Careers in child health nursing: the influence of course experiences

Findings presented in this paper are drawn from a longitudinal study of nurses' careers (Robinson et al 1998, 1999). As part of this study, a large cohort of child branch diplomates were asked about their clinical experience while on the course and its effects on their initial work plans. For 12 of the 23 specialties listed, more than half of the 634 respondents felt that they did not have sufficient experience to comment. Findings indicate that there were five specialties which more than half of those who had experience during the course felt encouraged to work in: general paediatrics (73 per cent), community (63 per cent), oncology (60 per cent), PICU (59 per cent), and cardiac (53 per cent). Overall, course experiences were more likely to encourage than discourage diplomates from wanting to work in a particular specialty; this was the case for 19 of the 23 specialties. Course experiences were significantly more likely to have discouraged than encouraged diplomates from considering working in theatres and psychiatry. Seventy-seven per cent of respondents (417) had obtained a first job in their preferred clinical specialty. Findings from this study indicate that course experiences influence the initial career plans of child branch diplomates. Data obtained from further phases of this longitudinal study will indicate to what extent course experiences influence later career decisions.     

Physiotherapists and human immunodeficiency virus/acquired immune deficiency syndrome: knowledge and prevention: a study in Durban,South Africa

This study determined what physiotherapists in Durban, South Africa know about human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), their attitudes towards patients and how they cope as individuals. Data were collected using a validated questionnaire. One-hundred-and-fourteen physiotherapists in Durban hospitals participated in the study. Seventy-two per cent of the questionnaires met the criteria for analysis. Ninety per cent of the participants believed that they knew about HIV/AIDS, but only 78% could identify all viral transmission modes. Of the 38 physiotherapists who believed that they knew the stages of an HIV infection, only 11% actually knew the stages, 28% could not explain them and 61% were vaguely aware. Fifty-six per cent of the respondents had treated patients who had died from HIV/AIDS. Only 38% of physiotherapists were completely at ease when treating HIV/AIDS patients despite the fact that 98% believed that physiotherapy was an integral component of the management of an AIDS patient. Fifty-one per cent of the respondents were unaware of support structures provided by their employers. The authors conclude that the perceptions of physiotherapists about their knowledge about HIV/AIDS do not stand up to scrutiny. Significantly more attention should be paid to the development, implementation and evaluation of the effectiveness of educational programmes on HIV/AIDS for physiotherapists in the workplace.     

Relationship between symptoms, subjective well-being and medication use in gastro-oesophageal reflux disease

AIM: To report data from a multinational survey investigating the relationship between gastro-oesophageal reflux disease (GERD) symptoms, treatment and subjective well-being. METHODS: Patients formally diagnosed with GERD (n=929) and undiagnosed subjects with symptoms suggestive of GERD (n=924) were included. RESULTS: Sixty per cent of diagnosed (mean age: 51.7 years) and 54% of undiagnosed (mean age: 44.3 years) participants were female. Over 50% of participants were overweight or obese. Most respondents consumed alcohol, and one-third were smokers. In total, 78% of diagnosed subjects were currently receiving medication prescribed by their doctor, and 65% were taking over-the-counter (OTC) treatments. The majority (97%) of undiagnosed subjects were taking OTC medication, the most common of which were antacids (78%). Despite medication, 58% of diagnosed and 73% of undiagnosed subjects still experienced GERD symptoms some of the time. Approximately one-third of subjects in each group reported that they ate less than usual, felt generally unwell, were tired/worn out or worried/fearful for the majority of the time because of their GERD symptoms, and around half reported decreased well-being, including reduced work or leisure time productivity. CONCLUSIONS: These findings attest to the severity and impact of GERD symptoms, highlighting the need to improve the management of GERD in routine practice. Many symptomatic and long-term sufferers, for example, may benefit from taking steps towards a healthier lifestyle (e.g. weight reduction) in addition to optimisation of acid-suppressive therapy.