Caring for People Living with HIV

This study shall investigate nursing students attitude and perception on their educational programs. The perception of students on their training significantly correlated to the nursing care that they will offer to HIV patients during their nursing practice. In Saudi Arabia, little research studies have been demonstrated to establish the attitudes of student nurses on the kind of education and training offered. In collection of data for analysis will be through demographic and . The study will involve 500 nursing students from the Saudi Nursing colleges from all study levels. The research findings shall offer insight to improve training of nurses in Saudi Arabia by determining the overall perception and attitudes on the course content in respect of HIV/AIDS.

Throughout her history, Saudi Arabia has recorded significant advancements in the field of nursing research with an aim of improving the theory and practice of nursing. Through training of nurses has received much attention, studies indicate that perceptions of practicing nursing professionals towards HIV/AIDS patients were still at its low rate (Akala, Jenkins, & World Bank, 2005). Research conducted both in Saudi and outside revealed that nurses were still not well knowledgeable about the pandemic and as such, their provision of nursing care to HIV patients was impaired. Despite that Saudi is the largest Gulf country in the Middle East, its nursing sector remains a young and fragile profession.

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Perceptions of nursing students correlated strongly with their willingness to accept caring for HIV patients ( Baumann & Blythe, 2008). Therefore, it is important to structure programs to enable nursing student to develop desired perceptions to facilitate better care for HIV/AIDS patients. According to Barbe (2005), there has been a controversy and discrepancy in the nature and level of correlation between attitude and knowledge about AIDS among nursing students and the relationship between the two over their four-year program.

In this research, the review will explore the current knowledge and literature regarding the level of comfort of nursing students on educational program preparation for the care of people living with HIV/AIDS in Saudi Arabia. In this study, students overall understanding of the concept of HIV will be factored in. additionally; perceptions on AIDS, factors that influence their attitude about course content, and the effects of the scourge in the society shall be discussed (Abu-Raddad, 2010). To gain understanding of nursing education, the study will consider a number of items. They shall include their comfort with people suffering from HIV, their future preparation for nursing care for HIV patients, and significance of their knowledge in nursing care.

In a study conducted by Aydin et al. (2007), 61.3% of practicing nurses expressed anxiety about HIV patients, and approximately 63 % feared socializing with HIV (+) persons. Extensive studies indicate that nurses working and with experience anxiety while administering care to people living with HIV/AIDS. This revelation may be because of lack of sufficient knowledge by nurses about transmission of HIV/AIDS. In a separate study conducted by Aydin (2007), 73% of the nurses expressed their right to refuse to deal with AIDS patients before they underwent educational training. The findings of this study indicated that uneducated health care nurses had negative attitude towards care for people living with HIV/AIDS (Oxford Business Group, 2009) and (ALJabri & AlAbri, 2004).

Interesting to note is that training in some nursing workers had no significant impact on change of attitude even long after the training (ALJabri & AlAbri, 2004). In assessing levels of comfort of students about the educational and course trainings are imperative in ensuring that they are competent enough to deal with the patients ailing from HIV/AIDS. Though discomfort may be a difficult item to measure, attitude submission will serve as a tool to establish the level of their comfort. In a report released by WHO, student nurses were very knowledgeable about transmission of HIV/AIDS (International Council of Nurses/World Health Organization, 2005)

A study by Miller-Rosser (2006) established that nursing students had little knowledge on virology as well as immunology. This study results compared nursing student, medical students, and general undergraduate about their confidence regarding knowledge in HIV/AIDS. Their findings suggested that 81% of the students were less or under-confident. The research attributed these eminent results to the fact that the knowledge related to a subject causing anxiety hence making them exercise caution on being over-confident about an issue perceived to be potentially risky (Miller-Rosser (2006)

A similar but separate study conducted by Al shehri (2009) revealed that nursing students generally had low scores on knowledge on HIV/AIDS. Students knowledge about HIV was high except in symptoms disease and immunopathology (Al shehri, 2009). Current studies still reveal that there are gaps in nursing student knowledge levels concerning the mode of HIV transmission; for example, student still expressed their thoughts that transmission of HIV was possible through contact with fishing hooks and mosquitoes (UNAIDS/ WHO, 2004).

Nursing students attitudes on Caring for People Living with HIV
The nursing Code of Ethics gives a guideline that practicing nurses must provide their nursing care to people living with HIV with great respect (ALJabri & AlAbri, 2004). This code acknowledges any patient as a person, seeks justice for all people and equity in access to health care, and is based on mutual relationships of respect, trust, and the dignity of all members of society. The International Code of Ethics for Midwives states that a nurse must above all put compassion and respect for the patients life, must be constantly ready to provide competent care to patients regardless of their age or sex, nature of the disease or other differences (Ellis &Hartley, 2001). Arrogance, neglect or degrading treatment of a patient is not allowed. A nurse is not entitled to impose their moral patient, religious and political beliefs. Failure to comply with this statement of the Code of Ethics substantially hampers the realization of the inalienable right of every individual on the confidentiality, obtaining quality health care and social support. To maximize patient care the nurse should be somewhat away from the meticulous execution of his/her direct responsibilities under the internal regulations of the hospital or other medical institution, and strive to establish long-term professional relationship with the patient and his or her milieu. Though this clarity has been made to nurses, some of the nurses still believed that they had the right to refuse to care for patients with HIV (UNAIDS/ WHO, 2004). In an older study by UNAIDS, students recognized that though patients with HIV were deserving of care, 49% of the students would rather not provide care to HIV/AIDS patients. Of these students, only approximately 24% would be willing to if there were no protective devices (UNAIDS/ WHO, 2004).

In a separate research conducted the same year, (Roupa et al, 2004) noted that 54% of the students suggested that nurses should be allowed to reject providing care to AIDS patients while 36% would out rightly be unwilling to provide health care to AIDS patients. In a study conducted in three large teaching Australian hospitals by UNAIDS & WHO (2004), nurses were refusing to provide care due to the underlying perceived risks and lifestyles of HIV/AIDS patients. The results of the surveys show that prejudice against HIV patients among nursing students is sufficiently high, though their awareness about HIV transmission. Infected are often denied treatment based on their HIV status, violate privacy, unreasonably impose quarantine, compulsory internment and / or segregation. Stigma and discrimination are major obstacles to effective treatment and care of HIV / AIDS patients. Stigma is a social stereotype that reflects the bias of medical officers as well as other people to HIV-positive. It leads to feelings of shame, guilt and isolation among people living with HIV infection, and negative attitudes of others (discrimination) are pushing these people to inaction or action that may cause harm to others. But the negative attitude of nurses to such patients can and should be changed by examining the needs and motives of fears. The determination of the causes and motives of fear of contamination among nurses makes possible to eliminate them in individual work with each individual or a group. This kind of work is to be carried out by professional psychologists and co-operation of HIV-infected persons.

The relationship between Prevalence of HIV/ AIDS in the Students Study Area and students perception and knowledge
The level of AIDS prevalence in the students environment is a fundamental aspect that affects their level of knowledge and attitude. This factor has far-reaching influence on the level of confidence that nursing students on the educational program preparing them for HIV care. Research reveals suggests that students whose origin is of an area characterized by low HIV prevalence have higher tendency to develop positive attitudes on patients with HIV/AIDS. On the other hand, students from areas with high-prevalence rates showed higher knowledge about HIV/AIDS pandemic (Aydin et al, 2007)

According to studies by Al-shehri (2009), results about high knowledge of students from was due to the widespread community awareness about HIV, increases in infection rates, and mandatory educational programs. This study approach was to establish the students attitude and knowledge about HIV in .

Maswanya et al. (2008) conducted a study on knowledge and attitudes about HIV/AIDS among nursing students in Nagasaki, Japan. The study involved a survey on 383 female nursing students. In their study, they found that students accessed knowledge about HIV/AIDS mainly through the media, and not from their teachers. Although students exhibited a high level of understanding about HIV/AIDS, a significant number of them had reserved attitudes about patients living with AIDS. The study concluded that an appropriate nursing training was required to reduce that gap between students knowledge and perception with respect to HIV/AIDS (Maswanya et al., 2008).

Qualitative study revealed absence of an effective training for nursing students in Japan especially on AIDS pandemic. In Japan, limited literature is available about education, attitude and perception of nursing interns on HIV/ AIDS. The study hence informs other researchers that absence of proper knowledge programs results in misconceptions about issues in dealing with HIV/AIDS. It is therefore imperative to note that cases where such reports are unavailable, students tend to develop negative perceptions during their preparation for HIV/AIDS nursing care.

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