Perceptions of Health and Self-Care Learning Needs of Outpatients With HIV/AIDS

Abstract

Health promotion increases healthy behaviors, enhances health status, and decreases health care costs of chronically ill persons. As HIV has become a chronic illness, many HIV-positive persons may have health learning needs that affect their behaviors, health status, and health care costs. Health learning needs may be general or HIV specific. Social stigma may affect learning resource usage. We used Pender's Health Promotion Model and community-based health promotion principles as theoretical underpinnings for an exploratory study of perceived health and self-care learning needs, barriers, and preferred learning modalities of outpatients with HIV/AIDS. A nonrandom sample of 151 adults completed a researcher-designed self-report survey. Most (97%) expressed interest in health and self-care. Many identified multiple topics, learning barriers, and preferred learning modalities. A statistically significant difference (p = .027) was noted in communication needs of participants diagnosed with HIV versus AIDS. Findings have led to practice changes, health promotion activities, and further research.     

Mapping the motor point in the human tibialis anterior muscle

ObjectivePercutaneous electrical stimulation of the motor point permits selective activation of a muscle. However, the definition and number of motor points reported for a given muscle varies. Our goal was to address these problems.MethodsThe area, location and number of motor points in human tibialis anterior were examined, using isometric dorsiflexion torque responses to electrical stimuli. Three methods were used: lowest electrical threshold, maximum muscle response, and approximate motor point.ResultsA single motor point was identified in 39/40 subjects regardless of method. The area of the site of lowest electrical threshold was smaller (median, 35 mm²) than those using the maximum muscle response (144 mm²) and approximate motor point (132 mm²). There was substantial, but not significant, between-subject variation in motor point location. Fifty three percent of motor points would have been missed if located only by reference to anatomical landmarks.ConclusionsThese results suggested that the motor point’s location cannot be determined a priori and that the identification method will affect both area and location.SignificanceIf it is important to maximally activate a single muscle in isolation, the motor point is best represented by the site producing a maximal but isolated muscle response at the lowest stimulation intensity.     

Domestic violence screening: when will we get it right?

ROUSH K. (2011) Domestic violence screening: when will we get it right? International Nursing Review 59 , 115–116 Domestic violence (DV) is a major health and human rights problem across the globe that causes serious mental and physical health consequences. Regulatory agencies and accrediting organizations include universal screening among required standards for hospitals and ambulatory clinics. Yet we are still failing to identify women suffering from DV and provide them with the resources and care they need. This commentary looks at a study of universal screening in a hospital in Israel and calls for a shift in focus from the question of whether we are screening and why to how we are educating healthcare providers about DV and interventional research for women experiencing DV.     

Promoting the Health of Frontier Caregiving Grandparents: A Demonstration Project Evaluation

Column Editor: Bonnie Gance‐Cleveland Family‐Centered Care provides a forum for sharing information about basic components of caring for children and families, including respect, information sharing, collaboration, family‐to‐family support, and confidence building.     

A Multicenter,Randomized, Double‐Blind,Placebo‐Controlled Trial of Intravenous Ibuprofen (IV‐Ibuprofen) in the Management of Postoperative Pain Following Abdominal Hysterectomy

Background: Ibuprofen and other nonsteroidal anti‐inflammatory drugs are widely used to block pain and inflammation in a variety of settings. Contrarily, opioid analgesia does not block the inflammatory component of pain and the use of these agents can be accompanied by serious side effects. We conducted a multicenter, randomized, double‐blind, placebo‐controlled trial to evaluate the safety and efficacy of intravenous ibuprofen (IV‐ibuprofen) as a postoperative analgesic. Methods: A total of 319 patients were randomly assigned in a 1:1 ratio to receive 800 IV‐ibuprofen or placebo every 6 hours; in addition patients had access to morphine at a dose of 1–2 mg every 5 minutes. The primary outcome measure was median morphine consumption within the first 24 hours following surgery. Results: During the first 24 hours of treatment, the median morphine requirement was reduced by 19% (P ≤ 0.001) and resulted in a significant reduction in pain at rest (AUC, 6 to 24 hours and 12 to 24 hours, P < 0.001) and pain with movement (AUC, 6 to 24 hours, P = 0.010 and 12 to 24 hours, P ≤ 0.001) as measured by the visual analog scale (VAS) in patients receiving 800 mg IV‐ibuprofen compared to placebo. Time to ambulation was significantly faster (P = 0.018) in the IV‐ibuprofen treated group, as well. Similar treatment‐emergent adverse events occurred across both study groups and there was no difference in the overall incidence of these events. Conclusion: This study demonstrated that IV‐ibuprofen is an effective analgesic medication that is safe and well tolerated when administered as an 800 mg dose every 6 hours in patients undergoing total abdominal hysterectomy surgery.