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Biomedical subjects

C J Portillo

Publications and source records attributed to C J Portillo.

At least 19 recordsLinked to original sources
PubMed2003

Symptom experience and functional status among HIV-infected women.

Irrespective of powerful drug therapies, there has been a slight increase in newly diagnosed cases of AIDS in women. HIV/AIDS-related symptoms develop from the illness itself, treatments or medications. Symptoms and their reoccurrence remain problematic. This study is a secondary analysis of data exploring symptoms, symptom distress and functional status in 104 ethnically diverse HIV-positive women. Measures included the Brief Symptom Inventory, a General Symptom Questionnaire, the Center for Epidemiological Studies Depression Scale, and the Inventory of Functional Status. Findings indicate that this sample of women was distressed, at risk for depression and had a moderate level of physical functioning. These findings support the need for symptom management interventions that enhance emotional wellbeing and self-care activities for HIV-infected women.

Activities of Daily Living↗
PubMed2001

The influence of sleep and activity patterns on fatigue in women with HIV/AIDS.

The cause of HIV-related fatigue is most likely multifactorial. When presented as a chief complaint, clinicians often include an assessment of stress level, depression, anemia, infection, and amount of sleep and activity. The empirical bases for these evaluations vary in their validity and implementation in clinical practice, but the basis for evaluating adequate amounts of sleep and activity currently lacks empirical research. The purpose of this study was to describe HIV seropositive women's sleep and activity patterns related to their fatigue experience. Sleep and activity were assessed with wrist actigraphy to obtain objective measures of total sleep time, number of awakenings, and sleep efficiency, as well as level of daytime activity, 24-hour activity rhythm, and naps. This sample of 100 women with HIV/AIDS averaged only 6.5 hours of sleep at night, and 45% of the sample napped. CD4 cell counts were unrelated to sleep and fatigue measures. Compared to the low-fatigue group, the women with high fatigue had significantly more difficulty falling asleep, more awakenings from nighttime sleep, poorer daytime functioning, and a higher frequency of depressive symptoms. Findings from this study provide clinicians with empirically based support for detailed clinical evaluations of sleep and activity patterns, as well as anxiety and depression, in clients who complain of fatigue. Findings also provide data for potential interventions to improve sleep and activity in persons living with HIV/AIDS and to reduce fatigue and depressive symptoms.

Adult↗
PubMed2001

Tuberculosis prevalence in an urban jail: 1994 and 1998.

SETTING: Despite a continuing decline in tuberculosis (TB) in the US, jails remain a high-risk setting for the identification of active and latent TB infection (LTBI). OBJECTIVE: The purpose of this study was to document the change in TB prevalence in the San Francisco City and County Jail. DESIGN: Two period prevalence analyses were done, for 1994 and 1998. The sample included all persons booked into jail during the two years. The rates of inmates screened and the prevalence of active TB and LTBI by sex and ethnicity were compared using computerized records. RESULTS: Prevalence of active TB was 72.1 per 100000 jail population for 1998, and did not change significantly from 1994. In 1998 one third of active TB cases were found through jail screening. Latinos represented respectively 20.1% and 17.7% of those booked in 1994 and 1998, but 43.0% and 41.7% of inmates with LTBI. In 1998, being Latino (odds ratio 2.9) and male (odds ratio 1.6) were most strongly associated with LTBI. CONCLUSION: Screening for TB among jail inmates is an increasingly valuable clinical and epidemiological tool for case-finding and for identifying persons who would benefit from preventive therapy.

Adult↗
PubMed2000

Hematological complications and quality of life in hospitalized AIDS patients.

The relationships among the biological and physiological indicators of cytopenias in AIDS and measures of quality of life are not well characterized. The purpose of this secondary analysis was to determine the relationships among anemia, neutropenia and thrombocytopenia and characteristics of the individual, physiological markers, symptoms, functional status, general health perceptions, and well-being in people with AIDS. The five dimensions of the Wilson and Cleary model of health-related quality of life provided the conceptual model for this study. In addition to descriptive statistics, logistic regression was used to analyze clusters of variables. The sample of 146 hospitalized patients with AIDS had an 85% prevalence of anemia, a 53% prevalence neutropenia and a 33% prevalence of thrombocytopenia. The mean age was 38 years old, 19% were female, 35% were white, 27% had a history of injection drug use and the mean T-helper cell count was 74 mm3. The five dimensions of the Wilson and Cleary model offered significant predictability for anemia only. Patients with higher symptom scores were more likely to have treatable anemia, defined as a hematocrit of < 30%. Treatable anemia was also associated with lower self-care scores and lower T-helper cells. Fifty-four percent of the cohort were candidates for colony stimulating factors, while only 17% of those eligible received them. These data suggest suboptimal treatment of anemia and neutropenia in this cohort of AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Predictors of self-reported adherence in persons living with HIV disease.

This study examined the relationships between the five dimensions of the Wilson and Cleary model of health-related quality of life and three self-reported adherence measures in persons living with HIV using a descriptive survey design. Data collection occurred in seven cities across the United States, including university-based AIDS clinics, private practices, public and for-profit hospitals, residential and day-care facilities, community-based organizations, and home care. The three dependent adherence measures studied were "medication nonadherence," "follows provider advice," and "missed appointments." The sample included 420 persons living with HIV disease with a mean age of 39 years of which 20% were women and 51% were white; subjects had a mean CD4 count of 321 mm3. HIV-positive clients with higher symptom scores, particularly depression, were more likely to be nonadherent to medication, not to follow provider advice, and to miss appointments. Participants who reported having a meaningful life, feeling comfortable and well cared for, using their time wisely, and taking time for important things were both more adherent to their medications and more likely to follow provider's advice. No evidence was found demonstrating any relationship between adherence and age, gender, ethnicity, or history of injection drug use. These findings support the need to treat symptoms, particularly depression, and to understand clients' perceptions of their environment as strategies to enhance adherence. A limitation of this study was that adherence was measured only by self-report; however, the study did expand the concept of adherence in HIV care beyond medication adherence to include following instructions and keeping appointments.

Adult↗
PubMed1998

Graduate program: advanced practice nurses in the home.

This article is a curriculum overview of a graduate program of the Advanced Practice Home Care Nursing (APHCN) Program, which began at the School of Nursing, University of California, San Francisco, in 1996. A historical perspective of home care and the need for advanced practice nurses in the home care industry is provided. Curricular components of the APHCN Program are outlined. The roles of the home care clinical nurse specialist, home care nurse practitioner, and home care administrator are presented. Finally, a discussion is presented in which home care nursing demonstrates the efficacy of the advanced practice role and the need for well designed outcomes-based research.

Community Health Nursing↗
PubMed1998

Informed consent in a multicultural cancer patient population: implications for nursing practice.

Obtaining informed consent, an ethical obligation of nurses and other health care providers, occurs routinely when patients make health care decisions. The values underlying informed consent (promotion of patients' well-being and respect for their self-determination) are embedded in the dominant American culture. Nurses who apply the USA's cultural values of informed consent when caring for patients who come from other cultures encounter some ethical dilemmas. This descriptive study, conducted with Latino, Chinese and Anglo-American cancer patients in a large, public, west-coast clinic, describes constraints on the informed consent process in a multicultural setting, including language barriers, the clinical environment, control in decision making, and conflicting desired health outcomes for health care providers and patients, and suggests some implications for nursing practice.

Asian↗
PubMed1996

Tuberculosis mortality associated with AIDS and drug or alcohol abuse: analysis of multiple cause-of-death data.

The resurgence in tuberculosis morbidity in the mid-1980s has increased interest in tuberculosis mortality. We examined mortality in the United States, from tuberculosis in 1990, using multiple cause-of-death data to describe the impact of AIDS and substance abuse, defined as drug or alcohol abuse, on mortality from tuberculosis. Tuberculosis mortality by age showed a bimodal pattern, with a peak between ages 25 and 55; by race/ethnicity, black and Hispanic males had the highest mortality rates, and black females had rates close to those of Hispanic males. Although in each of the race/ethnicity categories the removal of deaths with AIDS resulted in mortality curves closer to those of 1980, the bimodal pattern remained for black and Hispanic deaths. When we examined deaths with tuberculosis and substance abuse, we found that substance abuse without AIDS may account for additional deaths contributing to the bimodal pattern seen.

AIDS-Related Opportunistic Infections↗
PubMed1996

Physical and social correlates of perceived psychological support among hospitalized AIDS patients.

Persons living with HIV disease are faced with a broad array of physical and psychosocial problems across the trajectory of their illness. Almost all will be hospitalized for nursing care during the course of their disease. The purpose of this study was to explore the physical health and social correlates of perceived psychological support among hospitalized AIDS patients. The sample consisted of 168 AIDS patients hospitalized with Pneumocystis carinii pneumonia (PCP). Each patient rated his or her psychological support and physical condition on a scale of 1-10. Self-care ability was measured by the Quality Audit Marker. Physiological and social variables were obtained from an audit of the patient record. Stepwise regression analysis by sets indicated that only 12% of the variance was explained by the antecedent variables of physical health (self-care ability, white blood count, perception of physical condition, and first PCP admission)) and social (living alone and insurance status) correlates. Self-care ability and living alone were found to be significant predictors of self-rating of perceived psychological support in this sample. Further research is needed in the area of perceived psychological support among hospitalized AIDS patients as a basis for providing quality nursing care.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Angina, functional impairment and physical inactivity among Mexican-American women with depressive symptoms.

There has been a long-standing interest in the relationship between cardiovascular disease (CVD) and psychiatric morbidity, specifically depressive symptoms. The aims of this study were to determine the following: 1. The relationship between the presence of angina and depressive symptoms; 2. The influences of sociodemographic covariates on this relationship; and 3. The effects of functional impairment or inactivity level in mediating the relationship between angina and depressive symptoms. The data utilized for this study was from the Hispanic Health and Nutrition Examination Survey (HHANES) on 1,558 Mexican American women. The survey was cross sectional, conducted in 1982-84. The dependent variable was depression as measured by the Center for Epidemiologic Depression Scale (CES-D). The independent variable was the presence of angina as measured by the Rose Questionnaire. Covariates included functional impairment, physical activity, age, education, acculturation, poverty level, marital status, and work status. The findings suggest that functional impairment has a stronger association with depressive symptoms than angina or physical inactivity. Significant sociodemographic variables include single marital status and poverty. Comorbidity has been a neglected area of research for Mexican American women, but this study suggests that functional impairment is a more important factor associated with depressive symptomatology than angina.

Activities of Daily Living↗
PubMed1995

Capturing patients' perceptions in the computer-based patient record: essential prerequisites to the measurement of health-related outcomes.

The cost, quality, and outcomes of healthcare services have become the focus of national attention as providers, consumers, and payers of healthcare services grapple with healthcare reform in the United States. Given the importance of patient care data to the activities of all segments of the healthcare spectrum, the development and implementation of computer-based patient records (CPRs) has been recommended as CPRs have the potential to improve healthcare delivery, enhance outcomes research programs, and increase hospital efficiency [12]. The current paradigm shift in healthcare requires the active involvement of the patient in the delivery and evaluation of care. The patient must be considered as an essential user of CPRs in order to exploit the benefits of information technology for the purposes of outcome assessment. Research and development of the future CPRs must incorporate the needs of the patient. Systems should be designed to meet these needs in order to capture the patient's perceptions in CPRs.

Medical Records Systems, Computerized↗
PubMedDate not supplied

Social interactions, perceived support, and level of distress in HIV-positive women.

Although powerful pharmacological therapies are helping women with HIV infection live longer, women continue to experience the stressors of chronic illness. This study used a person-environment systems framework to describe social interactions, perceived social support, and psychological distress in HIV-positive women. A convenience sample of 104 HIV-positive women living in the San Francisco Bay Area completed a questionnaire on social interactions, perceived social support, and distress. Women reported limited social interactions with family and friends and a low level of perceived social support. Social support and level of distress did not differ by ethnicity. Limited perceived social support was a significant predictor of distress in this sample of women. Supportive interactions from health care providers can be useful in mediating the relationship between the stressor of HIV disease and distress in HIV-positive women. Community-based nurses can enhance HIV-positive women's support network by providing positive and supportive interactions as they intervene with women in symptom management, case management, and other health care services.

Adult↗
PubMedDate not supplied

Predictors of perception of cognitive functioning in HIV/AIDS.

This is a descriptive, correlational study of the predictors of perceived cognitive functioning. The convenience sample of 728 nonhospitalized persons receiving health care for HIV/AIDS was recruited from seven sites in the United States. All measures were self-reported. Self-perception of cognitive functioning, the dependent variable, was composed of three items from the Medical Outcomes Study HIV scale: thinking, attention, and forgetfulness. Data related to age, gender, ethnicity, education, injection drug use, CD4 count, and length of time known to be HIV-positive were collected on a demographic questionnaire. The scale from the Sign and Symptom Checklist for Persons with HIV Disease was used to measure self-reported symptoms. Data were analyzed using hierarchical multiple regression analysis. Predictors of perception of cognitive functioning explained a total of 36.3% of the variance. Four blocks--person variables (1.5%) (age, gender, education, history of injection drug use), disease status (2.3%), symptom status (26.5%), and functional status (5.4%)--significantly contributed statistically to the total variance. Among those individuals who completed the questions related to depression (n = 450), 28% of the variance in cognitive functioning was explained by this variable. The findings in this multi-site study indicate that symptom status explained the largest amount of variance in perceived cognitive functioning. Early identification of cognitive impairment can result in appropriate clinical interventions in remediable conditions and in the improvement of quality of life.

Adult↗
PubMedDate not supplied

The Client Adherence Profiling-Intervention Tailoring (CAP-IT) intervention for enhancing adherence to HIV/AIDS medications: a pilot study.

This article describes the Client Adherence Profiling-Intervention Tailoring (CAP-IT) intervention designed to enhance adherence to HIV/AIDS medications and reports the results of a pilot study aimed at assessing the feasibility of CAP-IT. Initially, CAP-IT was designed to be implemented by nurse case managers during regularly scheduled home visits; it is currently under revision for use in an outpatient, ambulatory care setting. CAP-IT is an innovative, structured nursing assessment and care-planning activity that allows a standardized assessment of client needs and tailored highly active antiretroviral therapy adherence intervention strategies. CAP-IT is significantly different from the current standard nursing case management practice. Pilot study results in a sample of 10 home care patients suggests that clients have knowledge and skill deficits related to adherence and in the management of the side effects of medications. In addition, the pilot study supported the acceptability of the protocol to clients and the feasibility of integrating CAP-IT into nurse case manager practice. The pilot study results also provided evidence for the efficacy of CAP-IT. The next steps include testing CAP-IT in a randomized clinical trial to determine its effectiveness.

Adult↗
PubMedDate not supplied

Problems of persons with HIV/AIDS hospitalized for Pneumocystis carinii pneumonia.

The authors of this prospective study describe the problems of persons living with HIV/AIDS hospitalized for Pneumocystis carinii pneumonia (PCP) (N = 90) and examine how the problems change over time. Data were obtained from four sources and were classified into major problem categories. The largest mean number of problems were reported in the category of PCP. Specific psychosocial problems were more likely to be reported in the patient and nurse interviews than in the chart and intershift report. The study findings validate the physical symptoms addressed in the published care plans and guidelines for caring for patients with PCP. The study identified the limitation of using the patient record as the only data source in determining nursing care needs and emphasized the importance of the patients perspective.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Research agenda for Hispanics in the United States: a nursing perspective.

Heterogeneity is perhaps the most salient characteristic that defines Hispanic populations of the United States. Hispanic populations include native-born, migrant, and immigrant peoples with distinctive national origins and regional settlement patterns. This multigenerational migratory and social adjustment process has produced important cultural variations within and among the respective Hispanic ethnic groups. Moreover, the demographic structure of Hispanic populations is also varied and complex. These historical, demographic, and sociocultural features shape the health and disease experience of Hispanics. As expected, respective Hispanic ethnic groups vary in health status and have differing needs for health services. This article provides demographic background, a historical perspective, a synthesis of Hispanic issues identified in major and authoritative government documents, summary on the state-of-the-science for nursing research with Hispanics, and recommendations for future nursing research directions.

Cause of Death↗