Measuring the stress associated with caring for clients with HIV/AIDS

The health care relationship (HCR) trust scale: development and psychometric evaluation

A sequential multi-method approach using focus groups, individual interviews, and quantitative instrument development procedures was used to develop and evaluate a scale to measure patient trust in health care providers (HCPs). The resulting 15-item Health Care Relationship (HCR) Trust Scale was tested for internal consistency, test-retest reliability, and construct validity. The Cronbach alphas were .92 (time 1) and .95 (time 2), respectively. Test-retest reliability was .59 (p < .01). The HCR Trust Scale did not correlate with the Marlowe-Crowne Social Desirability Scale (r = .20, p = .07) or the Rapid Estimate of Adult Literacy in Medicine scale (r = -.21, p = .13). Principal component factor analysis with varimax rotation revealed a three-factor solution that explained 69% of the estimated common variance in the HCR trust scale. Cronbach alphas for the 3 factors ranged from .81 to .89. Findings of this study support the use of the HCR Trust Scale for measuring trust in various HCPs by diverse patient populations. More work is needed to test the usefulness of the scale with a greater number of patients and in other chronic illness populations.

Health care workers and AIDS: a differential study of beliefs and affects associated with accidental exposure to blood

This study aimed to analyze affective and cognitive determinants of the professional work of individuals caring for patients with HIV/AIDS, in view of the risk and/or experience of accidental exposure to blood. We drew on the theoretical-methodological references of Fishbein & Ajzen and Maslow's theory. Fifty health care workers were evaluated using an attitudes questionnaire and a needs and motivations instrument. The research verified differences between answers by health care workers who had never suffered accidents and those who had already experienced accidental exposure to blood. Health care workers did their work activities motivated by the need for self-fulfillment and valued their own performance when they were able to meet the patients' emotional needs. Among health professionals who had never experienced accidental exposure to blood, the predominant beliefs was that patients feel remorse over having expose themselves to HIV. Accidental exposure to blood raises difficulties in personal life. Technical aspects are also associated with the possibility of accidental exposure to blood.

Stressors and rewards for workers in AIDS service organizations

The primary objective of this study was to examine the impact of recent advances in the treatment of HIV/AIDS on AIDS service providers. The study surveyed the motivations, stressors, and rewards of workers employed in AIDS service organizations. Employees of AIDS service organizations play a valuable role in providing services to people with HIV/AIDS, and their motives and attitudes about their jobs are significantly related to the quality of care provided to clients. A total of 180 employees from nine AIDS service organizations in New York City completed a self-administered questionnaire. The questionnaire consisted of demographic, motivation, stressor, and reward items. This ethnically diverse sample consisted of social service workers (56%), administrative workers (22%), health care workers (18%), and other workers (4%). Forty-two percent of respondents had been working in the AIDS field for 5 or more years. The main reasons for choosing this line of work were a desire to help others, followed by having experienced the loss of a loved one to AIDS. Overall, respondents rated the level of stressors in their jobs as moderate. The main category of stress was "lack of support" (referring to the availability of resources and support for clients). The most important individual stressors were societal attitudes towards AIDS, salary, client deaths, and administrative duties. The most highly valued reward factor associated with AIDS caregiving was "personal effectiveness." Overall, the rewards of AIDS caregiving outweighed the stressors, for respondents. Implications of these findings for administrators of AIDS service organizations are discussed.

Influence of a Persuasive Strategy on Nursing Students' Beliefs and Attitudes Toward Provision of Care to People Living With HIV/AIDS

Based on the theory of planned behavior and the elaboration likelihood model, the aim of this study was to verify the effect of persuasive messages on nursing students' beliefs and attitudes regarding provision of care to people living with HIV/AIDS. The assumption was that a persuasive communication strategy induces a constructive change in beliefs and attitudes regarding provision of care. Baseline data collection was performed among a group of 74 nursing students (experimental group = 27; control group = 47). The questionnaire assessed the variables of the theory of planned behavior (i.e., beliefs, attitudes, perceived behavioral control). The results confirmed that persuasive messages generated a change in beliefs and attitudes of the nursing students concerning providing care to people living with HIV/AIDS. It appears that this strategy of modifying behavioral predispositions is effective and generates cognitive and affective changes. Therefore, educational programs should take these observations into consideration to ensure that future nurses are better prepared to provide appropriate care to people living with HIV/AIDS.