Caring for persons with AIDS: Knowledge and attitudes of 1,047 health care workers attending AIDS action committee educational programs

Thirty-six educational programs on AIDS for 1047 massachusetts health care providers were evaluated by pre-and post-program questionnaires. Providers' knowledge about modes of transmission and means of preventing transmission were ascertained, as were professional and personal attitudes about persons with AIDS. Providers included 149 who established regulations, 345 supervisors, 468 inpatient care and 85 outpatient care providers. Results suggest 1. a need for provider education; and 2. significant differences among the four groups in knowledge and attitudes, both before and after programs, with regulators having the most accurate knowledge and inpatient care providers the least. Suggestions are made for development of effective education to prevent AIDS among caregivers and to prevent the emotional injuries associated with being an AIDS patient.     

Domestic violence and primary care. Attitudes, practices, and beliefs.

OBJECTIVE: To assess the attitudes and beliefs of the primary care provider team (physicians, physician assistants, nurses, and medical assistants) toward the identification and management of abused patients and perpetrators of domestic violence (DV). DESIGN: Survey of the health care team using a confidential questionnaire. SETTING AND SUBJECTS: Five primary care clinics with 240 providers at a large urban health maintenance organization. RESULTS: The response rate was 86% (206 respondents). Fifty percent of clinicians and 70% of nurses/assistants believed that the prevalence of DV in their practice was 1% or loss; 1 in 10 clinicians and nearly half of nurses/assistants had never identified an abused person; 45% of clinicians never or seldom asked about DV when examining injured patients; and all participants were much less confident in asking about DV than about smoking or consuming alcohol. Twenty-five percent believed the abused person's personality led to the violence; 28% believed they did not have strategies to help abused persons; and 20% were concerned for their personal safety in discussing DV. Only 10% believed they had management information, but 77% had not attended any educational programs on DV in the past year. CONCLUSIONS: This study provides important information about current knowledge, attitudes, and beliefs of health care providers toward the diagnosis and management of DV. This information should prove useful to all who attempt to design clinical strategies and educational programs to address this issue.     

HIV/AIDS knowledge and attitudes among alcohol and drug abusers in Egypt

The aim of this study was to assess knowledge, attitudes and practice towards HIV/AIDS among alcohol and drug abusers and the effect of health education (HE) on their knowledge and attitudes. Participants were 265 substance abusers, recruited from 8 addiction rehabilitation centers. A base line study preceding HE was done using a questionnaire composed of five sections. Three scores were developed to assess HIV/AIDS related knowledge. The base line study indicates that addicts with good knowledge scores > or =75%) regarding modes of transmission were significantly higher among males than females. About 70% of the addicts had negative attitudes towards dealing with HIV/AIDS patients, while 55.5% felt sympathy for them. Eleven percent of the injection drug abusers were sharing needle with others, while 38% of the participating females were previously convicted of prostitution. Logistic analysis showed that high level of education was the best predictive variable for good knowledge scores (> or =75%). Evaluation of the health education program revealed a highly significant increase in the knowledge scores among both males and females compared to the pretest scores. An increase in the percentages of male and female addicts with improved attitudes towards HIV/AIDS patients was also noted after HE. So, HE was found to be a successful tool in improving the knowledge and attitudes of substance abusers towards HIV/AIDS.     

The limitations of generic AIDS educational programs for the health professions

Three major trends are driving the widespread need for continuing education in AIDS. First, with the spread of AIDS, increasing numbers of health care professionals are becoming involved in the care and treatment of AIDS, ARC and HIV positive individuals. Second, as the disease spreads beyond current AIDS epicenters, more persons with minimal information are required to have a baseline working knowledge of AIDS. Finally, the reluctance of many health care professionals to care for HIV-positive individuals, along with already existing staff shortages, limits access to care and makes the provision of responsive educational programs even more important. Generic programs to educate health professionals frequently lack sufficient specificity and sensitivity to address the needs of health professionals with varying levels of knowledge and role responsibility. This paper briefly summarizes the literature on the similarities and differences in knowledge and attitudes across and within professional groups. In addition, it presents specific research designed to provide initial direction for considering the circumstances under which health professionals, particularly nurses and physicians, may or may not profit from generic programs aimed at mixed levels and types of health care provider.     

Opinions of Rural Texas Parents Concerning Elementary School Health Education

ABSTRACT: Parents of elementary school children in rural east-central Texas were surveyed about their attitudes toward and knowledge of Comprehensive School Health Education. Data indicated widespread support for health education compared to other subject areas. Parents felt alcohol and other drugs, nutrition, and first aid were the most important topics to be covered in elementary school, while sexuality, cancer, and stress were the least important. Parents were most comfortable discussing alcohol and other drugs, family life, and growth and development with their children and least comfortable discussing exercise, cancer, and sexuality. Implications for school health programs are discussed.     

Minnesota's Midwest AIDS Training and Education Center: helping health care providers remain current on a rapidly changing epidemic

Since 1990, the number of people in Minnesota living with HIV/AIDS has been steadily increasing. The demographics of who is infected with HIV have changed, with more women and people of color being diagnosed. In addition, with new therapies and continually updated treatment recommendations, the information needed to provide quality medical care to HIV-infected patients is constantly evolving. Thus, providers who care for patients with HIV/AIDS need ongoing education about the disease. The Midwest AIDS Training and Education Center (MATEC) is a federally funded program that helps health care providers stay abreast of HIV clinical care and management knowledge. Based at the University of Illinois at Chicago, MATEC provides services in seven states, including Minnesota. This article describes how MATEC's HIV/AIDS training and education programs are being implemented in Minnesota and the different ways MATEC is delivering provider education in this important area.     

Primary care physicians and barriers to providing care to persons with HIV/AIDS

Primary care physicians play an increasingly important role in the care of persons with HIV/AIDS due to the rising number and changing geographic distribution of persons infected with HIV/AIDS. The study explored the relationship between barriers to health services and the experience and willingness of primary care physicians to care for persons with HIV/AIDS. The study was based on a random survey of primary care physicians in South Carolina. The results indicate that although primary care physicians' willingness to treat persons with HIV/AIDS is significantly associated with many self-reported barriers (i.e., financial, structural, knowledge, and attitudinal), their HIV/AID care experience was most significantly correlated with self-reported knowledge that overrides financial and structural barriers. The results emphasize the importance of programs and policy initiatives aimed at enhancing the primary care physicians' knowledge level and improving their attitudes related to HIV/AIDS.     

南京市流动人口艾滋病健康教育效果评价

目的提高流动人口艾滋病相关知识水平,增强自我保护能力,减少感染性病艾滋病的风险,控制南京市流动人口性病艾滋病的蔓延。方法对南京市流动人口聚集地的流动人口开展一系列的艾滋病健康教育活动,干预前后分别作问卷调查,评估健康教育效果。结果除“接受未筛选的血液及血制品可传播艾滋病病毒”外,其余有关艾滋病传播途径及预防知识正确知晓率干预后较干预前有明显提高（P〈0.05）。对艾滋病的认识及态度在干预前后差异有统计学分析意义（P〈0.05）,特别是“愿意与艾滋病病毒感染者交往”的比例由干预前的43.2%（504/1168）上升到干预后的69.7%（798/1145）。求医行为以去公立医院看医生为主,干预前75.3%（879/1168）,干预后上升到93.3%（1068/1145）,差异有统计学意义。结论通过健康教育有效提高了居地流动人口艾滋病相关知识的正确知晓率,减少了对艾滋病的恐惧和歧视。     

IUD-related knowledge,attitudes and practices among Navajo Area Indian Health Service providers

CONTEXT: The IUD once accounted for about half of contraceptive use among Navajo women but is now little used in this population, which has a high rate of unintended pregnancy. Identifying barriers to use–including those stemming from providers'IUD-related knowledge, attitudes and practices–could help expand use of the method.
METHODS: In 2000, 107 Navajo Area Indian Health Service providers who offer contraceptive services completed a mailed survey. Responses of women's health providers and other types of providers were compared, using the Cochran-Mantel-Haenszel method.
RESULTS: Overall, 69-78% of providers had good factual knowledge about the IUD and felt adequately prepared to insert a device or counsel women about it; considerably larger proportions of women's health providers than of others felt able to counsel about and insert IUDs. Sixty-five percent of providers (88% of women's health providers and 50% of others) currently inserted IUDs, and only 8% (none of them women's health providers) never recommended the method. The main reasons providers cited for not recommending the IUD were concerns about its safety and about side effects (mentioned by 69% and 44%, respectively); these concerns did not differ by provider type.
CONCLUSIONS: Provider education and training should focus on insertion techniques and on the safety of available IUDs. Training should be targeted not only to women's health providers, but to family practice physicians, nurse practitioners and other providers who offer family planning counseling and services.     

Correlates of child care providers' interpretation of pediatric AIDS: implications for education and training

A total of 212 child care providers residing in a southeastern state were surveyed about their knowledge and attitudes toward AIDS and child care policies. Providers' feeling about caring for an HIV-infected child, rather than their perceived knowledge of AIDS, were most consistently correlated with their factual knowledge and positive attitudes toward AIDS. These results suggest that providers may pay more attention to AIDS information and become more accepting of recommended child care policies when they are able to personalize AIDS within the context of their work with young children. Implications for education are discussed within the context of the Health Belief Model.     

Knowledge and attitudes about AIDS among corporate and public service employees.

BACKGROUND. We examined the relationship between workplace AIDS education efforts and workers' knowledge about HIV transmission and their attitudes toward coworkers with AIDS. METHODS. Questionnaires were mailed to corporate and public service workers at 12 work sites to ascertain the extent of their knowledge about AIDS and their attitudes toward coworkers with AIDS. Each work site had offered an AIDS education program. The average response rate was 40%; 3460 workers returned questionnaires. RESULTS. Respondents' knowledge was largely consistent with available scientific evidence. However, a substantial minority still believe HIV infection can be transmitted through casual contact. Over 30% endorse the screening of new employees for AIDS, and 23% would fear contagion from an infected coworker. Thirty percent of the respondents expressed skepticism about the veracity of information from government sources and the scientific community. Work site comparisons show that where educational programs are minimal, employees know less about HIV transmission and hold more negative attitudes. CONCLUSION. Comprehensive workplace AIDS education programs can reinforce workers' knowledge about HIV transmission, thereby fostering more favorable views toward coworkers with AIDS.     

贵州省黔南地区受艾滋病影响的农村少数民族已婚妇女健康教育干预效果

目的:评价参与式生活技能教育模式在受艾滋病影响的农村少数民族已婚妇女中的适宜性与有效性,为相关健康促进工作及政策制定提供依据。方法:采用分层整群抽样的方法获得样本,对干预组进行为期6个月的多种形式健康教育干预,采用统一问卷调查,比较干预前后干预组和对照组少数民族已婚妇女对艾滋病的认识态度的变化。结果:干预后受艾滋病影响的已婚妇女对艾滋病认识态度明显提高,干预组妇女艾滋病知识、关爱态度、自尊量表(SES)、个人评价问卷(PEI)得分明显高于对照组。干预组和对照组艾滋病相关知识知晓率分别提高了59.28%和20.35%,干预组的干预效果好于对照组,相对干预效果为41.86%。接受过干预民族为布依族、苗族、水族和毛南族,妇女接受过艾滋病健康教育培训、丈夫接受过艾滋病健康教育培训、艾滋病知识得分低是影响妇女认识态度的正向因素,尤其对接受过艾滋病健康教育干预妇女的认识态度影响最大(OR=1.852)。结论:参与式教育模式是改善民族地区已婚妇女对艾滋病认识态度的有效措施。     

Stigma, discrimination, and HIV/AIDS knowledge among physicians in Barbados.

OBJECTIVE: To determine the extent of clinical knowledge of HIV/AIDS that physicians in Barbados have and their attitudes towards persons living with HIV/AIDS. METHODS: In 2000 the Barbados Association of Medical Practitioners conducted a survey in order to assess its members' views on HIV/AIDS issues. Over a two-month period 203 physicians (76% of all those practicing in the country) were interviewed. The survey included physicians working in private practice and the public sector. They were surveyed individually concerning their attitudes towards counseling as well as their clinical knowledge, perception of safe practices, fear of occupational exposure, views on ethical issues, experience treating HIV/AIDS patients, and background with HIV/AIDS continuing education. RESULTS: In comparison to physicians who had graduated in later years, physicians who had graduated in 1984 or earlier had seen fewer HIV/AIDS clients, had lower levels of knowledge about the disease, were more likely to test for HIV/AIDS without informed consent, and were less likely to have ever attended a continuing education training course on HIV/AIDS. Overall, knowledge of the clinical indications of HIV/AIDS was low, and 76% of the physicians did not think they had adequate counseling skills. Over 80% of the physicians were comfortable looking after HIV/AIDS patients. While 95% of the physicians would not release HIV test results without a patient's consent, 33% would test, without consent, a seriously ill patient, and 15% would test without consent a patient upon whom they had to perform an invasive procedure if they perceived the patient to be from a high-risk population such as gay men or commercial sex workers. Only 53% of the physicians had attended an HIV/AIDS in-service training program between 1995 and 1999. CONCLUSIONS: Physician training in Barbados should focus on all aspects of HIV/AIDS care, including clinical and emotional factors. Attendance at such training should be mandatory for public sector physicians, and medical school curricula need to be examined to ensure their HIV/AIDS content is current and comprehensive.     

AIDS education for health care professionals in an organizational or systems context.

Traditionally, health education for practicing health professionals, as well as members of the public, focuses on the individual and relies on changing personal behavior. However, health care for persons with acquired immunodeficiency syndrome (AIDS), and members of their families, mainly is delivered within health and human services organizations. Providing AIDS education for health care professionals in an organizational or systems context shifts the focus from the individual to the group and from changing a person's behavior to offering health care professionals opportunities for interaction. In an organizational or systems approach, they can address patient care issues collectively, share interdisciplinary knowledge, identify problems of common concern, plan coordinated and integrated responses, and provide mutual support. A strategy for planning AIDS education is proposed for key administrators, supervisors, and care providers, who are the gatekeepers, opinion makers, and role models of organizations. Addressing organizational, community, and health care delivery system issues as part of an education program provides a forum for defining problems and a basis for uniting professionals and developing solutions.     

Rural School Nurses'Attitudes about AIDS and Homosexuality

ABSTRACT: The AIDS epidemic has spread to rural areas of the United States. Conservative rural communities are facing the challenge of having children with HIV entering school. School nurses, as the only health care providers in the schools, are in a strong position to facilitate the education of children with HIV and to provide AIDS education to students, faculty, and parents. School nurses' knowledge and attitudes about AIDS and people with AIDS influence their effectiveness in prevention activities and care of HIV-infected children. This study examined the relationship between specific demographic, practice, and cultural variables and rural school nurses' attitudes about AIDS and homosexuality. Sixty-nine school nurses responded to a mailed questionnaire as part of a larger study of rural nurses. Results indicate attitudes about homosexuality were related to nurses' homosexual knowledge and religious beliefs while attitudes about AIDS were related to nurses' willingness to care for people with AIDS and feeling prepared to do so.(J Sch Health. 1997;67(8):341–347)     

AIDS education and training for health care providers

Many health care providers still harbor fears and misunderstandingsabout AIDS that negatively affect the delivery of patient care.In order to resolve these fears and misunderstandings, fiveregistered nurses representing the California Nurses Association,AIDS Project Los Angeles, the San Francisco AIDS Foundationand the California Statewide Nursing Program developed, implementedand evaluated an innovative AIDS ‘train the trainer’program. The program was designed to replace didactic lectureswith more effective methods to meet the needs of adult learners.Between November 1986 and April 1987, 27 two-day trainings wereconducted throughout California to train 759 key health careprofessionals in both adult learning principles and AIDS content.Creative teaching strategies such as guided fantasy, role playand case studies were utilized to encourage group interactionand the exploration of sensitive issues underlying the fearof AIDS. By June 1, 508 of the 759 Trainers had each conductedinstructional programs for groups of 25 or more health careproviders; a total of 18 879 people were educated in the secondarytrainings. Summative program evaluation showed that the trainingprogram gave participants the knowledge, skills and confidencenecessary to conduct AIDS education for health care providers.     

初中生艾滋病／性病健康教育近期效果评价

目的了解浙江省初中生对艾滋病/性病相关知识的知晓情况、相关态度及行为状况,初步评价在初中生中开展艾滋病/性病健康教育的近期效果。方法采用整群抽样方法,对2385名初中生在健康教育前和健康教育后1个月分别下发同一调查问卷进行相关问题调查。结果被调查对象健康教育后比健康教育前艾滋病/性病知识知晓率有明显提高;可以接受和艾滋病病毒感染者或病人一起学习、生活的学生由健康教育前的46.62%上升到健康教育后的62.09%(P<0.01)。结论通过专题讲座、小册子、VCD等多种形式,在初中生中开展艾滋病/性病健康教育能收到良好效果。     

Health literacy and health-related knowledge among persons living with HIV/AIDS

BACKGROUND: Functional health literacy is associated with illness-related knowledge, understanding, and treatment perceptions for several chronic illnesses. This study examined health literacy in relation to knowledge and understanding of HIV/AIDS. METHODS: Persons living with HIV/AIDS recruited from AIDS service organizations and HIV clinics completed the Test of Functional Health Literacy for Adults (TOFHLA) reading comprehension scale and measures of health status, knowledge and understanding of health status, perceptions of primary care givers, and perceptions of anti-HIV treatments. RESULTS: Eighteen percent of the sample scored below the cutoff for marginal functional health literacy on the TOFHLA. Controlling for years of education, persons of lower health literacy were significantly less likely to have an undetectable HIV viral load, somewhat less likely to know their CD4 cell count and viral load, and lower health-literacy persons who knew their CD4 count and viral load were less likely to understand their meaning. Lower health literacy was also related to misperceptions that anti-HIV treatments reduce risks for sexually transmitting HIV and beliefs that anti-HIV treatments can relax safer-sex practices. CONCLUSIONS: Poor health literacy creates barriers to fully understanding one's health, illness, and treatments. Misperceptions of treatment in the case of HIV infection creates danger for potentially transmitting treatment-resistant strains of HIV. These results have implications for patient education and treatment programming for people who have poor health-literacy skills and are living with HIV/AIDS.     

Long-term care survey reveals challenges. Facilities grapple with five broad issues, including changes in leadership and AIDS

The Catholic Health Association's 1992 survey of Catholic long-term care (LTC) facilities identified five broad issues LTC facilities face in the 1990s: leadership, system affiliation, community programs, resident issues, and care of persons with AIDS. The transition to lay leadership presents new challenges to the relationship between LTC facilities and their sponsors. Despite the dominance of religious sponsors, an increasing number of laypersons are serving as healthcare administrators both in long-term and acute care. Thirty percent of respondents reported being affiliated with a multi-institutional system. This percentage has changed little in the past few years, although the number of facilities that are system members continues to increase at the fastest rate of any type of LTC facility. Only 27 percent of survey respondents said they provide educational or informational programs for persons in their communities. Thirty-nine percent of system-affiliated LTC facilities reported offering such programs. One encouraging finding shows that 80 percent of facilities have written policies for living wills, 64 percent for designated proxy, and 86 percent for durable power of attorney for healthcare. LTC providers are struggling to determine their role in caring for persons with HIV and AIDS. Only 3.6 percent of respondents care for residents with AIDS. A major problem LTC administrators face is a fear of potential infection of staff or residents.     

广东省湛江市某高校大学生预防艾滋病健康教育效果评价

目的结合2007年世界艾滋病日开展大型健康教育活动,提高大学生预防艾滋病认知水平,并评价预防艾滋病健康教育活动效果。方法采用整群随机抽样方法,分别在健康教育前后抽取大学一年级学生447名和637名进行调查。结果健康教育后大学生预防艾滋病知识知晓率改善明显,艾滋病总知识知晓率从86．8％提高到91．0％,差别具有统计学意义（P〈0．05）。对艾滋病非传播途径“蚊子叮咬”及“共用浴缸、游泳池”答对率分别从71．6％和67．8％提高到80．8％和74．7％,对性病患者和同性恋患者感染艾滋病病毒的危险性认知,健康教育前后认知率分别从63．5％和73．4％提高到71．9％和84．9％,差别均具有统计学意义（P〈0．05）。行为态度方面改善有限,且差别均无统计学意义（P〉0．05）。健康教育后,有88．4％的学生对艾滋病病人持同情、理解态度,只有22．5％学生支持对艾滋病病毒感染者做好保密工作,愿意与艾滋病病人一同工作、学习的只有57．9％。有97．5％的学生认为有必要开展预防艾滋病健康教育,却只有72．8％的学生愿意向其他人宣传预防艾滋病知识。除电视、报刊杂志、网络等新闻媒体外,他们希望通过讲座／会议和医生／护士等途径获取更多的相关知识。结论本次大型预防艾滋病健康教育活动效果明显,大学生预防艾滋病知识有一定幅度提高,但需要进一步做好相关态度转化。