Added references for Wilson and Cleary model.
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Humans↗
Biomedical subjects
William L Holzemer
Publications and source records attributed to William L Holzemer.
HIV and AIDS stigma violates human rights in five African countries.
The situation and human rights of people living with HIV and AIDS were explored through focus groups in five African countries (Lesotho, Malawi, South Africa, Swaziland and Tanzania). A descriptive qualitative research design was used. The 251 informants were people living with HIV and AIDS, and nurse managers and nurse clinicians from urban and rural settings. NVivo software was used to identify specific incidents related to human rights, which were compared with the Universal Declaration of Human Rights. The findings revealed that the human rights of people living with HIV and AIDS were violated in a variety of ways, including denial of access to adequate or no health care/services, and denial of home care, termination or refusal of employment, and denial of the right to earn an income, produce food or obtain loans. The informants living with HIV and AIDS were also abused verbally and physically. Country governments and health professionals need to address these issues to ensure the human rights of all people.
Acquired Immunodeficiency Syndrome↗
HIV/AIDS symptom management in Southern Africa.
We describe self-reported strategies used by persons living with HIV/AIDS in Botswana, Lesotho, South Africa, and Swaziland to manage common HIV-related symptoms. A questionnaire asked participants to list three to six symptoms they had recently experienced, the care strategies they had used to make them better, where they had learned the strategy, and to rate the perceived effectiveness of the strategy. Data were collected in 2002 from 743 persons. The self-care management strategies were coded into eight categories: medications, complementary treatments, self-comforting, changing diet, seeking help, exercise, spiritual care, and daily thoughts/activities. Overall, participants reported medications as the most frequently occurring management strategy and the most effective. A very small inventory of behavioral strategies was available to participants to help them manage their HIV-related symptoms.
Acquired Immunodeficiency Syndrome↗
Quality of life and the concept of "living well" with HIV/AIDS in sub-Saharan Africa.
PURPOSE: To increase understanding of the meaning of quality of life for people living with HIV/AIDS in four countries in sub-Saharan Africa: Botswana, Lesotho, South Africa, and Swaziland. METHODS: Using a cross-sectional design and convenience sample, we administered a survey and collected data on demographic characteristics, measures of severity of illness, and perceptions of quality of life. The purposefully selected sample (N=743) consisted of community-based people living with HIV/AIDS in 2002. Based on the Wilson and Cleary framework for organizing variables related to quality of life, a hierarchical multiple regression was conducted with quality of life as the dependent variable. RESULTS: The sample of 743 persons was 61.2% female with a mean age of 34 years. Approximately 62 % of the sample reported having received an AIDS diagnosis. Ten predictor variables explained 53.2 % of the variance in life satisfaction. Those participants with higher life satisfaction scores were less educated, had worries about disclosure and finances, did not have an AIDS diagnosis or other comorbid conditions, had lower symptom intensity, had greater functioning, and had fewer health worries. None of these participants was taking antiretroviral medications at the time of this study. CONCLUSIONS: Several dimensions of the Wilson and Cleary model of quality of life were significantly related to life satisfaction for people living with HIV/AIDS in sub-Saharan Africa. Quality of life for this sample was primarily defined as overall functional ability and control over symptom intensity. These findings are similar to studies in developed countries that have shown the significant relationships among functional abilities, symptom control, and perceived quality of life. As antiretroviral medications become more available in these areas, community members and care providers can help clients realize the possibility of living well with HIV/AIDS, and can work with clients to improve functional ability and control symptom intensity to make living well a reality.
Adaptation, Psychological↗
Utility of a standardized nursing terminology to evaluate dosage and tailoring of an HIV/AIDS adherence intervention.
PURPOSE: To illustrate the utility of a standardized nursing terminology to calculate the dosage of the Client Adherence Profiling-Intervention Tailoring (CAP-IT) and to determine the extent to which a tailored intervention was delivered to 117 persons with HIV/AIDS who participated in the experimental arm of a randomized controlled trial (RCT). METHODS: The intervention nurse assigned nursing diagnoses from the Home Health Care Classification (HHCC) based upon CAP scores. During the IT phase of CAP-IT, the nurse delivered and documented a tailored set of nursing interventions associated with the CAP and assigned nursing diagnoses. Hierarchical linear regression was used to evaluate the extent to which the number of interventions and intervention times were tailored to client needs. RESULTS: Linear regression models that included CAP scores and nursing diagnoses as predictor variables explained 53.2% of the variance in total number of interventions and 58.9% of the variance in intervention time. CONCLUSIONS: The use of the standardized nursing terminology enabled calculation of the intervention dose and documentation that a tailored intervention was delivered.
Adult↗
An evaluation of the effects of a manual on management of HIV/AIDS symptoms.
The purposes of this study were to develop a symptom management manual for persons living with HIV disease and to evaluate the effects of the manual on symptom management and quality of life. After a careful review of the research literature and integrating related findings, a manual for managing HIV/AIDS symptoms was developed. A one-group pretest-posttest design was used with 31 HIV/AIDS patients recruited from one hospital in Taiwan that provides care for people with HIV/AIDS. Subjects were instructed on use of the manual, and completed the Chinese version of the Sign and Symptom Checklist for Persons with HIV and the HIV/AIDS Targeted Quality of Life Instrument for the pretest and two posttests (at one month and three months after the initial session). Results indicated that these participants' symptom intensity was significantly improved at posttest, but their quality of life did not show significant changes at either posttest. Based on the results of this study, the symptom management manual can be used as a teaching tool for clinical health-care providers to decrease these patients' symptom distress.
Adult↗
The effectiveness of Web-based vs. non-Web-based interventions: a meta-analysis of behavioral change outcomes.
BACKGROUND: A primary focus of self-care interventions for chronic illness is the encouragement of an individual's behavior change necessitating knowledge sharing, education, and understanding of the condition. The use of the Internet to deliver Web-based interventions to patients is increasing rapidly. In a 7-year period (1996 to 2003), there was a 12-fold increase in MEDLINE citations for "Web-based therapies." The use and effectiveness of Web-based interventions to encourage an individual's change in behavior compared to non-Web-based interventions have not been substantially reviewed. OBJECTIVE: This meta-analysis was undertaken to provide further information on patient/client knowledge and behavioral change outcomes after Web-based interventions as compared to outcomes seen after implementation of non-Web-based interventions. METHODS: The MEDLINE, CINAHL, Cochrane Library, EMBASE, ERIC, and PSYCHInfo databases were searched for relevant citations between the years 1996 and 2003. Identified articles were retrieved, reviewed, and assessed according to established criteria for quality and inclusion/exclusion in the study. Twenty-two articles were deemed appropriate for the study and selected for analysis. Effect sizes were calculated to ascertain a standardized difference between the intervention (Web-based) and control (non-Web-based) groups by applying the appropriate meta-analytic technique. Homogeneity analysis, forest plot review, and sensitivity analyses were performed to ascertain the comparability of the studies. RESULTS: Aggregation of participant data revealed a total of 11,754 participants (5,841 women and 5,729 men). The average age of participants was 41.5 years. In those studies reporting attrition rates, the average drop out rate was 21% for both the intervention and control groups. For the five Web-based studies that reported usage statistics, time spent/session/person ranged from 4.5 to 45 minutes. Session logons/person/week ranged from 2.6 logons/person over 32 weeks to 1008 logons/person over 36 weeks. The intervention designs included one-time Web-participant health outcome studies compared to non-Web participant health outcomes, self-paced interventions, and longitudinal, repeated measure intervention studies. Longitudinal studies ranged from 3 weeks to 78 weeks in duration. The effect sizes for the studied outcomes ranged from -.01 to .75. Broad variability in the focus of the studied outcomes precluded the calculation of an overall effect size for the compared outcome variables in the Web-based compared to the non-Web-based interventions. Homogeneity statistic estimation also revealed widely differing study parameters (Q(w16) = 49.993, P < or = .001). There was no significant difference between study length and effect size. Sixteen of the 17 studied effect outcomes revealed improved knowledge and/or improved behavioral outcomes for participants using the Web-based interventions. Five studies provided group information to compare the validity of Web-based vs. non-Web-based instruments using one-time cross-sectional studies. These studies revealed effect sizes ranging from -.25 to +.29. Homogeneity statistic estimation again revealed widely differing study parameters (Q(w4) = 18.238, P < or = .001). CONCLUSIONS: The effect size comparisons in the use of Web-based interventions compared to non-Web-based interventions showed an improvement in outcomes for individuals using Web-based interventions to achieve the specified knowledge and/or behavior change for the studied outcome variables. These outcomes included increased exercise time, increased knowledge of nutritional status, increased knowledge of asthma treatment, increased participation in healthcare, slower health decline, improved body shape perception, and 18-month weight loss maintenance.
Adult↗
Nurses' knowledge, attitudes, and practice related to HIV transmission in northeastern China.
The purpose of this study was to describe what nurses know about HIV/AIDS in the First Affiliated Hospital of Jiamusi University, Heilongjiang Province, China. This was a descriptive, cross-sectional study. Only 7.9% of the nurse (n = 177) used condoms during their first experience of sexual intercourse. Eight-six percent of the nurses had been stuck by sharps while working, and 76% of them had been splashed by patient fluids. For 12 basic HIV/AIDS questions, the mean score was 6.66. The mean score is 6.28 for 9 HIV/AIDS attitude questions. Knowledge and attitude are negatively related (r = -0.215, p < 0.005). Training in reducing the risk for occupational exposures in this sample is important. Nurses who have a better understanding of HIV/AIDS prevention are more likely to have negative attitudes toward HIV/AIDS. This study suggests the necessity of increasing HIV/AIDS education for nurses, family members, friends, and all health care providers.
Adult↗
Validation of a Chinese version of the sign and symptom checklist for persons with HIV diseases.
Symptoms are common in HIV-infected persons and occur at all stages of the illness. An effective symptom assessment tool can help health care providers quickly detect patients' problems and provide suitable care. Because no studies focusing on developing a sign and symptom checklist for persons with HIV can be found for Taiwanese patients or for those who speak Chinese, the purpose of this study was to validate a Chinese version of the Sign & Symptom Checklist for Persons with HIV (SSC-HIV-C). The Checklist first was translated from the English version into a Chinese version and then was back translated to examine accuracy. Both face and construct validity were used to examine overall validity of the instrument. Tests for internal consistency and test-retest reliability were used to examine the reliability of the instrument. The results indicated that the Chinese version of the SSC-HIV yielded highly acceptable parameters of validity and reliability. This Chinese version of the SSC-HIV can be used for measuring signs and symptoms of HIV-AIDS in persons in Taiwan who have HIV, as well as for other Chinese-speaking populations.
China↗
Symptom management in Taiwanese patients with HIV/AIDS.
The purpose of this study was to explore HIV/AIDS patients' symptom experiences and self-care symptom management strategies using a semi-structured questionnaire. Concurrently, the investigators gathered information about patients' symptom management strategies from healthcare providers. A total of 134 HIV-infected persons and 31 healthcare providers voluntarily participated in this study. Nausea, pain, anxiety, vomiting, diarrhea, fear and lack of appetite were described frequently by HIV-infected participants. Nausea, anxiety, diarrhea, fever, fear, pain and vomiting were observed frequently by healthcare providers. The management strategies used by these patients are presented and the differences in findings between Taiwan and Western cultures are discussed. In general, the results indicated that healthcare providers hold limited knowledge about self-care symptom management of HIV/AIDS. Filling this knowledge gap is an essential task for all healthcare providers in Taiwan.
Acquired Immunodeficiency Syndrome↗
HIV and AIDS: the symptom experience. What cell counts and viral loads won't tell you.
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Acquired Immunodeficiency Syndrome↗
Complementary therapy use in persons with HIV/AIDS.
The purpose of this study was to describe the frequency and correlates of complementary and alternative medicine (CAM) therapies used by people with HIV/AIDS to manage illness and treatment-related symptoms. Data were collected from a convenience sample (N = 422) of people living with HIV disease. Demographic variables (e.g., education, age, and gender) were compared for those who reported using at least one CAM therapy. There were significant differences for gender (chi2 = 4.003, df = 1, p = .045) and for ethnicity (chi2 = 6.042, df = 2, p = .049). Females and African Americans used CAM more frequently. More than one third of the participants used CAM, and there were a total of 246 critical incidents of nontraditional treatment use. It is possible that these nonallopathic interventions may positively affect health-related quality of life in persons with HIV by ameliorating or reducing the side effects associated with the disease and its treatments.
Acquired Immunodeficiency Syndrome↗
Reconciling incompatibilities: a grounded theory of HIV medication adherence and symptom management.
The purpose of this grounded theory study was to explain how ethnically diverse men and women living with HIV manage their interacting illness symptoms, medication side effects, and treatment adherence choices. The authors used the constant comparative method to analyze textual data from in-depth interviews with 66 HIV-infected people representing the changing HIV demographic profile in the San Francisco Bay area and generate a theory of Reconciling Incompatibilities. Adherence options of complying, not complying, or self-tailoring occurred in a context of attributional uncertainty as to whether distress was illness- or treatment-related, a sometimes silent virus, and perceived fickle medical markers. Conditions, including self-identity, illness ideology, concurrent treatment regimens, the meaning of time, medication burden and side effects, and lifestyle, coalesced to produce a state of mind that shaped adherence choices on a dose-by-dose basis. This theory offers a basis for interventions designed to promote optimal adherence choices concerning HIV therapies.
Adult↗
Self-care for fatigue in patients With HIV.
PURPOSE/OBJECTIVES: To identify when fatigue is reported as a problem by people who are HIV positive, what the perception of fatigue is, and which self-care behaviors are used and with what efficacy. DESIGN: Multisite descriptive study. SETTING: University-based AIDS clinics, community-based organizations, and homecare agencies located in cities across the United States, in Norway, and through a university Web site. SAMPLE: Convenience sample of 422 self-identified people who are HIV positive. MAIN RESEARCH VARIABLES: Symptom description, symptom relief, symptom help, and self-care strategies. FINDINGS: The sixth most reported symptom in this study, fatigue, was treated with a variety of self-designed strategies. In only three instances was consultation with a healthcare provider (i.e., physician) or an injection (medication not defined) mentioned. The most frequently used interventions were supplements, vitamins, and nutrition followed by sleep and rest; exercise; adjusting activities, approaches, and thoughts; distraction; and complementary and alternative therapies. In addition to self-designed strategies, the media and friends and family were sources of information. CONCLUSIONS: Fatigue was reported less frequently in this study than in other HIV-, AIDS-, or cancer-related studies. This may be an artifact of the study design. The use of informal networks for assistance, let alone the prevalence of unrelieved fatigue, indicates the need for more attention to this problem among people with AIDS. IMPLICATIONS FOR NURSING: Careful assessment of the pattern of fatigue and its onset, duration, intervention, and resolution is required if the varied types of fatigue are to be identified and treated successfully.
Acquired Immunodeficiency Syndrome↗
Measuring pain quality: validity and reliability of children's and adolescents' pain language.
Although considerable research has been conducted to identify children's and adolescents' language of pain, research is lacking regarding a method to quantify the pain quality described by this language. Three descriptive studies involving 1223 children, aged 8-17 years, were conducted in school and hospital settings. The aims were to develop and examine the validity and reliability of a word list for measuring pain quality that was free of age, gender, and ethnic biases. A word list with 43 words was developed and resulted in sensory, affective, evaluative, and total scores that correlated with pain location and pain intensity scores (r = 0.19-0.44; P less than or equal to 0.01). Pain quality scores decreased over time in a postoperative pain model. Test-retest reliability of the word list scores was high (r = 0.78-0.95; P less than 0.001). This word list was revised and resulted in a word list with 56 words relatively free of gender, ethnic, and developmental biases. Additional research is needed to assess the psychometric properties of this word list in pediatric populations experiencing different pain syndromes.
Adolescent↗
The symptom experience of people living with HIV/AIDS in Southern Africa.
This study describes the symptom experience of 743 men and women living with HIV/AIDS in Botswana, Lesotho, South Africa, and Swaziland. Data were obtained in 2002 by using a cross-sectional design. A survey of participants included 17 sociodemographic items and the 64-item Revised Sign and Symptom Checklist for Persons with HIV Disease. Results indicate a strong correlation between the frequency of reported symptoms and their intensity (r = .84, p < .00). Participants who reported having enough money for daily expenses also reported significantly fewer symptoms. There were no significant differences in symptom frequency between men and women or by location of residence. The study showed a complex picture of HIV-related symptoms in all four countries. Because of the high levels of symptoms reported, the results imply an urgent need for effective home- and community-based symptom management in countries where antiretroviral therapy is unavailable to help patients and their families manage and control AIDS symptoms and improve quality of life.
Adult↗
Gender differences in use of prayer as a self-care strategy for managing symptoms in African Americans living with HIV/AIDS.
The objective of this study was to explore the association of gender to use of prayer as a self-care strategy for managing the HIV-related symptoms of fatigue, nausea, depression, and anxiety among African American men and women who are HIV-seropositive. To accomplish this, data were determined using convenience sampling from a sample of 448 African American men and women from the United States who were participants in a national study on self-care symptom management of HIV/AIDS. Chi-square analyses were used to examine the potential relationships between gender and the use of prayer for managing the four symptoms. The mean age of the sample was 42.69 +/- 7.93 years (range, 20-66). Results showed the following gender differences in the use of prayer as a self-care strategy: fatigue-men 46% (n = 62), women 54% (n = 74); nausea-men 52% (n = 33), women 48% (n = 30); depression-men 55% (n = 90), women 45% (n = 73); and anxiety-men 77% (n = 83), women 87% (n = 73). Chi-square analyses determined that significant differences exist between African American men and women in the frequency of the use of prayer for managing HIV-related fatigue (chi(2) = 14.81, 1 df, p = .000), nausea (chi(2) = 4.10, 1 df, p =.043), and depression (chi(2) = 5.21, 1 df, p = .022). There was no gender difference in the use of prayer to manage anxiety. Prayer was reported as a self-care strategy by over 50% of the respondents for three of the four symptoms and was rated highly efficacious. The authors conclude that the African American men and women differed in their selection of prayer as a self-care strategy for managing HIV-related depression, fatigue, and nausea. A higher proportion of women than men used prayer to manage fatigue, and more men than women reported using prayer to manage nausea and depression.
Adaptation, Psychological↗
The Nursing Research Center on HIV/AIDS Health Disparities.
This report describes the partnership between the schools of nursing at the University of California San Francisco and the University of Puerto Rico to address the need for nursing research on HIV/AIDS health disparities. The partnership led to the creation of the Nursing Research Center on HIV/AIDS Health Disparities with funding from the National Institutes of Health/National Institute of Nursing Research. We provide background information on the disproportionate impact of the HIV/AIDS epidemic on racial and ethnic minorities, describe the major predictors of health disparities in persons at risk for or diagnosed with HIV/AIDS using the Outcomes Model for Health Care Research, and outline the major components of the Nursing Research Center. The center's goal is to improve health outcomes for people living with and affected by HIV/AIDS by enhancing the knowledge base for HIV/AIDS care.
Academies and Institutes↗