Bridging the Gap: Conference Record [Abstract book, International Conference on AIDS (12th: 1998: Geneva, Switzerland)]

356 Abstracts 22460-22465

12th World AIDS Conference

66*/22460 1 Effect of supportive nursing care on life satisfaction
and self care ability in HIV infected persons
Krongkarn Sangkard, S. Ratanasombat, S. Kimee. Faculty of Nursing, Mahidol
University, Prannok Bangkoknoi, Bangkok, Thailand
Objectives: To evaluate the effects of supportive nursing care on Life satisfaction
(LS) and Self care ability (SCA) in HIV infected persons.
Design: Quasi-Experimental study.
Methods: Subjects were HIV infected patients at the general medical unit,
Somdej Phrapinklao Hospital during March to October 1996. Fourty HIV infected
patients were purposely selected for this experiment and divided equally into two
groups. Twenty patients were assigned as an experimental group who received
the supportive nursing care provided by researcher, while those in the control
group received routine nursing care. The supportive nursing care method was
developed based on Orem's Self care theory, especially in supportive educative
system by researcher. Data were analyzed by using ANCOVA.
Results: The finding of this study revealed that after intervention the experimental group reported higher mean scores on LS and SCA than before intervention
(p <.01). The experimental group had higher scores on LS and SCA than the
control group (p <.01). The result of this study supports the value of supportive
nursing care based on the Orem's self care theory that bring on LS and SCA
of patients. The relationship between nurses and patients and proper health
education promote the patient's quality of life.
Conclusion: The study recomended that nurses should implement supportive
nursing care in order to promote LS and SCA of HIV infected persons. Thus,
They will be cope with their problems and properly maintain their lives.
22461 HIV/AIDS education for nurses: Forming community
partnerships to achieve effective outcomes
Anne Wyness1, B. Barrett2, D. Burdge3, I. Goldstone4, M. Summers2. 1School
of Nursing, Unversity of B.C. T201-2211 Wesbrook Mall, Vancouver B.C.;
2Positive Women's Network, Vancouver BC; 3Oak Tree Clinic, Vancouver BC;
4BC Centre for Excelence in HIV/AIDS, BC, Canada
Issue: Education that promotes understanding and fosters values and attitudes
basic to provision of quality HIV/AIDS prevention and care is required but is
difficult for educators to achieve independently.
Project: Faculty teaching an undergraduate HIV/AIDS nursing elective formed
a partnership with members of a community-based support/advocacy organization for women living with HIV and a physician specializing in the care of
HIV-positive women. One of the aims was to convey, in a 2 hour lecture and 2
hour seminar, a real appreciation for the issues women face and the nurse's role.
Teaching-learning activities were centered around case data. Students' opinions
about the learning experiences were obtained using open-ended questions about
helpful aspects, suggestions for changes and aspects to be certain to keep in
future presentations.
Results: Students reported that they benefited from the interprofessional teaching, organization of content using case data and expertise shared by individuals
working daily with HIV-positive women. The students were actively engaged in
learning. The case approach combined with lecture-discussions resulted in a
greater appreciation of women's experiences and care needs than the previous
didactic approach.
Lessons Learned: Education is enhanced when professionals from various
disciplines and members of community organizations collaborate to help students
explore values and gain understanding. Working in partnership to teach content
requires commitment and a willingness to examine difficulties as they arise. Partnerships offer an innovative and valuable model for teaching nurses and warrant
further exploration by educators in all the health care professions.
22462 Symptom distress and self-care burden among women
with late HIV disease
Kathryn M. Khalife1.3, F. Shea1 2, P. Schuman1. 1 Wayne State University,
2College Nursing, Detroit, MI; 346623 Springwood, Macomb, MI, USA
Purpose: To investigate aspects of self-care, self-care deficits and experience
of illness in women with late HIV disease by exploring symptom distress and
self-care burden.
Method: An exploratory, descriptive-correlational design was used to measure
symptom distress and self-care burden among a convenience sample of 35
seropositive women with CD4 T cell count of 200 or less attending an HIV/AIDS
clinical care program at a large, urban university in a major midwest city. The
theoretical framework was derived from Orem's Nursing Theory of Self-Care.
Symptom distress was measured by the McCorkle Symptom Distress Scale;
self-care burden was measured by the Oberst Self-Care Burden Scale.
Results: There is a moderately strong relationship between the distress of
physical and psychological symptoms and the burden of self-care among women
with late HIV disease (r =.74, p <.01). Skin itching, insomnia, negative mood
changes and fatigue were reported as the most distressing symptoms. Pain,

fatigue, and difficulties with concentration were significantly related to health deviation self-care burden of watching for and interpreting changes in symptoms
(all ps <.01). Appearance, fatigue, deterioration in mobility, and pain were significantly correlated with difficulty in the ability to perform personal care activities
(all ps <.01).
Conclusions: Women with late HIV disease demonstrate moderate symptom
distress and self-care burden related to interpreting symptom changes, receiving

information and education about their illness, personal self-care, ability to perform
household tasks, and ability to perform outside tasks. Appropriate referrals, case
management, psychological and spiritual support can assist the patient to provide
appropriate self-care in the context of HIV disease.
122463 Direct nursing time with AIDS and non-AIDS patients at a
mixed ward of the University Hospital Antwerp, Belgium
Veerle Willaeys', D. Berkvens1, N. Debbaut1, R. Koeck2, K. Depraetere1,
R. Colebunders1. Institute of Tropical Medicine Nationale Straat 155 B2000
Antwerp; 2University Hospital Antwerp Ede Gem 2650, Belgium
Objective: To compare the direct nursing time for patients with AIDS and patients
with other diseases in a mixed ward of the University Hospital Antwerp.
Study Site: B2 ward of the University Hospital Antwerp. In this ward the same
nurses provide care for patients with HIV infection and other diseases.
Methods: Nursing activities were recorded during ward rounds at 10 min. intervals, during 20 days. Patients were categorised according to their type of illness
and nursing care category: minimal care or self care, medium care, more than
medium care and intensive care (San Joaquin Score). During the study period
14 patients with AIDS (none of them terminally ill) and 100 patients with other,
mainly pulmonary, diseases including 31 patients with lung cancer (7 terminally
ill) were present in the ward. The duration of nursing care per day was calculated
for every type of illness and nursing care category.
Results: The mean time of direct nursing care for persons with HIV infection
was 47 min. per observation day compared with 36 min. for patients with non
terminal lung cancer, 78 min. for terminally ill non-AIDS patients, 43 min. for other
non-AIDS patients. The nursing care category (San Joaquin Score) was more
predictive for the duration of direct nursing care per day than the type of illness.
Conclusions: Time spent on direct nursing care for hospitalised AIDS patients
is only a relatively small part of the daily activities of nurses. At the University
Hospital Antwerp the nursing time spent with AIDS patients is similar to the time
spent with other patients belonging to the same category of nursing care (San
Joaquin score).
|63*/22464 Degree of comfort in providing care to clients with
HIV disease: A study of nurses in Ho Chi Minh City,
Vietnam
Patricia Correll1'2, T.T.V. Ninh3, T.D. Nguyen4, N.T. Le5, B.M. Nguyen6, V.N. Le7,
P.K. Kloser1. 1UMDNJ/New Jersey Medical School, Newark NJ, 2695 Cardinal
Hill Lane, Powell, Ohio, USA; 3Center for Tropical Diseases, Hochiminh City;
4 University Training Center, Hochiminh City; 5Hung Vuong Maternity Hospital,
Hochiminh City; 6Tu Du Obstetrical/Gynecological Hospital, Hochiminh City;
7Pham Ngoc Thach TB/Lung Hospital, Hochiminh City, Vietnam (USA)
Issue: As the number of clients with HIV infection present for treatment, nurses
may have fears about providing care. An understanding of these fears could
provide information for targeting education.
Project: One hundred and forty nurses currently working with clients were
asked to complete a questionnaire about their degree of comfort in providing
care for clients with HIV infection. The nurses were from maternity, tuberculosis
(TB) and tropical disease hospitals in Ho Chi Minh City. Questionnaires from
nurses working on an HIV ward were analyzed separately. The questionnaire was
translated into Vietnamese and reviewed by three English-speaking Vietnamese
nurses for accuracy. The questionnaire had been piloted on nursing students two
years ago and a similar group of nursing students given the tool this year were
used as a control group. A period of observation was also conducted to note
availability of supplies and handwashing practices.
Results: The return rate for the questionnaires was 76%. Nurses were most
comfortable giving instruction to a client's friend on assisting the client with
bathing. (Two years ago, the nursing students could not answer this question,
stating that this activity was not culturally appropriate). Nurses were most uncomfortable giving perineal care. Maternity nurses were the most comfortable in
caring for clients with HIV, however, the number of pregnant women with HIV
is low. Nurses at the TB hospital experienced the greatest discomfort, possibly
related to the large number of clients with HIV infection and tuberculosis.
Lessons Learned: Availability of supplies, cleanliness of equipment and frequent handwashing were related to increased comfort in nurses. The activities
rated least comfortable involved contact with body fluids. The availability of protective equipment and education in proper use of the equipment might decrease
the discomfort of the nurses. HIV infection is impacting cultural norms regarding
privacy and gender issues.
S22465 Developing symptom indices to assess health outcomes
in persons with HIV/AIDS
Martha Shively1, A.L. Gifford2, J.E. Bormann2, D.S. Timberlake2, S.A. Bozzette2.
1VA San Diego Health Care System 3350 La Jolla Village Dr, San Diego, CA
92161; 2SDVAMC, Univ. of Calif. San Diego, San Diego, CA, USA

Objectives: To develop and evaluate self-administered indices assessing frequency and bothersomeness of HIV symptoms and to determine the relative
importance of each.
Design: Descriptive, correlational.
Methods: Symptomatic, HIV+ adults participating in a randomized trial of
HIV/AIDS patient education completed questions about symptom frequency and