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

HIV care: continuing medical education and consultation needs of nurses, physicians, and pharmacists

This article explores the impact of provider characteristics on their HIV-related continuing medical education (CE) attendance, consultation needs, satisfaction with skills, and willingness to provide care. A total of 731 users (52% physicians, 26% nurses, 11% pharmacists, and 10% nurse practitioners and physician assistants) of an HIV consultation were surveyed by mail (76% response). Significant differences in provider variables were found to be related to HIV experience and profession. Experienced providers reported more CE, more satisfaction with skills, lower consultation needs, more consultations sought, and more willingness to take new patients than other providers. "Unwillingness" was commonly explained by concerns over quality of care or staying up-to-date. Relative to physicians, nurses had more CE hours, were more dissatisfied with their skills, and had greater consultation needs. Although all providers had high consultation or CE needs in some areas, accessibility to such programs is particularly important for low-volume providers.

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.

Nurse practitioner, nurse midwife and physician assistant attitudes and care practices related to persons with HIV/AIDS

Although multiple studies of nurses' attitudes toward people living with HIV/AIDS (PLWAs) can be found in the literature, little is known about the attitudes, beliefs and practices of nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs). A survey including a 21-item AIDS Attitude Scale measuring the constructs of Avoidance and Empathy was sent to 1,291 NPs, CNMs and PAs in Louisiana, Arkansas and Mississippi to describe their attitudes and care practices related to PLWAs. Respondents who were more comfortable treating PLWAs had significantly lower avoidance scores and significantly higher empathy scores than respondents with lower comfort levels in providing care. Greater than 80% of respondents indicated that they would provide health care to HIV-infected individuals. Respondents who referred HIV/AIDS patients for all care did so primarily due to lack of experience with HIV and the availability of more experienced providers. Avoidance and empathy scores were not found to be significantly associated with referral for care. This study suggests that this group of providers has relatively low avoidance and high empathy toward PLWAs and is willing to care for HIV-infected individuals.