Nurses' willingness to take care of people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)--does a teaching intervention make a difference?

Nursing students' attitudes on caring for people living with HIV/AIDS. A European Multicentre Study

BACKGROUND AND AIM

Caring for people with HIV/AIDS is a challenging issue for nursing students, involving sometimes misconceptions due to different cultural, political and religious views. The aim of this project was to investigate nursing students' attitudes on caring for people with HIV/AIDS.

METHODS

A convenient sample of undergraduate nursing students enrolled in four European universities was recruited. Data were collected by administering the AIDS Attitude Scale (AAS). Statistical analysis included the ANOVA test, the t-test for independent variables, and the Kruskal-Wallis test with a confidence level P <0.05.

RESULTS

The sample consisted of 594 students of which 162 (27.3%) were English, 246 (41.4%) Italian and 186 (31.3%) Greek. Study findings demonstrated that students' attitudes toward HIV/AIDS patients were relatively positive, although the majority of them indicated fear of contracting HIV through clinical practice. Nursing students' positive feelings for HIV/AIDS patients were also correlated with the strong willingness to take care of them.

CONCLUSIONS

Despite being exposed to different teaching and learning experiences, a significant part of the participants believe that HIV/AIDS make nursing a high-risk profession. Furthermore, students' misconceptions are not limited to clinical practice areas as they expressed concerns in sending their children in a class along with a child affected by AIDS and/or in dining in a restaurant where a chef affected by AIDS works. Students are in general well-disposed towards this patients' population but there is still stigma associated with this condition. A new teaching and learning approach may help redefining students' attitudes and in limiting the negative impact of misconceptions on the quality of nursing care. Further investigation in this area would help in shading light on the reasons why students are still biased in approaching AIDS/HIV patients. The use of a qualitative approach based on semi-structured interviews and/or focus group would be recommended.

Using a mHealth tutorial application to change knowledge and attitude of frontline health workers to Ebola virus disease in Nigeria: a before-and-after study

BACKGROUND

The Ebola epidemic exposed the weak state of health systems in West Africa and their devastating effect on frontline health workers and the health of populations. Fortunately, recent reviews of mobile technology demonstrate that mHealth innovations can help alleviate some health system constraints such as balancing multiple priorities, lack of appropriate tools to provide services and collect data, and limited access to training in health fields such as mother and child health, HIV/AIDS and sexual and reproductive health. However, there is little empirical evidence of mHealth improving health system functions during the Ebola epidemic in West Africa.

METHODS

We conducted quantitative cross-sectional surveys in 14 health facilities in Ondo State, Nigeria, to assess the effect of using a tablet computer tutorial application for changing the knowledge and attitude of health workers regarding Ebola virus disease.

RESULTS

Of 203 participants who completed pre- and post-intervention surveys, 185 people (or 91%) were female, 94 participants (or 46.3%) were community health officers, 26 people (13 %) were nurses/midwives, 8 people (or 4%) were laboratory scientists and 75 people (37%) belonged to a group called others. Regarding knowledge of Ebola: 178 participants (or 87.7%) had foreknowledge of Ebola before the study. Further analysis showed an 11% improvement in average knowledge levels between pre- and post-intervention scores with statistically significant differences (P < 0.05) recorded for questions concerning the transmission of the Ebola virus among humans, common symptoms of Ebola fever and whether Ebola fever was preventable. Additionally, there was reinforcement of positive attitudes of avoiding the following: contact with Ebola patients, eating bush meat and risky burial practices as indicated by increases between pre- and post-intervention scores from 83 to 92%, 57 to 64% and 67 to 79%, respectively. Moreover, more participants (from 95 to 97%) reported a willingness to practice frequent hand washing and disinfecting surfaces and equipment following the intervention, and more health workers were willing (from 94 to 97%) to use personal protective equipment to prevent the transmission of Ebola.

CONCLUSIONS

The modest improvements in knowledge and reported attitudinal change toward Ebola virus disease suggests mHealth tutorial applications could hold promise for training health workers and building resilient health systems to respond to epidemics in West Africa.

Reviewing Tribunal cases and nurse behaviour: putting empathy back into nurse education with Bloom's taxonomy

Recent events in the UK and Australia have shown how poor patient outcomes are achieved when the behaviour of nurses lacks empathy. The UK's Francis Inquiry and the Keogh Report both call for an increase in the 'caring and compassion' of health care workers. A review of cases presented to the nurses' disciplinary tribunal in New South Wales' (Australia) also suggests that the majority of complaints against nurses in this jurisdiction is the result of callousness or lack of empathy. Such events reinforce the need for nurse educators to support nursing students to develop the affective attributes of caring and empathy. This paper considers how to raise the awareness of undergraduate students as a first step to developing empathy by using Bloom's Taxonomy of Educational Objectives; and includes a description of how to facilitate interactions with undergraduate nursing students about caring with empathy. Enculturating empathy is an evidence-based method of increasing compassionate care in health organisations generally.

Living with and teaching about HIV: engaging nursing students through body mapping

Body mapping, an artistic method of narrating experiences alongside people living with HIV/AIDS (PHAs), was used to educate first year nursing students about social and personal aspects of the illness, including stigma. Body mapping creates a safe space where individuals can discuss personal, emotional, cultural, political and socio-economic dimensions of their lives in relation to HIV/AIDS. The aim of this study is to understand how individuals from multiple perspectives experience body mapping as an educational tool, including a nursing student, an expert facilitator, a PHA and a course professor. The stories they live and tell motivate and inform the content of this study. We conducted three individual in-depth interviews with a student, a PHA and an expert facilitator on their experiences of participating in body mapping. The interviews were transcribed and analyzed thematically. Field and observational notes were also collected and reflections have been incorporated in this paper. Three themes were derived from our analyses: 1) stock taking narratives, where body mapping serves as a mediator for reflecting, accessing and organizing past experiences; 2) transactional narratives where body mapping creates safe spaces within which relationships are created, and experiences are shared, and 3) give and take narratives that connote transformation of self as a result of participating in body mapping. In conclusion, the body mapping exercise as an educational tool is an opportunity to share experiences, and to learn about and to shift attitudes surrounding HIV/AIDS. Thus, body mapping can be a valuable tool for HIV education for first year nursing students.