Cost-effectiveness analysis of recruitment strategies in a community-based intervention study of HIV-infected persons.

This paper describes and evaluates recruitment methods used to reach adults with HIV infection and to enroll eligible candidates in a randomized trial of aerobic exercise. Potential participants residing in the metropolitan Washington DC area were recruited from January 1994 to December 1996. The yield and associated cost of clinic centre site-visit (CSV) recruitment are compared to similar outcomes for community-based (CB) recruitment strategies, which consisted of presentations to local groups, mail/phone canvasses of caregivers, neighbourhood network promotion, public site postings and print media notices. Of 833 HIV infected adults ascertained during the recruitment phase as prospective study candidates, 66.7% were initially contacted during CSV recruitment. The remainder, 33.3% were CB recruits. The percentage of screened candidates who were subsequently enrolled in the study was 13.5% for CSV recruitment and 21% for CB recruitment. Ascertainment and screening costs combined were $158 per CB recruit compared to $232 per CSV recruit. Using multiple recruitment approaches we successfully achieved our enrollment goal of at least 100 volunteers from diverse populations by the end of the planned recruitment period.

Evidence-based practice.

This article provides an overview of evidence-based practice (EBP). It will discuss the background of EBP and barriers to using it. The state of HIV nursing research evidence, as well as methods to rate that evidence, will be described. Types of data sources will be identified. The article will conclude with selected clinical applications of EBP.

Analysis of the nursing work force compared with national trends.

Nursing work force analysis gives crucial data for administrators, allowing them to anticipate employment opportunities and areas of limited growth. Using an economic model of supply and demand, this study examined the employment and educational needs for nurses. In many areas of data collection, the District of Columbia data paralleled national trends, indicating the nationwide relevance of the conclusions. Projected mismatches between the type of nurses (by educational preparation) entering the work force and the skills required for the job vacancies could lead to increased demand for nurses with certain credentials as well as shortages of nurses in certain types of facilities.

Nursing research and HIV infection: state-of-the-science.

PURPOSE: To provide an update of the nursing research literature on HIV infection and to develop an HIV/AIDS database using arcs computer software. METHODS: Nursing research literature from 1986 through 1997 on human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) was reviewed. With an emphasis on client-focused research, 246 studies were entered into the arcs HIV/AIDS database. FINDINGS: Analysis of over 1,000 citations in the HIV/AIDS nursing research literature over the past decade indicated that 22% (n = 219) of the nursing studies were client- or patient-focused; 29% (n = 292) were risk-group focused; and 49% (n = 492) were provider-focused. Of the 246 studies entered into the arcs HIV/AIDS database, 88 (35.7%) were classified in the psychologic domain, 65 (26.4%) in the physiologic domain, 24 (9.7%) in the behavioral domain, and 25 (10%) in the social domain. In addition, 17 (6.9%) of the studies were classified in the quality of life domain, and 27 (10.9%) in the stage of HIV disease domain. The majority (53%) of the 246 studies (n = 131) were correlational, 86 (35%) were descriptive, and 29 (12%) had experimental or quasi-experimental designs. CONCLUSIONS: Although nursing studies have described some of the problems that affect HIV-infected people, further research is needed, particularly related to clinical interventions.

Predictors of functional status in patients in a chronic-care facility.

OBJECTIVE: To identify those factors correlated with functional status levels (activities of daily living and mobility) in a chronically ill population in long-term care. METHODS: Retrospective chart reviews were conducted over 3 months for information associated with functional status on all 220 patients in an urban extended-care facility. Independent variables included demographic variables, presence of selected medical conditions, current mental status, and baseline functional status on admission. Mean length of stay was 39 months. Multivariate analysis was performed to identify predictors of functional status. RESULTS: Factors correlated with functional status levels for 217 patients included total score on admission functional status and total score on current mental status (both P < .0001). There were no significant differences in mean scores of total functional status by medical problem, age, gender, length of stay, condition, level of care, presence of infection, or use of psychotropic drugs.