The new epidemic.

Editor's note: From its first issue in 1900 through to the present day, AJN has unparalleled archives detailing nurses' work and lives over the last century. These articles not only chronicle nursing's growth as a profession within the context of the events of the day, but they also reveal prevailing societal attitudes about women, health care, and human rights. Today's nursing school curricula rarely include nursing's history, but it's a history worth knowing. To this end, From the AJN Archives will be a frequent column, containing articles selected to fit today's topics and times.This month's article, from the November 1982 issue, is the first AJN article published on AIDS. It was early in the epidemic; only 608 cases of Kaposi's sarcoma and opportunistic infections had been reported to the Centers for Disease Control and Prevention-a mere trickle in the flood that was to come. Reading it now, aware of all we've learned since, we have a sense of how much we were fumbling around in the dark in those early days, searching for a cause and a cure, often going in wrong directions. The closest we had come to the true nature of the syndrome was an understanding that "life-style factors seem to be involved and the agent appears to be infectious." To read the complete article from our archives, go to http://bit.ly/1iswhZe.

The crisis of IRIS: what every nurse should know about immune reconstitution inflammatory syndrome in patients infected with HIV.

Most health care providers are aware that beginning combination antiretroviral therapy (ART) for patients infected with HIV has reduced morbidity of AIDS-related opportunistic infections and subsequently reduced HIV-related mortality. Effective ART leads to significantly reduced viral loads and increased CD4+ T cell counts, especially in the first few months after initiation. ART stimulates immune system reconstitution, thereby reducing the risk of exacerbation or acquisition of an opportunistic infection.

Intervención de la enfermera gestora de casos durante el ingreso hospitalario de pacientes con infección VIH / Intervention of the case management nurse in hospital admissions of patients with HIV infection

En países como el nuestro, con acceso a tratamiento antirretroviral, a infección por VIH se caracteriza por ser una enfermedad crónica de tratamiento exclusivamente hospitalario, así como por el envejecimiento de la población afectada, la persistencia de infecciones oportunistas, la complejidad del tratamiento antirretroviral, la frecuencia de efectos adversos de la terapia, las interacciones farmacológicas y el elevado gasto que supone para el sistema sanitario. Esta situación podría justificar la necesidad de la creación de la figura de la enfermera gestora de casos para el seguimiento de personas con infección VIH, ingresadas en plantas de hospitalización convencionales, como elemento aglutinador de las necesidades del individuo y de coordinación de los recursos a través de la planificación y de la adecuada gestión de los cuidados(AU)

In countries with access to antiretroviral treatment such as ours, HIV is a chronic disease both characterized for being treated only in hospitals and for the aging of the affected population, the persistence of opportunist infections, the complexity of the antiretroviral treatment, the frequency of adverse effects due to therapies, drug interactions and the high costs of this disease for the Healthcare System. This could justify the need for the creation of the position of nurse case manager to monitor patients with HIV infection, admitted to conventional hospital wards, as a unifying element of the individual's needs and coordinate resources through proper planning and care management(AU)

Ambiguous diagnosis, futile treatments and temporary recovery: meanings of medical treatment among HIV/AIDS family caregivers providing care without ARVs.

The capacity of countries with high HIV and AIDS prevalence to provide antiretroviral treatment and care for all people who need support remains a public health challenge. In Lesotho, there are improvements in this area but the high proportion of people who need ART yet they do not receive treatment suggests that many HIV-infected people continue to depend on medicines that treat opportunistic infections. The objective of the article is to explore caregivers' experiences with diagnostic procedures and outcomes, prescriptions and treatment outcomes when ARVs were unavailable. A phenomenological design using in-depth face-to-face interviews was used to obtain the experiences of 21 family caregivers about caregiving, including access to and use of medical treatments. Caregivers' experiences indicate that most of the consulted health professionals provided vague and inconsistent diagnoses while the medication they prescribed failed to treat most of the symptoms. Unavailability of medicines that control pain and symptoms effectively continues to be a prominent feature of HIV and AIDS home-based caregiving in Lesotho. It is recommended that health professionals should facilitate disclosure of HIV diagnosis to family caregivers to assist them to understand unstable treatment outcomes; and policy makers should strengthen home-based care by developing policies that integrate palliative care into HIV and AIDS care.

My first patient as a nurse practitioner: a man with low literacy.

PURPOSE: The purpose of this case study is to demonstrate the use of the nursing process and the standardized nursing languages of NANDA-I, the Nursing Outcomes Classification (NOC), and the Nursing Interventions Classification (NIC) to assist a man with low literacy to self-manage his medication regimen. DATA SOURCES: The data sources for this article are clinical nursing practice, research evidence related to helping people with low literacy, and the books that explain NANDA-I, NOC, and NIC. DATA SYNTHESIS: This case study demonstrates nurses' clinical decision making in providing care for a person with low health literacy. CONCLUSIONS: Low health literacy should be considered when nurses identify the nursing diagnosis of Ineffective Self-Health Management. After trust is established, a screening tool should be used to evaluate the person's literacy level. Active partnership of the nurse and the person supports interventions to assist the person implement the medication regimen. IMPLICATIONS FOR NURSING: Inadequate evaluation of health literacy may result in mislabeling a person as "nonadherent" or "noncompliant" to a medication or treatment regimen. Low literacy is often an unrecognized barrier to effective self-health management.