“Can You Give Me Respect?” Experiences of the Urban Poor on a Dedicated AIDS Nursing Home Unit

What drives older men who have sex with men in China away from AIDS information?

A worrying phenomenon has emerged recently: more people are deliberately avoiding rather than seeking information regarding acquired immunodeficiency syndrome (AIDS). This is the first study to explore behaviors related to AIDS information avoidance and the potential influential factors among older men who have sex with men (MSM). We enrolled 11 older MSM from Wuhan, the largest city in central China, from January to March 2023 using a phenomenological method. This qualitative research was conducted using face-to-face semi-structured interviews. AIDS information avoidance was commonly observed among the respondents. Behaviors related to AIDS information avoidance included avoiding AIDS-related information, ignoring known AIDS information, and avoiding medical care. The main factors associated with AIDS information avoidance included information overload, high-risk sexual behaviors, over-optimism, fear of disclosure, and age. China should provide AIDS information in a manner suitable for older MSM, pay more attention to MSM over the age of 70 years, those who are not open about their sexual orientation and those who are too optimistic, and strengthen the censorship of AIDS information.

A systematic scoping review on patients' perceptions of dignity

Background

A socioculturally appropriate appreciation of dignity is pivotal to the effective provision of care for dying patients. Yet concepts of dignity remain poorly defined. To address this gap in understanding and enhance dignity conserving end-of-life care, a review of current concepts of dignity is proposed.

Methods

To address its primary research question “How do patients conceive the concept of dignity at the end of life?”, this review appraises regnant concepts and influences of dignity, and evaluates current dignity conserving practices. To enhance accountability, transparency and reproducibility, this review employs the Ring Theory of Personhood (RToP) as its theoretical lens to guide a Systematic Evidence Based Approach guided Systematic Scoping Review (SSR in SEBA) of patient perspectives of dignity. Three independent teams of reviewers independently analysed included articles from a structured search of PubMed, Embase, PsycINFO, Scopus, CINAHL and Cochrane Databases using thematic and content analyses. The themes and categories identified were compared and combined using the Funnelling Process to create domains that guide the discussion that follows.

Results

Seventy-eight thousand five hundred seventy-five abstracts were identified, 645 articles were reviewed, and 127 articles were included. The three domains identified were definitions of dignity, influences upon perceptions of dignity, and dignity conserving care.

Conclusions

This SSR in SEBA affirms the notion that dignity is intimately entwined with self-concepts of personhood and that effective dignity conserving measures at the end of life must be guided by the patient’s concept of dignity. This SSR in SEBA posits that such personalised culturally sensitive, and timely support of patients, their family and loved ones may be possible through the early and longitudinal application of a RToP based tool.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-01004-4.

Social dignity for marginalized people in public healthcare: an interpretive review and building blocks for a non-ideal theory

Jacobson (Social Science & Medicine 64:292-302, 2007) finds two distinct meanings of "dignity" in the literature on dignity and health: (1) intrinsic human dignity and (2) social dignity constituted through interactions with caregivers. Especially the latter has been central in empirical health research and warrants further exploration. This article focuses on the social dignity of people marginalized by mental illness, substance abuse and comparable conditions in extramural settings. 35 studies published between 2007 and 2017 have addressed this issue, most of them identifying norms for social dignity: civilized interactions, non-stigmatizing treatment, treatment as unique individuals, being taken seriously, maintaining a positive identity, experiencing independence, relating to others, and participating in daily life. We argue that these norms belong to ideal theory, whereas we agree with Robeyns (Social Theory and Practice 34:341-362, 2008) and others that improving practice is better served by non-ideal theory. Towards this end, we derive from the literature four building blocks for a non-ideal theory of dignity: (1) avoid violations of dignity rather than seeking to promote it; (2) dignity is not a goal to be reached; it requires ongoing effort; (3) promoting dignity is a balancing act; contradictory norms can make it impossible to realize; and (4) dignity can be undermined by organizational and discursive constraints.

Nursing students' satisfaction with narrative photography as a method to develop empathy towards people with Hiv: A mixed-design study

BACKGROUND

A major concern for people living with HIV during their lifetime is stigma and discrimination. It is therefore crucial to improve new generations of nurses' empathetic attitude towards these patients to eliminate fear and reduce discrimination using new educational interventions.

OBJECTIVE

To analyze nursing students' satisfaction with narrative photography as a method to develop empathy towards people living with HIV.

DESIGN

Concurrent mixed-method design.

PARTICIPANTS

Seventeen first-year nursing students from a public university in Barcelona, Spain.

METHODS

A 32-item questionnaire was administered at the end of the narrative photography training activity to determine nursing students' satisfaction with the methodology. Sociodemographic, attitudinal, skills, and satisfaction data were collected. Qualitative data were collected using a reflective open-ended question.

RESULTS

Of the participants, 82.4% stated that narrative photography helped them to develop reflective thinking and perceive how people living with HIV may feel. Further, 88.2% said that the new method helped them to eliminate some of their prejudices about HIV/AIDS, consider different points of view, understand the importance of providing humanized care, and identify discriminatory behaviors when caring for people living with HIV. Finally, 70.6% stated that narrative photography taught them more than traditional lectures.

CONCLUSIONS

Nursing students' satisfaction with narrative photography as a teaching strategy is very high; as a result, empathy is advanced in an academic and professional way during the nursing degree. However, more research is needed to demonstrate its efficacy in different scenarios.

Student nurses' views on respect towards service users - an interpretative phenomenological study

AIM

To explore student nurses' understanding and behaviours of respect towards patients in order to inform educational strategies to optimise respectful care.

BACKGROUND

There is a causal relationship between the perception of being treated with respect and patient satisfaction. Concerns over standards of care prompted a commissioned report into the quality of nurse education in the United Kingdom.

DESIGN

A hermeneutic phenomenological interview study was used to identify and interpret student nurses' behaviours and understanding of respect towards patients.

SETTING

University health and social care faculty in the north-west of England, United Kingdom.

PARTICIPANTS

Eight third-year student nurses (adult branch), on different university sites, with practice placements across different healthcare trusts.

METHODS

Interviews about their understanding of respect and their behavioural intentions of respect towards patients were recorded and transcribed, then analysed using interpretative phenomenological analysis (IPA) to produce themes from the data.

FINDINGS

Three themes of relevance to nurse education were identified. Respect is a complex concept that is difficult to apply in practice. Students are not always aware of incongruence between their feelings of respect towards patients and their behaviours towards them. Role-modelling of respectful care is variable, and essential care is often learned from healthcare assistants.

DISCUSSION

Awareness of emotional responses and their relationship to patient perceptions of respect should be facilitated in theory and practice. Rehearsal of the application of respect involving emotional labour, and reflection in and on the practice of respectful care, are needed to address student learning needs. The theory-practice gap in relation to respect, variation in professional practice and the under-recognised importance of healthcare assistants in student nurse education, are barriers to the learning of respect to patients.

CONCLUSIONS

Interactive education experiences are important to develop self-awareness and insight into respectful care. Mentorship in practice should encourage reflection in and on the practice of respect towards patients.

Welfare Homes for Patients Living with HIV/AIDS in Andalusia

AIMS

To study the AIDS welfare homes (AWHs) in Andalusia, assess their resources and the services provided, and describe the characteristics of their residents.

PATIENTS AND METHODS

Cross-sectional, observational study; an interview questionnaire technique was used with the managers and the residents of the AWHs.

RESULTS

A total of 7 AWHs and 96 residents were included; 32% of the staff were health care workers and 45.5% volunteers. The occupancy rate was 86% (2007) and 96% (2008). Residents' characteristics: mean age 45.6 years, 73% male, 92% with at least 1 AIDS-defining disease, median Karnofsky index 60 (50-80), and median Barthel index 80 (40-100). Half the residents had physical sequelae and 31% mental sequelae.

CONCLUSION

The AWHs perform an important role in the care of certain types of patients with HIV infection. They require human and material resources to be able to tackle the immense difficulties associated with this group of patients.

How has liberation theology influenced my practice?

In this paper, I would like to share with readers some concepts from liberation theology in relation to Christian nursing. First, I present liberation theology to explore its concepts and how they can shed light on Christian nursing. I introduce liberation theology and discuss the three concepts of relevance to Christian nursing: emancipatory knowing, contextual mindedness and socioeconomic inequality. Two case studies will be described to revisit the importance of building a rapport, learning the patient's story in a humble and respectful way, and addressing the social inequality and heath disparity of which we should be aware in a patient-nurse encounter. The possibility for collaboration between theologians and Christian nurses should be further explored in the future.

Dignity violation in health care

In this grounded theory analysis I sought to understand dignity violation in health care and to explore the context in which such violations take place. I found that dignity violation in health care occurs through processes of rudeness, indifference, condescension, dismissal, disregard, dependence, intrusion, objectification, restriction, labeling, contempt, discrimination, revulsion, deprivation, assault, and abjection. The conditions that promote these processes reside in the positions of the actors involved; in the asymmetrical relationships between the actors; in the health care setting itself, which is characterized by multiple tensions-including those between needs and resources, crisis and routine, experience and expertise, and rhetoric and reality; and in the embeddedness of health care in a broader social order of inequality. These findings suggest several interventions that might mitigate dignity violation in health care.