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Biomedical subjects

K M Nokes

Publications and source records attributed to K M Nokes.

At least 19 recordsLinked to original sources
PubMed2006

Strategies for self-management of HIV-related anxiety.

This study examines the frequency and effectiveness of commonly used strategies for self management of anxiety in an international sample of 502 participants from Norway (n=42, 8%), Taiwan (n=35, 7%), and the US (n=426, 85%). An activities checklist summarized into five categories of self-care behaviours including activities/thoughts, exercise, medications, complementary therapies, and substance use determined self-care behaviours. Ratings of frequency and effectiveness for each self-care activity were also included. Praying received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.10 (scale 1 to 10), followed by meditation (7.37), exercising (7.32), using relaxation techniques (7.22), cooking (6.98), and walking (6.90). An analysis of effectiveness scores for each self-care strategy by country reflected a wide variation. The three most effective anxiety self-care strategies reported by participants from Norway included exercise (7.31), walking (6.96), and reading (6.44). Highest ratings of effectiveness by participants from Taiwan included talking with others with HIV (6.0), attending support groups (6.0), and exercising (6.0). US participants allocated highest ratings of effectiveness to complementary/alternative therapies, including praying (8.10), meditating (7.43), and using relaxation techniques (7.35). Regardless of the country, watching television and talking with family and friends were the two most frequently reported strategies. These strategies for self-management of HIV-related anxiety are important for clinicians to be aware of in the care of persons with HIV/AIDS.

Adult↗
PubMed2002

Self-care management for neuropathy in HIV disease.

Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of peripheral neuropathy in HIV disease, the self-care strategies, and sources of information for self-care utilized by the sample. A convenience sample of 422 respondents was recruited from an Internet web-based site developed by the University of California, San Francisco International HIV/AIDS Research Network and from five geographic data collection sites (Boston, New York City, San Francisco and Paterson in the USA, and Oslo, Norway). Results of the study indicated that respondents with peripheral neuropathy identified 77 self-care behaviours including complementary therapies, use of medications, exercise and rest and/or elevation of extremities. Sources of information included health care providers, informal networks and media sources.

Adult↗
PubMed2001

Age-appropriate HIV prevention messages for older adults: findings from focus groups in New York State.

The Emerging Issues Committee of the New York State HIV Prevention Planning Group identified that prevention messages were not including persons 50 and older and that 15 percent of the newly reported AIDS cases in 1997 in New York were in this age group. Recognizing that there may be unique needs in targeting prevention messages for this age group, a consultant conducted five focus groups throughout the state to speak with people to determine what they identified as unique themes related to HIV prevention for this age group.

Aged↗
PubMed2001

Issues in cross-cultural quality-of-life research.

PURPOSE: To examine cross-cultural measurement of quality of life (QOL) and issues to consider in adapting quality-of-life instruments. ORGANIZING CONSTRUCT: Health-related quality of life. METHODS: Review of the literature on cross-cultural QOL using the Cumulative Index to Nursing & Allied Health Literature (CINAHL), 1982 to February 2000, and Medline, 1966 to May 2000, databases. FINDINGS: Use of research instruments beyond the samples with which they were initially tested, particularly if the new samples are cross-cultural, presents considerable challenges. The findings indicate consideration of these problems: phenomenon of interest, cross-cultural versus cross-national, salience, conceptual equivalence, cultural hegemony versus cultural validity, cultural equivalence versus verbal equivalence, fidelity versus appropriateness, privacy versus disclosure, appropriateness of format, and resource utilization for translation. Although the literature indicates increased discussion of theoretical, conceptual, and operational approaches to measuring cross-cultural QOL, problems continue in adapting instruments from one culture to another. CONCLUSIONS: Many issues about cross-cultural QOL were identified. By addressing these issues, researchers can develop appropriately translated and validated quality-of-life instruments to advance knowledge about cross-cultural QOL.

Cross-Cultural Comparison↗
PubMed2000

Relationships between perception of engagement with health care provider and demographic characteristics, health status, and adherence to therapeutic regimen in persons with HIV/AIDS.

The purpose of this descriptive, correlational study was to examine the relationships between perception of engagement with health care provider and demographic characteristics, health status, and adherence to therapeutic regimen in persons with HIV/AIDS. The convenience sample of 707 non-hospitalized persons receiving health care for HIV/AIDS was recruited from seven U.S. sites. All measures were self-report. Perception of engagement with health care provider was measured by the newly developed Engagement with Health Care Provider scale. Adherence to therapeutic regimen included adherence to medications, provider advice, and appointments. Health status was measured by the Medical Outcomes Study Short Form 36 (MOS SF-36), Living with HIV scale, CD4 count, and length of time known to be HIV-positive. There were no significant relationships between engagement with health care provider and age, gender, ethnicity, and type of health care provider. Subscales of the MOS SF-36 and Living with HIV explained a significant, but modest amount of the variance in engagement. Clients who were more engaged with their health care provider reported greater adherence to medication regimen and provider advice. Clients who missed at least one appointment in the last month or who reported current or past injection drug use were significantly less engaged.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Exploring the clinical nurse specialist role in an AIDS community-based organization.

Although community-based organizations (CBOs) serving persons living with HIV/AIDS have proliferated, the role of advanced practice nurses in these CBOs has not been articulated. This article describes four components of the clinical nurse specialist (CNS) role in a CBO: a nutrition program for ambulatory persons living with HIV disease. The CNS educates clients about strategies to improve and maintain their health and manage complex treatment regimens in daily lives that are often chaotic and limited by severe financial constraints. As a member of a multidisciplinary team, the CNS provides a healthcare perspective in policy development and staff education for a predominantly social service agency.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Validation of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV).

Symptom management for persons living with HIV disease is recognized as an extremely important component of care management. This article reports the validation of a new sign and symptom assessment tool designed to assess the intensity of HIV-related symptoms using two samples (study 1: n=247; study 2: n=686) of people living with HIV disease. Study 1 data were collected between 1994 and 1996 before the initiation of highly active antiretroviral therapy (HAART). Study 2 data were collected between 1997 and 1998 after the wide adoption of HAART therapy. The initial version of the Sign and Symptom Check-List for Persons with HIV Disease (SSC-HIV) included 41 signs and symptoms. This scale was submitted to a principal components factor analysis with a varimax rotation. The final solution reports six factors explaining 68.9% of the variance. The six symptom clusters (factors), the number of items in the factor, and the Cronbach alpha reliability estimates were: malaise/weakness/fatigue (six items, alpha=0.90); confusion/distress (four items, alpha=0.90); fever/chills (four items, alpha=0.85); gastrointestinal discomfort (four items, alpha=0. 81); shortness of breath (three items, alpha=0.79); and nausea/vomiting (three items, alpha=0.77). These six factors have strong reliability estimates and a stable factor structure that supports the construct validity of the 26-item instrument. Additional evidence supports the concurrent validity of the scale as well as its sensitivity to change over time. The final version of the SSC-HIV is a 26-item scale available for use by clinicians and researchers to measure the patient's self-report of HIV-related signs and symptoms.

Adult↗
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

Revisiting how the Chronic Illness Trajectory Framework can be applied for persons living with HIV/AIDS.

Over 7 years ago, the Chronic Illness Trajectory Framework was applied to persons living with HIV/AIDS (Nokes, 1991). This article addresses how new information about HIV-infection disease can be interpreted through the Chronic Illness Trajectory Framework. At the time of the first writing, HIV infection was diagnosed indirectly through the presence of antibodies and one or two medications were available to treat the infection. Currently, direct viral testing is used clinically and 18 medications, which can be used in a variety of combinations, should be available by the end of 1998. Although mortality rates from AIDS dropped sharply with the advent of new therapies, current anecdotal reports are indicating that some people, who initially felt much better on the medications, are now developing viral resistance and life-threatening toxicities. Unfortunately, it seems that as we approach the 21st century, information about HIV continues to evolve and another update will then be needed.

Adaptation, Psychological↗
PubMed1997

Teaching about the female condom.

Reality female condoms became available for over-the-counter purchase in the fall of 1994. Because the female condom is a new sexual barrier device, women need to learn how to use it correctly. Health care providers must also be knowledgeable about the correct use of the female condom so that they can teach women how to use it as a barrier method. To facilitate learning about the female condom, a curriculum was developed that included a quiz on knowledge about the female condom. Content validity was established through a content validity index completed by six content experts. This quiz was used to evaluate educational sessions offered to 42 persons in an urban college setting and 18 women in a community setting. The article describes the female condom along with the curriculum that was developed to teach its correct use and the reactions of potential users of the female condom.

Adult↗
PubMed1996

Professional nursing education's response to the HIV/AIDS pandemic.

Nurse educators have a responsibility to ensure that nursing students learn to respond to the healthcare needs of society even if those needs are evolving as the student's education is occurring. This paper examines the issues and challenges the HIV/AIDS epidemic presents to nurse educators. It then explores ways in which nursing education programs have responded to these challenges and develops a balanced discussion of these responses.

Attitude of Health Personnel↗
PubMed1996

Intervention to promote safer sexual behaviors and educate peers about HIV/AIDS.

Sexually active college students are at risk for infection with the Human Immunodeficiency Virus (HIV). Nursing students can learn a variety of desirable professional skills and provide an important service to their college peers by participating in an ongoing intervention to promote safer sexual behaviors. Since 1989, nursing students at a publicly supported urban college have been providing a HIV Primary Prevention intervention on a sustained basis. During each semester, at least 1,000 college students complete a quiz that tests their knowledge about condoms and engage in discourse with a nursing student about HIV/AIDS. Content analysis of the evaluations submitted by the nursing students (N = 43) identifies how this independent study enhances both professional and personal growth.

Condoms↗
PubMed1994

Development of an HIV assessment tool.

The objective of this study was to establish the validity and reliability of a visual analog scale that rates HIV-related symptom severity and general well-being. Three groups of subjects completed the HIV Assessment Tool (HAT): uninfected subjects (n = 53); people with HIV infection (n = 60), and people with CDC-defined AIDS (n = 43) according to the 1987 criteria. Test-retest reliability was .96 and Cronbach's alpha was .92. Face, content, and construct validity were established. Significant differences were found between healthy subjects and those with HIV or AIDS supporting discriminant validity. Correlation of the Karnofsky performance status with the HAT was significant (r = .51, p < .001) which demonstrated concurrent validity. Factor analysis helped identify general well-being, general symptoms, and HIV-specific symptoms. The instrument can be used to relate HIV symptoms to disease progression, and to evaluate the effectiveness of nursing interventions.

Activities of Daily Living↗
PubMed1994

Educating advanced practice nurses to respond to the HIV pandemic.

The subspecialization in the master's degree nursing program at Hunter College is preparing a cadre of nursing leaders and expert clinicians through formal didactic courses and clinical placements with master's prepared nurses who work in HIV/AIDS. The HIV/AIDS subspecialty option is offered to graduate nursing students in all of the six specialties: medical-surgical, psychiatric-mental health nursing, maternal-child nursing, community health nursing, gerontological nurse practitioner program, and nursing administration. The terminal objectives for the graduate program serve as the framework for the terminal objectives of the subspecialty and primary, secondary, and tertiary levels of prevention serve as the conceptual framework. The clinical aspect of the HIV/AIDS subspecialty content is coordinated within the specialization component in that the final advanced practicum in the student's specialty is with a master's prepared nursing preceptor who is caring for persons with HIV/AIDS.

Curriculum↗
PubMed1991

The meaning of living with AIDS: a study using Parse's theory of man-living-health.

This paper explores the meaning of living with Acquired Immune Deficiency Syndrome (AIDS) using Parse's theory of man-living-health as the conceptual framework. The design of the study is based on the qualitative descriptive method. Analysis of the data gathered from interviews with fourteen subjects reveals the emergence of three themes related to the meaning of living with AIDS: (a) an abrupt shift in patterns of being give rise to changing priorities, (b) fluctuating possibilities arise in the uncertainty of being with and away from close others, and (c) changing hopes and dreams surface from the insights of suffering. Practice propositions were identified from the findings of the study.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Applying the chronic illness Trajectory Model to HIV/AIDS.

The Corbin and Strauss chronic illness trajectory model is particularly helpful in explaining the different phases of HIV (Human Immunodeficiency Virus) disease, since this infectious process is characterized by both phases and subphases. The model is not particularly helpful in identifying when the illness trajectory begins, since the model starts with the onset of symptoms, and HIV disease is characterized by a long, symptomless phase. The importance of politics and economics is also underestimated when applying this model to HIV disease. While this model presupposes the existence of support systems as being significant others, HIV disease is unique in that whole family systems may be eliminated by this infectious process, i.e., the typical pattern of HIV disease in the 1990s is that of a father dying from AIDS, a mother sick with HIV disease, one or more siblings infected, and one or more siblings coping with tremendous losses at a very young age.

Adult↗
PubMed1991

Examining the ethical and legal issues generated by the HIV epidemic.

This article addresses ethical and legal issues related to the HIV epidemic. The author discusses individual and utilitarian schools of philosophy, and identifies philosophical issues in relationship to the stage of HIV infection that the client is experiencing. Prevention strategies and nursing interventions for three levels of prevention are also presented. HIV infection is now accepted as a chronic disease, which is characterized by different stages. Nursing intervention focused on prevention can be related to the stage of infection.

Acquired Immunodeficiency Syndrome↗