Attitude And Perception Of Student Nurses Towards The Care Of HIV Patients In Some Selected Tertiary Institutions
HIV/AIDS pandemic has brought huge demands on the healthcare workforce worldwide. Nurses play a critical role in caring for persons living with HIV/AIDS (PLWHA). Inadequate care and discrimination due to negative attitudes of nurses caring for persons living with HIV/AIDS will not only affect the patients, but will adversely affect the fight to halt the pandemic. The objective of this study was to determine the attitude and perception of student nurses towards the care of HIV patients in some selected tertiary institutions.
Descriptive survey design, with the aid of five-point Likert questionnaire administered on 240 student nurses caring for PLWHA in some selected tertiary institutions in Osun state, Nigeria was used.
Majority of the respondents had good knowledge of HIV/AIDS. There were significant relationships between the age (P<0.05), marital status (P<0.05), professional cadre of the respondents (P<0.05) and their level of knowledge. 227 (94.6%) of the respondents had positive attitude towards the care of PLWHA. Factors that negatively influenced student nurses’ attitude in caring for PLWHA include fear of contagion 56 (82.4%), social stigma 10 (14.7%), culture/religion 6 (8.8%). There were significant relationships between the academic level of student nurses (P<0.05), knowledge about HIV/AIDS (P<0.05) and their attitude towards the care of HIV/AIDS patients.
The study suggested the need for more in-service trainings on HIV/AIDS for student nurses to improve their knowledge and positive attitude towards the care of PLWHA.
1.1 Background to the Study
The Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) epidemic have become one of the most important public health problems in recent years, with Sub Saharan Africa carrying the heaviest burden of the epidemic in terms of new infections. The emergence of the Acquired Immunodeficiency Syndrome on the global scene has been a major source of concern worldwide. Since its discovery in 1981, HIV has spread to almost every country in the world. Sub-Saharan Africa has about 25.6 (23.1–28.5) million people living with HIV in 2015.
Nigeria accounts for about eight percent of the global burden of HIV/AIDS. Efforts in combating the scourge of HIV/AIDS in Nigeria has reduced the 2013 national HIV prevalence to 3.4% as compared to 3.6% reported in 2007.5 However, as at 2015, HIV population in Nigeria was estimated at 3.5million, with about 180,000 deaths from AIDS.6
Human Immunodeficiency Virus (HIV) is usually found in the body fluids like blood, semen, vaginal fluid and breast milk of infected persons, hence it can be transferred from one infected person to another, mostly from a mother to unborn child, through sexual intercourse and sharing of unsterilized instruments like knives and syringe which had once been used by infected persons.
Staff caring for PLWHA need to acquire new attitudes, knowledge and skill as they confront the multi- disciplinary problems of AIDS care and prevention.9 This is much as it has been reported that some nurses have reported in the past to experience nightmares and increased anxiety levels while nursing HIV/AIDS patients, while others have been known to request for transfer or even leave the profession.
An important issue that has emerged is how nurses adapt to these challenges in order to care for PLWHA. Similarly, the attitudes of Nurses towards these patients have long been under scrutiny since has the potential to affect the quality of care rendered and possibly quality of life of these patients.
Attitude can be positive or negative and can affect the behaviour of an individual. Previously in Nigeria, HIV/AIDS has been treated by some as a moral rather than a medical issue. The manner in which the disease is been described and classified reflects the same sociocultural prejudices that made the disease shameful in the first place.15 Stigma spreads to the whole person, debases the person, leading to discrimination and utter rejection, which ultimately will result in reduced opportunities.16 Attitude is gained through experience and contact with the world around us. It may be changed by new experiences and information. Extensive stigmatizing attitudes and discrimination among the general population have been found to cut across countries of the globe as reported by various surveys.
Unfortunately, various studies have also identified among nurses same compromising and discriminatory attitudes towards patients with HIV and AIDS.
Similarly, studies from several countries identified the various factors affecting stigmatized and discriminatory attitudes toward PLWHA among Health Care Workers to include level of irrational fear of HIV transmission, level of education, gender, stage of the disease, high-risk taking behaviour, individuals related to stigmatized identities, sources of HIV infection, relationship with an infected person, type of hospital, ethnicity and urban- rural locality.
To date, with the increasing knowledge of modes of transmission and infection-control measures, guidelines have now been established to ensure that staff and patients are adequately protected within the last decade.
Unfortunately, it is believed that much fear and ignorance still exist. The study was thus, conducted to empirically ascertain the attitude and perception of student nurses towards the care of HIV patients in some selected tertiary institutions.
1.3 Statement of the Problem
In Nigeria, the prevalence rate of HIV is estimated to be 1.47% amongst ages 15-49 years (United Nations Program on HIV/AIDS 2014:13). An estimated 250 000 of the population living with HIV and 10 000 deaths per annum makes it a public health problem in the country (UNAIDS 2014:14; Ghana AIDS Commission 2014:10). Hospitals are still struggling to deal with the issues of stigma and discrimination towards patients with HIV amongst their staff. Although some studies have been conducted on extant knowledge, attitudes and practices towards people living with HIV, those which show any interest in the status of student nurses in this regard are hard.
There is no known published study regarding registered student nurses attitudes and practices regarding HIV, despite numerous studies in other Sub-Saharan African countries. However, information about KAP regarding HIV is needed in order to devise appropriate educational program for nurses to alleviate nurses‘ anxiety about caring for patients with HIV positive and also alleviate the fear in their communities.
1.3 Objective of the Study
The main objective of the study is to examine the attitude and perception of student nurses towards the care of HIV patients in some selected tertiary institutions. Specifically, the study aims;
- Assess student nurses‘ HIV/AIDS-related knowledge;
- Ascertain student nurses‘ attitudes towards patients living with HIV and AIDS;
- Investigate the current practices of student nurses‘ towards patients living with HIV and AIDS; and
- Provide recommendations for addressing gaps and misconceptions identified.
1.4 Research Question
- What knowledge do student nurses in some selected tertiary institutions have on HIV and AIDS?
- Does the student nurses level of knowledge reflect on their attitudes and practice?
- What are the attitude of student nurses towards persons living with HIV and AIDS?
- Are the student nurses‘ attitude favourable or unfavourable?
- What are the current practices of student nurses towards persons with HIV and AIDS?
1.5 Hypothesis of the Study
The following hypothesis was formulated and tested by the study
Ho1: There is no Relationship between student nurse knowledge of HIV and demographic profile of participants
1.6 Significance of the Study
Nurses being health professionals at the forefront of the HIV/AIDS epidemic are well acknowledged globally. It is therefore essential to identify some gaps and misconceptions relating to occupational HIV transmission, disease presentation, and HIV risk prevention among nurses. This study will contribute towards providing a baseline analysis of the mentioned gaps and misconceptions in order to make recommendations for addressing these, to enhance nurses‘ training. This, in turn, will lead to the development of policies and training programmes aimed at capacitating nurses, and improving the effective management and relation with HIV/AIDS patients.
1.7 Scope of the Study
This research is limited to issues about the attitude and perception of student nurses towards the care of HIV patients in some selected tertiary institutions. The tertiary institution selected for the study are Adeleke university, Redeemers and Osun state university. A sample of 240 students nurses were used.
1.8 Limitation of the study
Finance, inadequate materials and time constraint were the challenges the researchers encountered during the course of the study.
1.9 Definitions of Key Concepts
Acquired Immune Deficiency Syndrome is a spectrum of diseases caused by infection with the human immunodeficiency virus (HIV) (WHO 2018a:1). In this study, AIDS will refer to a disease and illness associated with stigma, discrimination and prejudice at the clinical setting.
The extent of an individual‘s show of a positive or negative behaviour towards a particular object (Wilson & Scior 2015:2). In this study, attitude will refer to a display of a negative or an optimistic behaviour towards a patient infected with HIV.
The human immunodeficiency virus is a type of virus that attacks the cells of the immune system, destroying or impairing their function (WHO 2018a:1). In this study, HIV will refer to the viral organism responsible for the signs and symptoms of AIDS
Familiarity gained through experience or learning (Limaye, Sullivan, Dalessandro & Hendrix-Jenkins 2017:3). In this study, knowledge will refer to the facts, information, and skills acquired on HIV and AIDS through experience and education.
1.10 Organizations of the Study
The chapter one consist of the introductory part of the study which includes the study background, the statement of the research problem, the study objective and scope of the study.
The second chapter is a critical review of other literatures relevant to the study and its objectives including the theoretical framework for the study. While the third chapter is methods of data collection, sampling and data analysis used in conducting the study. The fourth chapter centres around the research findings including an analysis of how it relates to previous findings. The fifth chapter consists of the summary of findings, conclusion and recommendations base on the study objectives.
Summary, Conclusions and Recommendations:
This chapter summarizes the findings on the attitude and perception of student nurses towards the care of HIV patients in some selected tertiary institutions, Adeleke university, Redeemers and Osun state university as case study. The chapter consists of summary of the study, conclusions, and recommendations.
5.2 Summary of the Study
In this study, our focus was on the attitude and perception of student nurses towards the care of HIV patients in some selected tertiary institutions, Adeleke university, Redeemers and Osun state university as case study. The study is was specifically focused on examining the knowledge and attitude of Student nurses toward the care of HIV/AIDS patients in some selected tertiary institutions in Osun state; the selected tertiary institutions in Osun state are Adeleke university, Redeemers and Osun state university. The study was thus, conducted to empirically ascertain student Nurses’ knowledge and attitude to the care of HIV/AIDS patients in some selected tertiary institutions.
The study adopted the survey research design and randomly enrolled participants in the study. A total of 240 responses were validated from the enrolled participants where all respondent are student Nurses in some selected tertiary institutions.
With respect to the analysis and the findings of this study, the following conclusions emerged;
The findings of this study have provided evidence that majority of student Nurses in some selected tertiary institutions have an in depth knowledge of HIV/AIDS and positive attitude towards the care of PLWHA. The major factor that influences the attitude of Nurses in caring for PLWA is fear of contagion, hence nurses should be equipped with protective measures while in-service training on all aspects of HIV/AIDS is continued. This will enhance a non-discriminatory attitude towards the care of HIV/AIDS patients, thus improve the quality of care for PLWHA.
Based on the findings the researcher recommends that;
- Nurses ought to integrate the education of basic aspects of HIV/AIDS into the curricula of undergraduate nurses in order to help them develop the competencies required to care for HIV and AIDS patients.
- Hospitals ought to collaborate to create nurses‘ platforms through the establishment of journal clubs or focus groups. This will allow nurses from different hospitals to discuss issues relating to HIV/AIDS as well as report on new evidence and updates on HIV/AIDS. To ensure that this becomes effective, nurses ought to have free access to the internet, especially at the workplace.
- The government still has a big role to play, that of providing continuous workshops on HIV/AIDS, to let nurses remember that they also have a critical role to play in meeting the health care demands of the patients, infected or not infected with HIV.
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Frequently Asked Questions
Do nursing students have negative attitudes toward people with HIV/AIDS?
Data collection form, HIV/AIDS Knowledge Questionnaire, and AIDS Attitude Scale (AAS) were used to collect data. Results: The current results reveal that nursing students have negative attitudes toward people with HIV/AIDS, and knowledge score increases according to class grades.
What do we know about HIV/AIDS-related stigma and discrimination?
Respondents were found to have high knowledge (94.0%) of strategies for reducing HIV/AIDS-related stigma and discrimination. Also, 64% had moderate discriminatory attitude, 74% engaged in low discriminatory practice, while 26% engaged in high discriminatory practice.