German nursing students' knowledge of and attitudes to HIV and AIDS: two decades after the first AIDS cases

Professional commitment and willingness to care for people living with HIV among undergraduate nursing students: The mediating role of empathy

BACKGROUND

As future registered nurses, undergraduate students play a vital role in integrated care for acquired immunodeficiency syndrome; hence, there is a need to examine factors that can increase their willingness to care for persons with such conditions.

OBJECTIVE

This study examined the relationship among nursing professional commitment, empathy, and willingness to care for people living with human immunodeficiency virus and acquired immunodeficiency syndrome among undergraduate student nurses, and the mediating role of empathy in this relationship.

DESIGN

Quantitative, cross-sectional design.

SETTINGS

Nursing schools from five provinces of China, including Hunan, Jiangxi, Guangxi, Henan, and Hebei.

PARTICIPANTS

A total of 747 undergraduate student nurses were recruited via cluster sampling.

METHODS

Online survey was used to collect data. Nursing Willingness Questionnaire, Professional Commitment Scale, and Jefferson Scale of Empathy were the scales used to measure the variables. Structural equation modeling was used to determine significant relationships.

RESULTS

Respondents' professional commitment and empathy demonstrated moderate positive associations with willingness to care. Empathy demonstrated a 21 % mediating effect on the effect of professional commitment and willingness to care (p < 0.05).

CONCLUSIONS

Findings highlight the enabling role of professional commitment and empathy in improving undergraduate student nurses' willingness to care for persons living with human deficiency virus. Nurse educators can help improve the impact of students' professional commitment on their willingness by using educational strategies that enhance their empathy.

Attitudes Toward Caring for People Living with HIV/AIDS: A Cross-Sectional Study of Nursing Faculty in Six Countries

Background:

Since the earliest study about nursing faculty and student attitudes about caring for people living with HIV/AIDS (PLHIV) in 1992, there have been less than 20 additional studies reported in the literature. Yet, PLHIV continues to report stigma and experience discrimination. Nursing faculty attitudes are part of the informal curriculum. Negativity about caring for PLHIV can adversely impact student perceptions as well as their care. Current research in this area is essentially non-existent.

Objective:

To describe the attitudes of the university nursing faculty toward caring for PLHIV; and to identify the relationship between faculty attitudes and explanatory factors such as age, education, religion, nationality, teaching in a clinical setting, years of experience, and university attributes.

Methods:

This was a multicenter cross-sectional study with nonrandomized electronic purposeful sampling. The Healthcare Provider HIV/AIDS Stigma Scale (HPASS) is a 30-item scale with three subscales: Prejudice, stereotype, and discrimination. The English and Spanish versions of the HPASS exhibit stable psychometric properties for cross-cultural research. The HPASS was delivered to university nursing faculty in six countries across three continents.

Results:

A sample of 368 nursing faculty completed the HPASS. The mean composite score was 2.41 (SD = 0.69), six-point scale with lower scores indicating more positive attitudes, with subscale scores: Stereotypes 2.55 (SD = 0.84), discrimination 2.28 (SD = 0.74), and prejudices 2.41 (SD = 0.63). Peruvian faculty had the highest scores while Canadian had the lowest. Significant correlations were observed between attitudes and the three subscales, and between the three subscales and the composite score.

Conclusion:

Attitudes of the nursing faculty toward caring for PLHIV were slightly positive to slightly negative depending on the region and country. Knowledge deficiencies about HIV persist, incorrect beliefs are common, and attitudes appear to be influenced by culture. The correlation between subscales justifies continued research to implement targeted interventions. Education about HIV/AIDS can address knowledge deficits while structured interactions with PLHIV can facilitate experiential learning.

Faculty Attitudes About Caring for People Living With HIV/AIDS: A Comparative Study

BACKGROUND

People living with HIV/AIDS (PLHIV) experience stigma and discrimination. Negative attitudes of nursing faculty about caring for PLHIV can adversely affect student perceptions and their nursing care. The study purpose was to describe nursing faculty attitudes and beliefs about caring for PLHIV.

METHOD

The HPASS (Healthcare Provider HIV/AIDS Stigma Scale), Spanish version, was delivered to nursing faculty in Colombia and Peru.

RESULTS

The HPASS was completed by 98 nursing faculty. The overall mean score was 2.41 (SD = 0.69), with subscale scores: stereotypes, 2.55 (SD = 0.84); discrimination, 2.28 (SD = 0.74); and prejudices, 2.41 (SD = 0.63). Peruvian faculty had the highest scores, statistically correlated with the importance of religion, whereas Colombia had the lowest.

CONCLUSION

Nursing faculty attitudes toward PLHIV were slightly positive in Colombia to slightly negative in Peru; however, both countries had negative stereotypes. Knowledge deficiencies about HIV persist and attitudes appear to be influenced by culture and religion. [J Nurs Educ. 2019;58(12):712-717.].

Knowledge, attitudes, and practices of public secondary school teachers on Zika Virus Disease: A basis for the development of evidence-based Zika educational materials for schools in the Philippines

The Philippines is at risk in developing a Zika Virus (ZIKV) Disease Outbreak. One of the possible interventions is health education because students are potential health advocates and influencers to their communities through the knowledge transfers from their teachers. The competency of Filipino teachers on ZIKV Disease is yet to be described. This study aimed to assess the knowledge, attitudes, and practices of public secondary school teachers on ZIKV Disease. A modified version of the Knowledge, Attitudes, and Practices Survey Tool on Zika Virus Disease from the World Health Organization—Pan American Health Organization (WHO-PAHO) was used to assess the knowledge, attitudes, and practices of teachers of eight public secondary schools in five villages in Quezon City, Philippines. Out of the 609 respondents, 87.3% reported that their main source of information about ZIKV is tri-media, which includes television, print, and radio. Majority of the respondents mentioned that ZIKV is transmitted through a mosquito bite (80.3%). However, only half of the participants identified vector control as a preventive strategy. Moreover, only 54% admitted to have cleaned their water containers or water sources within the last week. Only a few identified mother-to-child (23%) and sexual intercourse (8%) as other means of transmission. Half (49.8%) of the respondents felt that it is possible to acquire ZIKV in their community, while 90% perceived that a private doctor (90%) or a public hospital (88%) can effectively treat the disease. Perceived stigma is high at 50%. This study showed there was good knowledge among teachers on vector transmission of ZIKV but poor knowledge on other aspects of the disease. Also, there was a low level of perceived susceptibility and severity of ZIKV which can be explained by the absence of a personal encounter with a Zika patient and the low number of cases in the Philippines. Half of the respondents said that they cleaned the possible mosquito breeding sites within the last week, followed by those who cleaned their water source more than a week ago (19%). None of the socio-demographic characteristics is significantly associated with respondents’ knowledge on Zika. Only income and location of residence were found to be significantly associated with attitudes towards Zika. These findings call for a comprehensive training program that includes development of teaching materials for public secondary school teachers on ZIKV Disease based from this study.

Awareness of HIV Transmission Risks and Determinants of Sexual Behaviour: Descriptive and Multivariate Analyses among German Nursing Students

BACKGROUND AND AIM

Nursing students play a crucial role in sexual health education. Evidence suggests, however, that nursing students had several gaps in their knowledge of HIV transmission. This study investigates how nursing students in Germany assess the potential risks of spreading HIV in defined situations and which factors influence the self-expressed sexual behaviour patterns of these students.

METHODS

A standardized anonymous questionnaire was administered to a sample (N=617) of nursing students in 2008 and 2013. The survey was conducted during lessons, resulting in a response rate of 100%.

RESULTS

For 17.4% of the students, assistance with personal hygiene was associated with higher HIV transmission risk. Also, changing dirty linen (17.6%) and physical examination (14.1%) were also noted similarly risky. The average age of first sexual intercourse was 15.5 years and the number of lifetime sexual partners was 4.3. The higher the average number of lifetime sexual partners, the higher the likelihood to use condoms only sometimes or never (OR 1.11). Forty students reported an unintended pregnancy. The likelihood to be unintentionally pregnant was six times higher among students aged 25 years or older (OR 6.16).

CONCLUSIONS

The results clearly show that students overestimated HIV transmission risks in most of the situations encountered during health services provided by nurses, but overall sexual health behaviour indicated rather less risky behaviour. Nonetheless, the relatively high rate of unintended pregnancies is quite concerning. The findings underline the need for stronger integration of HIV and sexual education in the curricula of nursing schools in Germany.

"The evil virus cell": Students' knowledge and beliefs about viruses

Education about virus biology at school is of pivotal interest to raise public awareness concerning means of disease transmission and, thus, methods to prevent infection, and to reduce unnecessary antibiotic treatment due to patient pressure on physicians in case of viral diseases such as influenza. This study aimed at making visible the knowledge of Austrian high school and university students with respect to virus biology, virus structure and health-education issues. The data presented here stem from comprehensive questionnaire analyses, including the task to draw a virus, from a cross-sectional study with 133 grade 7 and 199 grade 10 high school students, and 133 first-year biology and 181 first-year non-biology university students. Analyses were performed both quantitatively and qualitatively. ANOVA revealed a highly significant group effect for total knowledge relating to virus biology and health issues (F(3, 642) = 44.17, p < 0.01, η²p = 0.17). Specific post-hoc tests by means of the Tukey test showed significant differences between all groups (p < .01) with the exception of 1^st year non-biology students and grade 10 high school students. Students enrolled in university-level biology outperformed all other groups, even though they had not yet encountered this topic at their courses; part of this phenomenon might be due to their affinity for learning about biological topics. However, even many first-year biology students had a high number of severe misconceptions, e.g., defining a virus as a pro- or eukaryotic cell, or falsely naming malaria as a viral disease. Since there was no significant difference in virus-related knowledge between high schools, virus biology seems to have been taught similarly among the tested schools. However, the majority of participants stated that the virus-related knowledge they had acquired at school was not sufficient. Based on the results presented here we urgently suggest improving and intensifying teaching this topic at school, since virus-related knowledge was by far too fragmentary among many participants. Such lack of health-relevant knowledge may contribute to pressure on physicians by patients to unnecessarily prescribe antibiotics, and possibly lead to potentially dangerous neglect concerning vaccination. The effectiveness of newly developed virus-related teaching units and material could be tested with the instrument used here.

Turkish and American Undergraduate Students' Attitudes Toward HIV/AIDS Patients: A Comparative Study

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.

Willingness to take care of HIV positive people: Responses from Russian nursing students

This article is a report of a study on Russian nursing students’ willingness to take care of people living with HIV or AIDS (PLWHA). HIV and AIDS are continuing to spread in Russia. Nursing students’ willingness to care for people living with HIV or AIDS is one aspect that should also be taken in consideration on this transmission situation. In total, 102 nursing students participated in the study (the response rate was 95.3%). The data were collected using the Nurse Willingness Questionnaire (NWQ) and analysed using SPSS version 15 for Windows. The study showed that nursing students’ willingness to care for PLWHA was low when asked with one general question but quite high when asked more specifically related to some nursing activities. Nursing students were more willing to perform clean nursing activities than activities with infectious risk. There is a great need for improving understanding of and proficiency in safety work with HIV-infected patients.

Russian nursing students' knowledge level and attitudes in the context of human immunodeficiency virus (HIV) - a descriptive study

Background

The purpose of this study was to describe the knowledge of Russian nursing students regarding HIV and Acquired Immuno-Deficiency Syndrome (AIDS), and their attitudes towards caring for people/patients living with HIV or AIDS (PLWHA - People Living With HIV/AIDS) and their possible homophobic attitudes. The HIV epidemic in Russia is substantial and increasing rapidly. Hence this study provides important new information regarding this phenomenon.

Methods

The data was collected by questionnaire from students in three nursing schools (n = 102, response rate 95.3%). The data was analyzed using PASW Statistics version 18. For computing the level of the students’ AIDS knowledge, all correct answers were recorded as equal to (1), while all incorrect and “Don’t know” answers were recorded as equal to (0). Each respondent’s scores were totaled and individual scores were analyzed using regression analysis. The effect of demographic variables on the average scores of attitudes was also subjected to regression analysis.

Results

Overall, students’ knowledge level regarding HIV and AIDS was moderate (range 5–26). Of a maximum score of 33, the mean of correct answers was 19.8 (SD = 3.70). Nursing students’ attitudes were quite negative and they also demonstrated homophobic attitudes. The mean scale score for nursing students’ general attitude was 2.75, and for homophobic attitudes it was 3.3 (min = 1, max = 5). Only the background factor of gender correlated with the homophobic level demonstrated (p = .05, β = −.67). Nursing students’ overall willingness to provide care for PLWHA was associated with their attitudes (p = .003, β = −.534).

Conclusions

Given that the HIV epidemic in Russia is both substantial and increasing, it is essential to improve HIV nursing education to provide sufficient and up-to-date information about HIV and also to prepare nursing students for caring for PLWHA. In doing so, this may help to address both the deficits in student knowledge, and also modify their attitude towards PLWHA.

Attitude and knowledge of dental students of National Capital Region regarding HIV and AIDS

Background:

India is estimated to have third highest number of Human Immunodeficiency Virus (HIV) infection in world with about 2.4 million people currently living with HIV/Acquired Immunodeficiency Syndrome (AIDS). There is a possibility of HIV transmission in the oral health care setting and thus adequate knowledge and proper attitude among dental students is vital to prevent the chances of transmission and for proper care of the patient.

Aims and Objectives:

The present study aimed to investigate the knowledge of dental students about HIV infection and their attitude toward treating HIV/AIDS patients and behaviour practiced.

Materials and Methods:

A cross-sectional survey was conducted among 600 dental students of different colleges present in National Capital Region (NCR). The students were from third and fourth year and they completed a predesigned questionnaire assessing the knowledge, attitude and willingness to treat HIV/AIDS patients. One-way analysis of variance (ANOVA) was applied to compare mean level of knowledge and attitude toward HIV/AIDS.

Result:

The results showed that only 28% students have excellent knowledge regarding HIV/AIDS. Certain misconceptions were prevalent regarding mode of transmission. It also shows that around 43% of the dental students have an overall negative attitude.

Conclusion:

The findings suggest that the students had adequate knowledge about HIV/AIDS and their attitude toward this group of people was significantly negative. There is need and scope to provide correct and detailed information on HIV/AIDS for dental students.

Trends in attitudes toward people living with HIV, homophobia, and HIV transmission knowledge in Quebec, Canada (1996, 2002, and 2010)

People living with HIV (PWHIV) face negative attitudes that isolate and discourage them from accessing services. Understanding negative attitudes and the social environment can lead to more effective health promotion strategies and programs. However, a scale to measure attitudes has been lacking. We developed and validated attitudes toward PWHIV Scale to examine trends in attitudes toward PWHIV in Quebec in 1996, 2002, and 2010. We also examined the relationship between negative attitudes toward PWHIV, homophobia, and knowledge about HIV transmission. The scale included 16 items and had a five-factor structure: F1 (fear of being infected), F2 (fear of contact with PWHIV), F3 (prejudicial beliefs toward groups at high risk of HIV), F4 (tolerance regarding sexual mores and behaviors), and F5 (social support for PWHIV). The validity and reliability of the scale were assessed and found to be high. Overall, Quebecers had positive attitudes toward PWHIV, with more negative attitudes observed in subgroups defined as male, ≥50 years of age, <14 years of education, higher levels of homophobia, and below-average knowledge about HIV transmission. Scores were stable between 1996 and 2002, and increased in 2010. Negative attitudes were correlated with higher levels of homophobia and lesser knowledge about HIV transmission. The lowest scores for each factor were observed in the same subgroups that had low overall scores on the Attitudes Scale. The findings from this study can be used to intensify interventions that promote compassion for PWHIV, address attitudes toward homosexuality, and encourage greater knowledge about the transmission of HIV in these subgroups.

Measuring stigma among health care and social service providers: The HIV/AIDS Provider Stigma Inventory

Initial validation of the HIV/AIDS Provider Stigma Inventory (HAPSI), piloted on a sample of 174 nursing students, supported the psychometric qualities of a suite of measures capturing tendencies to stigmatize and discriminate against people living with HIV/AIDS (PLHA). Derived from social psychology and mindfulness theories, separate scales addressing awareness, acceptance, and action were designed to include notions of labeling, stereotyping, outgrouping, and discriminating. These were enhanced to capture differences associated with personal characteristics of PLHA that trigger secondary stigma (e.g., sexual orientation, injection drug use, multiple sex partners) and fears regarding instrumental and symbolic stigma. Reliabilities were strong (coefficients α for 16 of 19 resulting measures ranged from 0.80 to 0.98) and confirmatory factor analyses indicated good model fit for two multidimensional (Awareness and Acceptance) and one unidimensional (Action) measure. Evidence of convergent construct validity supported accuracy of primary constructs. Implications for training and professional socialization in health care are discussed.

The knowledge and attitude about HIV/AIDS among Jordanian dental students: (Clinical versus pre clinical students) at the University of Jordan

Background

The present study aimed to address the suspected deficiency in the level of understanding of HIV/AIDS among clinical and pre clinical dental students at the University of Jordan. In this cross-sectional study, structured questionnaires were distributed to fifth year dental students (n = 121) and to third year dental students (n = 144) in the academic year 2008/2009.

Findings

Significantly higher percentage of fifth-year students compared to third-year students felt that the teaching they received on cross-infection precautions and barrier dentistry was adequate (P < 0.001). Majority (84.2%) of fifth-year students were aware that individual carrying anti-HIV antibodies to be an HIV carrier, only 57.7% of third-year students were aware of this fact (P < 0.001). Majority recognized the association between Kaposi sarcoma, oral candidiasis and hairy leukoplakia with HIV/AIDS but knowledge of the association between HIV/AIDS with less frequent lesions was inadequate.

Significantly higher proportion of third-year students compared to fifth-year (39.2% vs. 26.3%) thought that HIV patients should be referred to other centers or support groups for treatment (P = 0.04).

Conclusions

The level of knowledge of Jordanian dental students about HIV and AIDS was generally acceptable; there were inadequacies, however, in their understanding regarding some aspects of AIDS epidemic which demands that dental school curriculum needs some improvement.

Knowledge, attitudes and risk behaviour related to HIV and AIDS: the case of international students in a Finnish university

The purpose of this pilot study was to illustrate international university students' knowledge of HIV and AIDS, attitudes towards HIV and AIDS and risk behaviours in relation to HIV and AIDS. Questionnaires were posted to 140 students, and 32 responded. Data were analysed statistically. The results indicated a fairly good knowledge level of HIV and AIDS. The majority of students were well aware of the general facts about HIV and AIDS, modes of transmission and main risk groups, and they were also aware of the universal precautions. The majority of students had positive attitudes towards persons with HIV and AIDS and were willing to care for them. The students identified well with risk behaviours. Most agreed that their knowledge level of HIV and AIDS did affect their risk behaviours, while others felt it was a matter of choice, personal attitude and practice. Choice is a determining factor for decisions made by students in relation to HIV and AIDS. Future research focusing on factors influencing these choices that put them at risk of contracting the HIV virus is recommended. Students also need to be enlightened on matters concerning symptoms of HIV and AIDS.

Knowledge and attitudes of Jordanian nurses towards patients with HIV/AIDS: findings from a nationwide survey

This study explored the knowledge and attitudes of Jordanian nurses toward patients with HIV/AIDS, particularly in regards to their sources of information and education. This survey utilized a cross-sectional design. A self-administered questionnaire developed by Eckstein was used in collecting the data. A total of 922 nurses completed the questionnaire. Overall, Jordanian nurses expressed negative attitudes toward patients with HIV/AIDS, and their level of HIV/AIDS knowledge was weak. Weak knowledge level was recorded among nurses in the following subsections: agent and immunology; course and manifestation; transmission and incidence; and precaution and prevention. Only in one subsection (risk group), did nurses show a good level of knowledge about HIV/AIDS. More than two-thirds of nurses (84%) refused to provide care to patients who tested positive for HIV/AIDS. Most of the nurse participants believed that currently provided HIV/AIDS information resources were inadequate (81.4 %). The majority of nurses were interested in support groups for staff nurses (96.5%). The major source of HIV/AIDS information obtained by Jordanian nurses was through Internet web sites (52.7%). The majority of nurses (96.2%) ranked their fear of getting AIDS from their nursing practice as overwhelming. The total attitude of participants towards patients with HIV/AIDS in all five subsections (i.e., fear of contagion, social stigma, fatal outcome of the disease, direct care, and education and counseling) was negative (84.3%). Accurate knowledge about HIV/AIDS along with an in-depth understanding of patients? needs can help alleviate much of the fear, anxiety, and stigma associated with caring for patients with HIV/AIDS.

Nursing and midwife students' willingness to provide care to patients with HIV/AIDS--a comparative study in Finland, Estonia and Lithuania

This article presents results on nursing and midwife students' willingness to care for patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). An international cross-sectional survey design was used and the data were collected from educational institutions in Finland (N=169), Estonia (N=132) and Lithuania (N=170) between autumn 2005 and spring 2006. Participants (N=471) were nursing and midwife students training to be RN, public health nurses or midwives. A modified version of a scale developed by Duppert et al. (1994) was applied to measure willingness to care for patients with HIV/AIDS. The study found a general willingness on the part of students to provide care for patients with HIV/AIDS. However, nursing and midwife students willingness varied between countries and was also related to specific nursing interventions. Factors associated with students willingness also varied within each country, depending on nurses' age, nursing experience (Finland), positive attitudes to treating patients with HIV/AIDS in general (Finland, Estonia), and previous experience in taking care of a patient with HIV/AIDS (Lithuania). It is important to develop strategies for nursing vulnerable patient populations and international nursing curricula to identify prejudicial thinking and intolerance towards patients with HIV/AIDS.

Homofobia en estudiantes de enfermería

La homofobia es una actitud negativa hacia personas homosexuales, frecuente en profesionales de la salud y con implicaciones en la salud pública. Este fenómeno había sido poco estudiado en estudiantes de enfermería. El objetivo fue conocer la prevalencia y las variables asociadas a la homofobia en estudiantes de enfermería. La revisión sistemática fue realizada de los artículos de investigación formal en EBSCO, Imbiomed, LILACS, MEDLINE, Ovid y ProQuest. Fueron incluidos los artículos publicados entre 1998 y 2008, escritos en español, inglés o portugués. Fueron utilizadas las palabras llave homophobia, homosexuality y nursing students. Se realizó un análisis descriptivo. Se revisaron ocho investigaciones. Entre el 7 y el 16% de los estudiantes presenta algún grado de homofobia. La homofobia es más común en varones y en los religiosos más conservadores. La homofobia es frecuente en estudiantes de enfermería y puede tener implicancias negativas para el ejercicio de la enfermería.

Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review

TITLE

Attitudes of nursing students towards caring for people with HIV/AIDS: thematic literature review.

AIM

This paper is a report of a literature review conducted to examine current research studies into attitudes of nursing students towards caring for people with HIV/AIDS and to identify factors that influenced those attitudes to inform current nursing practice and to develop nursing education regarding care provided to people with HIV/AIDS.

BACKGROUND

Attitudes of nurses towards people living with HIV/AIDS have long been scrutinized. Studies show that some nurses have negative attitudes and are reluctant to provide care to people with HIV/AIDS, resulting in poorer quality nursing support being provided. Attitudes of nursing students towards caring for people with HIV/AIDS is thus of vital importance since they become the future practising nurses.

DATA SOURCES

Eight electronic data bases were searched from 1996-2008.

REVIEW METHODS

Criteria used for study selection were: attitudes of nursing students towards caring for people with HIV/AIDS, primary research studies, published in English language in peer reviewed journals from 1996 to June 2008. Sixteen studies were identified for inclusion in this thematic review.

RESULTS

The following themes were identified: education and knowledge of HIV/AIDS; fear of contracting HIV/AIDS; reluctance to care for people with HIV/AIDS; homophobia; and stigma associated with HIV/AIDS.

CONCLUSION

There is reluctance on the part of some nursing students in specific regions of the world to provide care for people with HIV/AIDS. Educational programmes based on research evidence must play a leading role in developing strategies to help nursing students understand and overcome such attitudes.

HIV/AIDS and universal precautions: knowledge and attitudes of Nepalese nursing students

AIM

This paper is a report of a study exploring Nepalese nursing students' knowledge and attitudes about HIV/AIDS and universal precautions.

BACKGROUND

Nepal is facing an HIV epidemic, and nurses are primary caregivers for people living with HIV/AIDS. Insufficient knowledge and negative attitudes on the part of nursing students translate into fear, stigmatization and unwillingness to care for patients with HIV/AIDS.

METHOD

Data were collected in 2005 for this cross-sectional study in which we examined HIV/AIDS-related knowledge, attitudes and universal precautions in three levels of Nepalese nursing students (N = 127). Instruments included the HIV/AIDS Knowledge Questionnaire, HIV/AIDS Attitudes Questionnaire, HIV/AIDS Transmission Attitudes Questionnaire and Universal Precautions Questionnaire. Descriptive statistics and chi-square analyses were employed to examine socio-demographic data. One-way anova, with level in school as the between-groups factor, were calculated to examine students' knowledge and attitudes.

FINDINGS

Nepalese nursing students have a large knowledge gap and negative attitudes, regardless of level of education. Their HIV/AIDS knowledge differed statistically significantly by group but there were no statistically significant group differences in general attitudes towards HIV/AIDS. Although knowledge of universal precaution improved with year of education, overall universal precautions knowledge was poor among all students, regardless of level of education.

CONCLUSION

Nursing curricula must include adequate and culturally relevant content on HIV/AIDS, attitudes towards people living with AIDS, and universal precautions.

HIV/AIDS knowledge, attitudes, practices and perceptions of rural nurses in South Africa

AIM

This paper is a report of a study exploring HIV/AIDS-related knowledge, attitudes, practices and perceptions of nurses in the largely black and rural Limpopo Province of South Africa.

BACKGROUND

Studies of HIV/AIDS knowledge, attitudes and practices among healthcare workers in developing countries have shown gaps in knowledge and fear of contagion, coupled with ambivalent attitudes in caring for patients with HIV/AIDS and inconsistent universal precautions adherence.

METHOD

A cross-sectional study of a random sample of primary health care (PHC) (n = 71) and hospital nurses (n = 69) was carried out in 2005, using a questionnaire, focus groups and in-depth interviews.

FINDINGS

Hospital nurses reported a higher frequency of care for patients with HIV/AIDS (P < 0.05), but less HIV/AIDS training when compared to PHC nurses (P < 0.001). HIV/AIDS knowledge was moderately adequate and associated with professional rank, frequency of care and training (P < 0.001). Attitudes towards patients with HIV/AIDS were mainly positive and were statistically significantly correlated with HIV/AIDS knowledge (P < 0.01) and training (P < 0.05). Three out of four nurses reported that they practised universal precautions (76.1%), but fear of occupational HIV transmission and lack of injection safety was found. Seven in 10 nurses reported previous needlestick injuries, but postexposure prophylaxis was not available in all healthcare facilities. Participants reported a higher workload because of HIV/AIDS, lack of training impacting negatively on their work, and stigma and shared confidentiality affecting them emotionally.

CONCLUSION

There is a need for accelerated HIV/AIDS training of rural nurses and for wider implementation of universal precautions and postexposure prophylaxis availability in public health facilities in southern Africa.

Nurses' and nursing students' perceptions of sexual risk behavior: a study in Finland, Estonia, and Lithuania

The continuing escalation of the global HIV/AIDS epidemic has changed our perceptions of sexual health. This article reports on a study of nurses' and nursing students' perceptions of sexual risk behaviour in Finland, Estonia and Lithuania and of how these perceptions are associated with background variables. Questionnaire data were collected in year 2006 with a modified version of Chng and Moore's Safer Sex Scale (1993), which consists of 12 background questions and 10 items exploring nurses' and nursing students' perceptions of sexual risk behaviour. Responses were obtained from 1152 nurses and nursing students. Their perceptions of sexual risk behaviour appeared to be quite cautious. The results revealed statistically significant country differences, with Finnish and Estonian respondents showing more cautious perceptions of sexual risk behavior than Lithuanian respondents. Some background variables were found to be associated with perceptions of sexual risk behavior. Nurses' perceptions differed from those of nursing students: the latter were less cautious in their perceptions. The most important background factor was previous experience of nursing an HIV/AIDS patient: nurses and students who had such experience reported more cautious perceptions than those who did not. In addition, age was found to correlate with perceptions of sexual risk behavior. Nurses and nursing students need to be more aware of their own perceptions of sexual risk behavior and the impact of those perceptions on their clinical practice. Interventions need to be developed in order to promote safer sex practices. Health care personnel should have the opportunity in their training to work with HIV/AIDS patients.

Willingness to Care for Patients With HIV/AIDS

This study aims to describe and compare nurses' willingness to provide care for patients with HIV/AIDS and factors associated with this in three countries. An international cross-sectional survey was conducted among nurses working in medical, surgical and gynaecology units in Finland ( n =427), Estonia ( n =221) and Lithuania ( n =185) in early 2006. The response rates were 75% ( n = 322) in Finland, 54% ( n =119) in Estonia and 86% ( n = 160) in Lithuania. A modified version of a scale developed in 1994 by Dubbert et al. was applied. Our findings showed a general willingness of the nurse participants to provide care for patients with HIV/AIDS. However, this willingness varied both among and within countries and was also related to specific nursing interventions. The results underline the importance of providing education on ethical issues related to HIV/AIDS care in Europe and tailoring the content of this education to meet nurses' national educational needs.

HIV and AIDS related knowledge, sources of information, and reported need for further education among dental students in Sudan--a cross sectional study

Background

Information on the HIV and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS, and for attracting the attention of dental school educators towards the subject.

Purposes

Focusing on a census of dental students attending their 3^rd, 4^th and 5^th study year at publicly – and privately funded dental faculties in Khartoum, this study aimed to assess the prevalence and socio-economic correlates of dental students' knowledge, sources of information and reported need for further education related to HIV and AIDS.

Methods

At the time of the survey (March–May 2007), the total number of dental students registered was 782 of which 642 (response rate 82%, mean age 21.7 year, 72% girls) completed anonymous self-administered questionnaires in supervised class room settings.

Results

A total of 49% and 86% had correct sum scores with respect to knowledge of transmission through contamination and through shaking hands and eating, respectively. About half the dental students recognized a need for further education across HIV related issues, varying from 75% (basic HIV/AIDS related issues) to 84% (patient management). Only 38% of the students had correct sum scores regarding various occupational groups at risk for contacting HIV and AIDS. Multiple logistic regression analysis revealed that compared to privately funded dental school students, publicly funded dental school students were less likely to have correct knowledge about modes of HIV transmission (OR = 0.6) and occupational risk groups (OR = 0.6) and to have received information from lectures/health care workers (OR = 0.5).

Conclusion

Students attending privately funded schools were more knowledgeable about various HIV related issues than students from publicly funded schools. About half of the students investigated had received HIV/AIDS information from various sources and reported need for further education. This suggests that students are not adequately prepared for treating patients with HIV infection and AIDS and that the dental school curriculum needs improvements. Differences between public and private dental schools should be considered when planning such improvements.

Exploring knowledge and skills on HIV in student nurses and midwives

A cross-sectional survey design using a self-administered questionnaire was sent to a sample of 62 final-year student nurses and midwives to describe their knowledge of, skills related to, and attitudes towards, human immunodeficiency virus/acquired immune deficiency syndrome. Out of the 47 respondents who return the questionnaire, only 53% stated that they had received class instruction on the topic and 63.8% claimed to have increased their knowledge mainly from reading professional journals. Although only 32% said that they had cared for a patient or knew of a family member or another person with the disease, 91% indicated that they were willing to care for such patients. Overall, the respondents demonstrated positive attitudes towards this group of patients and a good level of knowledge about the subject, although some gaps were evident. However, a large majority stated that their skills to cater for the physical and psychological needs of this group of patients were deficient and would like further training.

Health professionals' attitudes toward caring for people with hepatitis C

An estimated 170 million people worldwide have hepatitis C, which is a significant cause of morbidity and mortality. Therefore, health professionals (HPs) are likely to care for people with hepatitis C at some stage in their careers. However, little is known about HPs' attitudes towards treating people with hepatitis C. An analytical, cross-sectional survey was conducted to explore the inter-relationship among HPs' hepatitis C knowledge and attitudes towards treating people with hepatitis C and their self-reported clinical behaviour: Self-administered questionnaires were distributed to 3675 complementary therapists, dentists, medical practitioners, nurses, pharmacists, undergraduate medical and nursing students and people with hepatitis C in Victoria, Australia. Forty-six per cent responded (n = 1510). Only HP (complementary therapists, dentists, medical practitioners, nurses and pharmacists) data is presented (n = 1347). Most HPs demonstrated adequate hepatitis C knowledge, but some displayed intolerant attitudes toward people with hepatitis C. Their self-reported compliance with infection control practices indicated that they frequently treated people with hepatitis C differently from other patients by using additional infection control precautions while treating patients with hepatitis C. In addition, fear of contagion and disapproval of injecting drug use emerged as barriers to their willingness to treat people with hepatitis C. The results suggest that focusing education strategies on changing HPs' attitudes toward people with hepatitis C, injecting drug users, and infection control guidelines rather than concentrating solely on medical information might ultimately improve patient care.

Knowledge and attitudes of nursing students toward patients living with HIV/AIDS (PLHIV): A Turkish perspective

The aim of this study was to assess the knowledge and attitudes towards HIV/AIDS of nursing students in Turkey. HIV/AIDS has become one of the most serious health problems in the world. It is important to understand nursing students' knowledge and attitudes towards people living with HIV (PLHIV) because the educational preparation of nurses has been known to affect the attitudes of the nurse and the effectiveness of the care provided to PLHIV. The study was conducted with 227 nursing students from the School of Health in Antalya, Turkey during the calendar year 2005/2006. Qualitative and quantitative methods were both used to collect data for the study. Analysis of variance, t-test, Mann-Whitney U-test, Kruskal-Wallis and inductive methods were used in data analysis. The majority of nursing students in this study had a moderate level of HIV/AIDS knowledge. Students correctly answered 64.4% of HIV/AIDS-related questions in the questionnaire (Mean 28.99; SD 7.03 out of 45 points). Scores increased parallel with student grade (F=26.925; p=0.000) and age (chi2 (K-W)=35.117; p=0.000). Fear of being infected and feelings of pity and empathy were the feelings most commonly indicated by the students. Students who had previous experience in caring for an AIDS patient and had known someone with HIV/AIDS were willing to care for PLHIV. Results underline the need to strengthen education on all aspects of HIV/AIDS. To improve nursing students willingness to care for PLHIV, particular emphasis should be placed on the training of nursing students as skilled nursing staff with humane attitudes towards PLHIV.

Empathy, inclusion and enclaves: the culture of care of people with HIV/AIDS and nursing implications

AIM

This paper reports an empirical research study investigating specific features of the culture of care on a specialized unit supporting people living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS).

BACKGROUND

The anxiety felt by healthcare workers coming into contact with people living with HIV and AIDS (PLWHA) has been recognized in numerous studies. There is often an amplified notion of threat and a worldview fuelled by stereotypes, which inevitably leads to negative attitudes and stigmatization.

METHODS

An ethnographic approach was used, including a 14-month period of observation and 31 semistructured interviews. The data were collected during 2000 and 2001 in a large teaching hospital in the United Kingdom.

FINDINGS

Carers working on this unit who regularly contributed to the care of this client group had a broad range of experience and in many cases had chosen to work in the field. They worked within a social context that had a high level of egalitarianism, a view of PLWHA that appeared more positive and less pejorative than others, and a strongly empathetic approach accompanied by close engagement with the client group.

CONCLUSION

Using nursing staff specially prepared for the care of PLWHA could be the most effective way to minimize stigma and discrimination against this client group in the healthcare sector.

Vinte anos de assistência a pessoas vivendo com HIV/AIDS no Brasil: a perspectiva de profissionais da saúde

O objetivo do estudo é descrever os significados atribuídos por profissionais de saúde à sua experiência de cuidar de pessoas com HIV/AIDS. Os dados foram coletados em entrevistas com 10 profissionais da saúde, em diferentes instituições paulistas. Três temas emergiram da análise dos dados: (a) o cenário da assistência ao paciente com HIV/AIDS; (b) relacionamento com o paciente; (c) aspectos éticos nesse cuidado. A despeito dos reconhecidos avanços na assistência a esse paciente, os achados revelam a persistência de comportamentos discriminatórios, relacionados a sentimentos de insegurança e medo do contágio, entre os profissionais nos serviços e hospitais gerais. O preparo específico para atender os pacientes estaria mais voltado aos profissionais dos centros especializados para a assistência ao HIV/AIDS, resultando em dificuldades na integração da assistência a esses pacientes nos demais serviços do SUS. Esses dados remetem aos aspectos da formação profissional na área da saúde como um todo, levando à reflexão sobre as competências que se espera dos profissionais da saúde em cuidar e relacionar-se com pessoas com HIV/AIDS, assim como sobre o impacto dessa realidade na prevenção da doença.

Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome

There exist few studies in the United States that examine the knowledge, attitudes, and beliefs of registered nurses regarding persons with human immunodeficiency virus and acquired immune deficiency syndrome. This information is needed to determine curriculum changes and continuing education needs.

Knowledge and attitude of nurses caring for patients with HIV/AIDS in Uganda

Nurses working in a regional hospital represent the largest group of health care workers in Uganda. Four hundred seventy-seven nurses and midwives completed the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) knowledge and attitude surveys (86% response rate). Approximately 95% (n = 452) had provided care to HIV/AIDS patients; yet 86% (n = 388) believed resources to obtain HIV/AIDS information were inadequate. Fear of contagion was great (47%, n = 232). HIV/AIDS knowledge gaps included "precaution and transmission" (64.7%) and "agent and immunology" (53.4%). Knowledgeable respondents had less fear of contagion. Positive attitudes toward patients with HIV/AIDS were displayed despite fear of contagion.

Nursing staff and nursing students' emotions towards homosexual patients and their wish to refrain from nursing, if the option existed

Studies have reported that homosexual patients fear they will not receive adequate care if they openly show their sexual orientation, for example, when introducing their partner. The aims of this study were to investigate the emotions of nursing staff and nursing students, and possible relations to cultural background and gender, towards homosexual patients; whether nursing staff and nursing students would choose to refrain from nursing homosexual patients, if the option existed; and, if so, how they express their wish to refrain from nursing this group of patients. All participants received verbal and written information before the study started. Returning a completed questionnaire indicated a participant's tacit consent. Approval was obtained from the heads of departments and persons in charge of nursing and nursing assistant programmes. The study had a descriptive, comparative design, and an Affect Adjective Checklist (AAC) and specially designed Nursing Behaviour Questionnaire (NBQ) were used. The participants included nurses and assistant nurses from an infectious disease clinic, and students enrolled in a university nursing programme and upper secondary assistant nurses' training, all in central Sweden. The findings showed that both professional nursing staff (response rate 67%, n = 57), and students (response rate 62%, n = 165), expressed emotions of homophobic anger, homophobic guilt and delight. Groups with a cultural background other than Swedish expressed more homophobia. No gender differences were indicated for homophobic emotions. In the professional group, 36% would refrain from nursing for homosexual patients if given the option. The corresponding figure for the students was 9%. The limitations were that the sample was small and not randomly selected, and as participation was anonymous no follow-up could be done. It was concluded that the emotional factors of homosexual anger and homosexual guilt might be of value in helping to explain and predict attitudes towards homosexuals.

Knowledge and attitudes of nurses working in sexual health clinics in the United Kingdom toward post-sexual exposure prophylaxis for HIV infection

The use of anti-human immunodeficiency virus (HIV) drugs after occupational exposure to HIV is a proven method of preventing some HIV infections. There is anecdotal evidence that this treatment is being used to treat recently exposed sexual contacts of HIV infection, known as non-occupational post-exposure prophylaxis (NONOPEP). This raises the issues of the impact of such treatment on sexual behavior and public health. Six hundred questionnaires were distributed to nurses working in sexual health clinics. Four hundred and six (67%) were returned. Questionnaires contained items related to awareness of HIV NONOPEP and items included attitudes related to its use. Seventy two percent of respondents were aware of HIV NONOPEP, and 17% had experience of its use in their clinic. Twenty one percent of respondents indicated that their clinic had a specific HIV NONOPEP policy. In relation to attitudes, practitioners were more positive of NONOPEP in relation to an HIV exposure within a long-term relationship than exposure within a casual relationship, indicating that the mode of HIV exposure was a factor in the justification of NONOPEP. Practitioners seemed to support the notion that HIV NONOPEP use in a casual exposure may increase the likelihood of unsafe sexual practice; however, practitioners with experience were less likely to express this view. It is suggested that an informed debate and NONOPEP policy development within all sexual health clinics will militate against judgmental views affecting access and care.

Misrepresenting random sampling? A systematic review of research papers in the Journal of Advanced Nursing

AIM

This paper discusses the theoretical limitations of the use of random sampling and probability theory in the production of a significance level (or P-value) in nursing research. Potential alternatives, in the form of randomization tests, are proposed.

BACKGROUND

Research papers in nursing, medicine and psychology frequently misrepresent their statistical findings, as the P-values reported assume random sampling. In this systematic review of studies published between January 1995 and June 2002 in the Journal of Advanced Nursing, 89 (68%) studies broke this assumption because they used convenience samples or entire populations. As a result, some of the findings may be questionable.

DISCUSSION

The key ideas of random sampling and probability theory for statistical testing (for generating a P-value) are outlined. The result of a systematic review of research papers published in the Journal of Advanced Nursing is then presented, showing how frequently random sampling appears to have been misrepresented. Useful alternative techniques that might overcome these limitations are then discussed. REVIEW LIMITATIONS: This review is limited in scope because it is applied to one journal, and so the findings cannot be generalized to other nursing journals or to nursing research in general. However, it is possible that other nursing journals are also publishing research articles based on the misrepresentation of random sampling. The review is also limited because in several of the articles the sampling method was not completely clearly stated, and in this circumstance a judgment has been made as to the sampling method employed, based on the indications given by author(s).

CONCLUSION

Quantitative researchers in nursing should be very careful that the statistical techniques they use are appropriate for the design and sampling methods of their studies. If the techniques they employ are not appropriate, they run the risk of misinterpreting findings by using inappropriate, unrepresentative and biased samples.

Nursing staff and nursing students' attitudes towards HIV-infected and homosexual HIV-infected patients in Sweden and the wish to refrain from nursing

BACKGROUND

Two decades after the emergence of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS), the infection remains enigmatic and shameful. In Sweden, many HIV-infected persons still encounter attitudes of avoidance.

AIMS

The aims were to investigate differences between attitudes of nurses, assistant nurses, nursing students and assistant nursing students towards HIV-infected and homosexual HIV-infected patients; to measure their fear of contracting HIV; and to investigate whether nurses, assistant nurses, nursing students and assistant nursing students wanted to refrain from caring for HIV-infected patients.

ETHICAL ISSUES

The participants were informed of the study orally and in writing. Completing and returning the anonymous questionnaires indicated the participants' tacit consent.

RESEARCH METHOD

The study had a descriptive, comparative quantitative design. The AIDS Attitude Scale was used, along with a questionnaire specially designed for the study. The participants were nurses and assistant nurses from one infectious disease clinic in central Sweden [response rate was 67% (n = 57)]. Students enrolled in a university nursing programme and students of upper secondary assistant nurses' training [response rate was 62% (n = 165)] were also included.

FINDINGS

In general, both the nursing staff and the nursing students expressed empathic attitudes towards HIV-infected and homosexual HIV-infected patients, as well as a low degree of fear of HIV contagion. The findings also showed, in the professional groups, that 36% would refrain from caring for HIV-infected patients if that possibility existed. The corresponding figure for the student groups was 26%.

LIMITATIONS

The chosen sample was small and not randomly selected therefore precludes a generalization in a wider context. Furthermore, the questionnaire was untested for reliability and validity, and may have influenced the findings with respect to the wish to refrain from nursing HIV-infected patients.

CONCLUSION

Suggested guidelines for nursing, mentor-ship by AIDS-dedicated nurses, and educational interventions, are given in 'Implications for nursing and nursing education'.