Journal of the Association of Nurses in AIDS Care

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2010-03-01

Just Get Over It

Lucy Bradley-Springer — 2010-03-01

What does this really mean?—Daniel J. Pesut, PhD, RN, PMHCNS-BC, FAANNovember 2009 at the 22nd Annual ANAC Conference I wish you had all been at the Saturday morning plenary session during the 2009 ANAC conference in Jacksonville, but I know that the economy and a number of other factors kept many of you away. If you weren't there, you missed a great presentation by Daniel Pesut, PhD, RN, PMHCNS-BC, FAAN. Dr. Pesut is a nurse and a futurist. He pays attention to what's going to happen and how that will affect nursing, health care, and a whole host of things. I learned a lot from the talk. Actually, it would be more accurate to say that Dr. Pesut stimulated a whole host of new ideas and images for me. I have to admit that some of those ideas were a bit overwhelming, and I'm not sure that I'm cut out to be a futurist. The good news is that I really don't have to be. Dr. Pesut said that “only” 20% of the time, 20% of the people need to focus on the future. I emphasize “only,” because that still means more of us need to pay attention to what is coming up. So I'm writing this to get the word out to all of you creative visionaries: Get started, nursing needs you, people living with HIV need you, and ANAC needs you.

The Tanzania HIV/AIDS Nursing Education (THANE) Preservice Curriculum

2009-10-12

The Schools of Nursing at Muhimbili University of Health and Allied Sciences and the University of California, San Francisco (UCSF) have been collaborating on a twinning partnership to develop an HIV nursing education preservice curriculum. The Tanzania HIV/AIDS Nursing Education (THANE) project was designed to increase the HIV education capacity of Tanzanian nursing schools by strengthening the knowledge and skills of the nurse educators. The THANE project includes three components: (a) development of 12 curriculum modules, (b) training of trainers, and (c) roll-out to all nurse educators in the eight zones of Tanzania and Zanzibar. The evaluation plan focuses on three main areas: (a) HIV knowledge, confidence in teaching, and thoughts about HIV, (b) participant satisfaction with the workshops, and (c) monitoring educators to assess implementation and dissemination of the THANE curriculum into existing curricula. To date, 300 nurse educators have been trained.

A Comparison of Death Anxiety and Quality of Life of Patients With Advanced Cancer or AIDS and Their Family Caregivers

Deborah Witt Sherman, Robert Norman, Christina Beyer McSherry — 2009-12-14

As an existential crisis, death anxiety may create suffering and impact quality of life. Based on a sample of 101 patients (63 patients with AIDS and 38 with advanced cancer) and 79 family caregivers (43 AIDS patients' caregivers and 36 cancer patients' caregivers), this study examined the death anxiety of patients with advanced cancer and patients with AIDS and that of their family caregivers and the relationship of death anxiety and quality of life. The results indicated that AIDS patients expressed greater death anxiety than cancer patients, but death anxiety was not different among family caregivers. Both AIDS and cancer patients experienced greater death anxiety than their caregivers. Greater death anxiety was associated with lower quality of life, particularly in the psychological domain for AIDS patients. There were significant correlations between the death anxiety subscales and the quality of life subscales for family caregivers, especially for AIDS caregivers. Interventions that lessen death anxiety may enhance quality of life as death approaches, particularly for AIDS patients and their family caregivers.

Integrating HIV-Related Evidence-Based Renal Care Guidelines Into Adult HIV Clinics

Brian K. Goodroad, Tracy Wright, Frank S. Rhame — 2010-01-29

The purpose of this evidence-based practice (EBP) project was to implement research-based, clinic-specific renal care guidelines into two adult HIV clinics. The two main components of the project included (a) implementation of clinic-specific renal care guidelines and (b) initiation of renal and general health patient education by clinic support staff. Overall, statistically significant improvement was shown postguideline implementation in proportion of urinalyses (UA) (p=.01) and estimated glomerular filtration rates (eGFR) (p=.002) completion for patients during initial clinic visits and for those requiring yearly (UA p < .001, eGFR p < .001) or twice-yearly (UA p < .001, eGFR p < .001) renal testing. The rate of renal health education provided to patients by nurses was 60.7%. Results suggest that advanced practice nurse-led EBP change implementation can result in better renal care in outpatient HIV care settings. The process described could be used to implement EBP in other clinic sites.

Risk Factors and Symptoms Associated With Pain in HIV-Infected Adults

2010-01-29

Studies suggest that people living with HIV (PLWH) experience many unrelieved symptoms. The purpose of this study was to estimate the occurrence of pain in adult PLWH and to determine whether participants with pain differed from those without pain on selected demographic factors, clinical characteristics, symptoms of fatigue, sleep disturbance, anxiety, or depression. The authors conducted a descriptive, comparative, and correlational study of 317 PLWH seen at academic and community clinics in San Francisco. Participants completed a demographic questionnaire, the Memorial Symptom Assessment Scale, the Fatigue Severity Scale, the General Sleep Disturbance Scale, the Profile of Moods State Tension-Anxiety subscale, and the Center for Epidemiological Studies-Depression Scale. Clinical characteristics (i.e., disease and treatment information) were obtained by self-report. A single item on pain from the Memorial Symptom Assessment Scale was used to classify participants into those with and without pain. Pain was highly prevalent (55%) and was associated with immune status (CD4+ T-cell count), race, and sleep disturbance, but not with age, gender, or symptoms of fatigue, depression, or anxiety.

Does Perceived HIV Stigma Contribute to Nurses' Intent to Migrate in Five African Countries?

2010-01-29

Nurse migration out of low-resource countries has occurred for many years, resulting in workforce shortages, particularly in countries with a high prevalence of HIV. A cross-sectional survey of 1,374 nurses from five African countries (Lesotho, Malawi, South Africa, Swaziland, and Tanzania) was conducted. A logistic regression analysis resulted in a profile of odds ratios predicting increased odds of intent to migrate for nurses who were more experienced and working in urban hospitals. These data provide the first support that HIV stigma experienced by nurses through their association as providers for people living with HIV may also be contributing to their intent to migrate. The study contributes to a greater understanding of the complexity of nurse migration in Africa.

Relationships Between Stigma, Social Support, and Depression in HIV-Infected African American Women Living in the Rural Southeastern United States

2009-11-02

This cross-sectional study examined relationships between HIV-related stigma, social support, and depression in a sample of 340 HIV-infected African American women living in rural areas of the Southeastern United States. Three aspects of social support (availability of different types of support, sources of support, and satisfaction with support) and two aspects of HIV-related stigma (perceived stigma and internalized stigma) were measured. Perceived availability of support (p < .0001), sources of support (p=.03), satisfaction with support (p=.003), perceived stigma (p < .0001), and internalized stigma (p < .0001) were all significantly correlated with depression. Social support variables were negatively correlated and stigma variables were positively correlated with depression. HIV-related perceived stigma and internalized stigma were found to mediate the effect of sources of available support on depression. Study findings have implications for designing and implementing interventions to increase social support and decrease HIV-related stigma in order to decrease depression among African American women with HIV disease.

Determinants of Adolescent Female Attendance at an HIV Risk Reduction Program

Dianne Morrison-Beedy, Michael P. Carey, Hugh F. Crean, Sheryl H. Jones — 2010-01-29

This study investigated attendance at an HIV-prevention randomized controlled trial for urban adolescent females. The intervention included four 2-hour sessions that were held at convenient community-based locations. Participants were recruited from reproductive and general health care clinics, as well as youth development programs. Of the 744 girls who consented to participate in the research study, 86% (n = 640) attended one or more of the risk reduction sessions, but 14% (n = 104) did not attend any sessions. Data analyses indicated that girls who attended were more likely to be younger, African American, and non-Hispanic. They also reported earlier sexual debut and more recent sexual partners. Results indicated that sexual risk reduction interventions are attractive to many at-risk female adolescents. Strategies to improve attendance are described for this vulnerable population subgroup.

An Examination of the Psychometric Properties of the Antiretroviral General Adherence Scale (AGAS) in Two Samples of HIV-Infected Individuals

2009-10-05

This article reports on the development and psychometric properties of the Antiretroviral General Adherence Scale (AGAS) in two National Institutes of Health-funded projects: the Get Busy Living Project, a behavioral clinical trial to promote consistent use of antiretroviral therapy, and the KHARMA (Keeping Healthy and Active with Risk Reduction and Medication Adherence) Project, which addressed issues of adherence and risk reduction behavior in women. AGAS assesses the ease and ability of participants to take antiretroviral therapy according to a health care provider's recommendations. Data were analyzed from completed baseline assessments of the two studies. The AGAS was internally consistent in both samples. Content, construct, and criterion validity were established using factor analysis and correlations of total AGAS scores with two measures of adherence: electronic drug monitoring and an Adult AIDS Clinical Trials Group adherence scale. Viral load, CD4 cell counts, and depression scores were also examined. Reliability and validity of the AGAS were supported in both samples.

The International Physical Activity Questionnaire Overestimates Moderate and Vigorous Physical Activity in HIV-Infected Individuals Compared With Accelerometry

Soula Fillipas, Flavia Cicuttini, Anne Elizabeth Holland, Catherine L. Cherry — 2010-01-29

This study evaluates the validity of the last-7-day, self-administered version of the International Physical Activity Questionnaire (IPAQ) long form in HIV-infected people, using accelerometry as the objective criterion. The ActiGraph GT1M accelerometer was worn during all waking hours for 7 days, and the IPAQ was completed on day 7. A total of 30 men were recruited as participants from the Alfred Infectious Disease Clinic, Melbourne, Australia. Self-reported total number of metabolic equivalents minutes per week correlated moderately with accelerometer total activity counts (r =.41, p =.02). However, mean differences showed overreporting with the questionnaire; 546.63 min/wk (95% confidence interval: 217.1-871.2 minutes) for moderate and 295.33 min/wk (95% confidence interval: 88.08-502.6 minutes) for vigorous activity. The IPAQ correlated with accelerometry, but substantial overreporting occurred. The tool may be useful in screening physical activity but should not be used to determine precise levels.

Masthead

2010-03-01

Editorial Board

2010-03-01

Board of Directors

2010-03-01

Journal of the Association of Nurses in AIDS Care

Cover 1

Just Get Over It

The Tanzania HIV/AIDS Nursing Education (THANE) Preservice Curriculum

A Comparison of Death Anxiety and Quality of Life of Patients With Advanced Cancer or AIDS and Their Family Caregivers

Integrating HIV-Related Evidence-Based Renal Care Guidelines Into Adult HIV Clinics

Risk Factors and Symptoms Associated With Pain in HIV-Infected Adults

Does Perceived HIV Stigma Contribute to Nurses' Intent to Migrate in Five African Countries?

Relationships Between Stigma, Social Support, and Depression in HIV-Infected African American Women Living in the Rural Southeastern United States

Determinants of Adolescent Female Attendance at an HIV Risk Reduction Program

An Examination of the Psychometric Properties of the Antiretroviral General Adherence Scale (AGAS) in Two Samples of HIV-Infected Individuals

The International Physical Activity Questionnaire Overestimates Moderate and Vigorous Physical Activity in HIV-Infected Individuals Compared With Accelerometry

Masthead

Editorial Board

Table of Contents

Board of Directors