–patient relationships, individualized care, direct communication and emotional involvement. The Tanzanian nursing students demonstrated a collectivist approach in nursing characterized by nurse–relative–patient relationships, and they emphasized curing attributes with skilful performance of procedures.
Conclusion.  A cultural encounter between students from different culture proved to be a fruitful way of teaching nurses. The opportunity to share thoughts, reflect on value systems and personal practice through dialogue with students from a different culture offer possibility in terms of cultural competence, reflexivity and consciousness of various ways practising nursing. This may contribute to bringing the practice of nursing a step forward in both cultures.     

Attitudes of professionals, students and the general public to HIV/AIDS and people with HIV/AIDS: a review of the research

This paper provides a review relating to the attitudes of health care professionals, students and the general public to HIV/AIDS and people with HIV/AIDS. This is done by describing the literature on attitudes to HIV and AIDS in three fields of research: medicine/nursing, psychology and the social sciences. In addition, we look at the countries in which research has been conducted in these issues and at the variety of tools and methodological approaches used and at the participants studied. The review shows that, during the 1990s, the research interest in issues related to HIV/AIDS attitudes has rapidly increased. Most of the work on HIV and AIDS has been done in the United States, with the main focus on empirical research using questionnaires. The attention has mostly been on students and their attitudes to AIDS/HIV and sexual behaviour, but increasing interest has also been shown in the attitudes of health care personnel and students. As it seems that attitudes have been highly resistant to change, more consideration needs to be given to finding appropriate ways of educating the general public, students and health care professionals. A comprehensive analysis is also needed of the different tools used in measuring attitudes and in international comparisons of the attitudes of adolescents, health care professionals and students towards AIDS and AIDS patients.     

Examining the role of vocational rehabilitation on access to care and public health outcomes for people living with HIV/AIDS

Abstract

Purpose: The purpose of this study is to examine the role of vocational rehabilitation services in contributing to the goals of the National HIV/AIDS strategy. Three key research questions are addressed: (a) What is the relationship among factors associated with the use of vocational rehabilitation services for people living with HIV/AIDS? (b) Are the factors associated with use of vocational rehabilitation also associated with access to health care, supplemental employment services and reduced risk of HIV transmission? and (c) What unique role does use of vocational rehabilitation services play in access to health care and HIV prevention? Method: Survey research methods were used to collect data from a broad sample of volunteer respondents who represented diverse racial (37% Black, 37% White, 18% Latino, 7% other), gender (65% male, 34% female, 1% transgender) and sexual orientation (48% heterosexual, 44% gay, 8% bisexual) backgrounds. Results: The fit of the final structural equation model was good (root mean square error of approximation?=?0.055), with 90% upper bound of 0.058, Comparative Fit Index?=?0.953, TLI?=?0.945). Standardized effects with bootstrap confidence intervals are reported. Conclusions: Overall, the findings support the hypothesis that vocational rehabilitation services can play an important role in health and prevention strategies outlined in the National HIV/AIDS strategy.

• Implications for Rehabilitation

• Vocational rehabilitation services can play a unique role in contributing to the goals of the National HIV/AIDS strategy by increasing access to care, increasing use of job support services and reducing health-risk behaviors.

• Increased job confidence and more positive health perception reduced HIV stigma, which is a key mediator to use of vocational rehabilitation services.

• The Behavioral Model of Vulnerable Populations is a useful framework to evaluate the impact of vocational rehabilitation services on access to health care and health-risk behaviors.

     

Nurses Fighting the HIV/AIDS Epidemic in Africa

Nurses involved in HIV/AIDS care must contend with many practical, professional and ideological issues. In doing so they must also be activists for social justice and human rights in health care, especially in countries where poverty and lack of knowledge are inextricably linked to the spread of HIV. Below, a report on where nurses are and should be going in Africa.     

护理人员HIV／AIDS知识、态度、技能的干预研究

目的探讨对护理人员系统进行艾滋病相关知识、态度、技能等培训后,护理人员对HIV/AIDS的认知、态度及实际技能的改变.方法采用便利抽样的方法,选择三级甲等医院800名护理人员进行培训,进行基线和终期及每期培训前后问卷调查.结果培训后护理人员有关艾滋病知识、操作技能与培训前有统计学差异(P＜0.01),而护理人员对艾滋病态度与培训前无显著差异(P＞0.01).结论对护理人员进行艾滋病相关知识和技能的培训是必要的.     

Caring for older people with dementia in residential care: nursing students' experiences

AIM: This paper is a report of selected findings from two projects aimed at improving nursing students' experiences of caring for older people in elder care settings. BACKGROUND: With a growing number of older people the prevalence of dementia is rapidly increasing, such that it is now a primary reason for admission to residential care. This has implications for the preparation and support of nursing students on clinical placements as people with dementia represent a key focus of their nursing activities. METHOD: Two projects were conducted in Tasmania between 2001 and 2005, involving 87 second year Bachelor of Nursing students who participated in 3-week clinical placements in eight residential elder care facilities. During the placements, students and their mentors participated in a series of weekly focus group discussions to explore their experiences of caring for residents with dementia. Thematic analysis of the data was conducted. FINDINGS: Staff in the facilities struggled to support students effectively and often failed to recognize that students found residents' behaviour disturbing. Despite having some theoretical understanding of dementia, students reported being unsure of how to respond to residents and often felt scared and intimidated. CONCLUSION: Better preparation and support are needed for students on placements involving residents with dementia. Feasible strategies for more effective support include increased curriculum content about caring for people with dementia, and improved collaboration between university schools of nursing and settings for care of older people.     

艾滋病科护士专业自我概念与工作满意度相关性研究

目的:探讨艾滋病科护士专业自我概念与工作满意度的关系,为提高艾滋病科护士专业自我概念和工作满意度提供理论依据。方法:采用护理专业自我概念量表(PSCNI)、护士工作满意度量表(MMSS)对广东省6家艾滋病定点医院的188名护士进行问卷调查。结果:艾滋病科护士专业自我概念总分为(83.36±10.69)分,工作满意度总分为(94.39±15.54)分;工作满意度与专业自我概念的管理能力、专业技能、灵活性、满意度呈显著正相关(P0.01),与专业自我概念的沟通能力无相关性。结论:艾滋病科护士的专业自我概念水平和工作满意度较高。专业自我概念中管理能力、专业技能、灵活性、满意度是工作满意度的影响因素。医院应培养护士积极的专业自我概念,从而提高护士工作满意度,发挥护士工作积极性和创造性,促进艾滋病护理专业的发展。     

The correlation between alcohol consumption and risky sexual behaviours among people living with HIV/AIDS

The objectives of this study were to determine if significant correlation exists between drinking any alcoholic beverage and risky sex among 326 AIDS patients. Participants completed anonymous surveys. The result of the regression and Pearson correlation analyses revealed a significant positive correlation between drinking alcohol before sex and frequency of condom use (p<0.0001). The number of sex partners respondents reported was also correlated with the frequency of alcohol use (p = 0.003). The result shows that the quantity of alcohol consumption was correlated with two indicators of risky sex: having multiple sexual partners (p<0.0001) and having sexual intercourse without a condom (p<0.001). Interventions are that integrate HIV risk reduction with alcohol risk reduction is very useful to minimize the risk of new HIV infections and/or manage existing infections.     

HIV/AIDS and disability: Differences in HIV/AIDS knowledge between deaf and hearing people in Nigeria

Purpose. Studies both in North America and Europe have found that deaf individuals lack access to AIDS information, due to problems in communication, low literacy and tightly woven social networks within the deaf community. However few comparable studies are available from countries in the Developing World. The present study was undertaken in Nigeria where there is an estimated adult HIV prevalence rate of 5.4%. We sought to compare HIV knowledge among deaf and hearing individuals in order to identify how effectively deaf members of the community are being reached by HIV/AIDS messages.

Methods. A survey comparing knowledge about HIV/AIDS among deaf and hard of hearing adolescents (n = 50) and young adults (n = 50) was undertaken.

Results. Significant differences (p < 0.05) in levels of understanding about certain aspects of how AIDS is spread were identified as well as differences in available resources for access to accurate information among deaf members of the population.

Conclusion. These findings from Nigeria speak strongly to the need for the development of interventions that include people with disabilities in public health and HIV/AIDS strategies and that address their specific vulnerabilities. Evaluating the adaptation of education material and the inclusion of the deaf population in HIV awareness programmes is an urgent ‘next step.’     

Assessment of palliative care needs for people living with HIV/AIDS in Rwanda

Abstract

The rising number of people living with HIV/AIDS (PLWHA) world-wide has made healthcare professionals and policy makers search for accessible healthcare that will meet the needs of people who are suffering from the disease and enhance their quality of life (QoL). This study investigated met and unmet palliative care needs of PLWHA in selected areas in Rwanda. The study sample included 306 participants: PLWHA, healthcare professionals and co-ordinators of HIV/AIDS units. Quantitative and qualitative methodologies were used. The data were analysed separately and then triangulated. In the findings, over 50% of PLWHA had symptoms related to HIV/AIDS most of the time, with the most common symptom being pain. Participation in activities of daily living was associated with the health status of PLWHA (P < 0.001). The most common perceived palliative care needs of PLWHA were: (i) medical needs, psychosocial needs and the need for financial assistance (77%); (ii) home-based care (47%); (iii) nutritional support (44%); and (iv) pain relief and management of other symptoms (43%). Most PLWHA indicated these palliative care needs were unmet, in particular, the need for pain relief, symptom management, financial assistance and nutritional support. Over 50% of healthcare professionals reported they were not trained in palliative care. They indicated that inadequate policy and resources were the main obstacles to the provision of optimal palliative care. Addressing unmet palliative care needs would enhance the QoL of PLWHA. In addition, developing policy related to the provision of palliative care and building the capacity of healthcare providers is essential for the provision of adequate palliative care services in Rwanda.     

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.