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The objectives of the study were to describe the level of self-efficacy and its relationship with resilience among women living with HIV in Niger State, Nigeria. Self-efficacy is an important predictor of treatment outcomes among people living with HIV. Using a systematic random sampling technique, 676 participants completed adherence self-efficacy and resilience measures from three selected hospitals in Niger State. The result showed high levels of self-efficacy among the participants, linear relationships between perceived stress and resilience (-.601), perceived stress and self-efficacy integration (-.504), perceived stress and self- efficacy perseverance (-.220), resilience and self-efficacy integration (.667) and resilience and self-efficacy perseverance (.377). Hierarchical multiple linear regression indicated that 48.3% of the variance in resilience was explained by the two sub -scales of self-efficacy (p = < .001). Also, 26% (p = < .001) of the variance in perceived stress was explained by the two subscales of the self-efficacy. It is concluded that self-efficacy is a significant predictor of resilience and perceived stress among women living with HIV in Niger State, Nigeria.
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Fármacos Anti-HIV/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Adesão à Medicação/psicologia , Resiliência Psicológica , Estresse Psicológico , Adaptação Psicológica , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Nigéria/epidemiologia , Autoeficácia , Inquéritos e QuestionáriosRESUMO
Background: Collaborative clinical facilitation converges key players to guide students individually and within groups towards achieving clinical nursing competence. However, experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and nursing and midwifery students are often fragmented and have been largely unexplored in Ghana. Aim: To describe the experiences of collaborative clinical facilitation among nurse educators, clinical preceptors and final year nursing and midwifery students in Northern Ghana. Setting: The study was conducted at two nursing and midwifery colleges and an academic hospital in Northern Ghana. Methods: A qualitative, descriptive, exploratory design was utilized. Forty-six participants comprising 16 nurse educators, 10 clinical preceptors, 10 nursing students and 10 midwifery students were purposively sampled. Focus groups and in-depth interviews were used to gather data and analysed thematically. Results: Three themes revealed facilitative experiences of collaborative clinical facilitation: team-based clinical mentorship and supervision, personalised preceptorship, and clinical conferences. Two themes emerged inhibitory to collaborative clinical facilitation: staff shortages and lack of timely communication. Conclusion: This study found that team mentorship, preceptorship and conferences fostered collaborative clinical partnerships for students' clinical learning. However, failure to engage in timeous communication in the midst of staff shortages hampered its smooth practice. Orientation workshops need to be organised for key players to share relevant updates and explore ways to navigate the challenges often experienced within the clinical training environment. Contribution: This paper provides insight into the collaborative nature of clinical facilitation; and highlights the need for coordinated clinical placements to enhance students' clinical learning.
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AIM: To map the evidence of the simulation debriefing phase in simulation activities of nursing education, to address and inform clinical teaching and learning in nursing. DESIGN: A scoping review. METHODS: A systematic review of literature published between 2008-2021 was conducted using CINAHL & ERIC, MEDLINE, EMBASE, APA PsycInfo, the Cochrane Library and JBI Evidence synthesis. Inclusion criteria were primary studies published in English on simulation debriefing at all levels in nursing education. RESULTS: Of 140 included references, only 80% (N = 112) framed simulation debriefing theoretically either by specific theories/models or as a literature review of the topic. A variety of simulation debriefing methods were identified; however, debriefing methods were only described in 79% (N = 110) of the references. There appears to be a gap in consensus concerning the theoretical or methodological frameworks characterizing simulation debriefing in nursing education. The majority of studies (86%) were conducted at a bachelor's degree level (N = 121).
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Educação em Enfermagem , Educação em Enfermagem/métodos , Aprendizagem , Competência Clínica , Simulação por ComputadorRESUMO
BACKGROUND: Children survive into adult life with Human Immunodeficiency Virus (HIV), which previously would have been lethal in early childhood. METHODS: The study aimed to describe the current transitional process for Adolescents Living with HIV (ALHIV) in a resource-limited setting in Ashanti Region, Ghana. The study was an explorative study that used an interpretive paradigm. A semi-structured interview guide was used to interview ALHIV, selected by purposive sampling. The study was conducted at a tertiary hospital in Kumasi. Data were analysed using thematic analysis. RESULTS: Transitioning of ALHIV was done without any guide; the themes generated were on the process of transition in which they used age (13 and above) and disclosure as the criterion to move ALHIV to the adult clinic. Most adolescents complained about being stigmatised, the attitude of staff, interruption of school and separation anxiety as experiences they went through during the transitioning process. On improving transition, ALHIV felt sexual and reproductive health services, information on treatment, privacy, and support were necessary transition components. CONCLUSION: The use of age and disclosure of status as a criterion for transitioning ALHIV affects moving and retaining this age group in HIV management programs in the adult clinics. There is, therefore, an urgent need for a guideline as the current transition process defeats the purpose of providing adolescents with age-specific care in the Adult Clinic.
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Instituições de Assistência Ambulatorial , Infecções por HIV , Adolescente , Adulto , Criança , Pré-Escolar , Revelação , Gana/epidemiologia , Infecções por HIV/terapia , Humanos , Comportamento SexualRESUMO
BACKGROUND: Globally, the healthcare system is burdened with the rise in communicable diseases compounded by the comorbidity of non-communicable diseases. South Africa in particular experiences a quadruple burden of diseases, and human immunodeficiency virus (HIV) and hypertension are amongst the burden of diseases reported. AIM: This article aims to explore and describe the lived experiences of people living with HIV (PLWH) and hypertension in the Eastern Cape, South Africa. SETTING: The study was conducted in the Sakhisizwe sub-district within the Chris Hani health district of the Eastern Cape. METHODS: A qualitative study design using Husserl's descriptive phenomenology underpinned this study. Purposive sampling method was used to select participants. Information was gathered using semi-structured interviews from nine participants who met the inclusion criteria. The interviews were recorded on an audiotape and conducted in isiXhosa, and these were verified through back and forward translation to English. The transcribed interviews were coded manually, and underpinned by Giorgi's phenomenological data analysis steps. RESULTS: This study yielded four themes that described the journey towards a new normal experienced by participants. These themes were (1) overcoming illness-related stigma, (2) sources of support, (3) self-love: taking ownership of the diseases and (4) creating transforming behaviours and self-care strategies. CONCLUSION: This study demonstrated that the central theme that emerged from the lived experiences of participants with HIV and hypertension was a process of finding a new normal for their lives. This process had several enabling and inhibiting conditions that enabled participants to develop self-acceptance and find strategies to transform behaviours to better live with two chronic illnesses.
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Infecções por HIV , Hipertensão , HIV , Infecções por HIV/complicações , Humanos , Pesquisa Qualitativa , Estigma Social , África do SulRESUMO
BACKGROUND: Despite significant gains in the HIV epidemic in South Africa, with reduction in mortality and elimination of vertical transmission, national HIV prevalence remains high, with women rather than men continuing to bear higher burden of the disease. Population subgroups, through ignorance, disbelief or recklessness, continue to engage in risky sexual behaviour. A substantial proportion of minibus taxi drivers engage in risky sex, seldom seeing themselves at risk for STIs or HIV/AIDS. These taxi drivers have been linked with so-called taxi queens, with whom they engage in transactional and intergenerational relationships. OBJECTIVES: The study explored condom use and condom negotiation strategies among taxi drivers and taxi queens in Kwa- Zulu-Natal, South Africa. METHODS: Applying explorative qualitative design, we conducted focus group discussion and individual interviews among participants who were purposively recruited in KwaZulu-Natal. RESULT: Qualitative data analysis revealed that condom use and negotiation are sources of conflict for the participants. In addition, the strategies employed by participants to ensure condom usage are not always sustainable and are likely to be problematic due to a variety of complex factors. CONCLUSION: Our study concludes by recommending a nested public health response that takes cognizance of factors that promote sustainable condom use strategies among this population subgroup.
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Condução de Veículo , Preservativos/estatística & dados numéricos , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Conhecimentos, Atitudes e Prática em Saúde , Ocupações , Sexo Seguro/estatística & dados numéricos , Parceiros Sexuais/psicologia , Adulto , Condução de Veículo/estatística & dados numéricos , Feminino , Grupos Focais , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Veículos Automotores , Pesquisa Qualitativa , Assunção de Riscos , Comportamento Sexual , África do Sul/epidemiologia , Inquéritos e Questionários , Meios de TransporteRESUMO
Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n=251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n=244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions.
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Infecções por HIV/psicologia , Pesquisa Metodológica em Enfermagem , Estereotipagem , Síndrome da Imunodeficiência Adquirida/psicologia , Adulto , África Austral/epidemiologia , Idoso , Feminino , Infecções por HIV/epidemiologia , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Qualidade de Vida , Tanzânia/epidemiologia , Estudos de Validação como Assunto , Adulto JovemRESUMO
BACKGROUND: Psychological morbidities concurrent with HIV have been the focus of considerable scientific investigations. However, researchers have largely overlooked HIV-related stress and resilience among women living with HIV in rural communities. AIM: This study explored the associations between psychological resilience and HIV-related stress among women living with HIV. SETTING: The study was conducted in three randomly selected hospitals that provide primary HIV care in Niger state, Nigeria. METHODS: A predictive cross-sectional design was used to describe the relationship between perceived stress and resilience among the study population. RESULTS: Out of 748 participants who completed the Connor-Davidson resilience scale and the perceived stress scale questionnaires, 676 returned the questionnaire in usable form. While the results showed moderate levels of perceived stress and a high level of psychological resilience, there was a significant and negative relationship between HIV-related stress and psychological resilience (r = -0.601, p = 0.001). Also, higher resilience was significantly associated with decreased perceived stress. CONCLUSION: It is concluded that measures to promote resilience and employment opportunity may ameliorate HIV-related stress among women living with HIV.
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Infecções por HIV/psicologia , Resiliência Psicológica , Estresse Psicológico/etiologia , Adaptação Psicológica , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Qualidade de Vida/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
People living with HIV (PLWH) and their families are subjected to prejudice, discrimination, and hostility related to the stigmatization of AIDS. This report examines how PLWH cope with HIV-related stigma in the five southern African countries of Lesotho, Malawi, South Africa, Swaziland, and Tanzania. A descriptive qualitative research design was used to explore the experience of HIV-related stigma of PLWH and nurses in 2004. A total of 43 focus groups were conducted with 251 participants (114 nurses, 111 PLWH, and 26 volunteers). In describing incidents of stigma, respondents reported strategies used or observed to cope with those incidents. Nurse reports of coping strategies that they used as well as observed in HIV-infected patients were coded. Coping strategies used by PLWH in dealing with HIV-related stigma were coded. A total of 17 different self-care strategies were identified: restructuring, seeing oneself as OK, letting go, turning to God, hoping, changing behavior, keeping oneself active, using humor, joining a support or social group, disclosing one's HIV status, speaking to others with same problem, getting counseling, helping others to cope with the illness, educating others, learning from others, acquiring knowledge and understanding about the disease, and getting help from others. Coping appears to be self-taught and only modestly helpful in managing perceived stigma.
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Adaptação Psicológica , Atitude do Pessoal de Saúde/etnologia , Atitude Frente a Saúde/etnologia , Infecções por HIV/etnologia , Recursos Humanos de Enfermagem/psicologia , Estereotipagem , Adulto , Essuatíni , Feminino , Grupos Focais , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lesoto , Malaui , Masculino , Moral , Pesquisa Metodológica em Enfermagem , Pesquisa Qualitativa , África do Sul , TanzâniaRESUMO
Most people with HIV have disclosed their status to someone, often with mixed results. Most health literature seems to favor disclosure by persons living with acquired immunodeficiency syndrome (AIDS), but it could be that to disclose is not always a good thing. We used a descriptive, qualitative research design to explore the experience of human immunodeficiency virus (HIV) and AIDS stigma of people living with HIV or AIDS and nurses involved in their care in Africa. Focus group discussions were held with respondents. We asked them to relate incidents that they themselves observed, and those that they themselves experienced in the community and in families. Thirty-nine focus groups were conducted in five countries in both urban and rural settings. This article is limited to a discussion of data related to the theme of disclosure only. The sub-themes of disclosure were experiences before the disclosure, the process of disclosure, and responses during and after disclosure.
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Adaptação Psicológica , Atitude Frente a Saúde , Infecções por HIV/psicologia , Nível de Saúde , Enfermeiras e Enfermeiros , Percepção , Preconceito , Revelação da Verdade , Síndrome da Imunodeficiência Adquirida/enfermagem , Síndrome da Imunodeficiência Adquirida/psicologia , Adulto , África , Feminino , Grupos Focais , Infecções por HIV/enfermagem , Pessoal de Saúde , Humanos , Relações Interpessoais , Pesquisa Qualitativa , Apoio Social , ConfiançaRESUMO
BACKGROUND: South Africa's prevention of mother-to-child transmission (PMTCT) of the human immunodeficiency virus (HIV) programme has undergone rapid changes in the last two decades. Initially, the provision of single antiretroviral therapy was based on eligibility criteria in the year 2001, which later changed to combination therapy. This was aimed at preventing mother-to-child transmission of HIV. Since 2015, all pregnant women were eligible for antiretroviral treatment regardless of their CD4 count. Although significant strides were made to reduce mother-to-child transmission of HIV, increased efforts are required to meet UNAIDS targets, World Health Organization (WHO) elimination framework goals and sustainable development goals to eliminate new HIV infections in children and ending the HIV epidemic by 2030. AIM: The aim of the study was to explore healthcare workers' experiences and patient perceptions of the implementation of rapid changes to the PMTCT programme in four public healthcare facilities. SETTING: The study was conducted in the four public healthcare facilities within the two highly HIV-burdened districts of iLembe and eThekwini in KwaZulu-Natal province, South Africa. METHODS: This study used a qualitative, exploratory, descriptive study design using interviews and focus group discussions. Participants were selected using purposive sampling. Following verbatim transcription of the data, thematic data analysis was used through data reduction and data display and the emergence of four themes. RESULTS: A total of 61 stakeholders were interviewed. Four major themes emerged: (1) impact of poor health system design, (2) impact of poor communication of changes, (3) contextual factors affecting innovation in healthcare and (4) skill deficit in change management and forward planning. CONCLUSION: A healthcare system more responsive to the experiences of healthcare workers and pregnant women is required to effectively implement changes in priority programmes.
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Infecções por HIV/prevenção & controle , Pessoal de Saúde/psicologia , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Feminino , Grupos Focais , Infecções por HIV/tratamento farmacológico , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Inovação Organizacional , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Prática de Saúde Pública , Pesquisa Qualitativa , África do Sul/epidemiologia , Adulto JovemRESUMO
BACKGROUND: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission. OBJECTIVES: The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi. METHODS: An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software. RESULTS: The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent's knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses. CONCLUSION: Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted.
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Programas Governamentais , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Enfermeiras e Enfermeiros/normas , Adulto , Competência Clínica/normas , Prática Clínica Baseada em Evidências , Feminino , Infecções por HIV/transmissão , Humanos , Malaui , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Prevention of mother-to-child transmission (PMTCT) of HIV is a life-saving public health intervention. Sub-Saharan African (SSA) countries have made significant progress in the programme, but little is known about the strategies used by them to eliminate mother-to-child transmission of HIV. AIM: To map evidence of strategies and interventions employed by SSA in bridging the implementation gap in the rapidly changing PMTCT of HIV programme policy. METHODS: Electronic search of the databases MEDLINE, PubMed and SABINET for articles published in English between 2001 and August 2016. Key words included 'Sub-Saharan African countries', 'implementation strategies', 'interventions to bridge implementation gap', 'prevention of mother-to-child transmission of HIV' and 'closing implementation gap'. RESULTS: Of a total of 743 articles, 25 articles that met the inclusion criteria were included in the study. Manual content analysis resulted in the identification of three categories of strategies: (1) health system (referral systems, integration of services, supportive leadership, systematic quality-improvement approaches that vigorously monitors programme performance); (2) health service delivery (task shifting, networking, shared platform for learning, local capacity building, supportive supervision); as well as (3) community-level strategies (community health workers, technology use - mHealth, family-centred approaches, male involvement, culturally appropriate interventions). CONCLUSION: There are strategies that exist in SSA countries. Future research should examine multifaceted scientific models to prioritise the highest impact and be evaluated for effectiveness and efficiency.
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Infecções por HIV/transmissão , Implementação de Plano de Saúde/organização & administração , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Complicações Infecciosas na Gravidez , Avaliação de Programas e Projetos de Saúde , África Subsaariana , Fortalecimento Institucional , Feminino , Humanos , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/virologiaRESUMO
This report is based on qualitative data gathered through a series of focus group discussions with people living with HIV or AIDS and nurses in five African countries. Participants were asked which words or phrases people use to refer to the illness and to people living with the illness. A total of 261 respondents were involved in the 40 focus group discussions, and an analysis of the data identified 290 descriptions. The descriptions were classified into 7 categories, which were (from most to least common): attributional, neutral, death-related, physical feature-related, factual statements, lingering illness-related, and common illness-related. Whereas some terms were used in more than one country, others were unique to a specific country. The descriptions show many negative labels and beliefs, but also an awareness of the devastating effects of the illness on individuals.
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Infecções por HIV , Preconceito , Estereotipagem , Terminologia como Assunto , África Subsaariana , Feminino , Grupos Focais , Infecções por HIV/psicologia , Humanos , MasculinoRESUMO
BACKGROUND: South Africa is currently focusing strongly on human resource development. The purpose of this study was to describe and compare the quality of nursing service and care in three health districts in the KwaZulu Natal Province. To identify deficiencies which could be addressed by education and training, it might be useful to measure the quality of care given by nurses. METHODS: From March to August 2002 a survey was done in six hospitals and six clinics in three health districts of the KwaZulu-Natal province of South Africa. Five different aspects of care was evaluated; hand-over from one nursing shift to another, implementation of universal precautions, patient satisfaction, nursing records, management of chronic illnesses. All these aspects were evaluated using checklists based on record reviews or direct observation, except for patient satisfaction, which was evaluated by questionnaires. RESULTS: The average scores on the different aspects varied from 11% (for nursing records) to 73% (for management of chronic diseases). Specific problems became evident. In one district three out of four hand-overs between shifts of nurses scored less than 50%. In all three districts the use of protective gear scored low (43%). While the average score for management of chronic illnesses were high at 73%, the blood pressures of only 23% was within the target range, and the blood sugar of only 38% of patients were controlled. Patient satisfaction averaged 72% across the three districts. CONCLUSION: The quality of care measurements identified specific training needs, but other management strategies are probably also indicated.
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BACKGROUND: Whilst the discourse of palliative care in HIV management is largely documented and regarded as being an essential component, various authors have further argued that within the context of HIV care in sub-Saharan Africa, palliative care and exploration of the dimensions thereof is largely lacking. This article presents the lived experiences of nurses involved in palliative care, thus providing the perspective of nurses and the multi-faceted dimensions of the nature of caring inherent. OBJECTIVES: This study explored the respondents' understanding of the concepts 'caring' and 'terminal patient' and described the experiences of nurses caring for terminally-ill patients with HIV and how these experiences influence the nature of care rendered. METHODS: Qualitative research using Husserl's approach of phenomenology design underpinned the study and Giorgi's steps of analysis were used to make meaning of the data. RESULTS: The concept 'caring' was experienced by the nurses as transforming the patients' quality of life through supportive care and hope for life. Palliative care made the nurses conscious of their own mortality, enabling them to be more sensitive, compassionate and dedicated to caring for their patients. The findings described the social networking that enabled nurses to collaborate with colleagues in the interdisciplinary teams and shared knowledge, skills and support within the palliative care team in order to optimise patient outcomes. CONCLUSION: Nurses with prolonged involvement in caring for terminally-ill patients with HIV experienced helplessness and emotional stress. Recommendations based on the results are that training in psychological and holistic care of the patient, professional counselling and stress management services are needed to support the nurse in this context.
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Síndrome da Imunodeficiência Adquirida , Enfermagem de Cuidados Paliativos na Terminalidade da Vida , Enfermeiras e Enfermeiros/psicologia , Assistência Terminal/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto JovemRESUMO
Background: HIV continues to be a global public health concern with Malawi being among the worst affected countries. The prevalence of HIV among pregnant women is also very high, thereby raising concerns of mother-to-child transmission of the virus. Prevention of mother-to-child transmission (PMTCT) of HIV is therefore a priority in the efforts to curb the HIV pandemic. Keeping in mind that the area of HIV management is rapidly evolving, underpinning nursing care with evidence-based practice is essential and has been reported to reduce mother-to-child transmission.Objectives: The aim of the study was to explore and describe the knowledge, attitudes and practices of nurses regarding evidence-based practice in PMTCT at a selected hospital in Malawi.Methods: An exploratory descriptive quantitative design was used, and 81 nurses working in paediatric, obstetrics and gynaecology departments completed a self-administered questionnaire. Data were analysed using Predictive Analytics Software.Results: The results showed that nurses had average knowledge of evidence-based practice and although their attitudes were favourable, their practice was very low. Certain sociodemographic variables had an influence on the respondent's knowledge, attitudes and practices. Furthermore, the results have indicated that evidence-based practice was mainly hampered by insufficient resources and difficulties in accessing research articles. It emerged from the study that mentoring, training and access to literature could facilitate evidence-based practice in PMTCT among nurses.Conclusion: Nurses need to be provided with the necessary support including education and resources if evidence-based practice in PMTCT is to be promoted
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Prática Clínica Baseada em Evidências , Infecções por HIV , Conhecimentos, Atitudes e Prática em Saúde , Transmissão Vertical de Doenças Infecciosas , Malaui , EnfermagemRESUMO
The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association.
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Infecções por HIV/psicologia , Enfermeiras e Enfermeiros/estatística & dados numéricos , Preconceito , Adulto , Essuatíni/epidemiologia , Feminino , Seguimentos , Infecções por HIV/epidemiologia , Humanos , Lesoto/epidemiologia , Malaui/epidemiologia , Masculino , Enfermeiras e Enfermeiros/psicologia , Isolamento Social/psicologia , África do Sul/epidemiologia , Tanzânia/epidemiologia , Adulto JovemRESUMO
This study explored the demographic and social factors, including perceived HIV stigma, that influence job satisfaction in nurses from 5 African countries. A cross-sectional survey was conducted of nurses (n = 1,384) caring for patients living with HIV infection in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Total job satisfaction in this sample was lower than 2 comparable studies in South Africa and the United Kingdom. The Personal Satisfaction subscale was the highest in this sample, as in the other 2. Job satisfaction scores differed significantly among the 5 countries, and these differences were consistent across all subscales. A hierarchical regression showed that mental and physical health, marital status, education level, urban/rural setting, and perceived HIV stigma had significant influence on job satisfaction. Perceived HIV stigma was the strongest predictor of job dissatisfaction. These results provide new areas for intervention strategies that might enhance the work environment for nurses in these countries.
Assuntos
Infecções por HIV/psicologia , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Estereotipagem , Adulto , África , Demografia , Feminino , Infecções por HIV/enfermagem , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year project entitled Perceived AIDS Stigma: A Multinational African Study was undertaken. The focus of the first phase of this project was on exploring and describing the meaning and effect of stigma on PLWA from the experiences of PLWA and the nurses involved in their care in five African countries: Lesotho, Swaziland, Malawi, South Africa and Tanzania. An exploratory descriptive qualitative research design was used to explore and describe the experience of stigma through the critical incident method. Purposive voluntary sampling was utilized. Forty-three focus group discussions were held with respondents to relate incidences which they themselves observed, as well as those that they themselves experienced in the community and in families. The transcribed data was analyzed through the technique of open coding using the NVivo 2.0 analysis package. Three types of stigma (received stigma, internal stigma and associated stigma) and several dimensions for each of these types of stigma emerged from the data. Recommendations were made to pursue these findings further.