The routine clinical evaluation of health-related quality of life (HRQOL) improves quality of care in patients with HIV/AIDS by effectively assessing and optimizing treatment outcomes, enhancing patient adherence, improving communication between patients and clinicians/nurses, and documenting changes in patients' health status over time. Existing HRQOL assessment tools may not be appropriate for this purpose, as they are designed for clinical trials and research, and exclude several aspects relevant to QOL in patients with HIV/AIDS in the clinical setting. Therefore, there is a need for a new, user-friendly, HIV-specific clinical assessment tool that briefly but effectively evaluates symptom-related HRQOL issues most relevant to patients with HIV/AIDS, including fatigue, depression, pain, nausea and vomiting, sleep disturbances, sexual dysfunction, and body image changes. This article describes the role of nurses in HRQOL assessment in HIV/AIDS, compares commonly used assessment tools, and evaluates the applicability of these tools for routine clinical use in this patient population.
With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug-drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of task-shifting, task-sharing, and scope of nursing practices.
This study is a follow-up of 39 working class couples who were interviewed after suffering economic stress or unemployment and again six years later. Repeated measures related to economics, stress, family functioning, anxiety, and depression were collected and analyzed for couples and for husbands and wives separately. A model of long-term coping was suggested for future testing. Initially stressed families appeared to grow stronger. Mental health correlated negatively to family problems. Depressed wives seemed to maintain their depression over time if they perceived family life as stressful. Irrespective of marital problems, husbands were less likely to stay depressed.
Modern health-care technology has complicated the ethical considerations of not only diagnosis and treatment, but also the social implications of diseases. Nurses are facing daily challenges as they struggle to protect and support confidentiality, justice, and beneficience for their clients. Community health nurses (CHNs), in light of their manner of primary care delivery, are often involved in these challenges. CHNs, due to their manner of primary care delivery, may find themselves in situations very different from those of other health-care workers. Often these situations have a moral component that cannot be addressed by the traditional problem-solving methods. Knowledge of ethical theories that offer frameworks for problem solving is essential as these CHNs struggle with ethical dilemmas.
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