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Biomedical subjects

R L Sowell

Publications and source records attributed to R L Sowell.

At least 19 recordsLinked to original sources
PubMed2001

HIV-infected women's experiences and beliefs related to AZT therapy during pregnancy.

To explore women's experiences and beliefs concerning zidovudine (AZT) therapy during pregnancy, short-answer and open-ended questions were asked of 322 human immunodeficiency virus (HIV)-infected women at increased risk for pregnancy. Specifically, we examined what women believed they had been told concerning AZT therapy during pregnancy by health care professionals and peers, experiences with taking AZT, how effective they believed AZT therapy to be, and if they would take AZT if they became pregnant. Women in the study were predominately African American (88%), single (79%), with a mean age of 32 years, and had annual incomes less than $10,000 (64%). Although 81.4% of the women had been told to take antiretrovirals, only 69.1% of the women were actually taking HIV-related medicines. Almost three-fourths of the women (70.8%) reported being told that taking AZT during pregnancy would reduce perinatal transmission. Women reported the most frequent reason for their stopping AZT was its side effects. When women who were not presently taking AZT were asked what would make them consider taking it, they most frequently said they would begin AZT if their health deteriorated or based on the advice of health care professionals. A small group of women said nothing would make them take AZT-type medications. More than one-half of the women said they felt AZT was effective in preventing perinatal HIV transmission. However, almost 20% of the women reported believing that their health care provider would not be positive about their taking AZT during pregnancy. Significant relationships were found between intent to take AZT if becoming pregnant and specific AZT-related beliefs and experiences.

Adolescent↗
PubMed2000

Levels of hope in HIV-infected African-American women of reproductive age.

HIV disease continues to grow at a staggering rate among women, with women of color becoming the group most frequently affected. Previous research has supported hope as an important factor associated with better health, quality of life, recovery from illness, and increased survival in life threatening illnesses such as HIV disease. The purpose of this study was to describe levels of hope in HIV-infected, African-American women, and to examine the relationships among hope and the women's reported symptoms, stage of illness, and perceived relationship with her primary health care provider (PHCP). A descriptive, quantitative design was used. The sample consisted of 49 African-American women 18 to 45 years of age. Face-to-face structured interviews were conducted. Hope was measured using the Herth Hope Scale, and the quality of the relationship with one's PHCP was measured using the Relationship with the PHCP Scale. The level of hope in these HIV-infected women was lower than women with breast cancer and hospitalized adults with cancer. No significant differences were found in level of hope related to relationship status, income, stage of illness, or if a woman had or did not have children. Hope was positively associated with a more positive relationship with the PHCP (r = .33, P = .02). This finding underscores the importance of the quality of the PHCP's relationship with their clients.

Adolescent↗
PubMed1999

Health care providers' influence on HIV-infected women's beliefs and intentions related to AZT therapy.

This study examined how women's relationship with their primary health care provider (PHP) and their perceptions about how effective their PHPs believe zidovudine (AZT) to be in decreasing perinatal transmission related to women's AZT beliefs and intentions. It used a cross-sectional design to collect data from 59 HIV-infected African American women. Almost half the women (45%) had given birth since HIV diagnosis. Most of the babies born to HIV-infected mothers (87%) were seronegative. Data analysis with Pearson's r indicated that the quality of the women's relationship with their PHP was positively correlated to how important the PHP would be in decision making related to AZT therapy. Significant positive correlation was observed between women's perceptions about how effective their PHPs believed AZT to be in decreasing perinatal HIV transmission and the women's own beliefs about AZT, their intent to take AZT if pregnant, and intent to give AZT to a newborn.

Adult↗
PubMed1999

The care of women with AIDS: special needs and considerations.

The growing number of women being diagnosed with HIV/AIDS mandates the need to focus attention on the special needs of this population. Although women have many of the same devastating physical manifestations of HIV infection as men do, they face unique psychological and social issues that influence their ability to respond to their disease in the same ways. Women with HIV/AIDS are disproportionally poor or minority women who lack resources to maintain their health. It is impossible to address HIV infection in women without considering such factors as poverty, discrimination, and gender role expectations. This article uses a biopsychosocial framework to discuss a range of specific issues affecting the health and well-being of women with HIV/AIDS.

Female↗
PubMed1998

Restructuring life to face the future: the perspective of men after a positive response to protease inhibitor therapy.

This article describes a qualitative study that explores the psychosocial changes and care delivery issues experienced by men with AIDS who were facing end-stage disease but then had dramatic physical improvement as a result of protease inhibitor therapy. In-depth interviews were conducted with 11 men with HIV/AIDS drawn from a community-based AIDS service organization in a large metropolitan area in the Southeast. Using Collaizi's model of content analysis, three broad categories, protease inhibitors as a reprieve, changed roles and relationships, and need for advocacy and support, emerged from the data. From the three broad categories, seven more specific themes were identified: guarded optimism, buying time, change in relationships, work versus disability, access to medications, access to HIV/AIDS competent health care, and focused support services. Collectively, the phenomenon resulting from these men's experiences and concerns can be described as efforts to restructure life to face a future they did not expect. These findings support the need for developing formal, structured interventions to help persons living with AIDS (PLWA) to restructure their lives as new antiretroviral therapies promote improvements in health.

Acquired Immunodeficiency Syndrome↗
PubMed1998

HIV-infected women's decisions to take antiretrovirals.

Despite the potential benefits of antiretrovirals, HIV-infected women may not be accepting or adhering to recommended drug therapies. To help women make informed decisions surrounding antiretroviral therapy, health care professionals need insight into how HIV-infected women decide to take or not to take antiretroviral drugs. The purpose of this study was to describe the influences affecting decisions made by women in the southern United States to accept and adhere to antiretroviral therapy. Focus group data with subsequent dimensional analysis were used to discover themes surrounding antiretroviral decisions among 22 women in two predominantly rural, southeastern states. The focus groups included some women who were currently taking antiretrovirals, some who had taken them in the past, and some who had never taken them. The analyses revealed four overarching themes that influenced women's decisions regarding antiretrovirals: health professionals, beliefs about antiretrovirals, side effects, and attitudes of peers and family.

Adult↗
PubMed1998

Relationships among HIV risk beliefs, attitudes, and behaviors in sexually active, seronegative gay men.

Safer-sex guidelines established during the early days of the HIV/AIDS epidemic have undergone very little revision despite some controversy. Although these guidelines have been widely disseminated in the gay community, many gay men continue to engage in behaviors that are believed to put them at high risk for transmission of HIV. This suggests either that they have not accepted safer-sex guidelines as accurate or that other factors override personal implementation of the guidelines. The study examined seronegative gay men's beliefs about the accuracy of safer sex guidelines and the men's participation in behaviors risky for transmitting HIV. The greatest disagreement between the men's beliefs and behaviors centered on the risk of oral intercourse; this suggests a need for clarification of the safer sex message about this behavior. The findings of this study support the need to reformulate safer-sex guidelines. When unprotected oral and anal sex are classified at the same level of risk, those who engage in unprotected oral sex may proceed to unprotected anal sex with less reservation.

Adult↗
PubMed1997

Quality of life in HIV-infected women in the south-eastern United States.

The purpose of this study was to evaluate the relative importance of social (social support, material resources, disclosure, and family functioning) and psychological factors (stigma, emotional distress, intrusion, avoidance, and fatalism) as predictors of the quality of life of women infected with HIV. The cross-sectional data were drawn from interviews of a sample of 264 women recruited from 8 HIV/AIDS treatment sites in a south-eastern state. Variance in quality of life variables, included limited daily functioning, general anxiety, and HIV symptoms was analyzed using ANOVA, correlations, and hierarchical multiple regression analysis. Limited daily functioning was predicted by stigma, fatalism, employment status, and stage of disease (R2 = 0.179). General anxiety was predicted by emotional distress, intrusion, and marital status (R2 = 0.503). Reported HIV symptoms were predicted by material resources, disclosure, intrusion, age, employment status, and race (R2 = 0.294). The results of this study support that social and, particularly, psychological factors are important in their influence on quality of life in women with HIV infection and suggest the need for interventions which address such factors.

Activities of Daily Living↗
PubMed1997

Self-care activities of women infected with human immunodeficiency virus.

The article describes a qualitative focus group study exploring the self-care activities undertaken by women testing positive for human immunodeficiency virus (HIV) to promote and maintain their health. The sample included 27 women who participated in one of four focus group sessions. Participants represented women from both rural and urban settings in the South. Subjects talked about and described the ways in which they took care of themselves. Content analysis was used to code the data and to determine major categories of activities. Seven categories were identified: special dietary and nutrition practices, choosing not to use medically prescribed therapies, spiritual reliance and rituals, staying active, cognitive strategies, self-education, and adopting healthy life styles. These findings support the value of developing a holistic approach to health care of women infected with HIV.

Adaptation, Psychological↗
PubMed1997

Resources, stigma, and patterns of disclosure in rural women with HIV infection.

A growing number of cases of HIV infection are being diagnosed in rural communities especially among women. Although HIV-specific education and care delivery programs have been focused on rural areas in recent years, limited data are available on the impact of such initiatives on the lives of women with HIV infection. The purpose of this study was to examine characteristics of women with HIV disease living in rural communities. The study used a cross-sectional sample of rural women in Georgia. Data analysis indicated that although a majority of the women reported adequate resources, there was a group of women for whom resources for basic needs were not always adequate. Additionally, women with HIV who had not progressed to AIDS had greater difficulty in obtaining a number of resources. Almost half of the women felt stigmatized due to having HIV. Yet, a high percentage of these women had disclosed their HIV status to health care workers, sexual partners, and family. Study results provide insight into the needs of HIV-infected rural women from their perspective. This information can be important to nurses working in public health and community settings as they face the challenge of developing effective health care services for this population.

Adolescent↗
PubMed1997

Decisions to have a baby by HIV-infected women.

As the epidemiologic picture of HIV changes to include increased numbers of women of childbearing age, particularly those of African American heritage and those from rural southern cultures, those who provide services to these women need to understand the processes used by HIV-infected women to make reproductive decisions. Focus-group data with subsequent content analysis were used to discover themes surrounding pregnancy decisions among 22 women in two predominantly rural southeastern states. The results both validated and amplified previous findings and added new perspectives. The analyses revealed six overarching themes: spiritual and religious beliefs, knowledge and beliefs about HIV, previous experience with childbearing attitudes of families and sex partners, personal health, and intrapersonal motivation to have a baby.

Adolescent↗
PubMed1996

HIV infection in rural communities.

HIV/AIDS is recognized as a growing problem in rural America. The community response model presented in this article provides a framework for developing a comprehensive approach to HIV/AIDS education and services. The model, while providing guidance in program development, allows for the adaptation of the model to address the unique needs associated with rural communities. Two programs that have been successful in responding to the need for HIV-related knowledge and services in rural areas are also presented.

HIV Infections↗
PubMed1996

Barriers to health-seeking behaviors for women infected with HIV.

There is a growing need to develop services for women with human immunodeficiency virus (HIV) infection, despite the reluctance of many to seek help. Yet, there is limited knowledge of the forces that act as barriers to health-seeking behaviors among these women. In the analysis of this focus group study of 46 women with HIV, eight distinct categories of perceived barriers to care were identified. These were: Lack of knowledge on the part of health care providers, fear of negative treatment, insensitivity of health care providers, fear by providers, lack of patient education, lack of confidentiality, lack of honesty, and blaming the victim. The women's descriptions of their experiences with health care providers are presented and discussed in the context of the potential impact of such behaviors on women's willingness to accept or continue treatment for HIV infection.

Adolescent↗
PubMed1995

The Georgia Rural-Based Nurse Model: primary care for persons with HIV/AIDS.

The need for specialized HIV education for nurses working in rural areas will increase as the incidence of HIV infection increases in rural areas. Public health nurses provide a viable alternative to providers in acute care facilities and will continue to be the primary care providers for persons with HIV/AIDS in rural areas. While approaches to HIV/AIDS education should include clinical treatment as the core, clinical knowledge alone will not promote the development of caring communities. The Rural-Based Nurse Model provides a comprehensive curriculum that addresses the many complex issues associated with the care of persons with HIV/AIDS. Additionally, participants are linked with care providers who serve clients across the continuum of HIV disease. Through meaningful educational opportunities and provider networking, this program has the potential for improving the quality of care in rural areas for persons with HIV/AIDS. HIV/AIDS education programs will require individualized community strategies that consider existing resources and barriers. However, the Rural-Based Nurse Model provides a formula for HIV/AIDS education that can be easily adapted to other settings.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Integrated case management: the AID Atlanta Model.

This article describes the integrated case management model being developed by AID Atlanta, Inc., a community-based AIDS service organization. The case management system features centralized supervision and coordination with decentralized delivery of case management services that avoid duplication of services. The model establishes a system that links clients to appropriate levels of service. The integrated model seeks to address the client's physical, psychological, emotional, and spiritual needs across a continuum of care delivery. The cornerstone of the system is the development of standards of service, systematic documentation, and outcome evaluation criteria.

Acquired Immunodeficiency Syndrome↗
PubMed1994

King's theory as a framework for quality: linking theory to practice.

Quality care has long been an elusive concept. The pushing of health care services into community settings by health care reform demands new attention to the concept of quality. King's theory of goal attainment can provide a framework for the definition and delivery of quality care in community-based health services.

Community Health Nursing↗
PubMed1994

An integrated case management model: developing standards, evaluation, and outcome criteria.

Case management has become an important strategy in responding to the complex physical and social needs of persons with human immunodeficiency virus (HIV) disease. Yet, inconsistent implementation and professional turf guarding, based on disciplinary differences, have rendered traditional models ineffective. AID Atlanta has adopted an integrated, multisite approach to case management that uses the expertise of social workers, nurses, pastoral counselors, and therapists to develop client-centered plans of care across the continuum of need. This article presents the integrated model and describes the standards of service and outcome evaluation criteria that underpin this model. The impact of nursing expertise on the development of the model is discussed.

Acquired Immunodeficiency Syndrome↗