I am a person, not a disease. Experiences of people living with HIV/AIDS

People living with Aids or HIV must face not only their illness and all its implications, but also the stigmatisation and the feeling of loss of control. Health professionals coming into contact with these people need to ensure that care is delivered in partnership with the patient, considering their individual needs.

Toxoplasmic encephalitis in the AIDS patient

Toxoplasmic encephalitis was observed early in the acquired immunodeficiency syndrome (AIDS) epidemic and has now been recognized as the major cause of opportunistic infection of the central nervous system after human immunodeficiency virus infection. This complication of AIDS usually represents a reactivation of latent infection. At present, the definitive diagnosis can be made only by demonstrating the protozoan causal agent, Toxoplasma gondii, in brain tissue. Pyrimethamine and sulfadiazine are effective treatments. Nurses are challenged to understand this neurological manifestation of AIDS. Since therapy is life-long, patient education is important in addressing discharge planning concerns and return-to-community issues.

AIDS nursing: patient care issues in the hospital setting

The types of settings in which the acute care of AIDS patients takes place range from AIDS-designated units to general medical-surgical wards. Though the settings may differ, many of the nursing interventions that these patients require remain relatively consistent. Alterations in respiratory, neurological, gastrointestinal, and integumentary systems are common in individuals with HIV infection, requiring nursing measures to address such problems as diarrhea, fever, poor nutrition, mucositis, impaired oxygenation, dyspnea, alterations in sensation and perception, impaired skin integrity, bleeding risk, pain, and altered thought processes. In addition, the bedside nurse is often in a position that enables him or her to coordinate a multidisciplinary approach to selected problems.

Strategies for AIDS prevention: leadership training and peer counseling for high-risk African-American women in the drug user community

A culturally congruent training program to promote HIV risk-reduction behaviors was implemented in a convenient sample of 9 African-American women in an urban methadone treatment program. At each of eight peer counseling and leadership training (PCLT) program sessions, the transmission and prevention of AIDS were discussed while emphasizing enhancement of participants' self-esteem, confidence, and control over high-risk behaviors. The results indicate that support of the women helped develop their sense of purpose and self-worth, reduced sexual and drug use practices associated with risk for HIV and AIDS infection, and promoted assumption of leadership roles and dissemination of accurate AIDS-related information in their communities. It was apparent that knowledge alone does not change behavior if it conflicts with established norms, values, beliefs, and life-styles and that individuals who have a sense of personal control are more willing to explore alternative lower-risk behaviors.

A nursing department's response to risks associated with human immunodeficiency virus

Nurses need to be aware of the risks associated with HIV. In particular, they must know the precautions to take to avoid occupational exposure and their legal and ethical obligations in caring for clients with HIV infection. The Nursing Department of Saint Anselm College has integrated content that deals with these and other issues related to HIV exposure and infection.

Fear of contagion and AIDS: nurses' perception of risk

Nurses' fear of contagion when caring for persons with AIDS remains high despite increased levels of knowledge. This paper examines the multiple factors that contribute to nurses' perception of risk within the workplace. The authors suggests that constructs from theories such as decision making, psychoanalysis and cognitive psychology can provide insight into the assessment of risk. Findings from a recent survey of nurses are used to illustrate the complex nature of fear of contagion. Understanding this complexity may be an essential first step in order to provide opportunities for resolution of fears and modification of behaviors.

Rural nursing research priorities

The magnitude and variety of clinical concerns in rural healthcare delivery mandate a focused plan for building a substantiated body of knowledge. The author identifies research priority areas to develop a body of knowledge for rural nursing.

Nursing care of the adult client with AIDS and cytomegalovirus infection

Cytomegalovirus (CMV) is a pathogen causing major disease in an HIV-infected individual. This AIDS-related opportunistic infection results in severe morbidity from chorioretinitis, pneumonitis, encephalitis, adrenalitis, esophagitis, cholangitis, and hepatitis. The author provides a comprehensive overview of CMV infection as seen in adults with HIV disease and related nursing care, and discusses issues related to concerns about occupational exposure among healthcare workers.

[Psychosocial aspects of certain fundamental needs of families with a child with HIV infection]

The presence of a family of a young child with AIDS, with the exception of a small number of transfusion-infected children, implies almost necessarily the presence of infected adults, usually the mother. The problem in such a situation is not that of a child with a fatal illness but that of an entire family. Our study included a sample of thirty natural caregivers. These were mostly mothers but others responsible for the care of a seropositive child, such as fathers, aunts and grandmothers, were also included. The aim of the project was to describe their perceptions of their own psychosocial needs. Our results reveal that these caregivers are economically disadvantaged. They do not know how to cope with stress and their life situation. They are not ready to confide in others because of the social stigma associated with this illness. Thus they participate unwittingly in the conspiracy of shame which denies them the aid which might help meet their needs. However, they do see the need to learn how to protect themselves and other members of the family against both HIV and other infections and to know the course and the treatments associated with this disease.

Caring for people with AIDS: nurses' attitudes and feelings

A qualitative, non-experimental study was conducted to identify the feelings and attitudes that nurses associate with caring for people with AIDS. Data collection and analysis were guided by the phenomenological method. Cognitive dissonance theory served as the theoretical framework to view the experience of caring for someone with AIDS. Data analysis of audiotaped, semi-structured interviews resulted in the identification of six mutually inclusive as well as exclusive themes which represent the attitudes and feelings of nurses: fear, anger, sympathy, self-enhancement, fatigue and helplessness. Particularly evident were differences in the way respondents perceived and treated AIDS patients who are intravenous drug users and those who are homosexuals.

Work-related activities to improve quality of life in HIV disease

The authors conducted an ethnographic analysis of various ways that persons with AIDS (PWAs) manage their illness in order to improve quality of life. According to Anselm Strauss (1975), illness management involves "work": The activities associated with work change as disease-related symptomatology presents different responses. Strauss' concept of work served as the theoretical orientation for this study. The researchers interviewed the respondents (N = 19) while they were hospitalized for problems related to their diagnosis of AIDS. Analysis was guided by grounded theory. Several categories of management activities emerged. The participants perceived all work-related activities as very important to life in the hospital. They perceived nurses as confederates who were involved in many of the work activities. Quality of life was enhanced when PWAs were able to conduct activities they felt were important and when the healthcare team supported their work.