Provider training and experience for people living with HIV/AIDS

Rackal, Julia; Tynan, Anne‐Marie; Handford, Curtis; Rzeznikiewiz, Damian; Agha, Ayda; Glazier, Richard H.

doi:10.1002/14651858.cd003938.pub2

Cited by 45 publications

(36 citation statements)

References 37 publications

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“…Consistent with previous reviews with a similar focus (Handford, Rackal, Tynan, Rzeznikiewiz, & Glazier, 2012;Rackal et al, 2011), we found positive associations between health-care provider expertise and health outcomes among HIV-infected patients. However, our results regarding facility volume were less convincing than those in previously published reviews (Handford et al, 2012;Handford, Tynan, Rackal, & Glazier, 2006).…”

Section: Discussionsupporting

confidence: 90%

Structure and quality of outpatient care for people living with an HIV infection

et al. 2016

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Policy-makers and clinicians are faced with a gap of evidence to guide policy on standards for HIV outpatient care. Ongoing debates include which settings of care improve health outcomes, and how many HIV-infected patients a health-care provider should treat to gain and maintain expertise. In this article, we evaluate the studies that link health-care facility and care provider characteristics (i.e., structural factors) to health outcomes in HIV-infected patients. We searched the electronic databases MEDLINE, PUBMED, and EMBASE from inception until 1 January 2015. We included a total of 28 observational studies that were conducted after the introduction of combination antiretroviral therapy in 1996. Three aspects of the available research linking the structure to quality of HIV outpatient care were evaluated: (1) assessed structural characteristics (i.e., health-care facility and care provider characteristics); (2) measures of quality of HIV outpatient care; and (3) reported associations between structural characteristics and quality of care. Rather than scarcity of data, it is the diversity in methodology in the identified studies and the inconsistency of their results that led us to the conclusion that the scientific evidence is too weak to guide policy in HIV outpatient care. We provide recommendations on how to address this heterogeneity in future studies and offer specific suggestions for further reading that could be of interest for clinicians and researchers.ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 90%

Structure and quality of outpatient care for people living with an HIV infection

et al. 2016

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“…The engagement between HCPs and patients seems to have an important impact on the major outcomes in HIV care ART adherence and QOL. Our study supports other studies showing that engagement with HCP plays a vital role in influencing the QOL of PLHIV [18,29,60]. Future studies should focus on the relative impact of these factors on disease management and HIV care, and on the extent to which enhancement of the engagement between HCPs and HIV-infected patients may advance patient QOL.…”

Section: Discussionsupporting

confidence: 89%

“…Research has shown that senior HIV clinicians provide care to improve medical outcomes compared to less-experienced providers [18], which affects the QOL of HIV-positive patients. In Brazil, HIV-positive women receiving care from providers with a preventative care perspective and trained in reproductive health report a better QOL compared to HIV-positive women who went to providers lacking reproductive health training and counseling skills [19].…”

Section: Introductionmentioning

confidence: 99%

Engagement with Health Care Providers Affects Self- Efficacy, Self-Esteem, Medication Adherence and Quality of Life in People Living with HIV

et al. 2013

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The engagement of patients with their health care providers (HCP) improves patients’ quality of life (QOL), adherence to antiretroviral therapy, and life satisfaction. Engagement with HCP includes access to HCP as needed, information sharing, involvement of client in decision making and self-care activities, respect and support of the HCP for the client’s choices, and management of client concerns. This study compares country-level differences in patients’ engagement with HCP and assesses statistical associations relative to adherence rates, self-efficacy, self-esteem, QOL, and symptom self-reporting by people living with HIV (PLHIV). A convenience sample of 2,182 PLHIV was enrolled in the United States, Canada, Puerto Rico, Namibia, and China. Cross-sectional data were collected between September 2009 and January 2011. Inclusion criteria were being at least 18 years of age, diagnosed with HIV, able to provide informed consent, and able to communicate in the local language with site researchers. In the HCP scale, a low score indicated greater provider engagement. Country comparisons showed that PLHIV in Namibia had the most HCP engagement (OR 2.80, p < 0.001) and that PLHIV in China had the least engagement (OR −7.03, p < 0.0001) compared to the PLHIV in the Western countries. Individuals having better HCP engagement showed better self-efficacy for adherence (t = −5.22, p < 0.0001), missed fewer medication doses (t = 1.92, p ≤ 0.05), had lower self-esteem ratings (t = 2.67, p < 0.01), fewer self-reported symptoms (t = 3.25, p < 0.0001), and better overall QOL physical condition (t = −3.39, p < 0.001). This study suggests that promoting engagement with the HCP is necessary to facilitate skills that help PLHIV manage their HIV. To improve ART adherence, HCPs should work on strategies to enhance self-efficacy and self-esteem, therefore, exhibiting fewer HIV-related symptoms and missing less medication doses to achieve better QOL.

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“…As a result, mothers could enjoy positive health care experiences and improved health outcomes for themselves and their babies. HIV-related stigma in health care contexts (Greene et al, 2016;Hodgson, 2006;Knussen & Niven, 1999) and patient-provider power dynamics are important factors in this process of capacity building for both health care providers and mothers alike (Rackal et al, 2011).…”

Section: Implications For Health Care Practice and Trainingmentioning

confidence: 99%