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Biomedical subjects

H Miramontes

Publications and source records attributed to H Miramontes.

10 recordsLinked to original sources
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↗
PubMed1994

HIV/AIDS training for health care providers working with women at risk.

Diagnosis of HIV/AIDS in women is frequently inadequate. Often women are not assessed for risk behaviors that put them at risk for HIV infection. Viral transmission is preventable through behavioral changes. Past experience has demonstrated that one effective method to educate women at risk is to train direct care providers who work with women. Highly skilled providers with expertise in prevention education strategies can facilitate and support behavioral changes in women at risk for HIV transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Progress in establishing safety protocols based on CDC and OSHA recommendations.

In 1987, following the first documented reports of occupationally acquired human immunodeficiency virus (HIV) in healthcare employees, the American Nurses Association and some labor unions petitioned the Occupational Safety and Health Administration (OSHA) to issue an emergency infection control standard. OSHA responded by enforcing a series of voluntary guidelines developed by the Centers for Disease Control (CDC) four years earlier. A draft of regulations proposed by OSHA was published in the Federal Register, and the final set of these regulations is expected in early 1991. In the proposed guidelines, hepatitis B is cited as a major health risk to healthcare personnel--a more significant risk than HIV. The degree of risk varies between units in the hospital and between hospitals and other facilities. Standards are set for types of protective clothing and equipment, and for housekeeping and laundry areas. The report sets rules governing infectious waste disposal. It establishes guidelines for tracking employees, pre- and post-exposure. In enforcing these rules and guidelines, hospitals should stress continued education and training in order to increase compliance. A recent study revealed that, after a two-year training/evaluation period, physician compliance with infection control procedures increased from 20% to 80%, and nurse compliance rose from 50% to 86%.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Nurse practitioners in rural California and AIDS.

A random sample of nurse practitioners located in the 26 rural counties of California were surveyed to assess their experience with HIV-positive patients. Of those selected, 70.5% participated; of those interviewed, 65.5% had seen a patient with HIV infection in the past 12 months. Of those providing primary care, 85% had seen HIV-positive patients. Their specific practice activities ranged from simply assessing to making all critical decisions with regard to therapeutic regimes in consultation with AIDS experts. Their most frequent activities involved education and/or counseling and the provision of psychosocial support.

California↗
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

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

The fatigue experience for women with human immunodeficiency virus.

PURPOSE: To examine fatigue as a symptom experienced by women with human immunodeficiency virus (HIV). SAMPLE: A convenience sample of 100 women with HIV. ANALYSIS: Independent sample t-tests were used to test for mean differences in fatigue related to variables in the women's sociocultural and home environment (ethnicity, employment, marital status, and parenting). Pearson product moment correlations were used to examine significant relationships between fatigue and physiologic variables (age, CD4 cell count, and sleep). FINDINGS: Lower CD4 cell counts were related to more daytime sleep, higher evening fatigue, and higher morning fatigue. Morning fatigue was related to duration of wake episodes during the night, napping, and perception of sleep disturbance during the past week. The number of awakenings during the first night predicted the severity of fatigue the next evening. CONCLUSION: To understand the fatigue experienced by women with HIV, researchers and clinicians must focus on the relative contributions of sociocultural, home, and physiologic environments within which these women live. Additional research is ongoing to identify the strategies these women use to manage daily activities such that gender-relevant and culturally relevant interventions for alleviating fatigue can be tested in women with a variety of chronic illnesses, including HIV and acquired immune deficiency syndrome.

Adult↗