Sources and Impact of Work-Related Stress Among HIV/AIDS Health Care Providers in Guangxi, China: A Qualitative Research

Student nurses' perceptions and experiences in caring for people living with HIV/AIDS: a qualitative study

BACKGROUND

Caring for people living with HIV/AIDS (PLWHA) requires clinical experience and quality care delivery skills. This study aimed to explore the perceptions and experiences of nursing students in caring for PLWHAs.

METHODS

This qualitative descriptive study interviewed 18 student nurses who had cared for PLWHAs from 14 tertiary hospitals across 7 provinces in China through semi-structured telephone interviews.

RESULTS

Two themes emerged from the narratives: student nurses' perceptions and attitudes toward PLWHAs and student nurses' practical experiences with PLWHAs. Five theme clusters were revealed, namely "negative attitudes held before the care-giving," "a series of psychological struggles in care-giving," "favorable attitudes increased after the care-giving," "consensus on care delivery for PLWHAs," and "considerations regarding contamination reduction."

CONCLUSIONS

Findings shed light on the development and changes in student nurses' perspectives on PLWHAs throughout their clinical experiences. Student nurses' perceptions and attitudes toward PLWHAs progressed through three distinct stages, and positive changes were observed after care-giving. Participants' perceptions and practical experiences with patients with AIDS enable patients to receive fair and high-quality care and provide valuable insights for nursing educators better prepare HIV nurses.

Health Care Worker Burnout During the COVID-19 Pandemic in HIV Clinics in Guangxi, China: A Cross-sectional Analysis of Risk and Protective Factors

ABSTRACT

Dual epidemics of coronavirus disease 2019 (COVID-19) and HIV cause burnout among HIV health care workers. Guided by a socioecological framework, we investigated risk and protective factors of their burnout in Guangxi, China based on an online survey (N = 1,029) from April to May 2020. Descriptive and bivariate analyses and hierarchical regression were conducted. COVID-19-related stressors (B = 0.648 [0.482-0.816], p < .001), challenges while delivering HIV services (B = 0.236 [0.174-0.298], p < .001), and working in province/city-level institutes (B = 2.302, [0.828-3.776], p =.002) were risk factors. Protective factors were resilience (B = -0.596 [-0.687 to -0.504], p < .001), workplace social support (B = -0.410 [-0.717 to -0.044], p =.03), and institutional responsiveness to COVID-19 (B = -0.138 [-0.205 to -0.071], p < .001), respectively. Burnout-related interventions may benefit from promoting resilience, creating a supportive work environment, and strengthening institutional response to public health emergencies.

Stress and Coping in Nurses Taking Care of People Living with HIV in Hunan, China: A Descriptive Qualitative Study

BACKGROUND/PURPOSE

Nurses engaged in the care of people living with HIV (PLWH) are commonly exposed to workplace stress. This study aimed to explore the stress experiences and coping strategies among nurses taking care of PLWH in China.

METHODS

Nurses were recruited from the AIDS department of a public, general, third-grade class-A hospital, which has the largest HIV care department in the Hunan Province of China. Thirty-three nurses working in the AIDS Department were recruited in this qualitative study. Eight nurses participated in a focus group and 25 nurses underwent in-depth individual interviews aimed at characterizing the nurse's feelings and struggles with stress during caregiving for PLWH. The interviews were audio-recorded, transcribed verbatim, anonymized, and imported into NVivo 8.0 software. The data were coded and subjected to thematic analysis.

RESULTS

Concerns about occupational exposure, heavy workload, mental health problems and risk behaviors of patients, and discrimination towards nurses caring for PLWH were the four main sources of stress. The negative impact of stress included problems with emotion regulation, somatic health and sleep, and work performance. Some participants also reported a positive impact of work stress on their mental health. Using personality strengths, problem-solving, help-seeking, concealing and avoiding/suppression were common coping strategies employed by nurses caring for PLWH.

CONCLUSION

Our findings help characterize the stress experienced by nurses caring for PLWH in the Chinese cultural context, and may inform specific interventions to help manage stress and promote mental health of nurses.

Stress coping strategies and their perceived effectiveness among HIV/AIDS healthcare providers in China: a qualitative study

Previous studies have suggested that many HIV/AIDS healthcare providers (HCPs), especially those in resource-poor settings, suffer from various work-related stress because of the complexity of HIV/AIDS patients' medical conditions, occupational exposure, HIV-related stigma, and challenges with patients' physical, mental, and social conditions. However, data are limited regarding how HIV/AIDS HCPs cope with the stress and their perceived effectiveness of these coping strategies. This qualitative study was designed to explore HCPs' coping strategies and their perceptions of effectiveness of these strategies. We conducted in-depth face-to-face interviews with 46 HIV/AIDS HCPs in Guangxi, China. The interviews were audio-recorded, transcribed and imported into NVivo V.11. Data were analyzed using a thematic approach. The analysis of the data revealed six general coping strategies: seeking social support, applying problem-solving strategies, adopting healthy lifestyle, developing self-compassion, using mindfulness-based stress reduction methods, and avoidance and escaping. It is imperative to increase institutional support and develop training programs to improve problem-solving skills, healthy lifestyle, and self-compassion among HIV/AIDS HCPs in China.

Challenges for accessing and maintaining good quality of HIV care among men who have sex with men living with HIV in China: a qualitative study with key stakeholders

HIV care in China is shifting toward a community-based model involving a wide range of stakeholders. We aimed to understand key stakeholders' perceived challenges of providing high-quality care for men who have sex with men (MSM) living with HIV. In-depth interviews were conducted with a diverse sample of stakeholders (N = 17) in two Chinese cities, including providers, policymakers, and community workers. Interviews focused on stakeholders' challenges in HIV-related work and perceived barriers for MSM in accessing and maintaining HIV care. Thematic analysis strategies were used. Three cross-cutting themes related to accessibility and quality of care (QoC) emerged. First, MSM- and HIV-related stigma were perceived to increase the risk of MSM dropping out of care. While acknowledging stigma, some providers also expressed discriminatory views such as stereotypes of the MSM community. Second, stakeholders expressed concerns about QoC including healthcare workforce shortages, limited training opportunities, and high work stress while facing increasingly unmet needs from clients. Third, stakeholders shared challenges in mobilizing community resources to expand HIV care including unclear division of responsibility and strict auditing. Supportive policies and resources may be needed to bolster China's primary care workforce and MSM-competent care and, more broadly, high QoC for sexual and gender minority patients.