Search

Objective: analyzing the effectiveness of an educational intervention on the knowledge of nursing professionals regarding the immunization of people with the human immunodeficiency virus., Method: a quasi-experimental study evaluated professionals' knowledge through a knowledge test applied before and after the development of an online training course. The data was analyzed using frequency, median, mean, standard deviation, and association tests., Results: the sample consisted of 77 nursing professionals whose mean age was 43.2 years (SD+/-8.2). More than half of the individuals worked in basic health units (58.4%), 22.1% worked in specialized services that provide clinical monitoring for people with the human immunodeficiency virus, and 42 (54.5%) were nursing assistants or technicians. The professionals' performance improved after the intervention, with an increase in the median number of correct answers from 23.0 to 27.0 (p<0.001)., Conclusion: offering an online training course on the immunization of people with the human immunodeficiency virus, as a continuing education activity, proved to be effective in improving nursing professionals' knowledge on this subject., Highlights: (1) Services do not evaluate the vaccination status of people living with HIV.(2) The knowledge of health professionals may influence vaccination rates.(3) Health professionals' knowledge of immunization may be insufficient.

The HIV and AIDS pandemic resulted in increased demands on the South African healthcare system and contributed to elevated stress levels among healthcare workers, including home-based care workers. The goal of the study was to evaluate a stress management programme for HIV and AIDS home-based care workers in Tshwane, South Africa. Social constructionism was adopted as the theoretical framework of the study. The study implemented intervention research and adopted a qualitative research approach, specifically the instrumental case study. Non-probability sampling, specifically volunteer sampling was utilised to recruit a group of twelve HIV and AIDS home-based care workers ( n  = 12). The data were collected through semi-structured interviews and administered before and after exposure to the stress management programme. The research findings, based on thematic analysis, revealed that the programme was effective in mitigating the impact of stress experienced by the HIV and AIDS home-based care workers in Tshwane. Recommendations are proffered for the refinement of the newly developed stress management programme for implementation among HIV and AIDS home-based care workers in similar field settings.

Objective: To identify and to measure entry level competencies (knowledge, skills, attitudes, judgements) for nurses to practice safely and effectively in the Kingdom of Eswatini., Introduction: Eswatini, formerly known as Swaziland, is a small sub-Saharan country between South Africa and Mozambique. There are four nursing programs approved by the Eswatini Nursing Council (ENC) that provide nursing education in the areas of general nursing, midwifery, mental health and community health. The mandate of the ENC is to protect the public and to this end licensed nurses must be able to meet standardized entry level requirements., Methods: We identified gaps in expected competencies of new nurses led to comprehensive strategies by many stakeholders to close the gaps. Nursing competencies were categorized into seven learning domains with specific, measurable indicators included in each domain. Specific clinical skills essential for entry to practice were identified., Results: Provision of Quality Care; Information Management Systems; Emergency/Trauma/Disaster Management; Infection Prevention & Control; Leadership and Management; Ethics/Legal Issues/Professional Conduct; and Prevention/Treatment & Care of HIV, AIDS, TB are the seven competency domains that are measured on a newly developed standardized entry to practice multiple choice examination. Essential clinical skills are also assessed prior to obtaining licensure., Conclusion: Implementing these standards will ensure that nurses in Eswatini have the appropriate skill set to deliver care to their patients, improve their communities' health, and enable the kingdom to make advances towards universal health coverage and attainment of the sustainable development goals., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)

Objectives: to develop and validate conceptual and operational definitions of nursing diagnoses of the International Classification for Nursing Practice for people living with Aids., Methods: methodological study with 100 individuals with Aids, in a hospital school. In addition, 19 nurses selected from the Lattes platform acted as experts in the validation process. The research was conducted, using three moments: identification and validation of the nursing diagnoses; construction of the conceptual and operational definitions of the diagnoses, and content validation, using the content validity index., Results: a total of 35 diagnoses were identified and 18 had their conceptual and operational definitions validated, with validity index of ≥ 0.8., Conclusions: the construction of the conceptual and operational definitions enables nurses to analyze the clinical inferences and endorse the nursing diagnosis, contributing to its predictive capacity.

Objective: To analyze the association between the empirical indicators and ICNP® nursing diagnoses in people living with AIDS, as well as to identify the predictive indicators for the establishment of these diagnoses., Method: A cross-sectional study with 120 people living with AIDS, in a hospital in Northeastern Brazil, conducted from August to September 2015, following the steps: identification and validation of Empirical Indicators; preparation and validation of the ICNP® Nursing Diagnoses; and analysis of the association between the Empirical Indicators and the Nursing Diagnoses resulting from the two previous steps. To analyze the data, we used logistic regression., Results: 74 Empirical Indicators were identified, being 31 of which were validated. 55 diagnoses were elaborated and 19 were validated, of which 16 were associated with the Empirical Indicators, identifying 31 predictors., Conclusion: The diagnoses presented significant associations with the Empirical Indicators. In addition, it was observed that the predictive factors of these diagnoses involved the human responses and complications related to the disease, which should be considered during the care provided by the nurse.

The encounter between a patient and the caregiver is always the encounter between two human beings. The commentary tells the story of the relationship between a 30-year-old man suffering from AIDS and a nurse who first accepts him at the hospital and then takes care of him, guaranteeing home care, even beyond the time strictly necessary for therapy, until the death of the patient. This relationship of care is renewed in the surprising encounter between the woman and the son of the patient who has become a man, a medical student.

Background: Most public hospitals in African countries are overpopulated with patients suffering from conditions related to HIV and AIDS. These patients increase the burden on healthcare providers, among which are enrolled nurses., Aim: To explore enrolled nurses' experiences of caring for patients living with HIV and AIDS at a public rural community hospital in the Vhembe district of Limpopo Province, South Africa., Design: The study was underpinned by the interpretative phenomenological design., Participants: A total of 11 purposively selected enrolled nurses who met the inclusion criteria participated in the study. The sample size was based on data saturation., Method: Data were collected through semi-structured individual face-to-face interviews guided by an interview guide. Interviews were audio-recorded; and field notes were also taken. Data were analysed thematically following a framework for interpretative phenomenological analysis., Results: The study revealed that enrolled nurses are working without adequate resources. They also experience minimal support despite the negative circumstances they are exposed to in the process of caring for patients admitted with HIV-related illnesses., Conclusions: A lack of resources, limited support and inadequate skills have a negative impact on the health care that enrolled nurses provide to patients admitted in hospital with HIV-related ailments. Researchers recommend the importance of supporting and equipping enrolled nurses to provide quality care to patients living with HIV., Implications for Nursing and Health Policy: The findings have highlighted the challenges faced by enrolled nurses while caring for patients with HIV. The identified gaps will assist the Department of Health in developing policies to enhance the support offered to enrolled nurses and improve the care provided to patients with HIV-related conditions that are admitted to rural hospitals., (© 2018 International Council of Nurses.)

Background and Purpose: This study examined the psychometric properties of a 9-item Morisky Medication Adherence Scale (MMAS-9) adapted specifically for patients with HIV/AIDS., Methods: We used data from two randomized controlled trials investigating telephone-delivered interventions for improving adherence to antiretroviral therapy to assess reliability (Cronbach's α and Pearson's product correlation) and validity (convergent and concurrent) of the MMAS-9., Results: The internal consistency (Cronbach's α) of the MMAS-9 was .66 (study 1) and .69 (study 2); 3-month test-retest reliability (Pearson's correlation) ranged from .50 to .74. Validity was supported by associations with electronic event monitored adherence, social support, depressive symptoms, self-efficacy, stigma, regimen complexity, and impact of side effects in the hypothesized direction., Conclusions: The adapted MMAS-9 demonstrated good convergent validity but somewhat lower internal consistency reliability than other reports., (© 2018 Springer Publishing Company, LLC.)

Background:  Adolescent sexual and reproductive health is one of the essential health care programmes in the world. However, adolescents still face numerous challenges in the area of sexual and reproductive health, which hinder their utilisation of available Sexual and Reproductive HealthCare Services (SRHCS). Male adolescents face further obstacles in accessing and utilising sexual reproductive health services owing to the influence of social constructions of masculinity, which has a bearing on how they view sexual and reproductive health services and their use., Objectives:  The aim of this study was to investigate individual determinants associated with utilisation of SRHCS for HIV and AIDS prevention by male adolescents., Method:  An exploratory, descriptive and contextual qualitative design was used and semi-structured interviews with 20 purposively selected male adolescents aged 18-24 years living in the South African seat of government were conducted. Data were analysed using Tesch's approach of data analysis., Results:  Knowledge of existing services was described as a significant individual determinant of utilisation of SRHCS. This was linked to the quality of SRHCS and violation of human rights of male adolescents., Conclusion:  The study recommends the development of a strategy that will enhance and promote the utilisation of SRHCS by male adolescents.

Background: Home-based care is used in many countries to increase quality of life and limit hospital stay, particularly where public health services are overburdened. Home-based care objectives for HIV/AIDS can include medical care, delivery of antiretroviral treatment and psychosocial support. This review assesses the effects of home-based nursing on morbidity in people infected with HIV/AIDS., Methods: The trials studied are in HIV positive adults and children, regardless of sex or setting and all randomised controlled. Home-based care provided by qualified nurses was compared with hospital or health-facility based treatment. The following electronic databases were searched from January 1980 to March 2015: AIDSearch, CINAHL, Cochrane Register of Controlled Trials, EMBASE, MEDLINE and PsycINFO/LIT, with an updated search in November 2016. Two authors independently screened titles and abstracts from the electronic search based on the study design, interventions and types of participant. For all selected abstracts, full text articles were obtained. The final study selection was determined with use of an eligibility form. Data extraction was performed independently from assessment of risk of bias. The results were analysed by narrative synthesis, in order to be able to obtain relevant effect measures plus 95% confidence intervals., Results: Seven studies met the inclusion criteria. The trial size varied from 37 to 238 participants. Only one trial was conducted in children. Five studies were conducted in the USA and two in China. Four studies looked at home-based adherence support and the rest at providing home-based psychosocial support. Reported adherence to antiretroviral drugs improved with nurse-led home-based care but did not affect viral load. Psychiatric nurse support in those with existing mental health conditions improved mental health and depressive symptoms. Home-based psychological support impacted on HIV stigma, worry and physical functioning and in certain cases depressive symptoms., Conclusions: Nurse-led home-based interventions could help adherence to antiretroviral therapy and improve mental health. Further larger scale studies are needed, looking in more detail at improving medical care for HIV, especially related to screening and management of opportunistic infections and co-morbidities.

The provision of HIV medications to HIV-negative persons after exposure to HIV is known as postexposure prophylaxis (PEP). Because this prevention strategy is primarily only available in emergency rooms, we piloted a nurse-led community-based PEP program in Ottawa from September 2013 through August 2015. As part of evaluating this program, we conducted qualitative interviews with persons who initiated PEP. Twelve men who had engaged in condomless anal sex with other males participated. Thematic analysis of the interview transcripts highlighted that PEP was considered unmentionable because the participants' saw it as proof of past behavior that was perceived negatively. Our results thus revealed that PEP was stigmatized, which made our participants reluctant to answer health care professionals' "questions" about why they needed PEP. To do so was to be exposed to stigma. The use of PEP for our participants was a balance between wanting to minimize the risks of HIV acquisition against the risks of disclosing the unmentionable. We take these findings to mean that clinicians and health service policy workers should move PEP into community clinics (decentralizing it from hospitals, and increase the involvement of nurses); aim to provide all required PEP services in community settings (consolidate PEP provision in these clinics); and ensure PEP services are streamlined to remove extraneous data collection (meaning history and exam tools should be standardized to minimize needless questions that may impede PEP access). Together, these recommendations may increase patients' access to PEP, and maximize its HIV prevention effects.

Since the 1980s, risk and harm reduction has been a public health issue in the area of addictions. A new approach has been adopted with drug users, who are considered as patients like any other and players in their own health care. The therapeutic alliance with the caregiver is therefore essential., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Background: Home-based care for HIV patients is popular in contexts severely affected by the epidemic and exacts a heavy toll on caregivers. This study aimed at understanding the experiences of caregivers and their survival strategies., Methods: A total of 18 caregivers (3 males and 15 females) were interviewed using a semi-structured interview guide, and thematic analysis was used to analyse the data., Results: Analysis suggests that the caregivers are burdened with insecure provisions for food and difficulties in accessing health care. They however survived these strains through managing their relationships, sharing burden with care-recipients, social networks and instrumental spirituality. These findings are discussed under two major themes: 1). Labour of caregiving and 2). Survivalism., Conclusions: Home-based care presents huge opportunities for community response to the HIV/AIDS epidemic in African settings. It is however burdensome and thus should not be left for families alone to shoulder. There is therefore an urgent need for protecting home-based care for HIV children in Uganda. Implications for improving and strengthening social interventions in home-based care of HIV/AIDS in the Ugandan context are addressed.

Objective: To evaluate the effect of psychological nursing intervention on the quality of life of AIDS patients. Methods: The experimental studies about the influence of psychological nursing intervention on the quality of life of AIDS patients were systematically retrieved in the following databases: PubMed, Web of Science, Cochrane Library, Chinese biomedical literature database (CBM), China journal full text database (CNKI), Wanfang database and VIP Chinese science and technology periodical database (VIP). The SF-36 scale scores in 8 dimensions were combined with Review Manager 5.3, the weighted mean difference and 95 % CI of the value of the combined effects were calculated. Results: In addition to the dimension of physiological function, the differences in weighted mean of the remaining seven dimensions of SF-36 scales were significant, among which the average score of physiological function increased to 6.48, but the average score of emotional function increased up to 19.90. It can be considered that in addition to the dimension of physiological function, the score of the other dimensions were improved after the psychological nursing intervention. The results of sensitivity analysis showed that the differences in weighted means of the eight dimensions of SF-36 scale were significant, indicating that the quality of life of the observation group was higher than that of the control group. Conclusion: Psychological nursing intervention can improve the quality of life of AIDS patients, and it is suggested to use it in clinical practice.

Objective: to analyze the quality of life of people living with HIV/AIDS and its relationship with sociodemographic variables, health satisfaction and time since diagnosis., Method: quantitative, cross-sectional study with a sample of 100 HIV positive people monitored in a specialized service in southeastern Brazil. Sociodemographic and health forms were applied, followed by the WHOQOL-HIV BREF, a short form instrument validated to evaluate the quality of life. Descriptive and inferential statistical analysis was performed., Results: the perception of quality of life was intermediate in all quality of life domains. A relationship was identified between greater satisfaction with health and better quality of life, as well as statistically significant differences among the dimensions of quality of life according to gender, employment status, family income, personal income, religious beliefs and time since diagnosis., Conclusions: the time since the diagnosis of HIV infection enables reconfigurations in the perception of quality of life, while spirituality and social relationships can assist in coping with living with this disease.

OBJECTIVE to elaborate and validate a proposal for a nursing care plan in people hospitalized with AIDS, in an infectious disease unit, using ICNP® version 2015. METHODS A cross-sectional study, followed by validation of content, performed with 20 nurses and 120 people, living with AIDS in an infectious disease unit of a hospital of infectious diseases in Northeast Brazil. The methodological trajectory was carried out in the following stages: elaboration of the diagnosis, nursing outcomes; Initial proposal of nursing interventions; Preparation of a care plan; And validation of the plan by field experts. RESULTS 42 diagnoses were elaborated and validated, 33 presented CVI > 0.80 (55.42%) among field experts. From this quantitative, 228 interventions were elaborated and 41 obtained a CVI > 0.80 (44.78%), considered validated. CONCLUSION The study allowed us to identify and validate nursing diagnoses, outcomes and interventions for the use in clinical practice, aiming to subsidize the process of care for people with AIDS.

Objective: to analyze the discourses about the care provided by nurses operating in Specialized HIV/Aids Outpatient Services in four public institutions of the city of Fortaleza, Ceará, Brazil., Method: descriptive and exploratory study with a qualitative approach, which used as a method the discourse analysis., Results: when titling the "care as negative", such title came from the analogy proposed by Freud (1912) with the photographic negative, represented by what that care can configure from the unconscious movement, since nurses did not perceive themselves in the care actions developed by supporting the work of other occupational categories, contributing to maintain the ideology of biomedicine., Conclusion: it is necessary to justify and theorize a nursing clinical practice from epistemological issues of the profession, in such a way that nurses can understand their relevance within the care provided.

Aims and Objectives: To examine the experiences of caregiving among Vietnamese family members of persons living with HIV/AIDS., Background: As the number of persons living with HIV/AIDS increases, the need of family caregivers who can take responsibility for the home care of these persons increases. Vietnam has one of the fastest growing HIV epidemics in Asia., Design: A descriptive cross-sectional study with quantitative and qualitative methods was used., Methods: A purposive sample of 104 family caregivers, both male and female, participated voluntarily by answering a questionnaire of caregiver burden, and 20 of them participated in in-depth interview., Results: Female caregivers were mainly mothers and wives while male caregivers were mainly husbands, fathers and siblings. The largest group of family caregivers reported moderate to severe burden. There was no difference between genders in total caregiver burden, but there were several differences between older and younger caregivers in some items of caregiver burden. Five categories of experiences emerged: Different types of caregiving to persons living with HIV/AIDS, cultural and religious issues associated with caregiving, keeping secret to avoid stigma and discrimination, lack of knowledge about disease and provision of care, and fear, anxiety and frustration., Conclusions: Stigma and discrimination should be decreased by providing knowledge to the general public about HIV/AIDS, in particular about ways of transmission and protection. Special knowledge should be given to family caregivers to enable them to give care to persons living with HIV/AIDS at home. This could be done through culturally appropriate training/intervention programmes in which coping methods should be included. Support group interventions should also be carried through. The results obtained can be used as baseline information., Relevance to Clinical Practice: Health care providers should consider gender, age and culture of family members of persons living with HIV/AIDS. Knowledge about HIV/AIDS, provision of care at home and in hospital, and support groups should be developed and implemented., (© 2016 John Wiley & Sons Ltd.)

Background: Being in its fourth decade, HIV remains an epidemic that requires combined efforts for the global fight. The strategies planned and implemented in the fight against HIV include reversing and halting the spread of HIV, increasing health care access, and strengthening the health care system. South Africa has made the fight one of its top priorities, and has developed plans to increase the role of nurses in the management of HIV, demonstrating its willingness, commitment and progress in the fight against HIV., Objective: This article presents the validation process conducted to confirm the integration and mapping of the HIV and AIDS related nursing competencies into the four-year Bachelor of Nursing programme at a university in South Africa., Methods: This study adopted a constructivist paradigm, using a qualitative approach, applyingthe design step of the process model of curriculum development, to validate the inte gration of the mapped HIV and AIDS related nursing competencies into the undergraduate nursing curriculum., Results: For each competency, outcomes were developed for each year. Participants confirmed completeness of outcomes and appropriateness of the mapping of the HIV and AIDS related outcomes into the nursing curriculum, as well as the feasibility and practicability of the integration., Conclusion: Required resources for integration of HIV and AIDS related nursing competencies, such as human resources and nurse educators' continued personal development were identified, as well as barriers to integration, and measures to eliminate them were discussed. The importance of integration of HIV and AIDS nursing competencies into the curriculum was reiterated.

Background: South African nursing environments are marked by various incapacitating stressors. This study explores work-family (W-F) and family-work (F-W) conflicts as aspects of stress amongst nurses working with patients who have AIDS., Objectives: The study sought to determine the value of W-F and F-W conflicts as predictors of work and family satisfaction, as well as turnover intentions and the moderating role of supervisor and significant other support, amongst nurses caring for patients with AIDS in public hospitals within the Capricorn and Mopani districts, Limpopo Province., Methods: The study used a cross-sectional design, with data collected at one point only. Ninety-one nursing staff provided the data for the study by completing structured, self-administered surveys. Analysis involved computing correlations of all study variables. Thereafter, associated variables were used as predictors. In each predictive analysis, the nurses' stress served as a control variable, W-F and F-W conflicts were the independent variables and significant others and supervisor supports were moderators. Interaction terms were derived from independent and moderator variables., Results: Although the findings of the study were not generally supportive of the hypotheses advanced, they nevertheless showed, amongst other findings, that F-W conflict predicted work satisfaction whilst W-F conflict predicted turnover intentions. Moreover, significant other support had a direct effect on family satisfaction whilst supervisor support moderated reports of W-F conflict and experiences of work satisfaction., Conclusions: The study showed that inter-role models that appear to be established in the context of developed societies require some further investigations in South Africa.

This one group pre- and post-test study evaluated the effectiveness of concept mapping and lecture method of teaching among 73 under graduate nursing students. One group was exposed to concept mapping technique and the other group was exposed to lecture method of teaching about HIV/AIDS. Findings indicated a statistically significant increase in the knowledge and attitude of students towards HIV/ AIDS among students exposed to concept mapping than students who underwent lecture method. The results of this study indicated that moden teaching strategies may enhance learning among nursing students. However further evaluation is needed.

Background: Critical care nurses provide palliative care to many patients; often, this includes the patient diagnosed with human immunodeficiency virus (HIV)/AIDS. Ongoing education about both palliative care and this complex diagnosis prepares the nurse to provide compassion and informed care., Objectives: This study examines the effects of an educational intervention addressing palliative care in the intensive care unit and the needs of the HIV/AIDS patients and families. The study will evaluate the critical care nurses' knowledge and competence in caring for this population following the educational sessions., Methods: Thirty critical care nurses were recruited from the critical care unit at a hospital in the south. An HIV/AIDS palliative care course provided participants background knowledge, general principles, and opportunities for critical thinking regarding palliative care. A pretest and posttest on palliative care were provided to each subject to assess knowledge and confidence in palliative care in critical care nursing., Results: The convenience sample of 30 nurses attained a mean pretest score of 82.9%. Their scores improved to 93.5% following the palliative care course. The nurses felt they improved in providing palliative care to patients and in taking responsibility for their practice. Ninety-three percent of the participants wanted to incorporate a palliative care course in nursing orientation., Discussion: The course improved nurses' knowledge of palliative care for HIV/AIDS patients and their competency in palliative care. Thus, the palliative care course gave nurses deeper insight and improved their ability to provide competence palliative care.

Objective: to analyze the AIDS epidemic trend from 1988 to 2012, in a tri-border area., Method: Ecological time-series study with data from the Department of informatics from the Brazilian Unified Health System (SUS)., Results: A total of 1427 cases of AIDS were registered, and 82.1% were aged 20-49 years and 56% in males. The relationship man/woman went from 9/1 to 1/1 and increased the number of cases among individuals with more years of education, also, people aged more than 50 years old the age group from 20 to 34 years old. The most common exposure category was heterosexual, significantly higher among women; on the other hand, drug injection use was associated with male gender., Conclusion: seeking to embrace the changes in the epidemiological scenario of AIDS, nursing professionals should implement intervention strategies for people identified as the most vulnerable to HIV infection.

The aim of this study was to create a term base for nursing practices with elderly women with HIV/AIDS. This documental descriptive research was conducted at the Universidade Federal de Paraíba, from August 2012 to July 2013, based on a list of terms from the Integrated Plan to Combat the Feminization of AIDS and other STDs. These terms were cross-mapped with those of the International Classification for Nursing Practices 2011 (CIPEr 2011) and use of these terms in nursing practices was confirmed with the help of 15 participants. The base comprised 106 constant terms and 69 non-constant terms in the CIPEr 2011. Results revealed the need to reconsider nursing care for elderly women with HIV/AIDS in light of epidemiological changes in relation to aging and feminization of the disease. The term base will support the construction of more appropriate wording for nursing diagnoses, results and interventions for elderly women with HIV/AIDS.

AIDS permeates all aspects of the lives of individuals, families and the society at large. In addition, it is beset with dynamics, dilemmas and complexities that have a bearing on people's psychosocial health. However, AIDS presents a wealth of learning opportunities to affected people and to governments. Using Botswana as an exemplar, the author explores the way AIDS has transformed the way of life of a people through the challenges and the opportunities that it presents. The author reflects on the interface of AIDS and mental illness. The paper concludes with recommendations for the way forward.

The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings.

Background: The number of people infected with HIV/AIDS continues to increase across the world. The awareness of HIV/AIDS and attitudes toward this disease among nurses and their willingness to care for those infected directly impacts upon the quality of HIV/AIDS-patient care., Purpose: This study explores the knowledge, attitudes, infection-risk perceptions, and willingness to care for HIV/AIDS patients among nurses and the correlations among these variables., Methods: This study used a descriptive, correlational design. Scales on HIV/AIDS-related knowledge, attitudes, perceived risk of infection, and willingness to care were used to collect data from 219 nurses who attended the course series on HIV/AIDS held by the Nurses AIDS Prevention Foundation in 2010., Results: The mean score for HIV/AIDS knowledge was 79.6%, with knowledge related to disease transmission pathways earning the highest score and knowledge related to HIV/AIDS protective measures earning the lowest. Participating nurses with higher knowledge scores held a more positive attitude toward HIV/AIDS (p < .001), a lower perceived risk of HIV/AIDS infection (p < .001), and a higher willingness to care for HIV/AIDS-positive patients (p = .001). In addition, those participants who had received in-service HIV/AIDS education training earned higher willingness-to-care scores (p = .046)., Conclusions / Implications for Practice: The results of the present study underscore the importance of HIV/AIDS education and may be referenced by health authorities and hospitals for promoting HIV/AIDS education. Further, the results suggest that nurses with a greater knowledge of HIV/AIDS protection and of prophylaxis after occupational exposure are more willing to care for HIV/AIDS patients.

Caregiving actions emanate from the family caregiver's care meanings. Therefore, this article presents caregiving actions as outgrowths of the family caregiver's cultural conceptions of care and as situated within constraining sociocultural factors. Qualitative data were collected through interviews and participant observations from 18 purposively selected family caregivers of people living with HIV/AIDS (PLWAs) in Addis Ababa, Ethiopia. Three lines of caregiving actions performed by the participating family caregivers are presented: nutritional and medication care actions, physical care actions, and psychological and spiritual care actions. We have also explicated the problematic situations and sociocultural factors constraining the family caregivers in performing the caregiving actions. This study underlines the significance of addressing such problematic situations as are raised, as well as the sociocultural issues that constrain the family caregivers' agentic scope for planning and executing caregiving actions., (© 2013 Wiley Publishing Asia Pty Ltd.)

Overview: HIV has evolved over the past 30 years from a virtual death sentence to a chronic and manageable disease. Nurses in the United States have helped to change the epidemic through advocacy, education, care, and support for people living with HIV infection. They have contributed to the expansion of HIV prevention methods, provided support to this population and their families, and helped make HIV treatments more effective and efficient. People with HIV infection who access and remain in care can now enjoy both an improved quality of life and a greater life expectancy. Here, the authors discuss HIV epidemiology and policy in the United States, the concept of the HIV care cascade, advances in HIV testing and treatment, and how nurses can continue to have a positive impact on the HIV epidemic by encouraging testing, connecting newly diagnosed patients to specialty care, retaining these patients in long-term care, and providing access to combination antiretroviral therapy.

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over the last century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives will be a frequent column, containing articles selected to fit today's topics and times.This month's article, from the November 1982 issue, is the first AJN article published on AIDS. It was early in the epidemic; only 608 cases of Kaposi's sarcoma and opportunistic infections had been reported to the Centers for Disease Control and Prevention-a mere trickle in the flood that was to come. Reading it now, aware of all we've learned since, we have a sense of how much we were fumbling around in the dark in those early days, searching for a cause and a cure, often going in wrong directions. The closest we had come to the true nature of the syndrome was an understanding that "life-style factors seem to be involved and the agent appears to be infectious." To read the complete article from our archives, go to http://bit.ly/1iswhZe.

Aim: To determine what encourages or discourages AIDS/HIV patients from completing questionnaires., Background: Data from surveys can provide important information but response rates can be poor. Factors that affect this in an HIV clinic population have not been assessed previously., Review Methods: The researchers used a qualitative approach and a structured interview schedule. Ten patients were recruited and participated in one-to-one interviews., Discussion: Most patients saw the potential value of completing a questionnaire in the clinic. Lack of privacy during completion was raised as a concern, particularly if there were sensitive questions to respond to. Lack of technical competence was identified by some as a barrier to participation in electronic surveys. Tickboxes were preferred over rating scales or open answers. Participants did not expect a cash incentive or entry in a prize draw when asked to complete a questionnaire in-clinic., Conclusion: Generally, AIDS/HIV patients were willing to participate in surveys. Availability of a private area to complete the questionnaire, avoiding complex electronic systems, completion in the clinic, tickbox answers and a length of under two sides of A4 were the most important features that improved acceptability of the questionnaire to patients. Implications for research Surveys that evaluate care need to be short, easy to complete and have clear relevance to the patients' experience.

Aims: To conduct a quantitative investigation of stress and the relationship with burnout among AIDS care volunteers., Background: Volunteer caregivers experience stress that could lead to burnout. Yet, very few studies quantify stress and its relationship with burnout among AIDS care volunteers., Design: This study uses a cross-sectional, exploratory survey design., Methods: Face-to-face interviews were conducted with 126 volunteer caregivers working in 13 semi-rural communities (townships) in Durban, South Africa in April 2009. All participants were women, Christian and with low levels of education. A 22-item instrument was drawn from Pearlin et al.'s role overload and role captivity scales, Van Dyk's stress factor scale and the Maslach Burnout Inventory., Results: Most of the volunteers had moderate-to-high levels of stress. 'Role/work overload' 'lack of support' and 'overwhelming nature of the disease' explained most of the variance in stress. Volunteers' age and number of patients in their care were predictors of stress. Caring for only AIDS patients, lack of support, stress emanating from perceived stigma and lack of training; and the overwhelming nature of AIDS were predictors of burnout., Conclusion: High levels of stress could negatively impact volunteers' health and well-being and on-the-job performance. Policy makers must develop and fund home-based care models that take into account the stressors associated with AIDS care, by reducing the work load, providing ongoing psychosocial support and recruiting nurses to assist volunteers. The small non-probability sample used in this study highlights the need to treat the findings with caution., (© 2013 John Wiley & Sons Ltd.)

The HIV/AIDS pandemic impacts people throughout the world and is complicated by fear, prejudice, and stigma. Nurses play a major role in the health care delivery systems, yet in many parts of the world with high HIV sero-prevalence rates, nurses lack sufficient training and education to provide care to patients with HIV/AIDS. In an effort to build capacity and improve knowledge, attitudes and beliefs regarding care of patients with HIV/AIDS, a 4-day workshop was provided by American nursing students for Cameroonian nursing students. The training program included HIV epidemiology, disease management, and natural course of the disease, testing, legal and ethical issues, and infection control practices. Pre- and post-test scores were calculated using a series of surveys that measured HIV-related knowledge, attitudes, and beliefs. Results indicated that these measures of HIV-related perceptions improved due to the train-the-trainer workshop.

This study sought to investigate the principles of bioethics considered by nurses involved in research while caring for patients with HIV/Aids under palliative care. An exploratory study, with a qualitative approach, was conducted with twelve nurses in a public hospital in the municipality of João Pessoa in the State of Paraíba. A form was used for data collection and the empirical material was analyzed qualitatively using the content analysis technique. The following categories emerged from the qualitative analysis: Respect for the autonomy of HIV/Aids patients under palliative care; and Enhancement of the principles of charity, non-malevolence and justice in providing palliative care to HIV/Aids patients. The results revealed that the participants acknowledge the importance of bioethical principles while caring for patients with HIV/Aids under palliative care. The work provides a reflection on and elicits the pursuance of further studies which can contribute to improve the quality of life of these patients with care based on ethical principles.

The aim was to investigate the perception of nursing faculty about their responsibility in teaching practice on HIV/AIDS and if they value the construction of knowledge on the subject of HIV/AIDS focused on parameters aimed to citizenship. This qualitative study had its theoretical framework on Morin Complex Thought. Seven professors from jive institutions of higher education in Sao Paulo participated of the study in the period from January to July 2010. Data were collected through focus group and analysed through content analysis. The semantic categories were: The importance of reflection and criticality of the professor in teaching HIV/AIDS; the exercise of citizenship through education of HIV/AIDS and; the understanding of the human in learning from the experience of a person with HIV/AIDS. The study shows that the role of the professor when teaching HIV/AIDS is essential to an ethical and a citizen development for the future nurse.

Pain has been recognized as an important, highly prevalent, and debilitating symptom of HIV and AIDS. In South Africa, many people living with HIV and AIDS utilize primary health clinics for pain management. Primary health clinics are nurse led and face a variety of challenges pertaining to pain management. The purpose of this study was to explore if HIV and AIDS pain is effectively managed in a primary health clinic in Tshwane, South Africa. The study aimed to explore the level and characteristics of HIV- and AIDS-related pain, the pain-related experiences of patients and if pain was managed according to the applicable guidelines of the Department of Health. A quantitative survey was conducted. The target population was HIV and AIDS patients who had been using the primary health clinic for chronic pain management. The sampling method was convenience (n = 500). Data were gathered by means of structured interviews and structured observation. The data were analyzed using the SSPS 15 program and open coding. The study provided evidence that HIV- and AIDS-related pain is not managed effectively. Despite repeated visits to the primary health clinic, the overwhelming majority of patients still experienced pain. Nurses added to the suffering, because they lacked knowledge of pain and pain management. It is recommended that nurses practicing in primary health clinics should be trained and supervised to effectively manage the pain of people living with HIV and AIDS., (Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.)

According to estimates, 1.2 million Americans are infected with human immuno deficiency virus (HIV). Because of antiretroviral therapy, persons who have HIV infection or have progressed to AIDS are living longer. As a result, the likelihood that they will need critical care nursing is increasing. Unlike in years past, when these patients were often admitted because of the consequences of immunosuppression, today they are also being cared for in critical care units for other conditions associated with aging, other chronic health conditions, and trauma. When persons who have HIV disease or AIDS are admitted to the intensive care unit, nurses must be prepared to provide care, especially management of complexities associated with antiretroviral therapy. Therefore, this article examines critical care nurses' role in initiating and administering antiretroviral therapy in the intensive care unit and reducing the risk of drug interactions associated with the therapy.

Background: A multidisciplinary team of 20 researchers and research users from six countries - Canada, Jamaica, Barbados, Kenya, Uganda and South Africa - are collaborating on a 5-year (2007-12) program of research and capacity building project. This program of research situates nurses as leaders in building capacity and promotes collaborative action with other health professionals and decision-makers to improve health systems for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) nursing care. One of the projects within this program of research focused on the influence of workplace policies on nursing care for individuals and families living with HIV. Nurses are at the forefront of HIV prevention and AIDS care in these countries but have limited involvement in related policy decisions and development. In this paper, we present findings related to the barriers and facilitators for nurses' engagement in policymaking., Methods: A participatory action research design guided the program of research. Purposive sampling was used to recruit 51 nurses (unit managers, clinic and healthcare managers, and senior nurse officers) for interviews., Findings: Participants expressed the urgent need to develop policies related to AIDS care. The need to raise awareness and to 'protect' not only the workers but also the patients were critical reason to develop policies. Nurses in all of the participating countries commented on their lack of involvement in policy development. Lack of communication from the top down and lack of information sharing were mentioned as barriers to participation in policy development. Resources were often not available to implement the policy requirement. Strong support from the management team is necessary to facilitate nurses involvement in policy development., Conclusions: The findings of this study clearly express the need for nurses and all other stakeholders to mobilize nurses' involvement in policy development. Long-term and sustained actions are needed to address gaps on the education, research and practice level., (© 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.)

In this exploratory and descriptive research, we identified the meaning of religion and spirituality in the experience of patients at a public health service for treatment of HIV/AIDS in a Brazilian upcountry town. Eight participants were selected through theoretical sampling. Data were collected through semistructured interviews, and analyzed by means of qualitative content analysis. The emerging themes were religion: a path to support, and God is everything. Religion, as a path that leads patients to different sources of support, included exploration of different churches, acknowledgment of guilt, and finding strength to cope with the disease, rationalization of the disease process, meeting other churchgoers, and finding God and faith. God, an important source of support, was present in prayers, in the belief in healing through faith, and in the feeling of comfort and relief. Because spirituality and religion were seen as important sources of support, in this study we that health professionals include these aspects in care planning., (© 2012 Wiley Publishing Asia Pty Ltd.)