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Rouleau G, Richard L, Côté J, Gagnon MP, Pelletier J. Nursing Practice to Support People Living With HIV With Antiretroviral Therapy Adherence: A Qualitative Study. J Assoc Nurses AIDS Care 2019; 30:e20-e37. [PMID: 31241513 PMCID: PMC6594722 DOI: 10.1097/jnc.0000000000000103] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Antiretroviral therapy (ART) management is a core competency for nursing practice in HIV as documented in best practice guidelines. Nurse-led interventions are effective in fostering ART adherence in people living with HIV (PLWH). However, these evidence-based interventions and professional expectations pertaining to these guidelines do not reflect current practice, nor do they expose the challenges faced by nurses. We conducted a qualitative exploratory study with nurses to explore their professional practices in the context of ART adherence. Sixteen nurses participated in data collection: nine in a focus group and seven in individual interviews. We identified four themes: building a therapeutic relationship with PLWH as a foundation of HIV nursing care; nursing activities to support PLWH with ART adherence; challenges faced by nurses providing ART-related care; and resource mobilization supporting nursing practice development in ART management and HIV care. Aspects of HIV nursing practice need to be strengthened to enhance best practice care, such as managing powerlessness in the context of ART nonadherence.
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Affiliation(s)
- Geneviève Rouleau
- Geneviève Rouleau, RN, MSc, is a PhD Candidate, Faculty of Nursing, Laval University, Quebec City, Quebec, Canada and is Coordinator of the Research Chair in Innovative Nursing Practices, University of Montreal Hospital Research Center, Montreal, Quebec, Canada. Lauralie Richard, RN, PhD, is a Research Fellow, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, New Zealand and an Associate Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. José Côté, RN, PhD, is the Holder of the Research Chair in Innovative Nursing Practices, Montreal; Researcher, University of Montreal Hospital Research Center, Montreal and Full Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. Marie-Pierre Gagnon, PhD, is a Full Professor, Faculty of Nursing, Laval University, Quebec City and a Researcher, University Hospital Center of Quebec-Laval University Research Center, Quebec City, Quebec, Canada. Jérôme Pelletier, RN, MSc, is a PhD Student, Faculty of Nursing, Laval University, Quebec City and Professor, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - Lauralie Richard
- Geneviève Rouleau, RN, MSc, is a PhD Candidate, Faculty of Nursing, Laval University, Quebec City, Quebec, Canada and is Coordinator of the Research Chair in Innovative Nursing Practices, University of Montreal Hospital Research Center, Montreal, Quebec, Canada. Lauralie Richard, RN, PhD, is a Research Fellow, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, New Zealand and an Associate Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. José Côté, RN, PhD, is the Holder of the Research Chair in Innovative Nursing Practices, Montreal; Researcher, University of Montreal Hospital Research Center, Montreal and Full Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. Marie-Pierre Gagnon, PhD, is a Full Professor, Faculty of Nursing, Laval University, Quebec City and a Researcher, University Hospital Center of Quebec-Laval University Research Center, Quebec City, Quebec, Canada. Jérôme Pelletier, RN, MSc, is a PhD Student, Faculty of Nursing, Laval University, Quebec City and Professor, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - José Côté
- Geneviève Rouleau, RN, MSc, is a PhD Candidate, Faculty of Nursing, Laval University, Quebec City, Quebec, Canada and is Coordinator of the Research Chair in Innovative Nursing Practices, University of Montreal Hospital Research Center, Montreal, Quebec, Canada. Lauralie Richard, RN, PhD, is a Research Fellow, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, New Zealand and an Associate Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. José Côté, RN, PhD, is the Holder of the Research Chair in Innovative Nursing Practices, Montreal; Researcher, University of Montreal Hospital Research Center, Montreal and Full Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. Marie-Pierre Gagnon, PhD, is a Full Professor, Faculty of Nursing, Laval University, Quebec City and a Researcher, University Hospital Center of Quebec-Laval University Research Center, Quebec City, Quebec, Canada. Jérôme Pelletier, RN, MSc, is a PhD Student, Faculty of Nursing, Laval University, Quebec City and Professor, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - Marie-Pierre Gagnon
- Geneviève Rouleau, RN, MSc, is a PhD Candidate, Faculty of Nursing, Laval University, Quebec City, Quebec, Canada and is Coordinator of the Research Chair in Innovative Nursing Practices, University of Montreal Hospital Research Center, Montreal, Quebec, Canada. Lauralie Richard, RN, PhD, is a Research Fellow, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, New Zealand and an Associate Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. José Côté, RN, PhD, is the Holder of the Research Chair in Innovative Nursing Practices, Montreal; Researcher, University of Montreal Hospital Research Center, Montreal and Full Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. Marie-Pierre Gagnon, PhD, is a Full Professor, Faculty of Nursing, Laval University, Quebec City and a Researcher, University Hospital Center of Quebec-Laval University Research Center, Quebec City, Quebec, Canada. Jérôme Pelletier, RN, MSc, is a PhD Student, Faculty of Nursing, Laval University, Quebec City and Professor, Université du Québec à Rimouski, Rimouski, Quebec, Canada
| | - Jérôme Pelletier
- Geneviève Rouleau, RN, MSc, is a PhD Candidate, Faculty of Nursing, Laval University, Quebec City, Quebec, Canada and is Coordinator of the Research Chair in Innovative Nursing Practices, University of Montreal Hospital Research Center, Montreal, Quebec, Canada. Lauralie Richard, RN, PhD, is a Research Fellow, Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, New Zealand and an Associate Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. José Côté, RN, PhD, is the Holder of the Research Chair in Innovative Nursing Practices, Montreal; Researcher, University of Montreal Hospital Research Center, Montreal and Full Professor, Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada. Marie-Pierre Gagnon, PhD, is a Full Professor, Faculty of Nursing, Laval University, Quebec City and a Researcher, University Hospital Center of Quebec-Laval University Research Center, Quebec City, Quebec, Canada. Jérôme Pelletier, RN, MSc, is a PhD Student, Faculty of Nursing, Laval University, Quebec City and Professor, Université du Québec à Rimouski, Rimouski, Quebec, Canada
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