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Saad RK, Khader Y, Aqel AJ, Satyanarayana S, Wilson N, Abaza H. HIV- related knowledge, attitude, practices, and stigma among healthcare providers caring for HIV in Jordan: Identification of several organizational challenges. Heliyon 2024; 10:e24423. [PMID: 38293408 PMCID: PMC10827484 DOI: 10.1016/j.heliyon.2024.e24423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/20/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024] Open
Abstract
Background There is a paucity of data on Healthcare Providers (HCPs) caring for people living with HIV in Jordan. Objective We aimed to understand HCPs' knowledge, attitude, stigma, and practices, to assess the gaps in HIV care in Jordan. Methods We conducted recorded in-depth interviews with all five HCPs working at the only HIV Service Center in Jordan, using semi-structured questions in 2021. Content analysis was performed. Results Several organizational challenges were identified. Only one had received HIV training. All were uncertain of updated recommendations with little knowledge of international guidelines, vertical transmission, contraception, sexually transmitted infections (STIs), non-communicable diseases (NCDs), and prophylaxis. Four HCPs perform counseling, focusing on easing anxieties, risk modification, and the importance of treatment adherence. However, their counseling on contraception, risk of transmission, STIs, and NCDs is inadequate, and they have little-to-no experience with prophylaxis. Most had a positive attitude towards people living with HIV, especially HCPs working at the center the longest, encouraging marriage and reproduction. Most do not approve of mandatory testing, or of breaching patient confidentiality. They repetitively described risky behavior as 'immoral behavior', empathizing more with patients who caught HIV through blood transfusion or birth, and demonstrating embedded stigmatized beliefs. They reported people living with HIV experience anticipated stigma and stigma by their general community including by other HCPs. Conclusion This is the first study on HCPs caring for people living with HIV in Jordan. It highlights the suboptimal knowledge, practices, and stigma which improve with greater participatory exposure to HIV care. HCPs had an overall positive attitude, more evident in HCPs working at the clinic the longest.
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Affiliation(s)
- Randa K. Saad
- Center of Excellence for Applied Epidemiology, Global Health Development, Eastern Mediterranean Public Health Network, Amman, Jordan
| | - Yousef Khader
- Department of Community Medicine, Public Health, and Family Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan
| | - Ashraf Jamil Aqel
- The Department of Sexually Transmitted Diseases, Jordan Ministry of Health, Jordan
| | | | - Nevin Wilson
- Migration Health Division, International Organization for Migration (IOM), Jordan
| | - Hiba Abaza
- Migration Health Division, International Organization for Migration (IOM), Jordan
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Ouzounakis P, Kourkouta L, Frantzana A, Iliadis C, Tsaloglidou A, Koukourikos K, Sialakis C, Alexopoulos E. Satisfaction of Patients with HIV/AIDS Infection from the Care Provided in the Special Infection Unit of University General Hospital of Alexandroupoli. Mater Sociomed 2023; 35:184-189. [PMID: 37795167 PMCID: PMC10545923 DOI: 10.5455/msm.2023.35.184-189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023] Open
Abstract
Background C HIV/AIDS infection is characterized by a very low number of T lymphocytes (CD4), which makes sufferers vulnerable to various infections, and so they seek continuous care in Special Infections Units. Objective The purpose of the survey is to investigate the factors that contribute to the satisfaction derived from the health services provided to people living with the human immunodeficiency virus; and they are monitored at the Special Infections Unit of the University General Hospital of Alexandroupoli. Methods All patients who came to the Special Infections Unit of the University General Hospital of Alexandroupoli during the period June - July 2021 were asked to complete an anonymous questionnaire on satisfaction derived from the health services provided (E - PQ - SPCSS) and satisfaction derived from their work and quality of life (Occupational Stress Questionnaire, JCQ). The statistical package SPSS 19.0 was used for the statistical analysis of the data. With the help of the ANOVA statistical test, the differences between the variables were checked. P-Value in all audits was set at 0.05. Values showing equal to or less than 0.05 were considered statistically significant. Results They were 85 patients who participated. Amongst them, they were mainly men (75.3%), the mean age was 35-50 years (50.6%), residents of Thrace (62.3%). 37.7% of the participants said they had some difficulty accessing SIU. Quality of life was positively correlated with education (p<0.001) where the higher reported level of education was, the higher satisfaction rates were. A positive correlation (p<0.001) was also observed amongst income rates where the higher incomes reported, the higher the satisfaction rates were. Lower incomes were significantly associated (p = 0.029) with mental disorders (anxiety, depression). Quality of life was positively associated with both satisfaction with medical as well as nursing care (p <0.008). The adequacy and clarity of the information the patients receive from SIU physicians during their visit shows a significant positive correlation (p<0.001). In addition, there is a significant correlation regarding the problems patients may have experienced in the last 6 months in terms of access to treatment (p<0.021). Conclusion Participants showed high satisfaction rates from the medical and nursing care provided at the SIU of the PGNA. The opportunity of expression given to users - patients through satisfaction studies promotes and creates a climate of trust between them and the decision-making teams of health units.
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Affiliation(s)
| | - Lambrini Kourkouta
- Nursing Department, International University of Greece, Thessaloniki, Greece
| | - Aikaterini Frantzana
- Department of Health Sciences, School of Sciences, European University Cyprus, General Hospital “G. Papanikolaou Thessaloniki, Greece
| | | | - Areti Tsaloglidou
- Nursing Department, International Hellenic University, Thessaloniki, Greece
| | | | - Christos Sialakis
- Trainee ENT GNTH "G. Gennimatas - Agios Dimitrios" Hospital, Thessaloniki, Greece
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El Ansari W, Arafa M, Elbardisi H, Majzoub A, Mahdi M, Albakr A, AlRumaihi K, Al Ansari A. Scoping review of sexual and reproductive healthcare for men in the MENA (Middle East and North Africa) region: a handful of paradoxes? BMC Public Health 2023; 23:564. [PMID: 36973770 PMCID: PMC10040932 DOI: 10.1186/s12889-022-14716-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/24/2022] [Indexed: 03/28/2023] Open
Abstract
Background No study appraised the knowledge gaps and factors impacting men’s sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task. Methods We searched PubMed and Web of Science (WoS) electronic databases for original articles on men’s SRH published from MENA. Data was extracted from the selected articles and mapped out employing the WHO framework for operationalising SRH. Analyses and data synthesis identified the factors impacting on men’s experiences of and access to SRH. Results A total of 98 articles met the inclusion criteria and were included in the analysis. The majority of studies focused on HIV and other sexually transmissible infections (67%); followed by comprehensive education and information (10%); contraception counselling/provision (9%); sexual function and psychosexual counselling (5%); fertility care (8%); and gender-based violence prevention, support/care (1%). There were no studies on antenatal/intrapartum/postnatal care and on safe abortion care (0% for both). Conceptually, there was lack of knowledge of the different domains of men’s SRH, with negative attitudes, and many misconceptions; as well as a deficiency of health system policies, strategies and interventions for SRH. Conclusion Men’s SRH is not sufficiently prioritized. We observed five ‘paradoxes’: strong focus on HIV/AIDS, when MENA has low prevalence of HIV; weak focus on both fertility and sexual dysfunctions, despite their high prevalence in MENA; no publications on men’s involvement in sexual gender-based violence, despite its frequency across MENA; no studies of men’s involvement in antenatal/intrapartum/postnatal care, despite the international literature valuing such involvement; and, many studies identifying lack of SRH knowledge, but no publications on policies and strategies addressing such shortcoming. These ‘mismatches’ suggest the necessity for efforts to enhance the education of the general population and healthcare workers, as well as improvements across MENA health systems, with future research examining their effects on men’s SRH. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14716-2.
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Affiliation(s)
- Walid El Ansari
- grid.413548.f0000 0004 0571 546XDepartment of Surgery, Hamad Medical Corporation, Doha, Qatar
- grid.412603.20000 0004 0634 1084College of Medicine, Qatar University, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
| | - Mohamed Arafa
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
- grid.7776.10000 0004 0639 9286Andrology Department, Cairo University, Cairo, Egypt
| | - Haitham Elbardisi
- grid.412603.20000 0004 0634 1084College of Medicine, Qatar University, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Majzoub
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Mahdi
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Albakr
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Khalid AlRumaihi
- grid.412603.20000 0004 0634 1084College of Medicine, Qatar University, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
| | - Abdulla Al Ansari
- grid.413548.f0000 0004 0571 546XDepartment of Surgery, Hamad Medical Corporation, Doha, Qatar
- grid.416973.e0000 0004 0582 4340Weill Cornell Medicine – Qatar, Doha, Qatar
- grid.413548.f0000 0004 0571 546XUrology Department, Hamad Medical Corporation, Doha, Qatar
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Plahuta A, Skrt S, Jazbec J, Ličen S. Odnos in pripravljenost zaposlenih v zdravstveni negi za oskrbo pacientov s HIV/AIDS-om. OBZORNIK ZDRAVSTVENE NEGE 2023. [DOI: 10.14528/snr.2023.57.1.3111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
Uvod: Medicinske sestre predstavljajo rizični del prebivalstva, saj se neposredno srečujejo s telesnimi tekočinami pacientov, okuženih z virusom HIV ali obolelimi z AIDS-om. Namen raziskave je bil ugotoviti, kakšen je profesionalni in afektivni odnos zaposlenih v zdravstveni negi do pacientov, okuženih z virusom HIV ali obolelih z AIDS-om.Metode: V opisni neeksperimentalni kvantitativni raziskavi je bil uporabljen v slovenščino preveden vprašalnik Lestvica odnosa do obolelih z AIDS-om (Cronbach α = 0,732). Sodelovalo je 164 zaposlenih v zdravstveni negi iz slovenskih zdravstvenih ustanov. Zbiranje podatkov je potekalo s spletnim vprašalnikom od novembra 2020 do januarja 2021. Podatki so bili analizirani z deskriptivno statistiko, Mann-Whitneyjevim U-testom in Kruskal-Wallisovim testom. Upoštevana je bila stopnja statistične značilnosti (p < 0,05).Rezultati: Zaposleni v zdravstveni negi izražajo pozitiven profesionalni in afektivni odnos do pacientov okuženih z virusom HIV ali obolelih z AIDS-om. Pozitivnejši odnos izražajo moški, zaposleni z visokošolsko izobrazbo ali magisterijem in zaposleni z delovno dobo od pet do petnajst let. Pri omenjenih spremenljivkah razlike v odnosih niso bile statistično značilne (p > 0,05).Diskusija in zaključek: Iz rezultatov raziskav povzemamo, da medicinske sestre v Sloveniji ne izražajo izrazito pozitivnega ali negativnega odnosa do oseb, okuženih z virusom HIV ali obolelih z AIDS-om, in so jim pripravljene nuditi holistično zdravstveno nego. V prihodnje bi si želeli raziskovanje osrediniti v merjenje splošnega znanja o HIV/AIDS-u med zaposlenimi in ugotoviti, koliko vpliva znanje na odnos zaposlenih do obolelih.
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Liao Y, Liu X, Huang J, Chen Q, Li N, Zhou P. Insulin injection knowledge, attitude and behaviour of nurses: A cross-sectional study in Guangdong Province. Nurs Open 2023; 10:3754-3765. [PMID: 36808890 PMCID: PMC10170902 DOI: 10.1002/nop2.1633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 12/07/2022] [Accepted: 01/13/2023] [Indexed: 02/20/2023] Open
Abstract
AIM To understand the insulin injection knowledge, attitude and behaviour of nurses and their influencing factors in Guangdong Province. DESIGN Cross-sectional study. METHODS A total of 19,853 nurses from 82 hospitals in 15 cities in Guangdong, China, participated in this study. The scores of the nurses' insulin injection knowledge, attitude and behaviour were determined through a questionnaire, and multivariate regression analysis was used to evaluate the influencing factors of insulin injection in different dimensions. STROBE. RESULTS Among all nurses involved in this study, 22.3% of nurses had good knowledge, 75.9% of nurses had good attitude and 92.7% of nurses had good behaviour. Pearson's correlation analysis showed that knowledge, attitude scores and behaviour scores were significantly correlated. The influencing factors of knowledge, attitude and behaviour included gender, age, education, nurse level, work experience, type of ward, diabetes nursing certification, position held and most recent insulin administration.
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Affiliation(s)
- Yangyang Liao
- School of Nursing, Jinan University, Guangzhou, China
| | - Xueyan Liu
- Department of Endocrine Metabolism, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiewei Huang
- School of Nursing, Jinan University, Guangzhou, China.,Nursing Department, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Qingling Chen
- Department of Endocrine Metabolism, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ningning Li
- School of Nursing, Jinan University, Guangzhou, China
| | - Peiru Zhou
- School of Nursing, Jinan University, Guangzhou, China.,Department of Health Management, The Fifth Affiliated Hospital of Jinan University, Heyuan, China
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Ali Abdulai M, E.F Mevissen F, Kramer A, Boitelet Z, Poku Asante K, Owusu-Agyei S, Ruiter RA, E.R Bos A. A qualitative analysis of factors influencing healthcare providers’ behaviour toward persons living with HIV in Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2023. [DOI: 10.1016/j.ijans.2023.100532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Mizuki K, Ishimaru T, Imahashi M, Ikushima Y, Takahashi H, Masuda M, Yokomaku Y. Workplace factors associated with willingness to undergo human immunodeficiency virus testing during workplace health checkups. Environ Health Prev Med 2023; 28:52. [PMID: 37743522 PMCID: PMC10519800 DOI: 10.1265/ehpm.23-00054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/28/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND To examine workplace factors associated with willingness to undergo human immunodeficiency virus (HIV) testing during workplace health checkups. METHODS This cross-sectional study used an Internet-based self-administered questionnaire to obtain data from a pool of 24,287 Japanese workers. Binary and multiple logistic regression analyses evaluated the association between workplace factors and HIV testing. Data were adjusted for sex, age, marital status, education, and history of HIV testing. RESULTS We gathered information from 4,143 (17.1%) respondents, of whom 1,129 (27.3%) were willing to be tested for HIV as part of a workplace health checkup. The participants were 20-59 years old. Approximately half of the participants were male (49.9%), half were married (48.9%), and half had completed higher education (47.6%). Workplace hepatitis testing was offered to 15.6% of the respondents, and most participants underwent health checkups without their colleagues (52.1%) at a medical facility (60.2%). Willingness to undergo HIV testing was positively correlated with having an increased risk of occupational blood exposure (vs. not at risk, adjusted odds ratio [OR]: 1.74, 95% confidence interval [CI]: 1.41-2.15) or working in medical and welfare roles (vs. manufacturing, OR: 1.40, 95% CI: 1.07-1.84). The presence of occupational health staff at the workplace (vs. their absence, adjusted OR: 1.35, 95% CI: 1.16-1.59) and hepatitis testing (vs. not testing, adjusted OR: 2.02, 95% CI: 1.66-2.44) increased willingness to undergo HIV testing. CONCLUSIONS A pilot HIV-testing program involving individuals at an increased risk of occupational blood exposure and undergoing hepatitis tests in workplaces providing occupational health staff support is recommended.
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Affiliation(s)
- Kazuyoshi Mizuki
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Tomohiro Ishimaru
- Department of Medical Humanities, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Mayumi Imahashi
- Department of Infectious Diseases & Immunology, Clinical Research Center, Nagoya Medical Center, Nagoya, Japan
| | | | | | - Masashi Masuda
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
| | - Yoshiyuki Yokomaku
- Department of Infectious Diseases & Immunology, Clinical Research Center, Nagoya Medical Center, Nagoya, Japan
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Alenezi A. Stigmatization and discrimination towards human immunodeficiency virus seropositive patients in psychiatric and mental health facilities. Int J Ment Health Nurs 2022; 31:1198-1212. [PMID: 35678330 DOI: 10.1111/inm.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 11/28/2022]
Abstract
Stigmatization and discriminatory attitudes of nurses towards human immunodeficiency (HIV) patients have been reported in many countries. The current study was undertaken to assess the knowledge, attitudes and factors associated with stigmatizing attitudes and discrimination among psychiatric and mental health nurses and nurse interns towards patients diagnosed with the human immunodeficiency virus; utilizing a single-centre hospital-based survey design. Primary data were collected using a previously validated questionnaire in a large mental health care hospital in Riyadh, Saudi Arabia. Knowledge, attitudes, acts of discrimination and associated factors on the part of mental health nurses towards those diagnosed with the HIV were identified. The study described herein is in accordance with the STROBE guideline. A total of 241 psychiatric and mental health nurses completed the questionnaire, yielding a completion rate of 74.4%. Overall, more than half of the nurses demonstrated gaps in knowledge and reported higher stigmatizing attitudes and acts of discrimination. Factors associated with stigmatization and/or discrimination include higher exposure to seropositive patients, no formal HIV training, lower religiousness, lower awareness of HIV testing policy and lower level of knowledge about HIV infection. There is an urgent need to implement a training program that will help to reduce stigma among nurses caring for people diagnosed with this illness.
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Affiliation(s)
- Atallah Alenezi
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
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Galal YS, Khairy WA, Mohamed R, Esmat G, Negm M, Alaty WHA, Saeed MA, Fouad R, Elzahaby AA, Zaky S, Sakr MA, Cordie A. HIV-related stigma and discrimination by healthcare workers in Egypt. Trans R Soc Trop Med Hyg 2022; 116:636-644. [DOI: 10.1093/trstmh/trab188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/27/2021] [Accepted: 12/17/2021] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
HIV-related stigma and discrimination (SAD) have imposed serious adverse health consequences on people living with HIV (PLHIV), including limited access to medical care and delayed diagnosis, which in turn limits the prevention and control of the disease. This study was conducted to explore the stigmatizing attitudes and behaviors of healthcare workers (HCWs) towards HIV patients and PLHIV.
Methods
A cross-sectional study targeted HCWs who attended the United Conference of Hepatogastroenterology and Infectious Diseases that was held on 25–28 September 2019 in Cairo governorate. A self-administrated questionnaire was completed by 359 HCWs.
Results
The majority of HCWs reported some discriminatory practices when rendering care to HIV patients, with nurses showing the highest significant number of discriminatory practices. A considerable proportion of HCWs reported witnessing HIV-related SAD at their health facilities.
Conclusions
HIV-related SAD was prevalent among HCWs. Hence, HIV-related training relevant to the needs of different groups of HCWs is recommended. Provision of infection control supplies to protect against occupational exposure is also needed. The setting and enforcement of anti-stigma policies and guidelines in various healthcare settings are crucial.
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Affiliation(s)
- Yasmine Samir Galal
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Walaa Ahmed Khairy
- Public Health and Community Medicine Department, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Rahma Mohamed
- Endemic Medicine Department, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Gamal Esmat
- Endemic Medicine Department, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Mohamed Negm
- Kasr Al Ainy Viral Hepatitis Center, Cairo University , Cairo, Egypt
| | | | - Maysaa A Saeed
- Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Zagazig University , Cairo, Egypt
| | - Rabab Fouad
- Endemic Medicine Department, Faculty of Medicine, Cairo University , Cairo, Egypt
| | - Amgad Ali Elzahaby
- Hepato-Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University , Cairo, Egypt
| | - Samy Zaky
- Hepato-Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University , Cairo, Egypt
| | - Mohamed A Sakr
- Tropical Medicine Department, Faculty of Medicine, AinShams University , Cairo, Egypt
| | - Ahmed Cordie
- Endemic Medicine Department, Faculty of Medicine, Cairo University , Cairo, Egypt
- Infectious Diseases Department, Armed Forces College of Medicine , Cairo, Egypt
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HIV Knowledge and Stigmatizing Attitude towards People Living with HIV/AIDS among Medical Students in Jordan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020745. [PMID: 35055566 PMCID: PMC8775845 DOI: 10.3390/ijerph19020745] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/08/2022] [Accepted: 01/09/2022] [Indexed: 02/01/2023]
Abstract
The stigmatizing attitude towards people living with HIV/AIDS (PLWHA) can be a major barrier to effective patient care. As future physicians, medical students represent a core group that should be targeted with focused knowledge and adequate training to provide patient care without prejudice. The aim of the current study was to examine HIV/AIDS knowledge, and the stigmatizing attitude towards PLWHA, among medical students in Jordan. The current study was based on a self-administered online questionnaire, which was distributed during March–May 2021, involving students at the six medical schools in Jordan, with items assessing demographics, HIV/AIDS knowledge, and HIV/AIDS stigmatizing attitude, which was evaluated using the validated HIV-stigma scale. The total number of respondents was 1362, with predominance of females (n = 780, 57.3%). Lack of HIV/AIDS knowledge among the study participants was notable for the following items: HIV transmission through breastfeeding (40.8% correct responses), HIV is not transmitted through saliva (42.6% correct responses), and vertical transmission of HIV can be prevented (48.8% correct responses). Approximately two-thirds of the respondents displayed a positive attitude towards PLWHA. For six out of the 14 HIV/AIDS knowledge items, lack of knowledge was significantly correlated with a more negative attitude towards PLWHA. Multinomial regression analysis showed that a significantly more negative attitude towards PLWHA was found among the pre-clinical students compared to the clinical students (odds ratio (OR): 0.65, 95% confidence interval (CI): 0.43–0.97, p = 0.036); and that affiliation to medical schools that were founded before 2000 was associated with a more positive attitude towards PLWHA compared to affiliation to recently founded medical schools in the country (OR: 1.85, 95% CI: 1.42–2.42, p < 0.001). About one-third of medical students who participated in the study displayed a negative attitude towards PLWHA. Defects in HIV/AIDS knowledge were detected for aspects involving HIV transmission and prevention, and such defects were correlated with a more negative attitude towards PLWHA. It is recommended to revise the current medical training curricula, and to tailor improvements in the overall HIV/AIDS knowledge, which can be reflected in a more positive attitude towards PLWHA, particularly for the recently established medical schools in the country.
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OUP accepted manuscript. Trans R Soc Trop Med Hyg 2022; 116:868-873. [DOI: 10.1093/trstmh/trac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/22/2021] [Accepted: 03/22/2022] [Indexed: 11/14/2022] Open
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Mulyani S, Suti Lasmani P, David Saifullah A, Fawadya A, Iffah A, Pramestya S. The Attitudes of Nurses in the Hospital toward Vulnerable People. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Vulnerable people are at higher risk for ill health and often experience discrimination in health services. Persons with disabilities, People with Dementia (PWD), and People with HIV/AIDS (PLWHA) are some groups of people with vulnerabilities who often need hospital care. Nurses are the largest group of health personnel and frequently meet with these patients so that the attitude of nurses can have a consequence on the quality of health care.
Research Objectives: To identify nurses' attitudes towards vulnerable people and factors related to their attitudes.
Methods: This quantitative research used a cross-sectional design. The research subjects were 386 nurses in the main public Dr. Sardjito hospital selected using a convenience sampling technique. Data were collected in January-February 2021 with a Google Form. Researchers used a demographic data questionnaire, an attitude questionnaire (Attitude Toward Disabled Person Scale Form O, Dementia Attitude Scale, and AIDS Attitude Scale), and a knowledge questionnaire (Self-Administered Questionnaire about Knowledge), Dementia Knowledge Assessment Scale, and HIV-Knowledge Questionnaire-18). Data were analyzed using non-parametric statistical tests, specifically the Spearman rank, Mann-Whitney, and Kruskal-Wallis tests.
Results: The score of nurses' attitudes towards persons with disabilities was 54.00 out of 120; the score of nurses' attitudes to PWD was 102.00 out of 140; and the score of nurses' attitudes toward PLWHA was -0.65 out of +5. Knowledge, history of interaction, and experience in caring have a significant effect on nurses' attitudes towards vulnerable people (p value <0.05). The education level only affects the attitudes of nurses towards persons with disabilities (p value = 0.042). Family history only affects nurses' attitudes to PWD (p value = 0.013). Age and special education/training only affect the attitudes of nurses on PWD and PLWHA (p value <0.05).
Conclusion: Nurses tend to present positive attitudes toward PWD, but nurses are inclined to show negative attitudes against people with disabilities and PLWHA. Knowledge, caring experience, and interaction are confirmed to have an effect on nurses' attitudes with the result that programs to increase knowledge and experience of nurses towards vulnerable groups are recommended for this group.
Keywords: Attitude, Dementia, Disability, HIV/AIDS, Knowledge, Nurse.
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Sources of Care Stress of Nursing Staff for Patients with Infectious Diseases during the Prevalence of COVID-19: A Case Study of Some Regional Teaching Hospitals in Southern Taiwan. Healthcare (Basel) 2021; 9:healthcare9040462. [PMID: 33919871 PMCID: PMC8070816 DOI: 10.3390/healthcare9040462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: The COVID-19 epidemic had caused more than 100 million confirmed cases worldwide by the end of January 2021. The focus of this study was to explore which stress was felt the most by nursing staff in isolation wards in the face of dangerous infectious diseases. (2) Methods: Nursing staff in negative pressure isolation wards were taken as the research objects. The sources of stress were divided into 14 items in three categories, namely, patient care, infection protection, and support system, and the questionnaire results were ranked by a Gaussian curve. (3) Results: Even during the COVID-19 epidemic, nurses in isolation wards still consider that the clinical symptoms of patients in isolation wards cannot be closely tracked as the primary consideration. (4) Conclusions: During the epidemic period, the ability and confidence of nursing staff were strengthened through education and training, and their chances of infection were reduced through comprehensive vaccination and the improvement of protective equipment. In the face of the unstable mood of patients and their families due to isolation, more protective measures should be prepared for nursing staff. In order to relieve the stress, supervisors can adjust the nursing manpower timely according to the difficulty and risk of patient care to reduce the care stress.
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14
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Cruz MLS, Darmont MDQR, Monteiro SS. HIV-related stigma among young people living with HIV transitioning to an adult clinic in a public hospital in Rio de Janeiro, Brazil. CIENCIA & SAUDE COLETIVA 2021; 26:2653-2662. [PMID: 34231678 DOI: 10.1590/1413-81232021267.07422021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 03/31/2021] [Indexed: 11/21/2022] Open
Abstract
This study analyzes how experiences of HIV-related stigma are expressed among HIV-positive young people transitioning to an adult clinic, the health service, the family, the affective-sexual interactions, and their relationship with inequalities and social hierarchies. This research included 31 young people (median age 21) transitioning to an adult clinic (G1) and 12 young people (median age 30) who had already made this transition (G2), both monitored at a health service in Rio de Janeiro. Seventy percent of the 43 young people were women and 65% were infected by mother-to-child transmission. Young people answered questionnaires and participated in focus groups on AIDS stigma and transition to adulthood. Most reported discrimination associated with HIV stigma in daily life and health care. G1 young people showed more significant concern about the consequences of HIV disclosure and difficulties with treatment. The G2 accounts suggest that establishing marital relationships, including HIV-negative partners and children, linked to treatment access allowed resignifying the fear of stigmatization. The findings aim to guide the training and action of professionals involved in the prevention and care of young people living with HIV.
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Affiliation(s)
- Maria Letícia Santos Cruz
- Hospital Federal dos Servidores do Estado. R. Sacadura Cabral 178, Saúde. 20221-903 Rio de Janeiro RJ Brasil.
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Algaralleh A, Altwalbeh D, Al-Tarawneh F. Health-Related Quality of Life Among Persons Living with HIV/AIDS in Jordan: An Exploratory Study. HIV AIDS (Auckl) 2020; 12:897-907. [PMID: 33335429 PMCID: PMC7737933 DOI: 10.2147/hiv.s277941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/18/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Diagnosis of HIV/AIDS infection can have adverse effects on the individual and may affect health-related quality of life (HRQoL). Numerous studies have previously assessed the HRQoL of persons living with HIV/AIDS (PLWHA) globally, but not in Jordan. The aim of the current study is to examine HRQoL among PLWHA residing in Jordan and to evaluate the effect of socio-demographic and disease-related factors on HRQoL. METHODOLOGY An exploratory approach employing a cross-sectional design was applied. The study applied a semi-structured face-to-face interview followed by administration of self-reported questionnaire using the World Health Organization's Quality of Life HIV brief questionnaire (WHOQOL-HIV-BREF). RESULTS Results showed that unemployment, low income, non-disclosure status, single status (separated, divorced or widowed), and having comorbidities were connected with poor HRQoL. CONCLUSION PLWHA require more than just being provided with antiretroviral therapy to rebuild their lives.
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Affiliation(s)
- Abdulnaser Algaralleh
- Department of Counseling and Special Education, Faculty of Educational Sciences, Mutah University, Mutah, Jordan
| | - Diala Altwalbeh
- Department of Allied Medical Sciences, Faculty of Karak, Al-Balqa Applied University, Karak, Jordan
| | - Fatima Al-Tarawneh
- Department of Allied Medical Sciences, Faculty of Karak, Al-Balqa Applied University, Karak, Jordan
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Abstract
The COVID-19 emergency has significantly transformed the working environment and job demands. Providing care was emotionally difficult for healthcare workers. Uncertainty, stigmatisation, and potentially exposing their families to infection were prominent themes for healthcare workers (HCWs) during the crisis, which first broke out in China at the end of 2019, and then in Italy in early 2020. This study examined the effects of stigma, job demands, and self-esteem, and the consequences of working as a “frontline care provider” with patients infected with the coronavirus (COVID-19). A correlational design study involved 260 healthcare workers (HCWs) working in a large hospital in southern Italy. The following questionnaires were administered: (1) the Job Content Questionnaire (JCQ), for assessing psychological and physical demands; (2) the Professional Quality of Life Scale (ProQOL) to measure the quality individuals feel in relation to their work as “frontline care providers”, through three dimensions: compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS); (3) the Rosenberg Self-Esteem Scale, for evaluating individual self-esteem; (4) a self-administered multiple-choice questionnaire developed by See et al. about attitudes of discrimination, acceptance, and fear towards HCWs exposed to COVID-19. The findings suggest that stigma has a high impact on workers’ outcomes. Stigma may influence worker compliance and can guide management communication strategies relating to pandemic risk for HCWs.
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Shah S, Elgalib A, Al-Wahaibi A, Al-Fori M, Raju P, Al-Skaiti M, Al-Mashani HN, Duthade K, Omaar I, Muqeetullah M, Mitra N, Shah P, Amin M, Morkos E, Vaidya V, Al-Habsi Z, Al-Abaidani I, Al-Abri SS. Knowledge, Attitudes and Practices Related to HIV Stigma and Discrimination Among Healthcare Workers in Oman. Sultan Qaboos Univ Med J 2020; 20:e29-e36. [PMID: 32190367 DOI: 10.18295/squmj.2020.20.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/07/2019] [Accepted: 10/07/2019] [Indexed: 11/16/2022] Open
Abstract
Objectives Stigma and discrimination undermine the quality of life of people with HIV and their access to health services. This study aimed to assess HIV-related knowledge, attitudes and practices among healthcare workers (HCWs) in Oman. Methods This cross-sectional study took place between July and November 2016. A questionnaire was distributed to 1,400 government HCWs to determine HIV-related knowledge, attitudes and practices. Results A total of 1,281 HCWs participated (response rate = 92%). Routine tasks, such as dressing wounds, drawing blood and touching clothes, were a cause of concern for 24-52% of HCWs. Only 69% correctly answered questions regarding the transmission of HIV via eating/drinking and mosquito bites. Compared to other HCWs, doctors had significantly higher knowledge (mean = 0.46, 95% confidence interval [CI]: 0.19 to 0.73; P <0.001), attitude (mean = 0.77, 95% CI: 0.31 to 1.24; P = 0.001) and practice (mean = 2.07, 95% CI: 1.59 to 2.55; P <0.001) scores. Expatriates also scored significantly higher in knowledge (mean = 1.08, 95% CI: 0.93 to 1.23; P <0.001), attitude (mean = 1.23, 95% CI: 0.98 to 1.48; P <0.001) and practice (mean = 1.08, 95% CI: 0.82 to 1.34; P <0.001) compared to Omani nationals. Finally, those with >15 years' work experience scored significantly higher on knowledge (mean = -0.60, 95% CI: -1.12 to -0.08; P = 0.025) and attitude (mean = -0.99, 95% CI: -1.87 to -0.10; P = 0.029) compared to those with less experience. Conclusion The high rate of HIV-related stigma among HCWs in Oman should be rectified in order to achieve the 90-90-90 target set by the Joint United Nations Programme on HIV/AIDS.
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Affiliation(s)
- Samir Shah
- Department of Communicable Diseases, Ministry of Health, Oman
| | - Ali Elgalib
- Department of Communicable Diseases, Ministry of Health, Oman
| | - Adil Al-Wahaibi
- Directorate General for Disease Surveillance & Control, Ministry of Health, Oman
| | - Maha Al-Fori
- Department of Communicable Diseases, Ministry of Health, Oman
| | - Prasanna Raju
- Department of Communicable Diseases, Ministry of Health, Oman
| | | | | | - Kishor Duthade
- Directorate General of Health Services, Ministry of Health, Oman
| | - Iyad Omaar
- Directorate General of Health Services, Ministry of Health, Oman
| | | | - Nilanjan Mitra
- Directorate General of Health Services, Ministry of Health, Oman
| | - Parag Shah
- Directorate General of Health Services, Ministry of Health, Oman
| | - Mohammed Amin
- Directorate General of Health Services, Ministry of Health, Oman
| | - Essam Morkos
- Directorate General of Health Services, Ministry of Health, Oman
| | - Vidyanand Vaidya
- Directorate General of Health Services, Ministry of Health, Oman
| | - Zeyana Al-Habsi
- Department of Communicable Diseases, Ministry of Health, Oman
| | | | - Seif S Al-Abri
- Directorate General for Disease Surveillance & Control, Ministry of Health, Oman
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18
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Improvisation and harm avoidance: An ethnographic study of adherence to postnatal care protocols in two hospitals in Southern Ghana. Midwifery 2019; 82:102576. [PMID: 31869728 DOI: 10.1016/j.midw.2019.102576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 10/30/2019] [Accepted: 11/16/2019] [Indexed: 11/22/2022]
Abstract
Providers' adherence to case management protocols can affect quality of care. However, how and why protocols are adhered to by frontline health workers in low- and middle-income countries is not always clear. This study explored midwives' adherence to national postnatal care protocols in two public hospitals in Southern Ghana using an ethnographic study design. Ninety participant observations and 88 conversations were conducted over a 20-months period, and two group interviews held with the midwives in the two hospitals. Data was analysed using a grounded theory approach. Findings: Midwives collectively decided when to adhere, modify or totally ignore postnatal care protocols. Adherence often occurred if required resources (equipment, tools, supplies) were available. Modification occurred when midwives felt that strict adherence could have negative implications for patients and they could be seen as acting 'unprofessionally'. Ignoring or modifying protocols also occurred when midwives were uncertain of the patient's health condition; basic supplies, logistics and infrastructure needed for adherence were unavailable or inappropriate; or midwives felt they might expose themselves or their clients to physical, psychological, emotional, financial or social harm. Regardless of the reasons that midwives felt justified to ignore or modify postnatal care protocols, it appeared in many instances to lead to the provision of care of suboptimal quality. Conclusion and recommendations: Providing clinical decision-making protocols is not enough to improve mother and new born care quality and outcomes. Faced with constraining conditions of work, providers are likely to modify guidelines as part of coping behaviour. Addressing constraining conditions of work must accompany guidelines. This includes adequate risks protection for health workers and clients; and resolution of deficits in essential equipment, infrastructure, supplies and staffing.
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Mumtaz GR, Hilmi N, Majed EZ, Abu-Raddad LJ. Characterising HIV/AIDS knowledge and attitudes in the Middle East and North Africa: Systematic review and data synthesis. Glob Public Health 2019; 15:275-298. [PMID: 31558094 DOI: 10.1080/17441692.2019.1668452] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This article reviews HIV/AIDS knowledge and attitudes in various population groups in the Middle East and North Africa (MENA), and highlights their relevance to HIV epidemiology and the design and implementation of preventions and treatment efforts. PubMed and the MENA HIV/AIDS Epidemiology Synthesis Project database of grey/unpublished literature were searched. Levels of knowledge were categorised based on presence of basic knowledge, comprehensive knowledge, and misconceptions and misinformation. Attitudes towards people living with HIV/AIDS (PLHIV) were classified into positive or negative. Basic knowledge was overall high among key populations at higher risk of infection (KPAR), and bridging and general population groups, but still a few population pockets had low basic knowledge. Level of comprehensive knowledge was overall low, and misinformation and misconceptions were prevalent. Some KPAR, including people who inject drugs, men who have sex with men, and female sex workers, were unaware of some modes of HIV transmission. Perception of risk of infection was low even among KPAR. We found differentials in knowledge putting women, rural populations, refugees, and other marginalised minorities at a disadvantage. Attitudes towards PLHIV tended to be negative. These findings are of concern, particularly for KPAR currently experiencing emerging HIV epidemics.
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Affiliation(s)
- Ghina R Mumtaz
- Department of Epidemiology and population Health, American University of Beirut, Beirut, Lebanon.,Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Nahla Hilmi
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - El Zahraa Majed
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
| | - Laith J Abu-Raddad
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.,Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, New York, USA.,College of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
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20
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Reyes-Estrada M, Varas-Díaz N, Parker R, Padilla M, Rodríguez-Madera S. Religion and HIV-Related Stigma among Nurses Who Work with People Living with HIV/AIDS in Puerto Rico. J Int Assoc Provid AIDS Care 2019; 17:2325958218773365. [PMID: 29756551 PMCID: PMC6748485 DOI: 10.1177/2325958218773365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
HIV-related stigma among nurses can impact health care services for people with HIV/AIDS (PWHA). health care professionals' religious views can potentially foster stigmatizing attitudes. There is scarce scientific literature exploring the role of religion on HIV/AIDS stigma among nurses. This study aimed to explore the role of religion in the stigmatization of PWHA by nurses in Puerto Rico. We conducted an exploratory study using qualitative techniques. We conducted 40 in-depth interviews with nurses who provided services to PWHA. Three main factors emerged in the analysis as contributors to HIV/AIDS stigmatization: (1) nurses' personal religious experiences, (2) religion as a rationale for HIV-related stigma, and (3) religious practices during health care delivery. The results show that religious beliefs play a role in how nurses understood HIV/AIDS and provided service. Results point toward the need for interventions that address personal religious beliefs while reducing HIV/AIDS stigma among nurses.
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Affiliation(s)
- Marcos Reyes-Estrada
- 1 School of Behavioral and Brain Sciences in Ponce, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Nelson Varas-Díaz
- 2 Department of Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | - Richard Parker
- 3 Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Mark Padilla
- 2 Department of Global and Sociocultural Studies, Florida International University, Miami, FL, USA
| | - Sheilla Rodríguez-Madera
- 4 Department of Social Sciences, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
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Kabbash IA, Abo Ali EA, Elgendy MM, Abdrabo MM, Salem HM, Gouda MR, Elbasiony YS, Elboshy N, Hamed M. HIV/AIDS-related stigma and discrimination among health care workers at Tanta University Hospitals, Egypt. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:30755-30762. [PMID: 27752955 DOI: 10.1007/s11356-016-7848-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/04/2016] [Indexed: 06/06/2023]
Abstract
HIV/AIDS-related stigma and discrimination among health care professionals is one of the most important factors of this disease expansion. This study aimed to assess the stigmatized attitude among health care providers toward people living with HIV (PLHIV) at Tanta University Hospitals. The study is a cross-sectional survey. Data was gathered from randomly selected 310 health care workers at Tanta University Hospital using a structured questionnaire. Among studied participants, only 24.0 % had previous contact with HIV patients during work and 21.3 % felt worried to touch cloths of HIV patients, 26.4 % were worried to dress the wounds of HIV patients and 27.4 % were afraid to get blood sample from HIV patients. Those who were unwilling to care for HIV patients represented 40 % and only 36 % reported that if discriminating against HIV patients, they may get in trouble. Less than one half (42 %) reported having enough supply for reducing risk of nosocomial infection with HIV and 86 % reported having no guidelines to deal with HIV patients. Out of the participants, 78.7 % reported that HIV patients should be ashamed of themselves. Among the participants, 35, 48, and 43 % preferred not to provide medical services to injecting drug users, men having sex with men and sex workers suspected to have HIV infection, respectively. Infection control is defective in the supplies and procedures. There is absence of policy and protocols with regard to dealing with PLHIV. Health care providers showed high levels of stigma and discrimination against PLHIV.
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Affiliation(s)
- Ibrahim Ali Kabbash
- Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ehab A Abo Ali
- Department of Public Health and Community Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt.
| | | | | | | | | | | | - Nader Elboshy
- Students in Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohammed Hamed
- Students in Faculty of Medicine, Tanta University, Tanta, Egypt
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22
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Onadeko MO, Balogun MO, Onigbogi OO, Omokhodion FO. Occupational exposure, attitude to HIV-positive patients and uptake of HIV counselling and testing among health care workers in a tertiary hospital in Nigeria. SAHARA J 2018; 14:193-201. [PMID: 29132270 PMCID: PMC5700496 DOI: 10.1080/17290376.2017.1398104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Health care workers (HCWs) are at risk of occupational exposure to HIV. Their attitude to HIV-positive patients influences patients' willingness and ability to access quality care. HIV counselling and testing (HCT) services are available to inform HCWs and patients about their status. There is little information about HCT uptake and attitude to HIV-positive patients among HCWs in tertiary health facilities in Nigeria. The aim of this study was to determine occupational exposure and attitude to HIV-positive patients and level of uptake of HCT services among HCWs in a tertiary hospital in Nigeria. A cross-sectional design was utilized. A total of 977 HCWs were surveyed using semi-structured, self-administered questionnaires. Nurses and doctors comprised 78.2% of the respondents. Their mean age was 35 ± 8.4 years. Almost half, 47.0%, reported accidental exposure to blood and body fluids (BBFs) in the preceding year. The main predictor of accidental exposure to BBFs in the last year was working in a surgical department, OR = 1.7, 95% CI (1.1-2.6). HCWs aged <40 years, OR = 5.5, 95% CI (1.9-15.9), who had worked for >5 years, OR = 3.6, 95% CI (1.4-9.3) and who work in nursing department, OR = 6.8, 95% CI (1.7-27.1) were more likely to be exposed to BBFs. Almost half, 52.9%, had accessed HCT services. Predictors for HCT uptake were age <40 years OR = 1.6, 95% CI (1.1-2.4), having worked for >5 years OR = 1.5, 95% CI (1.03-2.2) and working in medical department OR = 1.7, 95% CI (1.1-2.8). Respondents in nursing departments were more likely to require routine HIV test for all patients, OR = 3.9, 95% CI (2.4-6.2). HCWs in the laboratory departments were more likely to believe that HIV patients should be on separate wards, OR = 3.6, 95% CI (1.9-7.0). HCWs should be protected and encouraged to access HCT services in order to be effective role models in the prevention of HIV/AIDS.
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Affiliation(s)
- Modupe O Onadeko
- a FWACP, MPH, MD, Professor of Community Medicine, Department of Community Medicine , University College Hospital Ibadan , Ibadan , Oyo State , Nigeria
| | - Mary O Balogun
- b MBBS, MPH, FWACP, DOccMed, Lecturer and Consultant Community Physician, Department of Community Medicine , University College Hospital Ibadan , Ibadan , Oyo State , Nigeria
| | - Olanrewaju O Onigbogi
- c MBBS, MPH, FMCPH, Lecturer and Consultant Community Physician, Department of Community Health and Primary Care, College of Medicine , University of Lagos , Lagos State , Nigeria
| | - Folashade O Omokhodion
- d MBBS, MSc, PhD, FWACP, FFOM, FFPH, Professor and Consultant Community Physician, Department of Community Medicine , University College Hospital Ibadan , Ibadan , Oyo State , Nigeria
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Dong X, Yang J, Peng L, Pang M, Zhang J, Zhang Z, Rao J, Wang H, Chen X. HIV-related stigma and discrimination amongst healthcare providers in Guangzhou, China. BMC Public Health 2018; 18:738. [PMID: 29902990 PMCID: PMC6003171 DOI: 10.1186/s12889-018-5654-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 06/01/2018] [Indexed: 12/03/2022] Open
Abstract
Background HIV-related discrimination amongst healthcare providers is one of the strongest obstacles to effectively responding to HIV. This study was conducted to explore the occurrence of and other factors related to discrimination against people living with HIV/AIDS amongst healthcare providers in Guangzhou, China. Methods This was a cross-sectional study, conducted between July and October 2016, that enrolled healthcare providers from 9 healthcare institutions in Guangzhou, China. HIV-related discrimination was assessed using anonymous self-designed questionnaires. Chi-square tests were used to study the differences in the socio-demographic characteristics, occupational characteristics, HIV-related knowledge and personal attitudes between participants who had and had not discriminated against People living with HIV/AIDS (PLWHA). A multivariate logistic regression analysis was used to study the factors associated with HIV-related discrimination. Results A total of 972 healthcare providers were investigated, and 386 (39.7%) had previously served HIV-positive individuals in their work. Administering HIV antibody tests for patients without his or her consent was the most frequent act of discrimination (65.3%), and other forms of discrimination, including “differential treatment” (51.0%), “disclosed information” (46.4%) and “refused to treat” (38.6%), were also prevalent. The logistic regression analysis indicated that people who had worked for 3–7 years, worked in secondary hospitals or lower, worked in surgical departments, had lower scores on HIV transmission knowledge, were dissatisfied with the occupational exposure protection system offered by the government, were worried about HIV-related exposure and feared HIV-related exposure were more likely to commit an act of medical discrimination against PLWHA. Conclusion HIV-related discrimination was not unusual in the healthcare providers of Guangzhou, which may be related to their negative cognitions and attitudes as well as the hospital management system and government policy. Therefore, comprehensive HIV-related knowledge education should be implemented to change the attitude of healthcare providers. In addition, the current laws and regulations should be refined by the government to protect the rights of healthcare providers. The contradiction between designated hospitals and non-designated hospitals should be resolved to ensure that PLWHA receive timely and effective help and treatment.
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Affiliation(s)
- Xiaomei Dong
- Department of Epidemiology, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Jianwei Yang
- Department of Epidemiology, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Lin Peng
- Dongguan Municipal Centers for Disease Control and Prevention, Dongguan, Guangdong Province, China
| | - Minhui Pang
- Department of Epidemiology, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Jiayi Zhang
- Department of Epidemiology, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Zhan Zhang
- Department of Medical Statistics, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Jiaming Rao
- Department of Epidemiology, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Haiqing Wang
- Department of Epidemiology, School of Basic Medicine, Jinan University, Guangzhou, China
| | - Xiongfei Chen
- Guangzhou Centers for Disease Control and Prevention, Guangzhou, Guangdong, China.
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Abstract
In light of the chronic shortage of health professionals willing to care for HIV/AIDS patients, and rising epidemics in many Muslim countries, this qualitative study examined susceptibility and resistance to courtesy stigma as experienced by nurses, doctors, and social workers in Morocco. Forty-nine in-depth interviews provided rich insights into the process of courtesy stigma and how it is managed, within the context of interactions with Islam, interactions within the workplace (patients, other health professionals), and interactions outside the workplace (the general public, friends, and family). Theoretically, the findings extend understanding of courtesy stigma and the dirty work literature. The findings also offer practical suggestions for the development of culturally appropriate strategies to reduce susceptibility to courtesy stigmatization. This study represents the first to explore courtesy stigma as a process experienced by health professionals providing HIV/AIDS care in an Islamic country.
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Affiliation(s)
| | - Leila El Menzhi
- a School of Business Administration , Al Akhawayn University
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25
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Ishimaru T, Wada K, Smith DR. A consensus for occupational health management of healthcare workers infected with human immunodeficiency virus, hepatitis B virus, and / or hepatitis C virus. J Occup Health 2017; 59:304-308. [PMID: 28381816 PMCID: PMC5478506 DOI: 10.1539/joh.16-0275-op] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Occupational health management plays an important role in the prevention of provider-to-patient transmission in healthcare workers infected with human immunodeficiency virus (HIV), hepatitis B virus (HBV), and/or hepatitis C virus (HCV). Therefore, the Japan Society for Occupational Health's Research Group on Occupational Health for Health Care Workers has proposed a consensus for the management of healthcare workers infected with HIV, HBV, and/or HCV based on recent evidence for each concerned group. The consensus recommends that: (1) employers in medical institutions should establish a policy of respecting the human rights of healthcare workers, management strategies for occupational blood exposure, and occupational health consultation; (2) occupational health staff should appropriately assess the risk of provider-to-patient transmission of HIV, HBV, and/or HCV infection and rearrange their tasks if necessary. When conducting risk assessment, occupational health staff should obtain informed consent and then cooperate with the physician in charge as well as infection control experts in the workplace; (3) healthcare workers infected with HIV, HBV, and/or HCV should disclose their employment to their treating physician and consult with their doctor regarding the need for special considerations at work; and (4) supervisors and colleagues in medical institutions should correctly understand the risks of HIV, HBV, and HCV infection and should not engage in any behavior that leads to discrimination against colleagues infected with HIV, HBV, and/or HCV.
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Affiliation(s)
- Tomohiro Ishimaru
- Department of Health Management, Nishinihon Occupational Health Service Center.,Occupational Health Training Center, University of Occupational and Environmental Health.,The Research Group on Occupational Health for Health Care Workers, Japan Society for Occupational Health
| | - Koji Wada
- The Research Group on Occupational Health for Health Care Workers, Japan Society for Occupational Health.,Bureau of International Health Cooperation, National Center for Global Health and Medicine
| | - Derek R Smith
- College of Public Health, Medical and Veterinary Sciences, James Cook University
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Ledda C, Cicciù F, Puglisi B, Ramaci T, Nunnari G, Rapisarda V. Attitude of Health Care Workers (HCWs) toward Patients Affected by HIV/AIDS and Drug Users: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E284. [PMID: 28282937 PMCID: PMC5369120 DOI: 10.3390/ijerph14030284] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Revised: 02/14/2017] [Accepted: 03/07/2017] [Indexed: 11/16/2022]
Abstract
Caring for HIV/AIDS patients and/or drug users requires health care workers (HCWs) to have good knowledge of the issues. Cultural differences in HCWs, combined with professional ethics and personal beliefs, could also result in conflicting attitudes, leading to difficulties related to looking after people affected by HIV/AIDS or drug users. A cross-sectional study was carried out to assess the attitude towards HIV/AIDS patients and/or drug users in a sample of workers operating in a large university hospital in southern Italy. A total of 736 workers were surveyed from May to November 2016. During the periodic occupational health surveillance, a questionnaire was administered about attitudes of discrimination, acceptance and fear towards these patients. Respondents showed average levels of acceptance to HIV/AIDS and drug user patients. As years of experience and professional training increased, scores for discrimination, acceptance of HIV/AIDS, acceptance of drug users and fear decreased. Factors positively influencing levels of attitudes were being female and younger. Supplementary education is needed to strengthen the awareness of HCWs.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 95123 Catania, Italy.
| | - Francesca Cicciù
- University Hospital of Catania Policlinico-Vittorio Emanuele, Via Santa Sofia, 95123 Catania, Italy.
| | - Beatrice Puglisi
- University Hospital of Catania Policlinico-Vittorio Emanuele, Via Santa Sofia, 95123 Catania, Italy.
| | - Tiziana Ramaci
- Faculty of Human and Social Sciences, Kore University of Enna, Viale delle Olimpiadi, 94100 Enna, Italy.
| | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98124 Messina, Italy.
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Via Santa Sofia, 95123 Catania, Italy.
- University Hospital of Catania Policlinico-Vittorio Emanuele, Via Santa Sofia, 95123 Catania, Italy.
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Robb A, Reid B, Laird EA. Insulin knowledge and practice: a survey of district nurses in Northern Ireland. Br J Community Nurs 2017; 22:138-145. [PMID: 28252323 DOI: 10.12968/bjcn.2017.22.3.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Insulin is one of the top ten high-alert medications worldwide. Approximately 30% of people with diabetes in the UK use injectable therapies, most commonly insulin, to manage their condition. With an increasing number of people with diabetes being managed within the community, district nurses play an important role in the safe and effective use of insulin. This study surveyed a convenience sample of 164 district nurses working within one Health and Social Care Trust in Northern Ireland to ascertain their knowledge and practice regarding insulin. Study response rate was 38% (n=63). It was found that district nurses' knowledge and practice relating to insulin therapy was lacking as indicated by a total mean score of 53.1%. Total knowledge scores were slightly higher (58%) than total practice scores (46%). Nevertheless, 79.4% of district nurses felt secure and 6.3% felt very secure in managing diabetes. Deficits in district nurses' knowledge and practice were identified in areas relating to insulin action, dosage, storage, injection site technique and rotation, hypoglycaemic/hyperglycaemic management, pharmacological action and prescription format. These deficits highlight the need for workplacebased learning and development programmes, incorporating real time, point of care interventions, to enhance and maintain district nurses' insulin knowledge and practice.
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Affiliation(s)
- Alison Robb
- District Nurse, Western Health and Social Care Trust
| | - Bernie Reid
- Lecturer in Nursing, School of Nursing, Ulster University
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Ishimaru T, Wada K, Arphorn S, Smith DR. Attitudes of nurses toward HIV-infected colleagues in Japan. Contemp Nurse 2016; 53:133-142. [PMID: 27790951 DOI: 10.1080/10376178.2016.1254565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
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.
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Affiliation(s)
- Tomohiro Ishimaru
- a Department of Occupational Health and Safety, Faculty of Public Health , Mahidol University , 420/1 Rajvithee Rd., Rachathewee, Bangkok 10400 , Thailand.,b Occupational Health Training Center, University of Occupational and Environmental Health , 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555 , Japan
| | - Koji Wada
- c Bureau of International Health Cooperation, National Center for Global Health and Medicine , 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655 , Japan
| | - Sara Arphorn
- a Department of Occupational Health and Safety, Faculty of Public Health , Mahidol University , 420/1 Rajvithee Rd., Rachathewee, Bangkok 10400 , Thailand
| | - Derek R Smith
- d College of Public Health, Medical and Veterinary Sciences, James Cook University , Townsville , QLD 4811 , Australia
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Mkwinda E, Lekalakala-Mokgele E. Palliative care needs in Malawi: Care received by people living with HIV. Curationis 2016; 39:1664. [PMID: 27381722 PMCID: PMC6091792 DOI: 10.4102/curationis.v39i1.1664] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 03/14/2016] [Accepted: 03/28/2016] [Indexed: 11/28/2022] Open
Abstract
Background Infection with human immunodeficiency virus (HIV) has changed from an acute to a chronic illness in the past decade, because of highly active antiretroviral therapy (ART). Malawi’s response to the HIV challenge included provision of ART for people living with HIV or AIDS (PLWHA), which significantly reduced HIV- and AIDS-related mortality. In addition, palliative care for PLWHA was introduced as a strategy that improves the success of ART. Objective The purpose of the study was to explore the needs of PLWHA concerning care received from primary caregivers and palliative care nurses in Malawi. Methods A qualitative, explorative design was used and 18 participants were selected purposefully and interviewed individually using a semi-structured interview guide. Data were analysed using NVivo software package version 10. Results Results revealed that PLWHA needed physical care from the primary caregivers due to severity of illness, integration of healthcare services, and continuity of care and proper care from nurses. They also needed knowledge from nurses in several areas which affected decision-making and needed financial and nutritional support. Conclusion More could be done in meeting needs of PLWHA to improve their health and survival and assist them to achieve a better quality of life.
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Affiliation(s)
- Esmie Mkwinda
- Community Department, Kamuzu College of Nursing, University of Malawi, Lilongwe.
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Dunagan PB, Kimble LP, Gunby SS, Andrews MM. Baccalaureate Nursing Students' Attitudes of Prejudice: A Qualitative Inquiry. J Nurs Educ 2016; 55:345-8. [DOI: 10.3928/01484834-20160516-08] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/16/2016] [Indexed: 11/20/2022]
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Ishimaru T, Wada K, Arphorn S, Smith DR. Barriers to the acceptance of work colleagues infected with Hepatitis B and Hepatitis C in Japan. J Occup Health 2016; 58:269-75. [PMID: 27108645 PMCID: PMC5356951 DOI: 10.1539/joh.15-0288-oa] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Healthcare workers infected with Hepatitis B (HBV) or Hepatitis C virus (HCV) may undertake patient care activities if provider-to-patient transmission risks have been assessed in terms of viral load and clinical procedures. The present study investigated potential barriers to the acceptance of colleagues infected with HBV/HCV in healthcare settings after appropriate risk assessment. Methods: We conducted an anonymous, internet-based survey of Japanese nurses. Multivariate logistic analysis was used to assess factors associated with willingness to accept colleagues infected with HBV/HCV after risk assessment. Results: In total, 992 nurses responded to the survey, with 16% indicating that colleagues infected with HBV/HCV should not have patient contact after risk assessment. Willingness to accept HBV/HCV-infected colleagues was negatively associated with attitudes regarding the avoidance of contact with HBV/HCV-infected colleagues (OR: 0.49; 95% CI: 0.28-0.85). Previous professional contact with HBV/HCV patients (OR: 1.73; 95% CI: 1.36-2.12), experience of accidental injection from or personal exposure to HBV/HCV patients (OR: 2.00; 95% CI: 1.42-2.61), knowledge of HBV/HCV (OR: 2.00; 95% CI: 1.52-2.49), and female sex (OR: 1.60; 95% CI: 1.17-2.09) were positively associated with a willingness to accept HBV/HCV-infected colleagues. Conclusions: This study suggests that attitudes regarding the avoidance of contact with HBV/HCV-infected colleagues may be barriers to accepting these colleagues even after risk assessment has been performed. To protect the employment of nurses infected with HBV/HCV, employers should provide comprehensive education for nurses to reduce stigma and improve understanding about the management of staff infected with infectious diseases, such as HBV or HCV.
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Affiliation(s)
- Tomohiro Ishimaru
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University
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Alotaibi A, Al-Ganmi A, Gholizadeh L, Perry L. Diabetes knowledge of nurses in different countries: An integrative review. NURSE EDUCATION TODAY 2016; 39:32-49. [PMID: 27006032 DOI: 10.1016/j.nedt.2016.01.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/05/2016] [Accepted: 01/21/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The aim of this study was to identify, critically appraise and synthesise evidence of nurses' knowledge of diabetes and identify factors that function as barriers to nurses' acquisition of diabetes knowledge. DESIGN An integrative review METHODS A systematic search was conducted for English-language, peer reviewed publications of any research design via CINAHL, Medline, EMBASE, and Education Research Complete databases from 2004 to 2014. Of 374 articles retrieved, after removal of duplicates and quality appraisal, 25 studies were included in the review and synthesised based on study characteristics, design and findings. FINDINGS Studies originated from developed and developing countries and applied a variety of research designs and tools to assess nurses' knowledge of diabetes. Assessed aspects of diabetes care included knowledge of diabetes medications (12 studies), nutrition (7), blood glucose monitoring (7), diabetes complications (6), and pathology, symptoms and diabetes management (9). Factors/barriers affecting nurses' acquisition of diabetes knowledge were identified (11). Overall, findings indicated wide-spread serious and sustained deficiencies in nurses' knowledge of diabetes and diabetes care. CONCLUSION With nurses demonstrating significant and long-standing knowledge deficits in many aspects of diabetes care, strategies are urgently required to overcome the identified barriers to knowledge acquisition.
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Affiliation(s)
- Abdulellah Alotaibi
- Faculty of Applied Health Science, Shaqra University, University of Technology Sydney (UTS), NSW 2007, Australia.
| | - Ali Al-Ganmi
- Faculty of Nursing, University of Baghdad Iraq, University of Technology Sydney (UTS), NSW 2007, Australia.
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney (UTS), NSW 2007, Australia.
| | - Lin Perry
- Faculty of Health, University of Technology Sydney (UTS), NSW 2007, Australia; South Eastern Sydney Local Health District, NSW 2217, Australia.
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Li J, Mo PKH, Kahler CW, Lau JTF, Du M, Dai Y, Shen H. Prevalence and associated factors of depressive and anxiety symptoms among HIV-infected men who have sex with men in China. AIDS Care 2015; 28:465-70. [PMID: 26689341 DOI: 10.1080/09540121.2015.1118430] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
HIV-positive men who have sex with men (HIVMSM) face severe stigma and high levels of stressors, and have high prevalence of mental health problems (e.g., depression and anxiety). Very few studies explored the role of positive psychological factors on mental health problems among HIVMSM. The present study investigated the prevalence of two mental health problems (anxiety and depression), and their associated protective (gratitude) and risk (enacted HIV-related stigma, and perceived stress) factors among HIVMSM in China. A cross-sectional survey was conducted among 321 HIVMSM in Chengdu, China, by using a structured questionnaire. Over half (55.8%) of the participants showed probable mild to severe depression (as assessed by the Center of Epidemiologic Studies Depression scale); 53.3% showed probable anxiety (as assessed by the General Anxiety Disorder scale). Adjusted logistic regression models revealed that gratitude (adjusted odds ratio (ORa = 0.90, 95% confidence intervals (95% CI) = 0.86-0.94) was found to be protective, whilst perceived stress (ORa = 1.17, 95% CI = 1.12-1.22) and enacted stigma (ORa = 7.72, 95% CI = 2.27-26.25) were risk factors of depression. Gratitude (ORa = 0.95, 95% CI = 0.91-0.99) was also found to be protective whilst perceived stress (ORa = 1.19, 95% CI = 1.14-1.24) was a risk factor of anxiety. Gratitude did not moderate the associations found between related factors and poor mental health. It is warranted to promote mental health among HIVMSM, as depression/anxiety was highly prevalent. Such interventions should consider enhancement of gratitude, reduction of stress, and removal of enacted stigma as potential strategies, as such factors were significantly associated with depression/anxiety among HIVMSM.
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Affiliation(s)
- Jinghua Li
- a Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong Kong , Shatin , Hong Kong
| | - Phoenix K H Mo
- a Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong Kong , Shatin , Hong Kong.,b The Chinese University of Hong Kong Shenzhen Research Institute , Shenzhen , People's republic of China
| | - Christopher W Kahler
- c Department of Behavioral and Social Sciences , Brown University School of Public Health , Providence , RI , USA
| | - Joseph T F Lau
- a Division of Behavioral Health and Health Promotion, The School of Public Health and Primary Care, Faculty of Medicine , The Chinese University of Hong Kong , Shatin , Hong Kong.,b The Chinese University of Hong Kong Shenzhen Research Institute , Shenzhen , People's republic of China.,d Centre for Medical Anthropology and Behavioral Health , Sun Yat-sen University , Guangzhou , People's republic of China
| | - Mengran Du
- e West China School of Public Health, Sichuan University , People's republic of China
| | - Yingxue Dai
- f Chengdu Center for Disease Control and Prevention , Sichuan , People's republic of China
| | - Hanyang Shen
- g School of Public Health , Drexel University , Philadelphia , USA
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Mak WWS, Cheng SSY, Law RW, Cheng WWL, Chan F. Reducing HIV-related stigma among health-care professionals: a game-based experiential approach. AIDS Care 2015; 27:855-9. [PMID: 25671591 DOI: 10.1080/09540121.2015.1007113] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Stigmatizing attitudes from health professionals toward people living with HIV (PLHIV) constitute a key barrier to HIV care. Despite considerable progress in HIV stigma-reduction research, we are still searching for effective strategies that can be implemented on a larger scale. To narrow this research gap, the present study investigated a novel cost-effective approach to reducing HIV-related stigma among health professionals. Interactive experiential games were used to help participants gain first-hand experience of potential stressors that PLHIV might encounter. The effectiveness of this game-based experiential approach was compared with that of in vivo contact in reducing HIV-related stigma among students in the health-care fields. Eighty-eight students of health-related programs in Hong Kong were randomly assigned to either the game-based or in vivo contact program. They completed measures of stigmatizing attitudes and HIV/AIDS-related knowledge at pre-program, post-program, and one-month follow-up. Findings showed that the effectiveness of the game-based experiential approach in reducing HIV-related stigma was similar to that of in vivo contact both at post-program and one-month follow-up. Further research is needed to explore the potential value of the game-based approach in reducing HIV stigma among health professionals.
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Affiliation(s)
- Winnie W S Mak
- a Department of Psychology , The Chinese University of Hong Kong , Hong Kong , China
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Prevalence and drivers of HIV stigma among health providers in urban India: implications for interventions. J Int AIDS Soc 2013; 16:18717. [PMID: 24242265 PMCID: PMC3833193 DOI: 10.7448/ias.16.3.18717] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/23/2013] [Accepted: 08/29/2013] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION HIV stigma inflicts hardship and suffering on people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. Health professionals are often named by PLHIV as an important source of stigma. This study was designed to examine rates and drivers of stigma and discrimination among doctors, nurses and ward staff in different urban healthcare settings in high HIV prevalence states in India. METHODS This cross-sectional study enrolled 305 doctors, 369 nurses and 346 ward staff in both governmental and non-governmental healthcare settings in Mumbai and Bengaluru, India. The approximately one-hour long interviews focused on knowledge related to HIV transmission, personal and professional experiences with PLHIV, instrumental and symbolic stigma, endorsement of coercive policies, and intent to discriminate in professional and personal situations that involve high and low risk of fluid exposure. RESULTS High levels of stigma were reported by all groups. This included a willingness to prohibit female PLHIV from having children (55 to 80%), endorsement of mandatory testing for female sex workers (94 to 97%) and surgery patients (90 to 99%), and stating that people who acquired HIV through sex or drugs "got what they deserved" (50 to 83%). In addition, 89% of doctors, 88% of nurses and 73% of ward staff stated that they would discriminate against PLHIV in professional situations that involved high likelihood of fluid exposure, and 57% doctors, 40% nurses and 71% ward staff stated that they would do so in low-risk situations as well. Significant and modifiable drivers of stigma and discrimination included having less frequent contact with PLHIV, and a greater number of transmission misconceptions, blame, instrumental and symbolic stigma. Participants in all three groups reported high rates of endorsement of coercive measures and intent to discriminate against PLHIV. Stigma and discrimination were associated with multiple modifiable drivers, which are consistent with previous research, and which need to be targeted in future interventions. CONCLUSIONS Stigma reduction intervention programmes targeting healthcare providers in urban India need to address fear of transmission, improve universal precaution skills, and involve PLHIV at all stages of the intervention to reduce symbolic stigma and ensure that relevant patient interaction skills are taught.
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Akin S, Mendi B, Mendi O, Durna Z. Turkish nursing students' knowledge of and attitudes towards patients with HIV/AIDS. J Clin Nurs 2013; 22:3361-71. [PMID: 24127908 DOI: 10.1111/jocn.12378] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To assess nursing students' knowledge of and attitudes towards such patients and to determine the variables associated with students' knowledge and attitudes towards them. BACKGROUND Improving nurses' and nursing students' knowledge and attitudes towards patients with HIV/AIDS is vital for providing quality care for such patients. DESIGN This descriptive, cross-sectional study was conducted at three nursing schools located in two different cities in Turkey. The inclusion criteria for the nursing students were as follows: being at least 18 years old; being a first-, second-, third- or fourth-year nursing student; and giving consent to participate in the research. METHODS The sample comprised 580 nursing students. The study used three data collection tools: (1) the Student Socio-Demographic Questionnaire, (2) the HIV/AIDS Knowledge Questionnaire and (3) the HIV/AIDS Attitude Questionnaire. RESULTS Participants' knowledge was found to be insufficient, particularly with regard to HIV transmission routes. They generally had positive attitudes towards patients with HIV/AIDS. However, they expressed some concerns and were hesitant about working with AIDS and HIV-positive patients. CONCLUSIONS The current results reveal that nursing students still have misconceptions and a lack of knowledge of HIV/AIDS and that their attitudes need to be improved. RELEVANCE TO CLINICAL PRACTICE Improving education programmes about HIV/AIDS and using information sources effectively may contribute to better knowledge and more desirable attitudes towards HIV/AIDS.
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Affiliation(s)
- Semiha Akin
- Faculty of Health Sciences, Nursing Department, Bahçeşehir University, Istanbul, Turkey
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Wang G, Wada K, Hoshi K, Sasaki N, Ezoe S, Satoh T. Association of knowledge of HIV and other factors with individuals' attitudes toward HIV infection: a national cross-sectional survey among the Japanese non-medical working population. PLoS One 2013; 8:e68495. [PMID: 23874644 PMCID: PMC3713032 DOI: 10.1371/journal.pone.0068495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 05/29/2013] [Indexed: 11/23/2022] Open
Abstract
Background The stigma of and discrimination because of HIV has been described as the most important obstacle to prevention and treatment efforts. The purpose of this study was to investigate negative attitudes and prejudice toward HIV among the Japanese non-medical working population and to explore contributing factors. Methods An online anonymous nationwide survey involving approximately 3,000 individuals was conducted in Japan. Questions ranged from background information and HIV knowledge to individuals’ attitudes towards HIV infection in the workplace. Descriptive statistics and logistic regression were applied for analysis. Results Thirty-three percent of participants feared transmission of HIV from infected colleagues, 34% tended to avoid contact with them and 40% had prejudiced opinions about HIV infection. Despite a relatively high level of knowledge of HIV/AIDS overall (11.9±3.3 from 15 points), only 50% of individuals were aware of some issues. Greater knowledge was associated with less negative attitudes towards HIV infection (OR 0.39, 95% CI 0.31–0.48 for prejudiced opinion, high compared with low level of knowledge), whereas greater health consciousness was inversely related to attitude (OR 1.97, 95% CI 1.50–2.58 for prejudiced opinion, high compared with low health consciousness). Conclusion Knowledge neutralizes peoples’ negative attitudes towards HIV infection, whereas greater health consciousness may worsen them. Educational programs should balance knowledge with health consciousness to improve the efficacy of HIV interventions.
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Affiliation(s)
- Guoqin Wang
- Kitasato Clinical Research Center, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
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Abdelrahman I, Lohiniva AL, Kandeel A, Benkirane M, Atta H, Saleh H, El Sayed N, Talaat M. Learning about Barriers to Care for People Living with HIV in Egypt: A Qualitative Exploratory Study. J Int Assoc Provid AIDS Care 2013; 14:141-7. [PMID: 23792709 DOI: 10.1177/2325957413488180] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to identify obstacles health care workers face in providing care for people living with HIV and AIDS (PLWHA). Based on these findings, health authorities can design interventions to support health care workers in providing better medical care for PLWHA. Thirty in-depth interviews were conducted with physicians and nurses in one 300-bed tertiary care public hospital in Giza, Egypt. Thematic analysis was conducted by 2 investigators. Five main themes were identified (1) fear of infection; (2) disbelief in effectiveness of infection control measures to protect against HIV; (3) misconceptions regarding medical care for PLWHA; (4) fear of secondary stigma; and (5) moral judgments toward PLWHA and negative connotations related to HIV. Interventions targeting health care workers should be multidimensional, including knowledge and skills building as well as value and attitude change. Reducing stigma among health care workers will improve access to care for PLWHA.
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Affiliation(s)
| | - Anna Leena Lohiniva
- Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
| | | | - Manal Benkirane
- Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
| | - Hossam Atta
- Ouem El Masreyn General Hospital, Ministry of Health in Egypt, Cairo, Egypt
| | - Hanan Saleh
- Ouem El Masreyn General Hospital, Ministry of Health in Egypt, Cairo, Egypt
| | | | - Maha Talaat
- Global Disease Detection and Response Program, US Naval Medical Research Unit No. 3, Cairo, Egypt
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Nawafleh H, Francis K, Chapman Y. The Impact of Nursing Leadership and Management on the Control of HIV/AIDS: Ethnographic Study. Contemp Nurse 2012. [DOI: 10.5172/conu.2012.2074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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