Measuring HIV Stigma for PLHAs and Nurses Over Time in Five African Countries

The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho; Malawi; South Africa; Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection; their adherence to medication; and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69); and 67.1(N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63); and 88.6(N=784) were females. Eighty-four per cent PLHAs reported one or more HIV-stigma events at baseline. This declined; but was still significant 1 year later; when 64.9reported experiencing at least one HIV-stigma event. At baseline; 80.3of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.71 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions; particularly focused at healthcare providers who experience HIV stigma by association

Working Conditions; Work Life and Quality of Life of the Temporary Support Staff Involved with Telematic Learning

Transformation in the South African higher educational system compelled residential universities to introduce alternative education such as distance education (Department of Education; 1997:66-67). The university in this study also took this route and started offering Telematic Learning through a programme known as Telematic LearningSystems (TLS). Telematic learning refers to education offered through contact sessions presented over distance. It thus provides more intense contact than the traditional distance educational model. A consequence was that the university's academic administrative system and workload expanded; and mainly temporary support staff was employedto carry this burden. The workload for the telematic nursing programme was extensive; the remuneration package was poor with little benefits and working conditions were not pleasant; which caused frustrations and which affected the quality of life of the temporary support staff. The goal of this research was to explore and describe the experiences and expectations of the temporary support staff with regard to their working conditions; work life and quality of life by means of a qualitative; descriptive research design. A purposive sample according to set criteria was used for the selection of participants as identified by mediators. Data collection was done through a phenomenologicalmethod of unstructured in-depth interviews. Content descriptive analysis; as described by Tesch (in Creswell; 1994:153-159) was used to analyse data through open coding. Five major categories resulted: experiences of the organisational structure; work life; interpersonal relationships; occupational development and quality of life while working at TLS. Conclusions were that staff experienced working conditions mainly as unpleasant; but that they adapted because of the team spirit. Relationships are good amongst staff; but strained with management and training is needed. These factors resulted in frustration; in a feeling that life is without real meaning and in problems with a future vision. Guidelines were formulated for the facilitation of quality working conditions; work life and quality of life of the temporary support staff; as well as for encouraging management to take note of certain focus points

The Professional Nurse's Experience of Dying Process of Terminal AIDS Patient

The increase in HIV/AIDS raises international concern. Statistics indicate that South Africa has the fastest increasing HIV-infection rate in the world. Secondary infections complicate the issues and could result in hospitalisation and death of terminal AIDS patients. Nurses are increasingly exposed to this process. This directed the researchers to explore and describe the nurse's experience of the dying process of the terminal AIDS patient through a qualitative research design. Purposive; voluntary sampling was conducted followed by individual interviews. Data saturation was reached after 10 interviews. The data were then analysed involving a co-coder to ensure trustworthiness. The results indicated specific themes. Firstly; nurses experience that various factors influence the pace of the dying process. Secondly; contrasting experiences regarding medical treatment of these patients surfaced. The study indicated that the nurse experienced emotions such as powerlessness; relief and fear. Finally; the needs and behaviours of the terminal AIDS patient; and the specific behaviours of the nurses were revealed. Value judgements regarding the patient; his family; medical treatment and the nurse's conduct during the dying process were also noted. Recommendations focus on the following: nurses' personal coping with the dying process; extended coping skills in the guidance of terminal AIDS patients and their handling of specific themes during the dying process.regarding the patient; his family; medical treatment and the nurse's conduct during the dying process were also noted. Recommendations focus on the following: nurses' personal coping with the dying process; extended coping skills in the guidance of terminal AIDS patients and their handling of specific themes during the dying process

A Model for Psychiatric Nursing Accompaniment of the Patient with Mental Discomfort : Part III

The research process did not proceed in the traditional step-by-step manner. A theory generating approach was followed by way of exploration and description. The first three levels : factor isolating; factor relating and situation relating theories; were generated. A conceptual framework for psychiatric nursing accompaniment of the patient with mental discomfort was formulated on the basis of concept identification and classfication. The concepts mental discomfort; lifestyle finctioning and psychiatric nursing accompaniment were identified and subjected to concept analysis. A systematic; logical and consistent approach led to the conceptualisation of the model for psychiatric nursing accompani- ment of the patient with mental discomfort