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

500 Abstracts 24309-24314

12th World AIDS Conference

24309 1 Effectiveness of an educational course on HIV/AIDS
Serhat Unal1, Veli Duyan1, Y. Laleli2. 1Hacettepe University Section of Infectious
Diseases, 06100 Ankara; 2Duazen Laboratories, Ankara, Turkey
The aim of this study is to determine the effectiveness of an educatioanal course
on HIV/AIDS given to the physicians. A pretest-posttest design was used to evaluate programme effectiveness. This study included 16 female and 40 male (total
56) physicians. Data were collected from self-administered questionnaire completed anonymously. It contained gender, age, professional experience (year)
and 18 attitude expressive questions. Comparisons of pretest-posttest scores
were analyzed using independent sample t-tests. According to the results of this
study after an educational programme on HIV/AIDS a significant proportion of
physicians declared that they can work with professionals who have AIDS in the
same environment. This study also demonstrated that after such an educational
programme the level of consciousness of protecting themselves from HIV transmission was increased; and level of fear of caring for HIV/AIDS patients, level of
being worried about possible social contact with HIV/AIDS patients and level of
thinking that health care professionals have the right to refuse to give treatment
to HIV/AIDS patients decreased significantly (p < 0.05).
Our results indicate that an educational programme which incorporates medical, psychological, social, economic and cultural dimensions of HIV/AIDS was
effective on attitude changing significantly. Training for HIV/AIDS personnel must
be systematically planned, conducted and evaluated in collaboration with interdisciplinary health care professionals.
24310 Assistential and emotional aspects of AIDS patient
caregivers in a day-care unit in Brazil: A qualitative study
Rosely Moralez Figueiredo, E.R. Turato. State University of Campinas, Rua
Mogi Mirim 250 - Apt. 34, 13050-543 Campinas, SRP Brazil
Background: The advent of AIDS in families, following the chronic evolution of
the illness, produces crisis situations unknown until now. With the objective of
know this new reality, 20 caregivers of patients with AIDS of a university hospital
in the city of Campinas, southeastern Brazil, were interviewed.
Methods: The Clinical-Qualitative Research Method using the Semi-Directed
Interview Technique with Open-Ended Questions were employed, divided in two
groups: (a) assistencial aspects, and (b) emotional aspects, and a closed questionnaire with socio-demographic data. The contents of interviews were discussed
within the psycodynamic referential.
Results: All caregivers were female. The results found concern: (a) difficulties
for assistencial help, such as lack of orientation, of materials, of transport, and of
people to assume the role of caregiver, and (b) emotional difficulties, such as fears
from contagious (partners and children), revolt (treason, emergence of life styles
and sexual options), pity and impotence in front of death. The family receives a
load of responsibilities, that is not prepared to, resulting in its disorganisation.
Conclusions: The role of family is essential in the patient assistance, due the
incapacity of the health system attend all AIDS sicks. Nevertheless, the family
has to receive support, to be helped in executing the aid plain to the ill person at
home, to obtain precise orientations and professional and material aid always it
is necessary.
24311 The difficult condition of widowed women and orphaned
children affected by HIV/AIDS epidemics
Cecilia Oliveira. Al. Barros 86 cjto 2B Sao Paulo, BR, Brazil
Issues: When HIV/AIDS reach both parents it produces a strong impact on family
relationship. Women and children are the most vulnerable to family empoverishment and risk of desintegration; they are exposed to different risks to their future:
familiar, social, mental.
Project: APTA's Home Support Group offers long term psychosocial assistance
to plwaids and their families, mainly among poor people. Through a continuous
program health agents provide information, health education and emotional support from diagnosis to grieving period and family readaptation.
Results: Death of husbands leaves young mothers alone to sustain children
and house. It is possible to adress family needs over time, reducing psychosocial
impact. During the long time of crises brought by AIDS women and children deal
better with multiple and different losses to face sickness/death and to adjust in
bereavement period. Children receive special attention and the support to them
still continues after loosing both parents. All the orphaned children are adopted
by relatives; even seronegative orphaned children can be rescued from social
abandonment and lack of basic rights.
Lessons Learned: HIV increases the needs and the impact of economic, social
and emotional problems among HIV+ widows and children. It is necessary and
possible to look at orphaned children of seropositive parents, to support them to
deal with fears, losses and bereavement process.

24312 Long term HIV health care professionals: Learning from
experience and strategies for coping
CarolynK. Burr. National Pediatric & Family Resourse CTR., Newark, NJ, USA
Background: The stressful and challenging nature of HIV work for professionals
is well-recognized but little research has examined how and why professionals
continue in the field. This study used qualitative methodology to explore the learn
ing experiences of long-term professionals in the HIV field to better understand
what has helped them to continue in the work.
Methods: A sample of 11 MDs and 14 RNs with >10 years direct HIV experience (from 207 survey responses from New Jersey HIV providers) participated in a
45-75 min. semi-structured individual interview with the researcher. Transcribed
interviews were coded and themes emerged regarding positive and negative
learning experiences (LE), occupational risk (OR), and personal strategies for
coping with the work (ST).
Results: LE: 3 theme areas re: rewarding aspects of HIV work included working
with patients, personal growth and intellectual challenge, and relationships with
colleagues. Difficult aspects included the emotional toll, complex relations with
pts., lack of support from co-workers, and political/social aspects of HIV. OR:
10/25 providers had needle stick exposure to HIV, mostly early in the epidemic.
All continued to be aware of OR. 15 discussed their carefulness in risky situations.
ST: 3 theme areas included work strategies such as recognizing limits of the work
and support from colleagues; self-care such as "having a life"/interests away from
work, and spirituality; and personal characteristics such as optimism and honesty.
Conclusions: Long term HIV MDs and RNs find the work personally rewarding
because of relationships with patients and HIV colleagues and value the intellectual challenge of the work. To stay in HIV work, they continue to learn from pts.
and their families, recognize and deal with their risk of occupational exposure,
find support within their work settings, and, most important, cultivate and maintain
a private family/community life which gives them a balance with their HIV work.
124313 Competency in AIDS work; A new paradigm
Gloria Murrant, P.A. Williams, L. Durkee. Casey House Hospice 9 Huntley
Street, Toronto, Ontario, Canada
Issues: Working and/and or volunteering in HIV/AIDS care can be stressful. In
spite of the acknowledged level of stress and the availability of information about
approaches to managing stress and fostering self-awareness, people working
in AIDS often neglect themselves. By neglecting the importance of their own
feelings and perspectives they may be unwittingly undermining their ability to
sustain and/or continuously improve their level of competence in AIDS work.
Project: Casey House Hospice is located in the multicultural center of downtown
Toronto, Ontario, Canada. As a community based hospice there is an education
program to provide skills to professional and lay persons working with HIV/AIDS.
These programs create links with other community based organizations and support train the trainer opportunities. They have been designed from a model that
recognizes self-awareness as a cornerstone to competency in AIDS work. The
programs include Creativity and Self-Care and Conscious Communication which
attract participants from a diverse number of organizations and cultures.
Results: Participants have articulated the ability to integrate the content of
educational sessions more effectively when this model is the foundation of the
program. Both facilitators and participants experience increased capacity to bridge
differences. This model makes both educational programs and provision of care
more adaptable to a wide variety of cultural contexts.
In order to sustain oneself and/or continuously improve in HIV/AIDS work, is it
crucial to begin with self-awareness as a competency. Treating self-awareness,
self-esteem, self-respect, self-care, and the ability to communicate honestly, and
assertively as interconnected competencies is a model that facilitates this. This
model is also a mechanism that creates an effective learning and teaching environment and ensures that both education and provision of care is adaptable to a
wide variety of cultural contexts.
24314 Wellness enhancement through creativity: Art therapy as
an approach to self care
Douglas Amonite. 77 Maitland Place, #808 Toronto, Ontario, Canada
Issue: To provide additional support and coping strategies for persons living with
HIV/AIDS, and for professional and lay care-providers, utilizing Art Therapy as a
creative means of intervention.
Project: This interactive workshop will provide opportunities to examine and
develop techniques and coping strategies to enhance self care for persons living
with HIV/AIDS, and their health care providers. Art Therapy is a creative approach
to express emotional states and life experiences through the production of art
work, with relevance to image content, color, and symbols that are expressed
by the client. Applying directives and spontaneous art production followed by
discussion, participants can experience Art Therapy as an effective and creative
approach to address self care, burnout, and stress reduction.
Results: Art Therapy has been well received by persons living with HIV/AIDS
and their care providers as an effective approach for emotional care and treatment. As it encourages communication on both verbal and non-verbal levels,
it is particularly effective for persons who may have difficulty expressing themselves verbally, It has proven effective in reducing anxiety and stress, promoting
emotional healing, and enhancing quality of life.
Lessons Learned: Art Therapy is client centred and culturally sensitive therapeutic approach. Its adaptability to the individuals changing needs contributes

a sense of empowerment and control by direct involvement in the therapeutic
process.