Nurses' knowledge, attitudes, and practice related to HIV transmission in northeastern China

A Qualitative Study Into the Relative Stigmatization of Mental Illness by Mental Health Professionals

Mental health professionals stigmatize mental illness, which has significant ramifications for public health and policy. Within this domain, there is a lack of comprehensive research on relative stigma, emotions, and behaviors and an absence of literature that can guide research on these topics. The current study sought to address these limitations. Unstructured interviews were conducted with 22 mental health professionals, and data were analyzed using a grounded theory approach. The current study identified a collection of mental disorders (e.g., borderline personality disorder), stereotypes (e.g., dangerousness), emotion-related responses (e.g., fear), and behaviors (e.g., helping) as being key to the relative stigmatization of mental illness by mental health professionals. The results also suggested that professional context and familiarity with mental illness decrease the stigmatization of mental illness by mental health professionals. These variables and constructs were combined to form a grounded theory of mental health professionals stigmatizing mental illness. The current study has implications for the direction of future research on the stigmatization of mental illness by mental health professionals and interventions that strive to mitigate this type of stigmatization.

Construction of an evaluation system for medical staff's occupational protection ability based on knowledge, attitude, and practice theory, and a cross-sectional survey of current conditions

INTRODUCTION

Medical personnel should be in close proximity and high frequency of contact with patients, and be exposed to physical, biological and chemical risk factors for a long time. The incidence of various occupational exposures is high. however, there is still a lack of the medical staff Occupational Protection Core Competence Evaluation Index system with high reliability and validity.

AIM

Based on the theory of knowledge, attitude, and practice, the evaluation system of occupational protection ability of medical personnel was established, and the current situation of occupational protection ability of medical personnel at different levels was investigated, so as to take targeted training and intervention measures to improve the occupational protection ability of medical personnel and reduce the incidence of occupational exposure.

METHODS

Based on the knowledge, attitude, and practice theory, the index system of occupational protection core competence of medical personnel was initially constructed by literature retrieval, expert consultation, group discussion, semi-structured interview and other qualitative and quantitative methods, and the reliability and validity of the index system was tested by Delphi expert consultation method. By convenient cluster sampling method, from March to September 2021, the current status of occupational protection core competence of medical personnel was investigated among medical staff from one Class III Grade A hospital and two medical schools in Jinan City, Shandong Province, China.

RESULTS

The evaluation system for medical staff's occupational protection ability included 3 first-level indexes, 11 second-level indexes, and 109 third-level indexes. A total of 684 valid questionnaires were collected from Grade III, Class A hospital medical staff and two medical school students in clinical practice in Shandong, China. Kruskal Walls test showed that there were significant differences in the overall distribution of occupational protection knowledge, attitude, and practice among registered nurses, nursing students, registered physicians, and physician students (H = 70.252, P < 0.001; H = 76.507, P < 0.001; H = 80.782, P < 0.001); there were statistical significance in the knowledge/ attitude/ practice of nursing and physician students at different levels (H = 33.733, P < 0.001; H = 29.158, P < 0.001; H = 28.740, P < 0.001).

CONCLUSION

The results of the evaluation system for the medical staff's occupational protection ability are reliable and can provide a reference for training the medical staff's occupational protection ability. Managers should strengthen the training of theoretical knowledge of occupational protection ability of medical staff.

Willingness to care for blood-borne virus-infected patients in Thailand

Background

Although stigma and discrimination by nurses against patients infected with human immunodeficiency virus (HIV) or hepatitis C virus (HCV) have been reported, potential determinants of nurses' willingness to care for these patients have not been well studied in Thailand.

Aims

To identify factors associated with Thai nurses' willingness to care for patients infected with HIV or HCV.

Methods

Multivariable logistic regression analysis of data from a questionnaire completed by nurses at a large hospital in Bangkok, Thailand.

Results

Of 626 nurses, 546 (87%) nurses participated. Eleven per cent (59) and 6% (34) had previously experienced HIV- or HCV-infected blood contamination incidents, respectively. Forty-four per cent (240) and 38% (208) reported unwillingness to care for HIV- or HCV-infected patients, respectively. Willingness to care was less common [adjusted odds ratios 0.51 (0.34-0.74) for HIV and 0.62 (0.42-0.89) for HCV] in nurses aged ≥ 40 years and in those who feared HCV [0.63 (0.37-0.99)], but not HIV [0.84 (0.5-1.26)] transmission. Nurses who had confidence in protecting themselves against infection with HIV [1.84 (1.52-2.04)] and HCV [1.87 (1.45-2.18)], and accepting attitudes towards HIV-infected co-workers [1.39 (1.08-1.66)] but not HCV-infected co-workers [1.16 (0.83-1.5)], were more willing to care for HIV- and HCV-infected patients.

Conclusions

Around 4 in 10 Thai nurses in our sample were unwilling to care for HIV- or HCV-infected patients. Minimizing the risk of nosocomial transmission and improving the public perception of infected individuals may help improve nurses' willingness to care for such patients, in Thailand or elsewhere.

The impact of social organizations on HIV/AIDS prevention knowledge among migrants in Hefei, China

BACKGROUND

There is a growing recognition of the need to provide HIV/AIDS prevention and care to migrant workers. Social involvement, a type of social capital, is considered a 'critical enabler' of effective HIV/AIDS prevention. Designated participation in formal community groups by the government (e.g., political parties) and informal, voluntary local networks by NGOs (e.g., alumni association, cultural & sports club) play different roles in HIV prevention. The objective of this study is to assess the impact of different types of social organizations on HIV/AIDS prevention knowledge among migrant workers.

METHODS

A cross-sectional study of 758 migrants was conducted in Hefei, Anhui Province, China. Data were collected through a self-reported questionnaire. Logistic regression was used to assess associations between different social organizations and HIV/AIDS prevention.

RESULTS

Migrants who participated in social organizations had a higher awareness of HIV/AIDS knowledge than migrants who do not participate in social organizations. Higher levels of HIV/AIDS knowledge is associated with positive HIV/AIDS behaviors for people who attended political parties (odds ratio [OR] = 3.49, 95% CI: 1.22-9.99). This effect is not significant for alumni association. For both political parties and alumni association members (OR = 0.19, 95% CI: 0.06-0.66, OR = 0.20, 95% CI: 0.08-0.61, respectively), people who exhibited higher levels of HIV/AIDS knowledge had more negative attitudes than those with less knowledge.

CONCLUSION

Social organizations play an important role in improving HIV/AIDS knowledge and behavior in migrants, providing a great opportunity for HIV/AIDS prevention.

Attitudes of nurses toward HIV-infected colleagues in Japan

BACKGROUND

Nurses may be unwilling to accept HIV-infected colleagues who can continue to work with patients if the provider-to-patient transmission risks have been appropriately assessed.

AIMS

To assess the factors associated with nurses' willingness to accept HIV-infected colleagues as coworkers.

DESIGN

Descriptive and cross-sectional.

METHODS

An anonymous online survey targeting Japanese nurses working in hospitals or clinics (n = 992). Logistic regression analysis was used to evaluate factors associated with their willingness to accept HIV-positive colleagues before or after a risk assessment.

RESULTS

Respondents who avoided contact with, and expressed discriminatory views about, HIV-infected colleagues were less willing to accept them. After undertaking an appropriate risk assessment, a high level of knowledge regarding HIV transmission increased the likelihood of acceptance towards HIV-infected colleagues.

CONCLUSIONS

The use of risk assessment may increase nurses' willingness to accept HIV-infected colleagues, particularly among co-workers with a high level of knowledge about HIV.

An Integrated Intervention for Increasing Clinical Nurses' Knowledge of HIV/AIDS-Related Occupational Safety

Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses’ knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300) were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ² = 86.34, p = 0.00), and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4%) and post-test (66.6%) (χ² = 73.2, p = 0.00). When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly. The pre-test knowledge scores on universal precautions were relatively high. Correct answers about universal precautions improved significantly from pre-test (83.71%) to post-test (89.58%; χ² = 25.00, p = 0.00). After the intervention, nurses’ attitude scores improved significantly from pre-test (3.80 ± 0.79) to post-test (4.06 ± 0.75; t = 3.74, p = 0.00). Conclusions: Integrated educational interventions enhance nurses’ knowledge of risk reduction for occupationally acquired HIV infections and improve the observance of universal precautionary procedures. This enhancement allows nurses to assume a teaching role for prevention and management of HIV/AIDS.

Knowledge, Attitude, and Practices Regarding Occupational HIV Exposure and Protection among Health Care Workers in China: Census Survey in a Rural Area

BACKGROUND

Health care workers (HCWs) seek, treat, and care for patients living with HIV/AIDS on a daily basis and thus face a significant risk to work-related infections. To assess the knowledge, attitude, and practices regarding occupational HIV exposure and protection among HCWs in low HIV prevalence areas of rural China.

METHODS

A cross-sectional questionnaire survey was carried out among all medical units in Pucheng County, Shaanxi, China.

RESULTS

Response rate of this study was 94%. The average overall knowledge score of HCWs was 10.9 of 21.0. Deficiencies in general, transmission, exposure, and protection knowledge were identified among HCWs at all levels. A high rate of occupational exposure (85%) and lack of universal precautions practice behavior were recorded. Significant predictors of universal precautions practice behavior were female sex, prior training, and greater knowledge about HIV/AIDS.

CONCLUSION

Health care workers at various levels have inadequate knowledge on HIV/AIDS and do not practice universal precautions. Nurses and medical technicians at the county level faced more occupation risk than other HCWs. The key of AIDS training for different levels of HCWs should be distinguished.

An investigation on the association between students' knowledge and their tendency to take care of HIV patients among the students in nursing and midwifery school

BACKGROUND

Since nursing and midwifery students avoid taking care of the diseased patients and taking care of the patients with AIDS can be influenced by their level of knowledge, the present study aimed to define the association between students' knowledge and their tendency to take care of HIV patients.

MATERIALS AND METHODS

This is a descriptive analytical study conducted on 210 students of Nursing and Midwifery School, who were selected through random stratified and convenient sampling in 2012. Inclusion criteria were having Iranian nationality, being a Muslim, passing two credits of nursing internship, and not being an AIDS patient. The exclusion criterion was any one of the parents or relatives suffering from AIDS. The data were collected by questionnaires of personal and familial characteristics, the level of awareness, and tendency to take care of AIDS patients. Questionnaires of AIDS awareness scale and AIDS care tendency scale are valid and reliable. The data were analyzed by charts, Pearson statistical test, t-test, one-way analysis of variance (ANOVA), Kruskal-Wallis, and linear regression through SPSS version 16.

RESULTS

The findings showed that 79.5% of the students had average awareness about AIDS and 61.4% had no tendency to take care of AIDS patients. Pearson correlation coefficient showed that there was a linear association between the score of awareness and tendency to take care of AIDS patients. The results of linear regression also showed that there was a significant association between the score of the tendency to take care of the patients and sex, education level, awareness, and educational course.

CONCLUSIONS

Since students' awareness level was not so high, special attention should be paid in this regard through more organized and precise programs. A separate university credit concerning the diseases and education through mass media should be also considered.

Hospital pharmacists' knowledge about and attitude toward HIV/AIDS and patients living with HIV/AIDS in Kedah, Malaysia

INTRODUCTION

The current study aims to explore the knowledge, attitude, and perception of hospital pharmacists towards HIV/AIDS and patients living with HIV/AIDS (PLWHA) in the state of Kedah, Malaysia.

MATERIAL AND METHODS

This was a cross-sectional study conducted among the hospital pharmacists in three government hospitals in Kedah, using a self-administered 43-item questionnaire. Data analysis was done using non-parametric and multinomial regression.

RESULTS

A total of 75 respondents participated in this study, resulting in a response rate of 60.8%. The majority were found to be well aware of the causes of HIV/AIDS. However, about 34 (45.3%) believed erroneously that HIV/AIDS cannot be transmitted through tattooing or body piercing. Nearly 25 (33.3%) of the respondents believed that preventing the use of intravenous drugs may not be effective to prevent HIV/AIDS and endorsed social isolation as a measure to prevent HIV/AIDS. The majority (66.6%) had negative attitudes and about 20% held extremely negative attitudes. Findings from regression modelling revealed that hospital (-2 log likelihood = 215.182, χ(2) = 18.060, Df = 8, p = 0.021) and gender (-2 log likelihood = 213.643, χ(2) = 16.521, Df = 8, p = 0.035) were more likely to affect the attitudes of respondents.

CONCLUSIONS

Overall, more than one third of the respondents were found to have negative attitudes towards PLWHA. Gender, job experience, and hospitals with more HIV/AIDS patient visits were the main factors affecting attitudes.

Students and their parental attitudes toward the education of children affected by HIV/AIDS: a cross-sectional study in AIDS prevalent rural areas, China

OBJECTIVE

To investigate the prevalence and determinants of student and parental attitudes toward the education of children affected by HIV/AIDS in areas of rural China where AIDS is prevalent.

METHODS

A cross-sectional study of a random sample of students (n=732) and their parents (n=732) conducted in April 2010, using a questionnaire and in-depth interview.

RESULTS

Twenty-six per cent of students and 29% of parents had a 'good' attitude toward the education of children affected by HIV/AIDS. Following adjustment for sociodemographic characteristics, students' attitudes were significantly associated with knowledge of HIV/AIDS non-transmission (adjusted odds ratio [aOR]= 3.13) and their parents' attitudes (aOR= 2.38), but not with knowledge of HIV/AIDS transmission, prevention or their parents' knowledge. Parents' attitudes were significantly associated with knowledge of HIV/AIDS non-transmission (aOR= 2.12) and their children's attitudes (aOR= 2.52), but not with knowledge of HIV/AIDS transmission, prevention or their children's knowledge.

CONCLUSION

Stigma and discrimination undermine the right to education of HIV/AIDS-affected children in rural China. Improving non-transmission knowledge may improve caring attitudes.

IMPLICATIONS

HIV/AIDS public health educational campaigns highlighting non-transmission and extending family education, combined with school education, may help to enhance an environment of non-discrimination and safeguard public support programs for the right to education of children affected by HIV/AIDS.

HIV-related avoidance and universal precaution in medical settings: opportunities to intervene

OBJECTIVE

To determine the association between adherence to universal precaution (UP) and avoidance attitudes toward patients living with HIV/AIDS (PLH) among service providers.

DATA SOURCES/SETTING

A total of 1,760 health service providers were randomly selected from 40 county hospitals in two provinces of China.

STUDY DESIGN

A self-administered questionnaire was used to collect demographic characteristics, UP knowledge and training, UP adherence, availability of UP supplies at work, and avoidance attitudes toward PLH in a cross-sectional survey.

DATA ANALYSIS

A series of regression models were used to examine associations among the UP-related factors and their relationship to avoidance attitudes toward PLH.

PRINCIPAL FINDINGS

UP training was associated with better knowledge of and adherence to UP and perceived availability of UP supplies in hospitals. UP training, knowledge, and adherence were significantly associated with avoidance attitudes toward PLH in medical practice. Being a nurse was also related to HIV-related avoidance.

CONCLUSION

UP promotion campaigns, including in-service training and reinforcement of UP adherence, could play an important role in the battle against HIV-related avoidance in medical settings. Intervention programs should focus on not only individual providers' attitudes and behaviors but also on structural support for norms shifts in the medical community.

Knowledge, attitudes, perceived vulnerability of Chinese nurses and their preferences for caring for HIV-positive individuals: a cross-sectional survey

AIMS

The study was to assess HIV/AIDS knowledge, attitudes and perceived vulnerability with potential factors.

BACKGROUND

HIV/AIDS is a public health catastrophe in China. Nurses are expected to care for nurture, comfort and advocate for all patients regardless of their condition. However, in the area of HIV/AIDS, nurses suffer as a result of expectations put on them by their professional roles.

DESIGN

This was a descriptive, cross-sectional design that used a survey approach.

METHOD

Data were collected from Summer 2003-Winter 2004.

RESULTS

Nurses reported significant perceived severity of risk from occupational exposure. Many nurses were frequently exposed to being stuck by needles (86%) and being splashed by body fluids and more than half of them (59.7%) were concerned about contracting HIV/AIDS. Nurses who had experience of finger pricks worried about potentially contacting HIV and being unaware of it (odds ratio= 0.444, p = 0.004). Nurses demonstrated a lack of knowledge and training in infectious diseases which may be a result of the fact that the study location is not considered a 'concentrated area' for infectious disease transmission; therefore, the need for the infectious diseases training has not been considered urgent.

CONCLUSIONS

A well-designed educational programme on occupational hazards and risk behaviour should be implemented to educate nurses in suburban cities and the general public. Hospital administrators should implement on-site continuing education on HIV/AIDS throughout China. Armed with better knowledge of both transmission routes and precautions, nurses can protect themselves while providing care to patients.

RELEVANCE TO CLINICAL PRACTICE

Nurses in China urgently need psychosocial and physical supports from families, friends, communities and their working environments while combating HIV epidemic. With good support system, nurses will better educate patients and their family members on how to prevent transmission not only of HIV/AIDS but of a wide range of other infectious diseases as well.

A systematic review of the knowledge, attitudes and practice of trained nurses towards patients with HIV/AIDS

EXECUTIVE SUMMARY

Background Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a global health problem. Stigmatization and blame which are associated with the disease have made efforts to control the pandemic challenging. With discoveries of anti-retroviral drugs, HIV/AIDS patients are expected to live longer. Therefore, nurses being frontline workers are expected to nurse them in different clinical settings. Some studies have found that nurses hold discriminatory attitudes when caring for HIV/AIDS patients, have gaps in their knowledge and differing practicesObjective The objective of this review was to synthesize the evidence on the knowledge, attitudes and practice of trained nurses towards HIV/AIDS patients.

INCLUSION CRITERIA

Types of participants Studies that included trained nurses, specifically Registered Nurses (RN) and Enrolled nurses (EN).Types of interventions Studies that evaluated knowledge, attitudes and practice of trained nurses towards HIV/AIDS patients.Types of measured outcomes Studies that included outcome measures of knowledge, attitudes or practices of trained nurses towards HIV/AIDS patients.Types of studies Cohort studies, cross-sectional studies, case control studies and descriptive studies were considered for inclusionSearch strategy A three-step search strategy was utilised. Search was limited to English language studies published between January 1990 till December 2010.Assessment of methodological quality The reviewers used the JBI Critical AppraisalChecklists to assess methodological quality.Data extraction Data were extracted using the JBI Data Extraction Form for experimental/observational studies.Data synthesis Meta-analyses was not performed. Findings are presented in a narrative summary.Results Thirty-three studies were included for this systematic review. All studies were descriptive studies. The results showed that the knowledge, attitude and practices of nurses varied. In general studies showed that: nurses' knowledge of HIV/AIDS was satisfactory but knowledge deficits are prevalent in certain areas; nurses also had positive attitudes, but still held fears; nurse showed more prejudice towards HIV/AIDS patients in the high risk groups; practiced of universal precaution was irregular; and nurses also changed their practice behaviours after knowing the patient is HIV positive.Conclusion Knowledge, attitude and practices of nurses varied worldwide. The level of knowledge is satisfactory but gaps in knowledge exist. Nurses have positive attitudes but is affected by the ways which a person acquired HIV/AIDS. Strong stigmatization is still prevalent towards high risk groups. The use of universal precaution also needs to be address. More well established questionnaire should be used to measure practice towards HIV/AIDS patients.Implications for practice Institutions need to: develop strategies to assist nurses to overcome fears, create self-awareness with regards to their attitude; relook into programmes to address knowledge deficits; make trainings available to keep nurses up-to-date; make protective barriers available for nurses readily; put universal precaution policy in place; look into universal precaution education.Implications for research Research should focused on using well established questionnaire to measure nurses' practices; the relationship between knowledge, attitude and practices; factors affecting the use of universal precautions in different settings; comparison between nurses' knowledge, attitudes and practices towards HIV/AIDS with other infectious diseases; develop and test education program for nurses.

Nurses' knowledge and attitudes to HIV/AIDS--an international comparison between Finland, Estonia and Lithuania

This paper presents baseline data on nurses' knowledge of and attitudes to HIV/AIDS in three countries: Finland, Estonia and Lithuania. The prevalence of HIV/AIDS is steadily increasing in Finland, Estonia and Lithuania. At the same time, labour mobility and also nursing mobility between these countries increases. Previous international studies have shown that lack of knowledge and negative attitudes continue to exist. A total of 681 registered nurses from one Finnish (n = 322), one Estonian (n = 191) and one Lithuanian (n = 168) hospital were surveyed in spring 2006. The questionnaire was originally developed by Held in 1993 and modified for this study. The questionnaire has three scales: demographic and other background variable, nurses' knowledge related to HIV/AIDS, and nurses' attitudes towards people with HIV/AIDS and towards the disease itself. Across the whole sample respondents showed average levels of HIV/AIDS knowledge and attitudes towards people with HIV/AIDS. Years of work experience correlated negatively with the knowledge and attitude levels. A significant correlation was found between the level of knowledge and attitudes. Significant differences were found between countries, Finnish nurses showing the highest knowledge levels and most positive attitudes towards patients with HIV/AIDS. Factors positively influencing levels of knowledge and attitudes were education, previous experience of providing care to HIV/AIDS patient or knowing someone with the infection, and willingness to provide care to HIV/AIDS patients. Supplementary education is needed to strengthen nurses' knowledge. It is important to recognize that there might be differences in knowledge and attitudes between neighbour countries. This needs to be taken into account when planning education for degrees and for further nursing education.

Optimizing HIV care by expanding the nursing role: patient and provider perspectives

AIM

This paper is a report of a study conducted to explore HIV healthcare services from the perspectives of both healthcare providers and patients in order to understand how to optimize HIV nursing care.

BACKGROUND

In China, healthcare providers usually first diagnose HIV in a general hospital. Then, HIV-positive individuals are transferred to a specialist hospital. Between healthcare providers and healthcare institutions, there are many gaps in the process from diagnosis to treatment.

METHODS

One focus group with six healthcare providers and 29 in-depth interviews with people living with HIV/AIDS were conducted during 2005.

FINDINGS

Patients who were diagnosed with HIV in a general hospital often did not discuss their condition with a healthcare provider before being sent to a specialist hospital. Furthermore, since the patients had already been diagnosed, healthcare providers in the specialist hospital did not deal adequately with the disclosure process and emotional reactions to the diagnosis. They reported feeling overwhelmed in their role in providing healthcare services. Nurses reported that they were responsible for many 'non-nursing' tasks and did not have the opportunity to give the type of care they were trained to offer.

CONCLUSION

Optimizing HIV care in China will involve establishing clear boundaries between general and specialist hospitals and a division of labour among healthcare providers that eases the burden of care and takes advantage of the full scope of practice that nurses are trained to provide.

Relationship between HIV/AIDS knowledge and attitude among student nurses: a structural equation model

With the rising incidence of HIV/AIDS in China, nurses will increasingly be caring for patients with HIV/AIDS. Thus, it is necessary that they have enough knowledge to reduce the risk of occupationally acquired HIV infection and that they change their attitude to care for HIV/AIDS patients. The objective of this study is to explore the relationship between student nurses' HIV/AIDS knowledge and their attitude using a structural equation model (SEM). A cross-sectional survey was conducted in January 2008 among 528 student nurses at the technical secondary school of the China Medical University. An SEM is proposed to determine the direction and magnitude of the interdependent effects between the latent factors. The SEM was built using LISREL version 8.5. The measurement properties of the latent factors underlying the questionnaire were based on a confirmatory factor analysis (CFA). Our results as following, HIV/AIDS knowledge and attitude may be measured by seven underlying constructs, namely, preventive knowledge, knowledge of transmission routes, specialty knowledge, knowledge of nontransmission routes, positive attitude toward HIV/AIDS, negative attitude toward HIV/AIDS, and occupational attitude. The SEM fits the data well. The interdependent relationships between these constructs identified the factors of preventive knowledge, specialty knowledge, and attitude toward HIV/AIDS as having both direct and indirect effects on occupational attitude. In conclusions, our results represent an initial effort to assess the relationship between student nurses' HIV/AIDS knowledge and their attitude toward the disease. CFA and SEM analysis have demonstrated their usefulness in evaluating multifactor complex constructs.

Knowledge, attitudes and perceptions of nurses and nursing students towards HIV/AIDS

OBJECTIVE

To describe attitudes, knowledge and perceptions of nurses and nursing students towards the people who live with HIV/AIDS (PLWHA).

METHODOLOGY

Bibliographic study in which six electronic databases were searched using the key words: "attitude", "knowledge", "nursing", perceptions", "HIV/AIDS". Publications between 1998 and 2007 were considered.

RESULTS

560 articles limited by scientific researches or ministerial reports membership were retrieved. Finally a total of 38 publications were selected, the analysis showed that the level of knowledge of nurses and nursing students about PLWHA is good and the attitudes towards HIV/AIDS have improved over time. Nurses and nursing students have been able to identify both positive and negative aspects in the PLWHA care personally and professionally because there is a more favourable perception.

CONCLUSION

There are few studies in Latin America and Chile that study the attitudes and knowledge of the studied population towards PLWHA. According to publications found the knowledge and attitudes have improved because the perception is more favourable.

A survey of Cambodian health-care providers' HIV knowledge, attitudes and intentions to take a sexual history

Cambodia has one of the highest prevalence rates of HIV in Asia and is scaling up HIV testing. We conducted a cross-sectional survey with 358 health care providers in Phnom Penh, Cambodia to assess readiness for voluntary testing and counselling for HIV. We measured HIV knowledge and attitudes, and predictors of intentions to take a sexual history using the Theory of Planned Behaviour. Over 90% of health care providers correctly answered knowledge questions about HIV transmission, but their attitudes were often not positive towards people living with HIV. The Theory of Planned Behaviour constructs explained 56% of the variance in intention to take a sexual history: the control providers perceive they have over taking a sexual history was the strongest contributor (51%), while social pressure explained a further 3%. Attitudes about taking a sexual history did not contribute to intention. Interventions with Cambodian health care providers should focus on improving skills in sexual history-taking.

HIV stigma and nurse job satisfaction in five African countries

This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The Personal Satisfaction subscale was the highest in this sample, as in the other 2. Job satisfaction scores differed significantly among the 5 countries, and these differences were consistent across all subscales. A hierarchical regression showed that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influence on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These results provide new areas for intervention strategies that might enhance the work environment for nurses in these countries.

Help-seeking in a context of AIDS stigma: understanding the healthcare needs of people with HIV/AIDS in China

Despite the rapid increase of HIV infection cases in China, the majority of this population have not yet accessed AIDS-related healthcare services. Most current research in China focuses on HIV prevention and disease control, and pays inadequate attention to the barriers facing HIV-infected individuals in accessing and adhering with healthcare services. This article, as part of a research project on the illness experiences of people with HIV/AIDS in China, aimed to explore these individuals' healthcare experiences, shedding light on the gaps between their needs and existing healthcare services. Data for this qualitative study were collected through individual in-depth interviews with 21 HIV-infected adults in China. The results of data analysis suggest that these individuals' healthcare experiences were greatly affected by social discrimination and the limitations of healthcare resources. While AIDS stigma has reduced the social resources available for this population, HIV-related health institutions were perceived by them as an indispensable source of social support. It is concluded that healthcare institutions, as one of the few places in which HIV-infected people are willing to disclose their HIV positive status, should incorporate social care into healthcare service development and delivery so as to facilitate this population's accessing healthcare services and to address their unmet needs that go beyond the conventional scope of health care. Improving the visibility of people with HIV/AIDS in health care will also have a long-term impact on their own well-being and on HIV prevention in China.

Knowledge, attitude and willingness of Nigerian physiotherapists to provide care for patients living with Acquired Immunodeficiency Syndrome

BACKGROUND AND PURPOSE

Adequate knowledge, positive attitude, and willingness to provide services are important factors in rendering competent and compassionate care to patients living with Acquired Immunodeficiency Syndrome (AIDS). Inadequate knowledge and poor attitude could exclude the application of the principles of logic and scientific methods to the practice of physiotherapy, and could result in fragmented care, with a potentially negative impact on treatment outcome and patient satisfaction. The purpose of this study was (1) to investigate the Nigerian physiotherapists' global knowledge, attitude and willingness to provide care for patients living with AIDS (PLWA), and to (2) determine the relationship between socio-demographic variables and previous encounter with PLWA, and physiotherapists' knowledge, attitude and willingness to care for AIDS survivors.

METHODS

Using a 90-item two-part questionnaire that elicited sociodemographic and previous AIDS encounter information, and also assessed knowledge, attitude and willingness to provide care to PLWA, physiotherapists (N = 131) practicing in Nigeria were surveyed.

RESULTS

Overall, the physiotherapists showed unsatisfactory knowledge about AIDS, harbored negative attitude towards PLWA, and some were unwilling to provide care for PLWA. Previous experience caring for PLWA influenced their attitude, and modest but positive relationships were found between knowledge and attitude and between attitude and willingness.

CONCLUSION

The study underscores the need to address Nigerian physiotherapists' working knowledge deficits and negative attitudes to PLWA. A comprehensive AIDS education that would assist clinicians in exploring their attitude, stereotype and bias against PLWA is warranted.

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.

Chinese HIV-positive patients and their healthcare providers: contrasting Confucian versus Western notions of secrecy and support

In this qualitative study, 29 HIV-positive, Chinese patients reported highly favorable impressions of their healthcare providers, who were seen as providing important medical-related, financial, and emotional support. Generally, the patient-provider relationship positively impacted the participants and their ability to maintain their health and was especially critical when patients were isolated from familial sources of support due to intense AIDS stigma. Often family members were informed of an HIV diagnosis before the patient, revealing tensions between Confucian principles of collectivism and familial authority and increasingly prevalent Western ideals of individual autonomy and the privileged status of personal health information.

HIV-related stigma in health care settings: a survey of service providers in China

We examined how individual and institutional factors in health care settings affected discrimination toward persons with HIV/AIDS. A representative sample of 1101 Chinese service providers was recruited in 2005, including doctors, nurses, and laboratory technicians. Multiple regression models were used to describe associations among identified variables, the relationships with HIV-related personal prejudicial attitudes, and perceived institutional support and discrimination at work. Multivariate analyses revealed that respondents' general view of persons living with HIV/AIDS and their perceived levels of support from their institutions regarding protection procedures were both important predictors for discrimination intent. Perceived institutional support varied according to age, gender, ethnicity, and training background. A better understanding of HIV-related discrimination in health care settings requires consideration of both individual and institutional factors.

Inequality and unwillingness to care for people living with HIV/AIDS: a survey of medical professionals in Southeast China

This study was aimed at assessing physicians' and physician assistants' knowledge and attitudes toward HIV/AIDS and identifying determinants of willingness to care for infected individuals in Southeast China. From May to June 2004, 454 physicians and physician assistants from 5 different medical facility levels in Fujian Province, China, undertook a survey on knowledge, attitude, behavior, and practice (KABP). Only 40.4% (95% confidence intervals: 35.9, 44.9) were willing to provide healthcare services for people living with HIV/AIDS (PLWHAs). Knowledge (p < 0.001) and attitude scores (p = 0.01) as well as the proportion of those willing to provide care (p < 0.001) significantly differed by facility level. Multivariate analysis identified supportive attitudes toward PLWHAs (p < 0.001), self-confidence in providing care (p < 0.001), and facility level as significant predictors of willingness to care for infected individuals. Village medical stations showed the most unfavorable outcomes. Enhanced education as well as specific programs promoting supportive attitudes and willingness to care is therefore required, especially among those working at lower facility levels in remote areas.

Chinese health care providers’ attitudes about HIV: a review

China has one of the fastest growing HIV epidemics in the world with an increase in reported cases of about 30% yearly (UNAIDS, 2004). As the epidemic has grown, there have been several studies of health care provider attitudes towards HIV in China over the last 15 years. While attitudes have evolved, misconceptions about transmission of HIV, low levels of support for people living with HIV/AIDS and stigmatized groups, and a poor understanding of the importance of condoms in HIV prevention, remain. The studies are limited by a weakness of survey instruments and an absence of focus on the gendered nature of the HIV epidemic. Recommendations for future research in this area include development of a theoretical base, consideration of gender and stigma, and incorporation of these issues into the survey instruments.

Using case vignettes to measure HIV-related stigma among health professionals in China

BACKGROUND

We examined Chinese health professionals' attitudes towards patients with AIDS vs patients with hepatitis B.

METHODS

A representative sample of 1101 Chinese health professionals was used. Prejudicial attitudes and willingness to interact were measured based on two case vignettes.

RESULTS

Statistical analyses revealed that health professionals had negative biases against acquired immunodeficiency syndrome (AIDS) patients and reported much less willingness to interact with AIDS patients than hepatitis B patients. Perceived risk of infection at work was also negatively associated with willingness to interact with patients with human immunodeficiency virus (HIV)/AIDS, but relationships varied by profession.

CONCLUSIONS

This study underscores the importance of developing and implementing stigma reduction interventions in health care settings to address attitudinal biases and discrimination in clinical practice.

Knowledge, attitudes, behaviors, and perceptions of risk related to HIV/AIDS among Chinese university students in Hunan, China

The purpose of this paper is to describe HIV/AIDS knowledge, attitudes, and perceptions and identify personal risk behaviors among undergraduate students in China. A descriptive, cross-sectional survey of 1326 students between ages 17 through 28 was conducted in 2002. Results indicated that students held considerable misconceptions about HIV transmission by casual contact and needle sharing as well as stigmatizing attitudes about injection drug use, homosexuality and HIV-positive women who bear children. Results indicated that 14% of Chinese university students are sexually active and risk behaviors tended to increase with age. Additionally, 24% of the students considered themselves to be at moderate to very high risk of contracting HIV and 40% of sexually active students never used condoms. Therefore, it is important to design HIV prevention strategies that target university students in China.