Caring for people with AIDS: nurses' attitudes and feelings

Stigma: Its impact on professional responses to the needs of marginalised groups

The stigma associated with drug-use, prostitution and mental and physical illness is not just an experience, it is an active and dynamic process which is often perpetrated by professional responses. Stigma is a complex social phenomenon which resists simple definition. This paper examines the concept of stigma in relation to deviance and explores the notion of a trajectory from one to the other. It highlights the influence of public perceptions of deviance on drug abuse and explores the particular implications for female drug-users. By considering how the actions of health professionals may be reinforcing deviant labels, it emphasises the urgent need for educational interventions. Health professionals need to understand the sociological basis of stigma to create a consciousness of their own professional action. They are in a unique position to intervene and cut across this trajectory to promote awareness and change.

Stigma, an important source of dissatisfaction of health workers in HIV response in Vietnam: a qualitative study

Background

Like in many other low- and middle-income countries, the recent development of an HIV epidemic in Vietnam has led to a growing need for prevention, treatment, care, and support services for people living with HIV (PLHIV). This puts greater demands on the national HIV services, primarily on health workers, which increases the importance of their job satisfaction and working conditions. This study describes health worker perceptions and explores the factors that influence job satisfaction and dissatisfaction of health personnel working on the HIV response in Vietnam. Spector’s job satisfaction model was used as the theoretical framework for the study design and analysis.

Methods

The study employed a qualitative design with 7 focus group discussions and 15 semi-structured interviews with health workers, purposively selected from national and provincial organizations responsible for HIV services in 5 cities and provinces in Vietnam. Data were analyzed using a hybrid approach of theory-driven and data-driven coding and theme development using qualitative analysis software.

Results

HIV services are perceived by Vietnamese health workers as having both positive and negative aspects. Factors related to job satisfaction included training opportunities, social recognition, and meaningful tasks. Factors related to job dissatisfaction included unsatisfactory compensation, lack of positive feedback and support from supervisors, work-related stress from a heavy workload, fear of infection, and HIV-related stigma because of association with PLHIV. An adjusted Spector’s model of job satisfaction for HIV service health workers was developed from these results.

Conclusion

This study confirmed the relationship between stigmatization of PLHIV and stigma experienced by staff because of association with PLHIV from families, colleagues, and society. The experiencing stigma results in additional work-related stress, low self-esteem, poor views of their profession, and lower income. The study shows the importance of actions to improve staff job satisfaction such as pay raises, supportive supervision, stress management, stigma reduction and workplace safety. Immediate actions could be the provision of more information; education and communication in mass media to improve the public image of HIV services, as well as improvement of workplace safety, therefore making health workers feel that their work is valued and safe.

Attitudes of US physician assistants toward persons with HIV/AIDS

BACKGROUND

Early in the HIV/AIDS epidemic, a large number of health care workers had negative attitudes toward persons infected with HIV, but a more positive shift has occurred in these attitudes over the past decade. However, recent information about attitudes of physician assistants (PAs) is missing.

METHODOLOGY

A nationwide randomized sample of 1,500 PAs was surveyed through the US mail. The AIDS Attitudes Scale (AAS) developed by Froman, Owen, and Daisy in 1992 was used for this purpose. The results were analyzed using descriptive, t test, and analysis of variance (ANOVA) statistics.

RESULTS

A majority of respondents had high empathy, low avoidance, and positive general attitude scores. Respondents living in the South had the highest avoidance and lowest general attitude scores compared with those living in other regions (ANOVA, P < .05).

CONCLUSION

The results were consistent with similar current studies of health care workers, which demonstrated supportive attitudes towards persons with HIV/AIDS.

Male patient perceptions of HIV stigma in health care contexts

Individuals living with HIV may have a heightened sensitivity to the behaviors of others that may signal bias or discrimination. Identifying and avoiding these potentially problematic behaviors may be especially important for service providers, such as health care personnel, who regularly interact with HIV-positive clientele. This study examines the experiences of 50 male American military veterans living with HIV and their perceptions of HIV stigma within health care contexts. Participants described a variety of behaviors performed by health care personnel that they perceived to be indicative of HIV stigma, ranging from ambiguous nonverbal cues (e.g., minimal eye contact) to blatant discrimination (e.g., physical abuse of HIV-positive patients). These findings extend previous research on HIV stigma in health care settings by (1) focusing on health care personnel's actual behaviors rather than their attitudes and beliefs about HIV-positive patients, (2) including patients' perceptions regarding the behaviors of both clinical and nonclinical health care personnel, and (3) identifying behaviors patients perceive as stigmatizing that are unique to health care contexts. Combined, these findings provide health care personnel a tangible list of behaviors that should either be avoided or further explained to HIV-positive patients, as they may be interpreted as stigmatizing.

Obstetric nurses' attitudes and nursing care intentions regarding care of HIV-positive pregnant women

OBJECTIVE

To define attitudes toward pregnant women with HIV and how these attitudes correlate with and affect prejudice and nursing care intentions.

DESIGN

Cross-sectional descriptive correlational study of obstetric nurses.

SETTING

Eight hundred (800) mailed surveys in the United States (N = 350).

PARTICIPANTS

A random sample of nurses certified in inpatient obstetrics.

MAIN OUTCOME MEASURES

Background information tool, the Pregnant Women with HIV Attitude Scale, the Prejudice Interaction Scale in response to four vignettes, and the Marlowe-Crowne Social Desirability Scale-Form C.

RESULTS

Obstetric nurses had more positive Mothering-Choice attitudes than Sympathy-Rights attitudes (p= .000). Nurses who knew more than four people affected by HIV/AIDS had more positive attitudes (p<or= .05). Nurses with more positive attitudes were less prejudiced and more willing to care for pregnant women with HIV (p= .05). Nurses were significantly more prejudiced and less willing to care for women with than without HIV (p<or= .0001).

CONCLUSIONS

Nurses' clinical care may be influenced by their attitudes and prejudice toward pregnant women with HIV. Nursing education should include how prejudice can affect our clinical decision making and behaviors. Research is needed to explicate the effects on patient outcomes.

Sexual stigma and sympathy: attitudes toward persons living with HIV in Jamaica

As the number of persons living with HIV continues to increase in Jamaica, attitudes and values become more important. This study aimed to examine the attitudes of university students in Jamaica toward persons living with HIV, including homosexual men, heterosexual men, women sex workers, other women, and children. One thousand two hundred and fifty-two students were surveyed between June 2001 and February 2002 using a 193-item questionnaire measuring a variety of HIV-related knowledge, attitudinal and behavioural items. Less than half of students reported sympathetic attitudes toward homosexual men or women sex workers living with HIV while a majority reported generally sympathetic attitudes toward heterosexual men and non-sex worker women living with the disease. Predictors of sympathy varied by target group. Male students were significantly less likely to report sympathy for homosexual men than for any other group. Spirituality was associated with sympathy for homosexual men and women sex workers, but not for the remaining two groups. Findings suggest that levels of negative attitudes are high in Jamaica and warrant attention to both individual and societal-level actions and interventions. In addition, messages and interventions must be targeted, recognizing both the differences in level of sympathy expressed toward different groups and predictors of sympathy across the groups.

Self-reported infection control practices and perceptions of HIV/AIDS risk amongst emergency department nurses in Botswana

This descriptive exploratory study investigated the reported practices and perceptions of emergency nurses related to infection control in the context of the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) pandemic in Botswana. Quantitative and qualitative data were collected using a self-administered questionnaire. Forty questionnaires were distributed to nurses with emergency department experience in Botswana, with a response rate of 55% (n = 22). Quantitative data were analysed using descriptive statistics while qualitative data were subjected to thematic and content analysis. The majority of respondents reported compliance with universal precautions at the hospital emergency department. However, qualitative data highlighted resource constraints that may hinder compliance with universal precautions such as a lack of appropriate facilities, a shortage of equipment and materials, inadequate staffing and absence of sustainable in-service education programs. Further, the reported compliance with Universal Precautions had not removed the fear of exposure to HIV/AIDS and perceived risk of transmission to family. The authors recommend in-service education and practice initiatives to promote sustainable compliance with universal precautions and realistic risk perception among nurses. Further research is required to evaluate nurses' compliance with universal precautions in developing countries using observational methods or in-depth interviews. This would enable exploration of nurses' actions regarding compliance with universal precautions.

HIV/AIDS and the workplace: perceptions of nurses in a public hospital in South Africa

AIM

The purpose of this article is to report a study of the perceptions and experiences of nurses caring for people living with HIV/AIDS in the public health sector in South Africa.

BACKGROUND

The number of people living with HIV/AIDS in South Africa has escalated at an alarming rate. Many people being hospitalized are HIV positive, and hence nurses are in more regular and prolonged contact with people suffering from HIV/AIDS than is the case in other working environments. Although studies focusing on nurses' experiences of caring for patients with HIV/AIDS have been done in numerous countries, little is known about nurses' views in Africa, and South Africa in particular. To ensure quality care for patients with HIV/AIDS, it is important to understand nurses' experiences of nursing HIV-positive patients and how they may influence their attitudes towards these patients.

METHOD

A qualitative approach was used, the primary method of data collection being in-depth interviews. These interviews were conducted with 35 nurses at a public hospital in the Gauteng province of South Africa in 2002-2003.

FINDINGS

Seven themes were identified: helplessness, emotional stress and fatigue, fear, anger and frustration, occupational-related concerns, empathy, and self-fulfilment.

CONCLUSIONS

Increased understanding of the stresses and rewards experienced by these nurses can contribute to policy development in this area. It is also important to provide appropriate preregistration and continuing education and support for nurses working in this field, and to ensure that the working environment is adequate in terms of resources.

Rural nursing students' knowledge, attitudes, and beliefs about HIV/AIDS: a research brief

The purpose of this study was to explore rural student nurses' knowledge, attitudes, and beliefs about caring for people with HIV/AIDS. The results from this study were consistent with other past studies where judgmental attitudes toward patients with HIV/AIDS were demonstrated. Data indicate that nursing students' attitudes, beliefs, and knowledge about HIV/AIDS have not changed over the past decade. Based on these findings, many implications for nurse educators exist. Nurse educators need to examine approaches to teaching about HIV/AIDS that can increase knowledge and influence the actual treatment of individuals who have this disease. In addition, the focus for rural nursing programs should be on increasing the understanding of the impact of HIV/AIDS on rural communities and to help project future needs for HIV/AIDS-related services.

HIV-positive patients' experiences of stigma during hospitalization

The aim of this research study was to explore, within an Irish context, HIV-positive patients' experiences of hospitalization and particularly their experiences of nursing care. This article reports on one of the dominant themes to emerge in the study--the experience of stigma during hospitalization among persons with HIV. A volunteer sample of 10 former inpatients of hospitals in the Republic of Ireland's capital, Dublin, were interviewed in depth, and the resulting data were analyzed using a qualitative content analysis. Findings indicate that while some participants experienced stigma from nurses, such stigma was stratified according to the means by which the disease had been contracted, with drug users expressing the greatest feelings of stigma from nurses. Data also suggest that the type of nursing care favored by many participants was that of segregated care within specialized units. This type of care was preferred because it enabled the patient to avoid being discredited by other patients who did not have the virus. This environment also offered the potential of social support from other patients with similar diagnoses. Finally, patients experienced breaches in confidentiality because of institutional policies that made their disease conspicuous and from some nurses' nonchalance in handling information about their disease. The analysis used in this study draws on Goffman's conceptualizations of stigma to explain the social process underlying the accounts given by study participants.

Reluctance amongst nurses and doctors to care for and treat patients with HIV/AIDS

A survey was carried out, using a questionnaire and semi-structured interviews, to examine why nurses and doctors might be reluctant to care for patients with HIV/AIDS. The findings provided four main themes: perceptions about sexual promiscuity; blaming certain patients with HIV/AIDS; belief in the right to refuse to provide care; and discriminatory care. The paper concludes by acknowledging the limitations of the study and examining the implications of the findings for clinical practice.

Attitudes of university students towards HIV/AIDS

The purpose of this study was to assess, in one university in Finland, students' attitudes and feelings towards HIV/AIDS while they were studying for their first year at the University of Oulu. This study is part of a larger research project concerning HIV/AIDS in the Department of Nursing at the University of Oulu. The results can be used in planning and implementing health education for young people. The data were collected by using a questionnaire with both structured and open-ended questions. The study group consisted of 245 students who had started their studies in the autumn of 1993. The data were analysed by using cross tabulation (chi-square test) and inductively by content analysis. The most important source of knowledge concerning HIV/AIDS was television (84%) and 30% of the students had obtained their knowledge from a school nurse. Even when there was a lot of knowledge available to the students, they estimated their knowledge as insufficient and defined HIV more correctly than AIDS. Knowledge did not increase the use of safe sex but limited sexual behaviour. Religion had an importance for sexual behaviour. Female students were more sexually active than male students. The feelings towards HIV/AIDS were more often negative than positive or neutral and the students felt stronger negative feelings towards AIDS than HIV. The negative feelings were often based on fear. The differences between the faculties were minimal.

Prisoners as Patients The Experience of Delivering Mental Health Nursing Care in an Australian Prison

Correctional or prison mental health nursing is a highly specialized area of practice that has undergone substantive role development in recent years. However, little research has explored aspects of prison-based nursing practice or practice arrangements. The experience of delivering mental health nursing care in prison can be disempowering, resulting in feelings of frustration, isolation, and stigma. In developed nations, prison mental health nurses face the rewarding challenge of gaining greater recognition for the specialized nature of their practice and their key role in the correctional and criminal justice continuum.

Homophobia: an evolutionary analysis of the concept as applied to nursing

Homophobia is a socially accepted, culturally based belief, which is heavily influenced by an individual's or a community's inherent attitudes, beliefs and values. This conceptual analysis of homophobia has endeavoured to review existing literature on homophobia and subsequently identify and examine the phobic constituents of the concept. References to homophobia are mostly from the 1970-1980 period and there is much unacknowledged conceptual baggage that accompanies the term, which results in restrictive and inappropriate ideas about this concept. This is mainly the consequence of comparisons of homophobia to other phobias, which directly infers fear of homosexuals, while in reality homophobia is more of a biased disgust at homosexuals' lifestyles. This paper attempts to re-conceptualize homophobia so that empirical research can begin to test the critical attributes of the concept. This forms the basis for the development of a comprehensive social psychological theory of attitudes towards homosexuals. Such a theory would transcend the unilateral and unidimensional concept of homophobia as a fear and help the understanding of attitudes and feelings towards homosexuals.

Attitudes towards people with HIV/AIDS: entropy and health care ethics

Attitudes held by health care workers towards people with HIV and AIDS are on the whole negative, and numerous studies confirm the reality and complexity of this tendency. This paper will provide a related literature review, and identify four particular factors that go some way towards explaining the robustness of these attitudes. These are social, psychological, political and anthropological in nature. A model from classical physics will be used metaphorically to illustrate and articulate the apparent inevitability of this harmful process, and also a possible solution.

A situational analysis of an HIV/AIDS clinical area

The following paper is an account of a situational analysis in a human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) ward. Initially it was intended to test a number of hypotheses extracted from the literature, and, using previous experience from participant observation, apply them to this particular clinical area. Becoming established ('getting in') in the new unit to be studied (situation) took 6 months and, although it was eventually possible to test the original hypotheses, the process of 'getting in' became the main point of analysis. Taking into account the situation of 'getting in', the conversations with the nursing staff and the background information, it is concluded that the HIV/AIDS predicament is and will continue to provide a major challenge for nurses and nurse educators.

HIV infection: challenges for dialysis personnel

Patients with human immunodeficiency viral (HIV) infection who also require dialysis present a complex constellation of challenges for dialysis personnel. The major challenges that health care providers (HCPs) face when working with HIV-infected patients are related to overcoming personal fears and to adapting to HIV-specific patient care needs. Dialysis personnel who encounter these concerns do so with a background of experience that has prepared them to cope effectively with HIV disease in the dialysis setting. This article explores the problems of occupational exposure to HIV and chronic health care issues common to patients with HIV infection and renal disease.

Nurse practitioners' reactions to persons with HIV/AIDS: the role of patient contact and education

Attitudes about caring for patients with HIV/AIDS (PWAs) were investigated in a survey mailed to all nurse practitioners (NPs) in Georgia. There was a 53% response rate to the survey (286 of 539 questionnaires were returned). It was hypothesized that exposure to continuing education on HIV/AIDS and to HIV-positive patients would be associated with more positive attitudes and less extreme behavioral changes associated with fear of transmission. Factor analytic procedures were used to generate three scales: resentment of PWAs (RESENT), anxiety or fear about contact with PWAs (FEELINGS), and changes in personal life related to fear of transmission after contact with PWAs (CHANGE). Descriptive findings indicated that a significant minority of NPs were worried about risk, harbored some resentment toward PWAs, and had changed their behavior out of concern about the possible transmission of HIV. Differences of means and stepwise regression analyses (with several potentially confounding variables controlled) found exposure to continuing education associated with less fear and anxiety, less resentment, and less behavioral change. Exposure to HIV-positive patients was associated with less behavioral change, as predicted, but not with less fear/anxiety or resentment. The cross-sectional survey design limits the attribution of causality, but offers some support for the role of continuing education in improving attitudes toward PWAs.

Attitudes of baccalaureate nursing students toward persons with acquired immunodeficiency syndrome according to mode of human immunodeficiency virus transmission

The purpose of this descriptive correlational study was to (1) examine differences in baccalaureate nursing students' attitudes toward persons living with acquired immunodeficiency syndrome (AIDS) (PLWAs) according to mode of transmission and (2) identify demographic and academic variables influencing baccalaureate nursing students' attitudes toward PLWAs. Two hundred forty-six students from five geographically dispersed baccalaureate programs returned a completed demographic data sheet, AIDS Knowledge Scale, and AIDS Attitude Scale. The AIDS Attitude Scale, based on Goffman's theory of stigma, assesses stigmatizing attitudes, perceptions of deservedness of care, and attitudes of respect and regard for PLWAs according to five modes of human immunodeficiency virus transmission. The findings of this study demonstrated overall that baccalaureate students were the most stigmatizing toward persons who had developed AIDS through injecting drugs followed by sexual contact (both homosexual and heterosexual) and least stigmatizing toward PLWAs who contracted the virus through maternal transmission or a blood transfusion. Perhaps the PLWA who contracted AIDS through either maternal transmission or a blood transfusion was viewed as an "innocent victim" of the disease, whereas PLWAs who contracted the virus through either shared needles or sexual transmission were viewed as having acquired the infection through the results of their actions. The demographic characteristics of the respondents did not influence AIDS attitudes.

Health care workers and HIV/AIDS: a critical review of the literature

This paper reviews the extensive literature which looks at the impact of HIV/AIDS on health care workers (HCWs). The knowledge and attitudes of HCWs toward people with HIV/AIDS and other relevant attitudes, for example those regarding male homosexuality have been widely studied whereas attitudes to intravenous drug use are perhaps under-investigated. Three major themes of the literature are examined. These are fear of infection, beliefs about the right to refuse care and the stresses associated with caring for HIV positive people. A number of educational interventions which attempt to change HCWs attitudes and beliefs are reviewed. Some notable gaps in the literature are identified. Neglected areas include attitudes to women, people of colour and consideration of the organizational and societal factors mediating the impact of HIV upon healthcare workers. Limitations of the research techniques used are identified and future implications for health care workers are considered.

Managing occupational HIV exposures: a Canadian study

The findings reported in this paper are part of a larger study that explored how nurses cope with the risk of acquiring HIV infection while caring for persons with AIDS (PWAs). The data were collected through in-depth interviews with 13 nurses who cared for PWAs in a large Western Canadian hospital. Seven of these nurses perceived that they had been exposed to HIV-infected blood or body fluids. This paper describes how these seven nurses coped with actual exposures to HIV-infected blood or body fluids. Data were analyzed using the methodology of grounded theory. Nurses' coping efforts after exposure were grouped into four categories: minimizing the effect of exposures, reducing a sense of vulnerability, selective disclosure to others, and assigning meaning. Nurses minimized the physical effects of exposure through measures such as 'bleeding' the needlestick injury and immersing the affected area in bleach solution. Nurses reduced their sense of vulnerability by assessing the possibility of harm, avoiding situations that aroused fear, and confronting the decision for HIV testing. Nurses limited their disclosures to co-workers to avoid rejection and to preserve professional self-esteem. Disclousre to significant others was influenced primarily by the support nurses perceived they would receive. Finally, nurses attempted to assign meaning to the exposure by determining why the event occurred and by evaluating the implications it has had on their lives. The article concludes with implications for nursing practice.

Infection control and human immunodeficiency virus: perceptions of risk among nurses and hospital domestic workers

In December 1993 the first case of patient-to-patient transmission of human immunodeficiency virus (HIV), at a doctor's surgery in New South Wales, was documented. In an environment of heightened anxiety about HIV transmission and the adequacy of infection-control measures taken by health providers, it is important to explore perceptions of occupational risk of exposure to infection among hospital workers, reasons why hospital domestic workers sometimes depart from standard procedure in infection control, and how they regard the patients who have infectious diseases. In this study, at an infectious diseases hospital where there is an acute awareness of such issues, nurses had accurate knowledge about control of infection, including HIV, but had limited trust of that knowledge. They gave rationales for why they sometimes departed from infection-control procedures. They had low levels of fear of homosexuals and of acquired immune deficiency syndrome. The hospital domestic workers had lower levels of accurate knowledge about infection control, including HIV, and less trust of that knowledge and of protection by health provider from occupational exposure to infection. They had low levels of fear of homosexuals and HIV. Both groups sought regular, small-group, interactive education programs on infection control and HIV to allow them to discuss their concerns. Participatory education of workers should include eliciting concerns of participants, and should discuss concerns regarding administrators' and educators' interests in their safety and wellbeing.

Community health nurses' HIV care behavior

The purpose of this study was to examine community health nurses' attitudes, subjective norms, and intentions to care for patients who are HIV positive using the theory of reasoned action. One hundred and forty-five participants completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (1980). Consistent with the theory, nurses' attitudes and subjective norms were found to be significant predictors of intentions to care for persons who are HIV positive (R2 = .15). Personal beliefs found to discriminate between intenders and nonintenders were those related to possible consequences for self, family, and friends, but not to job-related consequences. In addition, qualitative data showed persistent concerns about occupational risk for contracting AIDS. Based on the results of this research, it is recommended that nurse educators in both clinical and academic settings target specific educational and training interventions to include transmission, prevention, and exploration of feelings, attitudes, beliefs, and behavioral intentions about HIV-related topics. Further theory-based research and testing of interventions to change community health nurses' attitudes and beliefs about HIV disease are advocated.

HIV/AIDS education for nurses in Poland

Funded by an agreement with the World AIDS Foundation, a team of American and Polish healthcare professional was established to provide expert and timely training on HIV/AIDS course for nurses was conducted in Gdansk, Poland. The course identified significant professionals concerns of Polish nurses, including fear of infection, discomfort with male sexuality, and lack of information about drug users. Precourse and postcourse evaluations demonstrated significant changes in level of comfort during discussions of sensitive topics and improvement in instructional self-confidence.

Responding to a challenge: nursing care and AIDS

Those providing nursing services have been at the forefront in responding to the AIDS epidemic. This paper poses the question as to what extent AIDS work makes unique demands of nursing staff. It explores the implications of AIDS-related nursing work and considers these within the broader context of the role of nurses and their work environment. Although intense, many of the demands of AIDS-related work are also features of nursing in other contexts. There is thus potential to draw on already formulated training responses and to contribute significantly to ongoing debates about nursing and nurse education.

HIV/AIDS--knowledge, attitudes and education of nurses: a review of the research

This paper provides a review of research relating to knowledge, attitudes and education of nurses in relation to HIV/AIDS. Early studies portrayed nurses (and other health-care workers) as fearful of AIDS, ill-informed, and negative and discriminatory in their attitudes towards people with HIV/AIDS. Several major surveys in the UK in the late 1980s produced broadly similar findings and, in the absence of more recent countering evidence, it cannot be assumed that there has been significant improvement. Research surveys of HIV/AIDS education provision for nurses are also reviewed. A recent survey of UK nursing colleges revealed weaknesses in provision, and a lack of training and confidence among nurse teachers. Although evaluation research has been scarce, some studies have demonstrated the beneficial effects of various forms of education on nurses' HIV/AIDS-related knowledge and attitudes, and these are also reviewed. Although early predictions of a rapidly escalating AIDS epidemic have proved to be exaggerated, at least in developed countries, it is vital that nurses do not become complacent. This review should encourage nurses, irrespective of clinical specialty, to reconsider their own knowledge and attitudes and to press for further HIV/AIDS education if they consider that it is still lacking.

Mode of acquiring AIDS and nurses' intention to provide care

The intention of 322 staff nurses to provide care to male patients who acquired AIDS either through sexual activity with males, sexual activity with females, sharing needles, or a blood transfusion was examined. For each mode of acquiring AIDS, respondents indicated their intent to perform 11 care-giving behaviors, whether they were comfortable performing the behaviors, and if they felt in danger by performing the behaviors. No statistically significant differences related to mode of acquiring AIDS were found in nurses' intention to provide care. Comfort was the only significant predictor of intent to provide care.

Changing emphasis in nursing research

There is a changing emphasis in nursing research towards qualitative studies rather than quantitative ones. Phenomenology as a research methodology has value in discovering the real needs of patients and clients which The Scope of Professional Practice (UKCC, 1992) suggests should be the aim of each registered practitioner. Phenomenology is closely linked to nursing's humanistic philosophy. Phenomenology has given nurses valuable insights into the patients' perspective on a range of health and hospitalisation issues. Nursing research should not be allowed to remain a cottage industry.

Nurses' knowledge, attitudes about HIV, AIDS. A replication study

The AIDS epidemic is now in its second decade and shows no sign of relenting. Unfortunately, however, the AORN study shows that perioperative nurses' knowledge regarding HIV and AIDS is not adequate to enable them to provide patient care while maintaining safe practices. Focused educational programs should be made available to perioperative nurses to help them apply universal precautions and OSHA standards to everyday practice. Perioperative nurses must become knowledgeable about the disease and sensitive to the needs of patients who have this illness. All nurses have a special obligation to care for all patients; education and management strategies that enable exploration of values, fears, and prejudices will help nurses understand their own beliefs and those of other individuals. Recommendations from this study may be viewed as a starting point for this perioperative education.

Attitudes of practicing nurses as predictors of intended care behavior with persons who are HIV positive: testing the Ajzen-Fishbein Theory of Reasoned Action

The purpose of this descriptive correlational study was to examine practicing nurses' attitudes, subjective norms, and intentions to care for HIV positive patients, using the Theory of Reasoned Action. One hundred and forty-one subjects completed a questionnaire developed according to guidelines described by Ajzen and Fishbein (1980). Consistent with the theory, nurses' attitudes and subjective norms were found to be significant predictors of intentions to care for persons who are HIV positive (R2 = 0.27). Personal beliefs found to discriminate between intenders and nonintenders were those related to possible consequences for self, family, and friends, but not job-related consequences. Normative beliefs which discriminated between groups were also related to nonprofessional referents' expectations. In addition, qualitative data showed persistent concerns about occupational risk for contracting AIDS. Based on the results of this research, it is recommended that nurse educators in both clinical and academic settings, target specific educational/training interventions to include transmission, prevention, as well as exploration of feelings, attitudes, beliefs, and behavioral intentions about HIV-related topics. Further theory-based research and testing of interventions to change practicing nurses' attitudes and beliefs about HIV disease are advocated.