Online course on vaccinating people with HIV/AIDS - effectiveness in the knowledge of nursing professionals.

OBJECTIVE: analyzing the effectiveness of an educational intervention on the knowledge of nursing professionals regarding the immunization of people with the human immunodeficiency virus. METHOD: a quasi-experimental study evaluated professionals' knowledge through a knowledge test applied before and after the development of an online training course. The data was analyzed using frequency, median, mean, standard deviation, and association tests. RESULTS: the sample consisted of 77 nursing professionals whose mean age was 43.2 years (SD+/-8.2). More than half of the individuals worked in basic health units (58.4%), 22.1% worked in specialized services that provide clinical monitoring for people with the human immunodeficiency virus, and 42 (54.5%) were nursing assistants or technicians. The professionals' performance improved after the intervention, with an increase in the median number of correct answers from 23.0 to 27.0 (p<0.001). CONCLUSION: offering an online training course on the immunization of people with the human immunodeficiency virus, as a continuing education activity, proved to be effective in improving nursing professionals' knowledge on this subject. HIGHLIGHTS: (1) Services do not evaluate the vaccination status of people living with HIV.(2) The knowledge of health professionals may influence vaccination rates.(3) Health professionals' knowledge of immunization may be insufficient.

Diagnóstico de enfermagem risco de infecção e infecções relacionadas à assistência à saúde em pacientes com aids / Diagnóstico de enfermería Riesgo de Infección e Infecciones Asociadas a la Atención de Salud en pacientes con sida / Nursing diagnosis risk for infection and cross-infections in aids patients

Resumo Objetivo Identificar quais fatores de risco do diagnóstico de enfermagem risco de infecção estão associados a chances maiores de pessoas com HIV/aids hospitalizadas desenvolverem Infecções Relacionadas à Assistência à Saúde. Métodos Estudo caso-controle no qual os casos foram pacientes com aids hospitalizados que apresentaram Infecções Relacionadas à Assistência à Saúde (n = 104) e os controles foram pacientes com aids hospitalizados que não evoluíram para Infecções Relacionadas à Assistência à Saúde (n = 104). Usaram-se o teste qui-quadrado de Pearson e a regressão logística, e calculou-se a odds ratio. Resultados Peristaltismo alterado, tabagismo, nível reduzido de hemoglobina e leucopenia foram significativamente associados com o desfecho estudado. Na regressão logística, a redução na hemoglobina foi considerada um fator preditor da detecção de risco de infecção. Conclusão Os indicadores tabagismo, leucopenia e nível reduzido de hemoglobina foram identificados na regressão como os preditores mais importantes para identificar o risco de infecção em pessoas vivendo com HIV/aids.

Resumen Objetivo Identificar qué factores de riesgo del diagnóstico de enfermería Riesgo de Infección están relacionados con mayores probabilidades de que personas con el VIH/sida hospitalizadas presenten Infecciones Asociadas a la Atención de Salud. Métodos Estudio caso-control, en el cual los casos fueron pacientes con sida hospitalizados que presentaron Infecciones Asociadas a la Atención de Salud (n = 104) y los controles fueron pacientes con sida hospitalizados que no contrajeron Infecciones Asociadas a la Atención de Salud (n = 104). Se utilizó la prueba χ2 de Pearson y la regresión logística y se calculó el odds ratio. Resultados El peristaltismo alterado, el tabaquismo, el nivel reducido de hemoglobina y la leucopenia fueron significativamente asociados al resultado estudiado. En la regresión logística, la reducción de la hemoglobina fue considerada un factor predictor de la detección del riesgo de infección. Conclusión Los indicadores tabaquismo, leucopenia y nivel reducido de hemoglobina fueron identificados en la regresión como los predictores más importantes para identificar el riesgo de infección en personas que viven con el VIH/sida.

Abstract Objective To identify which risk factors of the Nursing Diagnosis Risk of infection are associated with a greater chance of Hospitalized People Living with HIV/AIDS developing Healthcare-associated Infections. Methods This is a case-control study in which the cases were composed by hospitalized AIDS patients who presented Healthcare-associated Infections (n=104) and, the controls by those who did not progress to Healthcare-associated Infections (n=104). The Pearson Chi-square test, Odds Ratio calculations for risk factors and Logistic Regression were used. Results Altered peristalsis, smoking, decreased hemoglobin and leukopenia were significantly associated with the outcome investigated. In logistic regression, the decrease in hemoglobin was considered a predictor factor for the detection of infection risk. Conclusion The indicators smoking, leucopenia and decreased hemoglobin were recognized in the regression as the most important predictors for identifying the risk of infection in People Living with HIV/AIDS.

Faculty Attitudes About Caring for People Living With HIV/AIDS: A Comparative Study.

BACKGROUND: People living with HIV/AIDS (PLHIV) experience stigma and discrimination. Negative attitudes of nursing faculty about caring for PLHIV can adversely affect student perceptions and their nursing care. The study purpose was to describe nursing faculty attitudes and beliefs about caring for PLHIV. METHOD: The HPASS (Healthcare Provider HIV/AIDS Stigma Scale), Spanish version, was delivered to nursing faculty in Colombia and Peru. RESULTS: The HPASS was completed by 98 nursing faculty. The overall mean score was 2.41 (SD = 0.69), with subscale scores: stereotypes, 2.55 (SD = 0.84); discrimination, 2.28 (SD = 0.74); and prejudices, 2.41 (SD = 0.63). Peruvian faculty had the highest scores, statistically correlated with the importance of religion, whereas Colombia had the lowest. CONCLUSION: Nursing faculty attitudes toward PLHIV were slightly positive in Colombia to slightly negative in Peru; however, both countries had negative stereotypes. Knowledge deficiencies about HIV persist and attitudes appear to be influenced by culture and religion. [J Nurs Educ. 2019;58(12):712-717.].

Evaluation of Nurses' Knowledge and Attitude toward HIV-Infected Patients in Barbados.

BACKGROUND: Continued assessment of nurses' knowledge and attitude is necessary for improving their performance at workplace. We attempted to evaluate nurses' knowledge and attitude toward HIV-infected patients and their underlying factors. METHODS: We conducted a descriptive, cross-sectional study participated by 218 nurses and collected relevant data. RESULTS: Majority (57.3%) of the nurses had 1 to 5 years of experience in the nursing job, and 78.4% of them were involved in the provision of direct care to HIV-infected individuals for ≤5 years, and only 6.4% for ≥11 years. The overall knowledge and attitude of the participants were good (3.25/5 and 3.42/5 scores, respectively). The knowledge regarding appropriate care of HIV-infected patients was significantly better among the registered nurses compared to nursing assistants (NA) with limited years of formal education (odds ratio [OR] = 0.37; 95% confidence interval [CI] = 0.20-0.69; P <.001). In the provision of care to the HIV-infected patients, the attitude of female participants was significantly better than the males (unadjusted OR = 0.18; 95% CI = 0.05-0.60; P = .01). CONCLUSION: Inclusion of relevant HIV- and AIDS-related topics in the curriculum for NAs and closely guided hands-on training of the nurses are likely to improve nurses' knowledge and attitude toward the provision of care to HIV-infected individuals.

Management of nursing care in HIV/AIDS from a palliative and hospital perspective / Gestión del cuidado de enfermería en VIH/SIDA en la perspectiva paliativa y hospitalaria / Gerência do cuidado de enfermagem em HIV/aids na perspectiva paliativa e hospitalar

ABSTRACT Objectives: To understand the meaning attributed by the nurse to the management of nursing care to the person hospitalized due to clinical complications caused by AIDS; to analyze actions related to palliative care; and to construct a theoretical matrix regarding the management of nursing care. Method: Qualitative, exploratory research, guided by the Grounded Theory. Seven nurses and ten nursing technicians were interviewed between May and September 2015, in a university hospital, located in Rio de Janeiro State, Brazil. Results: Five categories that covered the profile of the hospitalized person, palliative care, intervening conditions for care management, the need for professional qualification, and other aspects to better organize and manage care, including conflict management arose. Final considerations: The theoretical matrix values the quality of life, the need to understand the flow of care to avoid readmissions and not adherence to medications, requiring new research in the area, such as implementation.

RESUMEN Objetivos: Comprender el significado atribuido por el enfermero al manejo del cuidado de enfermería a la persona hospitalizada por complicaciones clínicas del sida; analizar las acciones que remiten a los cuidados paliativos; y construir una matriz teórica referente al manejo del cuidado de enfermería. Método: Investigación cualitativa, exploratoria, guiada por Grounded Theory. Siete enfermeros y diez técnicos de enfermería fueron entrevistados entre mayo y septiembre de 2015, en un hospital universitario, Río de Janeiro, Brasil. Resultados: Se han generado cinco categorías que abarcar el perfil de la persona hospitalizada, los cuidados paliativos, las condiciones intervinientes para la gestión del cuidado, la necesidad de cualificación profesional, y aspectos para organizar y administrar el cuidado. Consideraciones finales: La matriz teórica valoriza la calidad de vida, la necesidad de entender el flujo de atención para evitar reinternaciones y no adherencia a las medicinas, requiriendo nuevas investigaciones en el área, como las de implementación.

RESUMO Objetivos: Compreender o significado atribuído pelo enfermeiro à gerência do cuidado de enfermagem à pessoa hospitalizada por complicações clínicas da aids; analisar as ações que remetem aos cuidados paliativos; e construir uma matriz teórica referente à gerência do cuidado de enfermagem. Método: Pesquisa qualitativa, exploratória, guiada pela Grounded Theory. Sete enfermeiros e dez técnicos de enfermagem foram entrevistados entre maio e setembro de 2015, num hospital universitário, localizado no Rio de Janeiro, Brasil. Resultados: Foram geradas cinco categorias que abarcaram o perfil da pessoa hospitalizada, os cuidados paliativos, as condições intervenientes à gerência do cuidado, a necessidade de qualificação profissional, e outros aspectos para melhor organizar e administrar o cuidado, incluindo a administração de conflitos. Considerações finais: A matriz teórica valoriza a qualidade de vida, a necessidade de entendimento do fluxo de atendimento para evitar reinternações e não aderência às medicações, requerendo novas pesquisas na área, como as de implementação.

Care sharing for people with HIV/AIDS: a look targeted at young adults / La distribución del cuidado de la persona con VIH/Sida: una mirada hacia el adulto joven / Compartilhamento do cuidado da pessoa com HIV/Aids: olhar direcionado ao adulto jovem

ABSTRACT Objective: To understand the care sharing for people living with HIV/AIDS, especially young adults, as well as the structuring of the line of care in the capital of Santa Catarina. Method: Qualitative research, anchored by theory based on data collected in the Health Care Network of Florianópolis, totaling 19 participants distributed between two sample groups. The data collection and analysis were concomitant, with comparative analysis method. Results: The municipality has been transitioning in the health care model for people with HIV/AIDS, especially young adults, whose care is shared within the Health Care Network. Final considerations: In the municipality, there is the inclusion of management of HIV in primary health care services along with the establishment of a more resolutive care model. Thus, the care of this population is shared in different points of the health care network.

RESUMEN Objetivo: Comprender la distribución del cuidado a la persona con convive con VIH/Sida, enfocándose en el adulto joven y en la estructuración de una línea de cuidado en la capital catarinense (Brasil). Método: Investigación cualitativa, con base en la teoría fundamentada en los datos, que fueron recolectados en la Red de Atención a la Salud de Florianópolis, con un total de 19 participantes distribuidos en dos grupos de muestreo. La recolección de los datos y su análisis fueron simultáneos al análisis comparativo. Resultados: El municipio en cuestión pasa por la transición en el modelo de atención ofertado a las personas con VIH/Sida, principalmente a los adultos jóvenes, quienes reciben un cuidado que se distribuye dentro de la Red de Atención a la Salud. Consideraciones finales: En el municipio en cuestión, hay la inclusión del manejo del VIH en los servicios de atención primaria, al mismo tiempo que el establecimiento del modelo asistencial matricial y más resolutivo. De esta forma, el cuidado de esta población está distribuido en los diferentes aspectos de la red de atención a la salud.

RESUMO Objetivo: Compreender o compartilhamento do cuidado à pessoa vivendo com HIV/Aids, com destaque ao adulto jovem e à estruturação de linha de cuidado na capital catarinense. Método: Pesquisa qualitativa, ancorada pela teoria fundamentada nos dados, os quais foram coletados na Rede de Atenção à Saúde de Florianópolis, totalizando 19 participantes distribuídos em dois grupos amostrais. A coleta e a análise dos dados se deram concomitantemente, com método de análise comparativa. Resultados: O município de estudo passa por transição no modelo de atenção às pessoas com HIV/Aids, em especial aos adultos jovens, cujo cuidado se compartilha dentro da Rede de Atenção à Saúde. Considerações finais: No município de estudo, tem-se a inclusão do manejo do HIV nos serviços da atenção primária, concomitantemente ao estabelecimento de modelo assistencial matriciado e mais resolutivo. Desta forma, o cuidado desta população compartilha-se nos diferentes pontos da rede de atenção à saúde.

Management of nursing care in HIV/AIDS from a palliative and hospital perspective.

OBJECTIVES: To understand the meaning attributed by the nurse to the management of nursing care to the person hospitalized due to clinical complications caused by AIDS; to analyze actions related to palliative care; and to construct a theoretical matrix regarding the management of nursing care. METHOD: Qualitative, exploratory research, guided by the Grounded Theory. Seven nurses and ten nursing technicians were interviewed between May and September 2015, in a university hospital, located in Rio de Janeiro State, Brazil. RESULTS: Five categories that covered the profile of the hospitalized person, palliative care, intervening conditions for care management, the need for professional qualification, and other aspects to better organize and manage care, including conflict management arose. FINAL CONSIDERATIONS: The theoretical matrix values the quality of life, the need to understand the flow of care to avoid readmissions and not adherence to medications, requiring new research in the area, such as implementation.

Care sharing for people with HIV/AIDS: a look targeted at young adults.

OBJECTIVE: To understand the care sharing for people living with HIV/AIDS, especially young adults, as well as the structuring of the line of care in the capital of Santa Catarina. METHOD: Qualitative research, anchored by theory based on data collected in the Health Care Network of Florianópolis, totaling 19 participants distributed between two sample groups. The data collection and analysis were concomitant, with comparative analysis method. RESULTS: The municipality has been transitioning in the health care model for people with HIV/AIDS, especially young adults, whose care is shared within the Health Care Network. FINAL CONSIDERATIONS: In the municipality, there is the inclusion of management of HIV in primary health care services along with the establishment of a more resolutive care model. Thus, the care of this population is shared in different points of the health care network.

Aspects that influence the self-care of patients living with human immunodeficiency virus.

OBJECTIVE: to analyze aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus treated in a specialized outpatient service. METHOD: analytical cross-sectional study with 135 patients aged 18 and over, of both sexes, who are followed up on the service. The independent variables and outcomes were collected from the nursing consultation instrument, whose theoretical reference is the Orem's Theory. The data were analyzed by parametric approach. Relationships or differences were considered significant if p <0.05. The analysis was done with SPSS v21.0 software. RESULTS: most participants were male (56.3%), with a mean age of 42.1 years. Patients who needed to conceal the diagnosis had less self-care (ß = -0.72 (-1.38, -0.06), p <0.031). The chance of performing self-care decreased with increasing age (OR = 0.93 (0.89, 0.97), p <0.003). On the other hand, patients with a permanent partner had a higher chance of performing self-care (OR = 3.46 (1.27, 9.46), p <0.015). CONCLUSION: aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus were evidenced. However, further studies are necessary to emphasize the analytical character of the self-care of these patients.

Nursing diagnoses for elderly women vulnerable to HIV/AIDS.

OBJECTIVE: Classify the diagnoses in the conceptual framework of vulnerability of Ayres and in the Orem's self-care theory; Elaborate operational definitions of nursing diagnoses for elderly women vulnerable to HIV/AIDS. METHOD: A descriptive exploratory study, developed from March to December 2016 in the stages: 1. Classification of diagnoses in the conceptual framework of vulnerability of Ayres and in the Orem's self-care theory; 2. Operational definition of nursing diagnoses. RESULTS: 70 nursing diagnoses were classified in the conceptual framework of vulnerability of Ayres and Orem's self-care theory, and their operational definitions were constructed, where 75.7% of these were validated. FINAL CONSIDERATION: Diagnoses represent conditions that make older women vulnerable to HIV/AIDS and are linked to their self-care practices. Operational definitions contribute to a systematic approach to care and greater clarity in its implementation.

Integrative review of literature: nursing care to aged people with HIV.

OBJECTIVE: To identify evidences in scientific Brazilian literature on nursing care to aged people with HIV. METHOD: Integrative review of literature from databases: Latin American and Caribbean Literature on Health Sciences (LILACS), Scientific Eletronic Library Online (SciELO), Cochrane and the Nursing Database (BDENF). The applied inclusion criteria were publications that were fully available from 2001 to 2015 and answered to the guiding question of this study. RESULTS: We included 13 studies; and the categories that allowed a better presentation of the scientific evidence on nursing care to aged people with HIV carrier were: Epidemiological profile, perceptions and experiences of aged people with HIV and nursing care to aged people with HIV. CONCLUSION: The studies address nursing care from a clinic that follows NANDA diagnoses of strong individualizing approach and low consideration of social aspects.

Nursing diagnoses for elderly women vulnerable to HIV/AIDS / Diagnósticos de enfermería para mujeres mayores con vulnerabilidad al VIH/ SIDA / Diagnósticos de enfermagem para mulheres idosas com vulnerabilidade ao HIV/aids

ABSTRACT Objective: Classify the diagnoses in the conceptual framework of vulnerability of Ayres and in the Orem's self-care theory; Elaborate operational definitions of nursing diagnoses for elderly women vulnerable to HIV/AIDS. Method: A descriptive exploratory study, developed from March to December 2016 in the stages: 1. Classification of diagnoses in the conceptual framework of vulnerability of Ayres and in the Orem's self-care theory; 2. Operational definition of nursing diagnoses. Results: 70 nursing diagnoses were classified in the conceptual framework of vulnerability of Ayres and Orem's self-care theory, and their operational definitions were constructed, where 75.7% of these were validated. Final consideration: Diagnoses represent conditions that make older women vulnerable to HIV/AIDS and are linked to their self-care practices. Operational definitions contribute to a systematic approach to care and greater clarity in its implementation.

RESUMEN Objetivo: Clasificar los diagnósticos en el marco conceptual de vulnerabilidad de Ayres y en la teoría del autocuidado de Orem; establecer definiciones operativas de diagnósticos de enfermería para mujeres mayores con vulnerabilidad al VIH/ SIDA. Método: Estudio de carácter exploratorio descriptivo, desarrollado de marzo a diciembre de 2016 en las etapas: 1. Clasificar los diagnósticos en el marco conceptual de vulnerabilidad de Ayres y en la teoría del autocuidado de Orem; 2. Definición operacional de los diagnósticos de enfermería. Resultados: Se clasificaron 70 diagnósticos de enfermería en el marco conceptual de vulnerabilidad de Ayres y en la teoría del autocuidado de Orem, y se construyeron sus definiciones operativas, de las cuales el 75,7% fueron validadas. Consideraciones finales: Los diagnósticos representan condiciones que hacen mujeres mayores vulnerables al VIH/ SIDA y están interconectados a sus prácticas de autocuidado. Las definiciones operativas contribuyen a un enfoque sistemático del cuidado y una mayor claridad en su aplicación.

RESUMO Objetivo: Classificar os diagnósticos no quadro conceitual de vulnerabilidade de Ayres e na teoria do autocuidado de Orem; elaborar definições operacionais de diagnósticos de enfermagem para mulheres idosas com vulnerabilidade ao HIV/aids. Método: Estudo de natureza exploratória descritiva, desenvolvido de março a dezembro de 2016 nas etapas: 1) Classificação dos diagnósticos no quadro conceitual de vulnerabilidade de Ayres e na teoria do autocuidado de Orem; 2) Definição operacional dos diagnósticos de enfermagem. Resultados: Foram classificados 70 diagnósticos de enfermagem no quadro conceitual de vulnerabilidade de Ayres e na teoria do autocuidado de Orem, e foram construídas as suas definições operacionais, em que 75,7% destas foram validadas. Considerações finais: Os diagnósticos representam condições que vulnerabilizam mulheres idosas ao HIV/aids e estão interligados às suas práticas de autocuidado. As definições operacionais contribuem para uma abordagem sistemática do cuidado e maior clareza na sua implementação.

Integrative review of literature: nursing care to aged people with HIV / Revisión integrativa de la literatura: asistencia de enfermería a la persona anciana con VIH / Revisão integrativa da literatura: assistência de enfermagem a pessoa idosa com HIV

ABSTRACT Objective: To identify evidences in scientific Brazilian literature on nursing care to aged people with HIV. Method: Integrative review of literature from databases: Latin American and Caribbean Literature on Health Sciences (LILACS), Scientific Eletronic Library Online (SciELO), Cochrane and the Nursing Database (BDENF). The applied inclusion criteria were publications that were fully available from 2001 to 2015 and answered to the guiding question of this study. Results: We included 13 studies; and the categories that allowed a better presentation of the scientific evidence on nursing care to aged people with HIV carrier were: Epidemiological profile, perceptions and experiences of aged people with HIV and nursing care to aged people with HIV. Conclusion: The studies address nursing care from a clinic that follows NANDA diagnoses of strong individualizing approach and low consideration of social aspects.

RESUMEN Objetivo: Identificar en la literatura brasileña las evidencias científicas sobre la asistencia de enfermería al anciano portador del VIH. Método: Revisión integrativa de la literatura, realizada en las bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Scientific Eletronic Library Online (SciELO), Cochrane y la Base de Datos en enfermería (BDENF). Los criterios de inclusión aplicados fueron las publicaciones que estuvieron disponibles en la versión completa, en el período de 2001 a 2015, y que respondiera la cuestión orientadora del estudio. Resultados: Fueron incluidos 13 estudios; y las categorías que permitieron una mejor presentación de las evidencias científicas sobre la asistencia de enfermería al anciano portador del VIH, fueron: El Perfil epidemiológico, las percepciones y las vivencias de los ancianos portadores de VIH y la Asistencia de enfermería delante el anciano seropositivo. Conclusión: Los estudios abordan la asistencia de enfermería todavía a través de una clínica basada en los diagnósticos de NANDA con fuerte abordaje individualizante y baja consideración de los aspectos sociales.

RESUMO Objetivo: Identificar na literatura brasileira as evidências científicas sobre a assistência de enfermagem ao idoso portador do HIV. Método: Revisão integrativa da literatura, realizada nas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scientific Eletronic Library Online (SciELO), Cochrane e a Base de Dados em Enfermagem (BDENF). Os critérios de inclusão aplicados foram publicações que estivessem disponíveis na íntegra, no período de 2001 a 2015, e que respondesse a questão norteadora do estudo. Resultados: Foram incluídos 13 estudos; e as categorias que permitiram uma melhor apresentação das evidências científicas sobre a assistência de enfermagem ao idoso portador do HIV, foram: Perfil epidemiológico, percepções e vivências dos idosos portadores de HIV e Assistência de enfermagem frente ao idoso soropositivo. Conclusão: Os estudos abordam a assistência de enfermagem ainda através de uma clínica baseada nos diagnósticos da NANDA com forte abordagem individualizante e baixa consideração dos aspectos sociais.

Impaired religiosity and spiritual distress in people living with HIV/AIDS. / Religiosidade prejudicada e sofrimento espiritual em pessoas vivendo com HIV/aids.

OBJECTIVE: To verify the inference of Nursing Diagnoses, Impaired religiosity and Spiritual distress in people living with HIV/AIDS. METHODS: This is a cross-sectional study with a quantitative approach, performed in a specialized Service CenteR of Recife, Pernambuco, from June to November 2015. The results related to 52 people living with HIV/AIDS and that were interviewed were analyzed by three nurse judges. RESULTS: Spiritual distress was estimated at 73.1% (38), Impaired religiosity at 36.5% (19), with an average number of defining characteristics of 3.88 ± 2.05 and 2.55±0.69. The main defining characteristic for Impaired religiosity was: "reports a need to reconnect with previous beliefs" (92.3%); and for Spiritual distress, it was: "Expresses a lack of purpose in life/expresses lack of meaning in life" (86.5%). CONCLUSIONS: The results point to the need to consider the religious-spiritual dimension in care protocols and research in nursing.

Results of an Integrative Analysis: A Call for Contextualizing HIV and AIDS Clinical Practice Guidelines to Support Evidence-Based Practice.

BACKGROUND: Practice guidelines aim to improve the standard of care for people living with HIV/AIDS. Successfully implementing guidelines requires tailoring them to populations served and to social and organizational influences on care. AIMS: To examine dimensions of context, which nurses and midwives described as having a significant impact on their care of patients living with HIV/AIDS in Kenya, Uganda, South Africa, and Jamaica and to determine whether HIV/AIDS guidelines include adaptations congruent with these dimensions of context. METHODS: Two sets of data were used. The first came from a qualitative study. In-depth interviews were conducted with purposively selected nurses, midwives, and nurse managers from 21 districts in four study countries. A coding framework was iteratively developed and themes inductively identified. Context dimensions were derived from these themes. A second data set of published guidelines for HIV/AIDS care was then assembled. Guidelines were identified through Google and PubMed searches. Using a deductive integrative analysis approach, text related to context dimensions was extracted from guidelines and categorized into problem and strategy statements. RESULTS: Ninety-six individuals participated in qualitative interviews. Four discrete dimensions of context were identified: health workforce adequacy, workplace exposure risk, workplace consequences for nurses living with HIV/AIDS, and the intersection of work and family life. Guidelines most often acknowledged health human resource constraints and presented mitigation strategies to offset them, and least often discussed workplace consequences and the intersections of family and work life. LINKING EVIDENCE TO ACTION: Guidelines should more consistently acknowledge diverse implementation contexts, propose how recommendations can be adapted to these realities, and suggest what role frontline healthcare providers have in realizing the structural changes necessary for healthier work environments and better patient care. Guideline recommendations should include more explicit advice on adapting their recommendations to different care conditions.

Revealing an HIV diagnosis for children and adolescents: subsidy for the practice of care. / Revelação do diagnóstico de HIV para crianças e adolescentes: subsídios para prática assistencial.

OBJECTIVE: To collectively build a guide for following-up on HIV diagnosis disclosure to children and adolescents in a specialized service. METHOD: Convergent-care research approach with observation triangulation, interview and groups, conducted from May to June 2015 with seven health professionals in a pediatric outpatient clinic for infectious diseases. Thematic content analysis was developed. RESULTS: The discussion of understanding the disclosure, its triggers, actors involved, used strategies, and limits and possibilities listed by the professionals subsidized the construction of a guide to be applied in the stages: analyzing children's questions and curiosities; evaluating their cognitive ability; discussing the reasons to reveal; listing the professionals involved on follow-up process; including family; developing strategies for disclosure. CONCLUSION: This guide may mediate changes in care practice to ensure the child's rights and to make the professionals co-accountable.

Quality of life of people living with HIV/AIDS: temporal, socio-demographic and perceived health relationship.

OBJECTIVE: to analyze the quality of life of people living with HIV/AIDS and its relationship with sociodemographic variables, health satisfaction and time since diagnosis. METHOD: quantitative, cross-sectional study with a sample of 100 HIV positive people monitored in a specialized service in southeastern Brazil. Sociodemographic and health forms were applied, followed by the WHOQOL-HIV BREF, a short form instrument validated to evaluate the quality of life. Descriptive and inferential statistical analysis was performed. RESULTS: the perception of quality of life was intermediate in all quality of life domains. A relationship was identified between greater satisfaction with health and better quality of life, as well as statistically significant differences among the dimensions of quality of life according to gender, employment status, family income, personal income, religious beliefs and time since diagnosis. CONCLUSIONS: the time since the diagnosis of HIV infection enables reconfigurations in the perception of quality of life, while spirituality and social relationships can assist in coping with living with this disease.

Quality of life of people living with HIV/AIDS: temporal, socio-demographic and perceived health relationship / Calidad de vida de personas conviviendo con HIV/SIDA: relación temporal, sociodemográfica y perceptiva de la salud / Qualidade de vida de pessoas convivendo com HIV/aids: relação temporal, sociodemográfica e perceptiva da saúde

Abstract Objective: to analyze the quality of life of people living with HIV/AIDS and its relationship with sociodemographic variables, health satisfaction and time since diagnosis. Method: quantitative, cross-sectional study with a sample of 100 HIV positive people monitored in a specialized service in southeastern Brazil. Sociodemographic and health forms were applied, followed by the WHOQOL-HIV BREF, a short form instrument validated to evaluate the quality of life. Descriptive and inferential statistical analysis was performed. Results: the perception of quality of life was intermediate in all quality of life domains. A relationship was identified between greater satisfaction with health and better quality of life, as well as statistically significant differences among the dimensions of quality of life according to gender, employment status, family income, personal income, religious beliefs and time since diagnosis. Conclusions: the time since the diagnosis of HIV infection enables reconfigurations in the perception of quality of life, while spirituality and social relationships can assist in coping with living with this disease.

Resumen Objetivo: analizar la calidad de vida de personas con HIV/SIDA y su relación con variables sociodemográficas y satisfacción con salud, así como con el tiempo de diagnóstico. Método: estudio cuantitativo, transversal, con muestra de 100 personas seropositivas acompañadas en servicio especializado en la región sureste de Brasil. Se utilizaron formularios sociodemográfico y de salud, y también el WHOQOL-HIV Bref (forma abreviada de instrumento validado en la evaluación de la calidad de vida). Se empleó el análisis estadístico descriptivo e inferencial. Resultados: la percepción de la calidad de vida fue intermedia en todos los dominios de la calidad de vida. Se identificó relación entre mayor satisfacción con salud y mejor calidad de vida, así como diferencias estadísticamente significativas entre dimensiones de la calidad de vida según género, situación de empleo, renta familiar, renta personal, orientación religiosa y tiempo de diagnóstico. Conclusiones: el tiempo de diagnóstico de la infección por el HIV posibilita reconfigurar la percepción de la calidad de vida, así como la espiritualidad; y las relaciones sociales pueden auxiliar en el enfrentamiento de la vivencia con esta enfermedad.

Resumo Objetivo: analisar a qualidade de vida de pessoas com HIV/aids e sua relação com variáveis sociodemográficas, satisfação com saúde, bem como tempo de diagnóstico. Método: estudo quantitativo, transversal, com amostra de 100 pessoas soropositivas acompanhadas em serviço especializado na região sudeste do Brasil. Utilizou-se formulários sociodemográfico e de saúde, seguido pelo WHOQOL-HIV Bref, forma abreviada de instrumento validado na avaliação da qualidade de vida. Empregou-se análise estatística descritiva e inferencial. Resultados: a percepção da qualidade de vida foi intermediária em todos os domínios da qualidade de vida. Identificou-se relação entre maior satisfação com saúde e melhor qualidade de vida, bem como diferenças estatisticamente significantes entre dimensões da qualidade de vida segundo gênero, situação empregatícia, renda familiar, renda pessoal, orientação religiosa e tempo de diagnóstico. Conclusões: o tempo de diagnóstico da infecção pelo HIV possibilita reconfigurações na percepção da qualidade de vida, bem como a espiritualidade e as relações sociais podem auxiliar no enfrentamento da vivência com esta doença.