Abstracts Vol. 1 [International Conference on AIDS (11th: 1996: Vancouver, Canada)]

Monday, July 8, 1996

Mo.B.184 - Mo.B.195

worst (p<.05), but was unrelated to coping through wishful thinking or through voiding
thinking about AIDS (p's>.50). Substitution was also related to negative attitudes toward
taking AZT and anti-retrovirals in general (ps<.001). Use of alternative therapies to augment conventional treatment and disclosure of alternative therapy use to pr oviee-s were
not related to any of the variables examined.
Conclusions: Alternative therapies were often used in ways that may rinfluence conventional
treatment.The behavior that most directly does so, use of alternatve, instea-d of conventional medications, appears to be associated with the belief that more effective treatments
for HIV exist than those that have been identified by conventional medrctne. this belief is
separate fbrom denial. Findings require further study in a broader saritle of per sns with F IV.
R.L. Collins, RAND, 1700 Main Street, Santa Monica, CA, 90402, USA
Telephone: [phone], FAX: (3 I0) 451-6917, email: RebeccaCollins(arand.or
Mo.B. 184
EVOLVING STRATEGIC PLANNING IN COMPLEMENTARY THERAPIES:A NATIONAL
CARETREATMENT & SUPPORT APPROACH
Bhatia, Reeta, McDonald John**. *Consultant, AIDS Care,Treatment & Support Program,
Health Canada, Ottawa, Ontario; * Professor, Faculty of Social Wor k, University of Calgary
Calgairy, Alberta
Issue: In North America, upwards of 70% of HIV positive persons make use of complementary therapies. In Canada, few resources have been committed and little done to take a
national approach to the use and place of complementary therapies in HIV/AIDS treatment.
Project: In November of 1995 the AIDS Care,Treatment and Support Program i of Health
Canada undertook the development of a working paper to review complementary therapies in HIV/AIDS and outline strategic directions for future planning in this area.
Results: In March of 1996, the Report was completed. It reviews HIV/AIDS related complementary therapy practice in North America and outlines strategic options in the following
areas. I) information gathering and dissemination, 2) research agendas and activities, and 3)
delivery of complementary therapy programs.
Lessons Learned: The Report entitled, The Complementary Imperative: Evolving and integrating comprehensive care, treatment and support for persons with HIV/AIDS serves as
a strategic plan and guide to the AIDS Care,Treatment and Support Program of Health
Canada in its efforts to evolve a national approach to appropriate use and integration of
complementary therapies in the treatment HIV/AIDS.This presentation describes initiatives
presently underway and directions for the future.
Rt. Bhatia, FHealth Canada, HPSB, AIDS Care,Treatment Division, Room 2 10,Tower A, 2nd
Floor, I I Holland Avenue, Postal Locator 3002A, Ottawa, Ontario, Canada KA It Bd
Telephone: [phone] Fax: [phone]
Mo.B. 190
A TRAINING PROGRAM TO ENHANCE NURSES' CLINICAL ASSESSMENT OF HIV
PATIENTS VIA STANDARDIZED PROCEDURES
Katsufirakis Peter J, Hummel D, Saunders JM, Nyquist JG. Pacific AIDS Education and Training
Center, University of Southern California, Los Angeles, CA, USA.
Issue: Nurses approach to health promotion, symptom management and integrated care is
needed by patients with HIV.This program increases nursing participation in primary care of
HIV/AIDS patients, necessary in the face of increasing numbers of patients, inadequate
access to care, and burnout" of existing providers.
Project: A small group of RN's (5-I10) receive I week of didactic instruction on HIV specific
history and physical assessment, followed by 60 hours of clinical preceptorship in HIlV clinics. Faculty are nurses, physicians and PA's experienced in HIVTrainees hone their assessmen1 skills, increase their ability to differentiate clinical problems, enhance their role in an
interdisciplinary treatment team, and expand their advocacy skills. Nurses learn to write
standardized procedures that guide nursing practice for specific clinical problems for implementation at their home institution.
Results: Trainees reported high overall satisfaction and increases in their ability to care for
HIV-infected patients.Trainees showed good to excellent mastery of skills and content
needed for initial assessment of HIV patients. For some, training resulted in expanded professional activities. Most required more than 10 weeks to complete 60 hours of preceptorship training. Recruitment was more difficult than anticipated, perhaps due to 'he program's
time requirement and instability of Los Angeles' health care system, causing individuals and
institutions to defer a time-intensive training program.
Lessons Learned: This program has taught nurses to develop HIV-specific standardized procedures and expand their roles.The total time commitment is greater than individual nurses
can reasonably make in today's health care economy so new strategies for recruitment
must be considered: partnerships with institutions, flexible time frames, individualized content and different training sites may each be effective alternatives.
Peter J. Katsufrakis, 1975 Zonal Avenue, KAM-100, Los Angeles, CA 90033
Tel: [phone] Fax: [phone]
Mo.B. 191
WHO IS SERVING WHOM:THE CHALLENGE OF CONTINUITY AND
CUSTOMER SERVICE
Veldhorst, Georgina*, Grondin, M**, Harrison, H.*. *The Wellesley Hospital, I fhe
Wellesley Health C entreToronto, Ontario, Canada
Issue: People living with HIV receiving care at a medium sized teaching hospital were concerned that the traditional models in which nursing care was delivered was not satisfactorily
meeting their needs. Frequent interactions with the health care system and the complex
physical manifestations affecting the body mind and spirit required the nuses to explore
new ways of providing continuity of care and better customer service.
Project: This paper will address current work being done to address the,bove concerns.
The wor-k includes establishing systems to foster both continuity of i.e isd care,ive
within the inpatient unit and across the continuum of care. A nurse patien pa sits-shif
model was used to enhance continuity of care and care giver.
Results: This model of nursing care began to evolve in the fall of 1994. Signicant yains have
been made in establishing continuity within the inpatient unit, across primary care and day
care. Further links need to be established between these sites and the emergency department, chronic and palliative care. As the nurses grasped these concepts and acquired the

necessary skills, shift in practice occurred and job satisfaction increased. Feedback from
patients supported the premise that this model decreases many frustrations for the patients
and their families.
Lessons Learned: Committed leadership and communication were important factors in
enhancing this shift in practice. Supporting nurses to make the role shift required continuous mentoring and role modelling on a one to one basis.This method provided the most
positive results. Staff who developed the skills and expertise required became excellent
mentors and role models for their peers.
Geo igina Veldhorst, Room 925TW,The Wellesley Hospital, 160 Wellesley St. EastToronto,
Outar ir, Cainada, MN14Y IJ3;Telephone [phone] ext. 3917; Fax [phone].
Mo.B. 193
KNOWLEDGE AND ATTITUDES REGARDING HIV INFECTION AMONG
AUXILLARY NURSES WORKING AT IMIP'S HOSPITAL
Ansjo,W'ilrra 5, Souza E, Santos R, Mendonca K, Cantarutti L. Instituto Materno Infantil de
Pernambuco (IMIP), Recife, Pernambuco, Brazil.
Objective: to determine the current knowledge and attitudes of auxiliary nurses (AN)
working at Instituto Materno Infantil de Pernambuco's (IMIP) Hospital, reference center for
mother and child health and HIV infection in children, in a cross-sectional study
Methods: -Or July 1995, 100 out of 400 AN working at IMIP were randomly selected from
day and night shifts and asked to participate on this studyThey received a self applicable
anonymous questionnaire to answer and were asked to attend a following training section
about HIV infection for health care workers.
Results: Ninety eight AN answered properly the questionnaires.The median age was 31
year s (range 19 to 56). Ninety-night percent were female, 52,7% working with child care
and 28.6% with women care.The distribution according to their working years was the follow: < 3 years, 45.6%; 3-10 years, 37.8% and > 1I0 years, 16.7%. Singles/divorced/windowed
accounted for 56.2% while married/living together for 43.9%. Only 20.4% referred previous
IHIV infection information attending training sections held at IMIP and 37.7% also at other
services. Fifty three percent had provided health care to HIV infected patients and 50.0%
thought they were at some risk of acquiring HIV during their duties. When asked to quantify the risk of exposure to HIV infection during diverse procedures, the most frequent procedures quantified as high risk were: venipuncture, i.v. injections, normal and cesarean delivery Surprisingly blood donation was considered as high risk of transmitting HIV. Sixty-one
percent were heterosexuals and 28.9% refused to inform their sexual preference. Sixty percent reported active sexual life, none had history of i.v. drug use and 7.4% had received
blood transfusion. Fifty percent considered use of condom as unsafe and only 17.0%
reported use of condom. Single women were more prone to use condomn in their sexual
activities compared with married women (p<O.05).
Conclusions: AN were forgotten by HIV infection training programs designed for health
care providers.The level of knowledge was low and sometimes conflicting. Moreover, personnel attitude about HIV infection and condom use might also reflect failure of public
information campaigns to reach this study population.raining courses need to be urgently
planned and periodically given to AN.
Edvaldo Souza. Rua dos Coelhos, 300, Boa Vista, Recife-PE, 50070-550, Brazil.
Te1:55 81 -4237566 Fax: [phone]
Mo.B. 194
CONTINUITY OF NURSING CARE IN AN HIV OUTPATIENT CLINIC
WILKINSON Mandie, PULLEN, Sally PHILLTPS, Mary Grahame Hayton Unit, Ambrose
King Centre, Royal London Hospital, England, UK
Project: to implement a system providing continuous care by the same nurse throughout a
patient's stay in the clinic.The nursing staff comprised of three registered general nurses, all
with post-registration HIV training and varying levels of both general and HIV nursing and
research experience. A total of 344 patients regularly attended the clinic.
Results: A nurse was allocated to a specific group of patients each day As well as the routine health check appointments, a number of specialised treatments were offered on an
outpatient basis.These treatments included intravenous administration of anti-viral therapy
and cytotoxic chemotherapy often requiring the more experienced nurse to administer
them.The patient would remain in the care of their specific nurse under the direct supervi
sion of a more senior nurse.This provided continuity of care for the patient and an opportunity for the junior nurses to develop their skills. Communication with other members of
the multi disciplinary team imnproved as the nurse caring for the individual patient was easily
identified and accessible.
Lessons learned: Implementation of continuity of nursing care in an outpatient setting differs from the care provided on the ward.There are fewer outpatient nursing staff, more
patients to deal with each day for variable amounts of time, the workload may be difficult
to predict. Howevern when patients are allocated a "named nurse" on a daily basis it proves
an efficient way to organise nursing staff and is beneficial to both patients and other health
care worker.
Mandie VV lknson, 13 Lime CloseWapping, LONDON El 9QP England
Mo.B. 195
HEALTH CARE PERSONNEL EDUCATION ON AIDS
Mrs. Simpson, C., dMrs. Augustine |ebamani. Christian Medical College & Hospital,
Vellore - 4, INDIA.
ISSUES: Nursing personnel have irrational fear towards AIDS Care.
PROJECTS: Education plays a major role in prevention of HIV infection and enhancement
of compassionate care to AIDS patients. Hence, inservice education was arranged in all the
clinical depatments, by the supervisor Protocols on AIDS care was prepared and given to
th wards. Ptes were displayed in the patient care area. Essential supplies were adequately provided in hgh risk areas to follow universal body fluid precaution.
Results: Stud a done during January I995 on Nurses knowledge and attitude regarding AIDS
revealed that the Staff Nurses sharing a high score of 80% in knowledge and 70% in attitude. heir irrational fears have been removed. Nurses working in high risk areas followed
universal body erecaution.

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