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Leyva-Moral JM, Gómez-Ibáñez R, San Rafael S, Guevara-Vásquez G, Aguayo-González M. Nursing students' satisfaction with narrative photography as a method to develop empathy towards people with Hiv: A mixed-design study. NURSE EDUCATION TODAY 2021; 96:104646. [PMID: 33160157 DOI: 10.1016/j.nedt.2020.104646] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/29/2020] [Accepted: 10/25/2020] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Juan M Leyva-Moral
- Universitat Autònoma de Barcelona, Faculty of Medicine, Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Barcelona, Spain.
| | - Rebeca Gómez-Ibáñez
- Universitat Autònoma de Barcelona, Faculty of Medicine, Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Barcelona, Spain
| | - Sabiniana San Rafael
- Universitat Autònoma de Barcelona, Faculty of Medicine, Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Barcelona, Spain
| | | | - Mariela Aguayo-González
- Universitat Autònoma de Barcelona, Faculty of Medicine, Department of Nursing, Grupo de Investigación Enfermera en Vulnerabilidad y Salud (GRIVIS), Barcelona, Spain
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Ngcobo SJ, Mchunu GG. Bachelor of Nursing students' HIV and AIDS knowledge in KwaZulu-Natal province: An evaluation study. Curationis 2019; 42:e1-e11. [PMID: 31291729 PMCID: PMC6620523 DOI: 10.4102/curationis.v42i1.1928] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 11/12/2018] [Accepted: 01/29/2019] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Currently, human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) education and training in nursing suffer from various inadequacies and lack any real formalisation in their governance. As a result, Bachelor of Nursing students find themselves challenged in providing effective HIV and AIDS healthcare management, largely because of the deficit in training identified. An HIV and AIDS education intervention programme was introduced at a selected KwaZulu-Natal university to assist in bridging the perceived knowledge gap. This article communicates programme evaluation findings. OBJECTIVES The aim of this article was to determine levels of HIV knowledge achieved following an HIV education intervention programme. METHODS A pure, descriptive quantitative research design was employed, using total population sampling (N = 133). A modified G3658-11 Collecting Evaluation Data: End-of-Session Questionnaire, developed by the University of Wisconsin-Extension, was administered for data collection. RESULTS Females predominated in the study, and most participants were African with 1 to 3 years of education programme exposure. Perceived HIV knowledge increase was evident: pathophysiology (n = 93, 70.2%); immunology (n = 97, 72.9%); transmission (n = 116, 87.5%); diagnosis (n = 109, 81.8%); prevention strategies (n = 118, 88.4%); staging and monitoring (n = 106, 80%); pre- and post-test counselling (n = 104, 78%). CONCLUSION Pre- and ongoing in-service HIV and AIDS training can improve perceived HIV knowledge levels for both nursing students and professionals. Mandatory HIV and AIDS healthcare management training is therefore recommended in planning for its effective impartation by nursing educators.
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Affiliation(s)
- Silingene J Ngcobo
- School of Nursing and Public Health, Howard College, University of KwaZulu-Natal, Durban.
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Aboshaiqah A, Qasim A. Nursing interns' perception of clinical competence upon completion of preceptorship experience in Saudi Arabia. NURSE EDUCATION TODAY 2018; 68:53-60. [PMID: 29886285 DOI: 10.1016/j.nedt.2018.05.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 04/15/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Nursing interns are newly graduate students with limited real-life work experiences. These novices are in the process of enhancing their competencies in the delivery of quality nursing care with the guidance of the preceptors. Hence, it is relevant to examine the impact of preceptorship, as a teaching strategy, among nursing interns during their preceptorship years in clinical settings. OBJECTIVE The aim of this study is to determine if the preceptorship program has provided the nursing interns the needed education in enhancing clinical competence. SETTING The study was conducted in one of the tertiary hospitals in Riyadh, Saudi Arabia. PARTICIPANTS Convenience sampling was used to recruit 92 undergraduate nursing interns who have completed the five-years nursing education including preceptorship. METHODS The nursing interns completely answered the survey questionnaires which covers Benner's Competencies, Knowles' Adult Learning Theory and the Nursing Process. DESIGN The study followed a mixed-methods design wherein a descriptive cross-sectional approach was used to identify factors affecting the nursing interns' perception towards clinical competence. Two open-ended questions referring to the improvement of internship program and competency were concurrently collected which was the qualitative portion of the study. RESULTS The preceptorship program enhanced the preceptees competencies in the clinical setting primarily in priority-setting with acutely ill patients, multitasking and demonstrating complex nursing skills. The majority of the nursing interns perceived preceptorship as a constructive experience. The availability, approachable attitude, and trustworthiness of the preceptor were viewed as influential factors in improving the interns' clinical competence. Variations were significant with phases of internship and type of school. Furthermore, results showed positive correlation between the nursing interns' efficacy and clinical competencies in professional behavior, general performance, and core nursing skills. CONCLUSION Preceptorship program positively impacts nursing interns' skills in handling actual patients in clinical setting. Hence, the preceptorship program is an effective teaching strategy which advances the novice to the next stage of developing clinical competence.
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Affiliation(s)
| | - Abdiqani Qasim
- College of Medicine, King Fahad Medical City Riyadh, Saudi Arabia.
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Leyva-Moral JM, Terradas-Robledo R, Feijoo-Cid M, de Dios-Sánchez R, Mestres-Camps L, Lluva-Castaño A, Comas-Serrano M. Attitudes to HIV and AIDS among students and faculty in a School of Nursing in Barcelona (Spain): a cross-sectional survey. Collegian 2017. [DOI: 10.1016/j.colegn.2016.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Leyva-Moral JM, Palmieri PA, Feijoo-Cid M, Cesario SK, Membrillo-Pillpe NJ, Piscoya-Angeles PN, Goff M, Toledo-Chavarri A, Edwards JE. Reproductive decision-making in women living with human immunodeficiency virus: A systematic review. Int J Nurs Stud 2017; 77:207-221. [PMID: 29112908 DOI: 10.1016/j.ijnurstu.2017.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Analyze and synthesize the research evidence to understand the reproductive decisions made by women living with HIV from the beginning of the epidemic to the present. Evaluate the barriers and the facilitators for reproductive decision-making. Identify areas of strength, improvement, and those requiring further research. DESIGN AND DATA SOURCES Systematic review following the PRISMA guideline. PubMed, CINAHL, PsycINFO, Cochrane Library, SocINDEX, Embase, and Scopus databases were searched from 1985 to 2016 using the following Keywords: HIV, AIDS, pregnancy, reproduction, and decision-making. STUDY SELECTION A total of 42 research papers were included in this review. Initially, 1563 papers were identified for the review by database (n=1544) and hand (n=19) searches. With three review levels, 1521 papers were excluded (title review, n=1272; abstract review, n=136; and full paper review, n=113). Studies published in English in peer-reviewed journals using both quantitative and qualitative methods and addressing reproductive decisions in women living with HIV were included. Thirdly, inclusion eligibility was assessed by title, abstract, and full text. REVIEW METHODS Random allocation conducted by the primary researcher assigned an equal number of papers to each researcher for review, including detailed instructions with an abstraction form. Discrepancies were resolved by two researchers. Research quality was assessed using the NCHBL Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, the Critical Appraisal Skills Programme for the qualitative studies and its version for systematic reviews RESULTS: The review included 42 papers, both quantitative (n=24) and qualitative methods (n=14). Most studies were completed by physicians (n=16) or nurses (n=15). More than two-thirds of the studies were performed in urban settings with predominantly African-American women (n=27). Eight factors were identified as influencing the reproductive decision-making process in women living with HIV: 'Socio-demographic, Health status and Pregnancy', 'Religion and spirituality', 'Beliefs and Attitudes about Antiretroviral Therapy', 'Healthcare providers', 'Significant others', 'Motherhood and fulfillment', 'Fear of perinatal infection and infection of partner(s)', 'Birth control and pregnancy management'. CONCLUSIONS Health care providers are not providing patient-centered care by applying scientific evidence to their practice when advising women with HIV in making reproductive decisions. Despite the strong evidence indicating pregnancy for women with HIV results in a safe birthing trajectory, one not likely to jeopardize the health of the either the mother or fetus, providers continue to recommend the women with HIV avoid pregnancy and neglect to invite partners to participate in the discussion.
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Affiliation(s)
- Juan M Leyva-Moral
- Universidad Autónoma de Barcelona, Department of Nursing. Faculty of Medicine. Avda. Can Domenech, Building M. Office M3/211, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.
| | - Patrick A Palmieri
- Facultad de Ciencias de la Salud, Universidad Privada Norbert Wiener. Jr. Larrabure y Unanue 110 Urb. Santa Beatriz, Lima, Perú; College of Graduate Health Studies, A.T. Still University (Mesa, Arizona, USA).
| | - María Feijoo-Cid
- Universidad Autónoma de Barcelona, Department of Nursing. Faculty of Medicine. Avda. Can Domenech, Building M. Office M3/211, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.
| | - Sandra K Cesario
- College of Nursing, Texas Woman's University, 6700 Fannin St., Houston, TX 77030, United States.
| | | | | | - Marilyn Goff
- Texas Woman's University (Houston Campus). 6700 Fannin St., Houston, TX 77030, United States.
| | - Ana Toledo-Chavarri
- Canary Islands Foundation of Health Research and the Center for Biomedical Research of the Canary Islands. Facultad de Medicina - Universidad de La Laguna San Cristobal de La Laguna, Santa Cruz de Tenerife 38071, España.
| | - Joan E Edwards
- College of Nursing, Texas Woman's University, 6700 Fannin St., Houston, TX 77030, United States.
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Rickles NM, Furtek KJ, Malladi R, Ng E, Zhou M. Pharmacy Student Attitudes and Willingness to Engage in Care with People Living with HIV/AIDS. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2016; 80:45. [PMID: 27170816 PMCID: PMC4857640 DOI: 10.5688/ajpe80345] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 07/01/2015] [Indexed: 05/14/2023]
Abstract
Objective. To describe the extent to which pharmacy students hold negative attitudes toward people living with HIV/AIDS (PLWHA) and to determine whether background variables, student knowledge, and professional attitudes may affect willingness to care for PLWHA. Methods. An online survey tool was developed and administered to 150 pharmacy students in their third professional year. Descriptive and stepwise multivariate regressions were performed. Results. While descriptive results showed a majority of respondents had favorable professional attitudes towards caring for PLWHA, most pharmacy students expressed discomfort with specific attitudes about being in close physical contact and receiving selected services from PLWHA. Multivariate results revealed that: (1) being a minority predicted greater knowledge; (2) having received prior HIV instruction and greater HIV knowledge predicted more positive professional attitudes caring for PLWHA; (3) being more socially liberal, having more positive professional attitudes caring for PLWHA, and having greater empathy towards PLWHA predicted student willingness to provide services. Conclusion. Future educational interventions specifically targeted toward socially conservative whites may impact greater student willingness to care for PLWHA. Additional research should also explore the generalizability of the present findings and modeling to pharmacy students in other regions of the country.
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Affiliation(s)
| | | | | | - Eric Ng
- Northeastern University, Boston, Massachusetts
| | - Maria Zhou
- Northeastern University, Boston, Massachusetts
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Nursing Students' Willingness to Care for Human Immunodeficiency Virus-Infected Patients in the Future. Nurse Educ 2016; 40:E1-5. [PMID: 25997151 DOI: 10.1097/nne.0000000000000172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Recent studies in various countries have shown controversy regarding students' willingness to care for human immunodeficiency virus (HIV)-infected patients as well as factors associated with students' decisions about this issue. This survey, based on the Theory of Planned Behavior, explored factors associated with Israeli nursing students' willingness to care for HIV-infected patients in the future. The results suggest that appropriate education and experience in caring for HIV-infected patients are critical for improving students' willingness to care for these patients.
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A Mixed-Methods Outcome Evaluation of a Mentorship Intervention for Canadian Nurses in HIV Care. J Assoc Nurses AIDS Care 2016; 27:677-97. [PMID: 27039195 DOI: 10.1016/j.jana.2016.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/16/2016] [Indexed: 11/23/2022]
Abstract
We assessed the impact of an HIV care mentorship intervention on knowledge, attitudes, and practices with nurses and people living with HIV (PLWH) in Canada. We implemented the intervention in two urban and two rural sites with 16 mentors (eight experienced HIV nurses and eight PLWH) and 40 mentees (nurses with limited HIV experience). The 6- to 12-month intervention included face-to-face workshops and monthly meetings. Using a mixed-methods approach, participants completed pre- and postintervention questionnaires and engaged in semistructured interviews at intervention initiation, mid-point, and completion. Data from 28 mentees (70%) and 14 mentors (87%) were included in the quantitative analysis. We analyzed questionnaire data using McNemar test, and interview data using content analysis. Results indicated positive changes in knowledge, attitudes, and practices among nurse mentees, with qualitative interviews highlighting mechanisms by which change occurred. Mentorship interventions have the potential to engage and educate nurses in HIV treatment and care.
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Active learning improves nursing student clinical performance in an academic institution in Macao. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.cnre.2015.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Atav AS, Sendir M, Darling R, Acaroglu R. Turkish and American Undergraduate Students' Attitudes Toward HIV/AIDS Patients: A Comparative Study. Nurs Forum 2015; 50:116-124. [PMID: 24387272 DOI: 10.1111/nuf.12059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is a complex healthcare problem. Research has demonstrated that negative attitudes affect healthcare provision. AIMS The purpose of this study was to compare nursing students' attitudes using the AIDS Attitude Scale (AAS). SETTINGS A descriptive, cross-sectional study was conducted in nursing schools in Istanbul, Turkey, and in Upstate New York (NY). PARTICIPANTS Baccalaureate nursing students (n = 613) from both countries completed the questionnaire. METHODS Demographic data, overall AAS attitudes, and attitudes within each subscale were compared. Analyses included frequency and percentages of the grouped variables, arithmetic means and standard deviations, t-test for independent samples, and multiple analysis of variance. RESULTS Upstate NY students' mean total AAS scores were significantly more positive toward HIV+ patients than Turkish students'. Scores for Professional Resistance and Emotions subscales were significantly more positive for the Upstate NY students, but Fear of Contagion was not. Upstate NY students had more negative attitudes in the contexts of job risk and eating in a restaurant where the chef has AIDS; more professional resistance to referring patients and training specialists for HIV/AIDS patients; and lower tender feelings for people with HIV/AIDS (p < .01 for each). CONCLUSIONS Improvement in students' attitudes is beneficial for promoting nonjudgmental, compassionate care for the HIV+ population.
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Affiliation(s)
- A Serdar Atav
- Decker School of Nursing, Binghamton University, Binghamton, NY
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Bell A, Bray L. The knowledge and attitudes of student nurses towards patients with sexually transmitted infections: Exploring changes to the curriculum. Nurse Educ Pract 2014; 14:512-7. [DOI: 10.1016/j.nepr.2014.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 12/06/2013] [Accepted: 05/06/2014] [Indexed: 11/26/2022]
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Özakgül AA, Şendir M, Atav AS, Kızıltan B. Attitudes towards HIV/AIDS patients and empathic tendencies: a study of Turkish undergraduate nursing students. NURSE EDUCATION TODAY 2014; 34:929-933. [PMID: 24268638 DOI: 10.1016/j.nedt.2013.10.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/24/2013] [Accepted: 10/21/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Studies indicate that the attitudes of nurses, nursing students, and other health care professionals towards Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) patients are affected by cultural differences and the fear of HIV/AIDS infection, resulting in both negative attitudes and reluctance to care for these patients. Empathy is critical for all health professionals in the delivery of effective care. Research indicates that as empathic tendencies develop, so do better communication skills, better attitudes, and better quality of care. OBJECTIVES The purpose of this study was to examine the relationships among demographic factors, familiarity with HIV/AIDS, attitudes towards HIV/AIDS, and empathic tendencies in a Turkish sample of nursing students. DESIGN AND METHODS Using a non-experimental, correlational design, data on demographics, HIV/AIDS Attitude Scale (AAS) and the Scale of Empathic Tendency (SET) were collected. PARTICIPANTS The study sample consisted of 614 undergraduate nursing students in two universities located in different geographic regions of Turkey. RESULTS The results of this study indicated that attitudes and empathic tendencies are related to knowledge and exposure to patients. As well, those students with more positive attitudes had higher empathic tendencies towards HIV/AIDS patients. CONCLUSIONS It is important to adopt strategies to improve the empathic tendencies and attitudes of nursing students. These strategic changes would increase the quality of care provided to all patients.
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Affiliation(s)
- Aylin Aktaş Özakgül
- Istanbul University, Florence Nightingale Faculty of Nursing, Istanbul, Turkey.
| | - Merdiye Şendir
- Istanbul University, Florence Nightingale Faculty of Nursing, Istanbul, Turkey.
| | - A Serdar Atav
- Binghamton University, Decker School of Nursing, Binghamton, NY, United States.
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Akin S, Mendi B, Mendi O, Durna Z. Turkish nursing students' knowledge of and attitudes towards patients with HIV/AIDS. J Clin Nurs 2013; 22:3361-71. [PMID: 24127908 DOI: 10.1111/jocn.12378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To assess nursing students' knowledge of and attitudes towards such patients and to determine the variables associated with students' knowledge and attitudes towards them. BACKGROUND Improving nurses' and nursing students' knowledge and attitudes towards patients with HIV/AIDS is vital for providing quality care for such patients. DESIGN This descriptive, cross-sectional study was conducted at three nursing schools located in two different cities in Turkey. The inclusion criteria for the nursing students were as follows: being at least 18 years old; being a first-, second-, third- or fourth-year nursing student; and giving consent to participate in the research. METHODS The sample comprised 580 nursing students. The study used three data collection tools: (1) the Student Socio-Demographic Questionnaire, (2) the HIV/AIDS Knowledge Questionnaire and (3) the HIV/AIDS Attitude Questionnaire. RESULTS Participants' knowledge was found to be insufficient, particularly with regard to HIV transmission routes. They generally had positive attitudes towards patients with HIV/AIDS. However, they expressed some concerns and were hesitant about working with AIDS and HIV-positive patients. CONCLUSIONS The current results reveal that nursing students still have misconceptions and a lack of knowledge of HIV/AIDS and that their attitudes need to be improved. RELEVANCE TO CLINICAL PRACTICE Improving education programmes about HIV/AIDS and using information sources effectively may contribute to better knowledge and more desirable attitudes towards HIV/AIDS.
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Affiliation(s)
- Semiha Akin
- Faculty of Health Sciences, Nursing Department, Bahçeşehir University, Istanbul, Turkey
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Bias in medicine: a survey of medical student attitudes towards HIV-positive and marginalized patients in Russia, 2010. J Int AIDS Soc 2012; 15:17372. [PMID: 23031336 PMCID: PMC3494162 DOI: 10.7448/ias.15.2.17372] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Revised: 06/21/2012] [Accepted: 08/20/2012] [Indexed: 11/08/2022] Open
Abstract
Background Russia has a substantial HIV epidemic which is poised to escalate in the coming years. The increases in prevalence of HIV will result in increased healthcare needs by a medical system with limited experience with HIV. A healthcare provider's attitude towards a patient plays a significant role in determining the patient's health-related behaviours and medical outcomes. Previous studies have identified negative attitudes of medical students towards people living with HIV. Studying the prevalence of such attitudes is of particular interest, as medical students represent the future workforce and also as the schooling years present a unique opportunity to nurture bias-free healthcare providers. The study measures prevalence of prejudicial attitudes towards HIV-positive and HIV-negative patients who belong to marginalized subgroups. Methods The cross-sectional survey was conducted among medical students of a Russian medical university. Of 500 students surveyed, 436 provided sufficient data to be included in the analysis. Prejudicial attitudes were defined as reluctance to provide medical care to a specified hypothetical patient. Nine hypothetical HIV-positive and HIV-negative patients were proposed: physicians, injecting drug users, commercial sex workers, men who have sex with men and a patient HIV-positive due to blood transfusion. A log-binomial regression solved using generalized estimating equations was utilized to identify factors associated with reluctance to treat. Results Prevalence of reluctance to provide medical care to HIV-positive patients in marginalized subgroups was high (ranging from 26.4% up to 71.9%), compared to a maximum of 7.5% if a patient was an HIV-negative physician. Students in their clinical years reported more negative attitudes than preclinical students. In general, female students were less willing to provide care than their male counterparts. Conclusions Prejudicial attitudes about HIV-positive patients and those in marginalized subgroups of the population are prevalent among medical students in Russia. Given the increasing prevalence of HIV in the country, reasons for this hesitance to treat must be identified and addressed. Educational programs for healthcare providers are urgently needed to eliminate bias in the delivery of critically needed medical care. These targeted interventions should be coupled with other programs to eliminate structural barriers to care.
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