Health care needs of persons with HIV/AIDS in various settings.

This study describes the psychosocial and physiological health care needs of persons with HIV/AIDS in hospital, outpatient, home care, and long-term care settings. A cross-sectional descriptive design with 386 patients selected from the four settings was used to test between-setting differences on Healthcare Needs Scales. Univariate analyses of variance of scale and subscale scores and Kruskal-Wallis analyses of variance by ranks on item scores were computed. There was neither a relationship between psychosocial and physiological health care needs nor a distinctive pattern of needs across settings by HIV classification. The patients' needs varied between settings on health behaviors/social support, health management, and elimination/physical/sensory functions but were quite similar in psychosocial/financial support and neurological/digestive functions. These results question assumptions about the relationships among stage of HIV infection, level and type of health care need, and type of setting and suggest that health system resources and nursing care focus on both the psychosocial and physiological needs of persons with HIV/AIDS using individualized protocols.

Healthcare needs of HIV-infected persons in hospital, outpatient, home, and long-term care settings.

In this descriptive study, healthcare needs reported by 386 HIV-infected persons from all risk categories and their primary nurses from four care settings (hospital, outpatient, long-term care, and home) are identified. Healthcare needs were classified into four domains of nursing practice using a conceptual framework from community health nursing--physiologic, psychosocial, health behaviors, environmental--and were assessed using the Healthcare Needs Scale for Patients with HIV/AIDS. Nurses' perceptions of major healthcare needs across all settings centered around decreased physical endurance, limited physical mobility, and sensory deficits. Patients' needs focused on financial issues. The results reflect the multidimensional nature of this infection and provide direction for clinical practice.

Consistency and cost of home wound management by contract nurses.

The purposes of this descriptive study were to determine the consistency of wound care provided by home health care nurses with the physician's order and the agency's written wound protocol; and the type and cost of wound-management products and nursing services associated with home care. Eleven registered nurses were observed providing wound care in 117 home visits to 31 patients. In addition to the observational component, data were also collected by chart review to facilitate comparison of observed vs. documented care. There were statistically significant differences between observed care given and that which was documented in patients' records. Consistency of care for individual patients was high when care was delivered by the same nurse, but lower when different nurses were involved. The mean dollar value of supplies used for all visits was $9.40, and the average nursing charge per visit was $89.

HIV infection, exercise, and immune function.

Decreased physical endurance is viewed by both HIV-infected people and their primary nurses as a major healthcare problem. There is a widespread belief among HIV-infected people that the way to improve their endurance is through exercise. Yet healthcare providers are divided about the role of exercise. This paper presents an overview of decreased endurance as a major problem in this population, with a review of the literature on exercise in healthy and chronically-ill populations, including those with HIV infection, and its effect on immune function.

Healthcare needs scale for patients with HIV/AIDS: content validation.

The authors of this study adapted Peters' (1987) community health specifications of patients' nursing requirements so they could be applied to patients with HIV/AIDS in hospital, dedicated outpatient HIV clinic, home care, and long-term care settings. The authors then collected validity evidence on the revised specifications, developed a sample of 62 multiple-choice items, and obtained content-related validity evidence via a judgmental review panel. The results produced: (a) a set of specifications for the environmental, psychosocial, physiological, and health behaviors domains; and (b) a 44-item scale of patient characteristics related to four levels of healthcare needs.

Managing urinary incontinence in community-residing elderly persons.

This two-year project demonstrated a significant decrease over time in urinary accidents after instruction in Kegel exercises augmented by the use of biofeedback, habit training, and relaxation techniques in 54 cognitively intact volunteers aged 60 years and over who had stress, urge or complex types of incontinence. This decrease in urinary accidents per week was maintained from the end of focused treatment through 6-month and 1-year follow-up, despite the age of the participants, previous urinary-related surgeries, or duration of incontinence.