People Living With HIV: Implications for Rehabilitation Nurses

Exploring experiences engaging in exercise from the perspectives of women living with HIV: A qualitative study

OBJECTIVES

To explore experiences engaging in exercise from the perspectives of women living with HIV, specifically, i) nature and extent of exercise, ii) components that characterize exercise experiences, iii) facilitators and barriers, and iv) strategies for uptake and sustainability of exercise.

DESIGN

Qualitative descriptive study involving online semi-structured interviews.

RECRUITMENT

We recruited women living with HIV from a specialty hospital, community-based organization, and medical clinic in Toronto, Canada.

PARTICIPANTS

Ten women living with HIV who may or may not have engaged in exercise.

DATA COLLECTION

Using a semi-structured interview guide, we asked participants to describe their experiences with, facilitators and barriers to, and strategies to facilitate uptake of exercise. We electronically administered a demographic questionnaire to describe personal, HIV and physical activity characteristics of participants. We conducted a descriptive thematic analysis with the interview data, and descriptive analysis (medians, frequencies, percentages) of questionnaire responses.

RESULTS

Women characterized their experiences with exercise with six intersecting components: (1) culture, (2) gender, (3) HIV-related stigma, (4) episodic nature of HIV, (5) sense of belonging, and (6) perceptions of exercise. Facilitators to exercise included: aspirations to achieve a healthy lifestyle, using exercise as a mental diversion, having an exercise companion, and receiving financial support from community-based organizations to facilitate engagement. Barriers to exercise included: limited resources (lack of mental-health support and fitness resources in the community), financial limitations, time and gym restrictions, and cold winter weather conditions. Strategies to facilitate uptake of exercise included: creating social interactions, provision of online exercise classes, raising awareness and education about exercise, and offering practical support.

CONCLUSIONS

Experiences with exercise among women living with HIV were characterized by intersecting personal and environmental contextual components. Results may help inform tailored implementation of exercise rehabilitation programs to enhance uptake of exercise and health outcomes among women living with HIV.

Construction and validation of conceptual and operational definitions of the defining characteristics of the nursing diagnosis "Ineffective health self-management" in people living with HIV/AIDS

PURPOSE

Build and validate the content of conceptual and operational definitions of the defining characteristics of the nursing diagnosis of NANDA-I "Ineffective health self-management" in people living with HIV/AIDS.

METHODS

Methodological study, with a quantitative approach. The validation was performed by 26 specialist nurses selected through the Lattes do Brazil platform. The process followed two steps: (a) proposal of new defining characteristics to the Nursing Diagnosis "Ineffective Health Self-Management" and elaboration of conceptual and operational definitions; (b) content validation of the new defining characteristics of the Nursing Diagnosis "Ineffective Health Self-Management" and the conceptual and operational definitions. Data were collected between October 2020 and May 2021.

FINDINGS

The researchers included six defining characteristics as components of the diagnosis, adding to the 10 already existing in the NANDA-I version (2021-2023). Then, the experts judged these components and 13 defining characteristics were validated using the binominal test with adequacy ratio above 85% and p value <0.05. After this stage, the conceptual and operational definitions of these defining characteristics were constructed, validating them by the content validation index ≥0.80 by the expert nurses.

CONCLUSIONS

Three new defining characteristics for Ineffective health self-management were proposed and validated by specialists. Conceptual and operational definitions of the new and current defining characteristics were elaborated and validated for people living with HIV/AIDS.

IMPLICATIONS FOR NURSING PRACTICE

The knowledge and study of the conceptual and operational definitions of nursing diagnoses can contribute to good nursing practices, assisting in the care and evaluation of nurses in the provision of care to people living with HIV/AIDS, and can avoid misunderstandings and inappropriate interpretations and can guarantee assertive clinical judgment.

SEARCH TERMS

Nursing diagnosis, validation studies, nursing processes, acquired immunodeficiency syndrome.

Nursing - a core element of rehabilitation

AIM

2020 was been acknowledged by the World Health Organization as the International Year of the Nurse and the Midwife. On this occasion, the Global Rehabilitation Alliance and the International Council of Nurse would like to conceptually reflect the role of nurses in rehabilitation.

BACKGROUND

Rehabilitation and nursing are strictly ingrained. Rehabilitation aims at improving, reaching and maintaining optimal functioning of persons with disability and persons with health conditions experiencing disability. Nursing is defined as use of clinical judgement in the provision of care to enable people to improve, maintain, or recover health, to cope with health problems, and to achieve the best possible quality of life. Nursing has a crucial role in all phases of rehabilitation care (acute, post-acute and long-term rehabilitation). Nurses deliver rehabilitation in many settings, in nursing homes and community-based rehabilitation. The main principle is not to deliver care for the patient but deliver care with the patient. This includes explaining, demonstrating and practising with the goal to help the patient to (re-)gain independence.

DISCUSSION

Nurses play an important role in delivering rehabilitation and are involved in all aspects of the multidimensional rehabilitation process. One of the important points is that in most settings, nurses are the professionals with a prolonged relationship with patients and families, and may have the best insight into the patients' personal and contextual factors with regard to the rehabilitation process.

CONCLUSION AND IMPLICATIONS FOR NURSING AND/OR HEALTH POLICY

Strengthening nursing in rehabilitation is a vital factor to deliver high-quality rehabilitation and to achieve optimum outcomes. For this reason, we urge all relevant stakeholders at governmental and rehabilitation service provider levels to work towards these goals.