Asunto(s)
Curriculum , Educación en Enfermería/tendencias , Adulto , Femenino , Predicción , Humanos , Masculino , Persona de Mediana Edad , Modelos Educacionales , Estados Unidos , Adulto JovenRESUMEN
The vulnerability of children in Haiti has increased dramatically since the earthquake in January 2010. Prior to the earthquake, the prevalence of orphans and at-risk children was high but since the earthquake, more than 1 million people-with more than 380,000 children remaining displaced and living in over 1200 displacement sites. These existing conditions leave orphans and at-risk children vulnerable to exploitation, abuse, and increased risk of HIV/AIDS. This article will focus on the complex issues affecting orphans and at-risk children and the intersection with HIV/AIDS and human rights. Specific recommendations by United Nations Children's Fund are discussed. Nursing in Haiti must address the policy-related and population-specific approaches for the care of children living with or affected by HIV/AIDS.
Asunto(s)
Servicios de Salud del Niño/ética , Niños Huérfanos , Terremotos , Infecciones por VIH/epidemiología , Infecciones por VIH/enfermería , Derechos Humanos , Atención de Enfermería/organización & administración , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/enfermería , Niño , Desastres , Haití/epidemiología , Política de Salud , Humanos , Poblaciones VulnerablesRESUMEN
Unhealthy substance-use behaviors, including a heavy alcohol intake, illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage their disease-related symptoms. This study, based on data from a larger randomized controlled trial of an HIV/AIDS symptom management manual, examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms. The mean age of the sample (n = 775) was 42.8 years and 38.5% of the sample was female. The mean number of years living with HIV was 9.1 years. The specific self-reported unhealthy substance-use behaviors were the use of marijuana, cigarettes, a large amount of alcohol, and illicit drugs. A subset of individuals who identified high levels of specific symptoms also reported significantly higher substance-use behaviors, including amphetamine and injection drug use, heavy alcohol use, cigarette smoking, and marijuana use. The implications for clinical practice include the assessment of self-care behaviors, screening for substance abuse, and education of persons regarding the self-management of HIV.
Asunto(s)
Infecciones por VIH/psicología , Asunción de Riesgos , Autocuidado , Trastornos Relacionados con Sustancias/epidemiología , Adulto , África/epidemiología , Anciano , Alcoholismo , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/patología , Conductas Relacionadas con la Salud , Encuestas Epidemiológicas , Humanos , Masculino , Cumplimiento de la Medicación , Persona de Mediana Edad , Modelos Psicológicos , Psicometría , Puerto Rico/epidemiología , Factores de Riesgo , Estadística como Asunto , Trastornos Relacionados con Sustancias/psicología , Estados Unidos/epidemiología , Adulto JovenRESUMEN
BACKGROUND: Colonoscopy is a screening modality for the early detection of colonic polyps and cancers but is underutilized, particularly among minorities. OBJECTIVE: To identify potential barriers to screening colonoscopy among low income Latino and white non-Latino patients in an urban community health center. DESIGN, PARTICIPANTS, AND APPROACH: We conducted semistructured interviews with a convenience sample of patients 53 to 70 years old, eligible for colorectal cancer screening that spoke English or Spanish. Open-ended questions explored knowledge, beliefs, and experience with or reasons for not having screening colonoscopy. We performed content analysis of transcripts using established qualitative techniques. RESULTS: Of 40 participants recruited, 57% were women, 55% Latino, 20% had private health insurance, and 40% had a prior colonoscopy. Participants described a wide range of barriers categorized into 5 major themes: (1) System barriers including scheduling, financial, transportation, and language difficulties; (2) Fear of pain or complications of colonoscopy and fear of diagnosis (cancer); (3) Lack of desire or motivation, including "laziness" and "procrastination"; (4) Dissuasion by others influencing participants' decision regarding colonoscopy; and (5) Lack of provider recommendation including not hearing about colonoscopy or not understanding the preparation instructions. CONCLUSIONS: Understanding of the range of barriers to colorectal cancer screening can help develop multimodal interventions to increase colonoscopy rates for all patients including low-income Latinos. Interventions including systems improvements and navigator programs could address barriers by assisting patients with scheduling, insurance issues, and transportation and providing interpretation, education, emotional support, and motivational interviewing.