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Indian Journal of Community Medicine

Attitude of Nursing Students of Kolkata Towards Caring for HIV/AIDS Patients

Author(s): S. Deb, A. Mukherjee, S. Acharya

Vol. 29, No. 3 (2004-07 - 2004-09)

Abstract

Objective: To study the attitude of the nursing students towards caring for HIV/AIDS patients and their knowledge and perceptions about the disease.

Study design: Exploratory study.

Setting: College of Nursing, University of Calcutta.

Participants: A group of 72 nursing students studying in second and third year of Nursing course.

Results: Findings revealed a very positive outlook of the nursing students in regard to caring for HIV/AIDS patients. Although an overwhelming number of them (70/72) expressed their willingness to accept any job offer concerning caring for HIV/AIDs patients, 34.3% (24/70) apprehended resistance from their family members in this regard. However, they also viewed that it would be possible for them to overcome the resistance. Although 100% of the students have heard of HIV/AIDS, a good number of them had some misconceptions with regard to various aspects of the disease. On probing it was found that during the course the nursing students had the opportunity to attend only two or three lecture sessions on the said issue which is inadequate to have complete and correct knowledge about the disease. It is suggested that another study with larger sample covering different categories of health workers should be carried out for understanding the knowledge and attitude of the health workers about the issue which would help in designing need-based training programme for them. Besides disseminating adequate information among nursing students about STDS in general and HIV/AIDS in particular, special effort should be made to develop their counselling skills.

Introduction

A person suffering from HIV/AIDS undergoes severe psychological stress and feels loss of hope. Death phobia is also prominent among the HIV/ AIDS victims. These people are often stigmatized, rejected and isolated in the society. This discrimination often put them under great mental pressure, for which many HIV/AIDS patients commit suicide. During this period they need empathy and mental support to cope with the stressful situation. In this regard, health workers especially nurses can play a vital role. The students who are undergoing nursing course are supposed to take care of any patient, irrespective of nature of the disease. Since HIV/AIDS is a dreaded disease, there are a lot of misconceptions among cross-section of the society about the mode of transmission and methods of prevention. The studies show that the doctors and other health care professionals do discriminate patients with HIV/AIDS. This is caused by lack of knowledge, their negative attitude, which hampers the quality of care provided to the patient with HIV. But in India, especially in Kolkata no such study has so far been conducted to understand the attitude of nursing students towards caring for HIV/AIDS patients. Hence, in the present study an attempt was made to fill up this knowledge gap.

Material and Methods

A group of 72 nursing students studying in 2nd and 3rd year degree course in SSKM Hospital under the University of Calcutta were covered in the study. They were selected purposively for the purpose of the present study.

A specially designed pretested, semi-structured questionnaire was used for collection of data from the nursing students. The questionnaire consisted of the following broad sections like demographic and Socio-economic information; and attitude towards caring for HIV/AIDS patients and knowledge and perception about different aspects of HIV/AIDS.

A prior appointment was made with the Principal of the Nursing College to appraise her about the objective of the study. Accordingly she was briefed and a schedule was developed for collection of data from the students. First day data were collected from 48 students studying in 3rd year through self-administration method. Second day data were collected from 27 students studying in 2nd year following the same method. After initial checking, three questionnaires were found to be incomplete and they were rejected. Finally, 72 questionnaires were considered for analysis.

Data Analysis

Both qualitative and quantitative data generated in the study were analyzed manually. In case of quantitative data, percentages were calculated while content analysis were carried out in case of qualitative data.

Results

The broad objective of the study was to understand the attitude of the nursing students towards caring for HIV/AIDS patients and their knowledge and perception about different aspects of the disease. Findings revealed that an overwhelming number of the nursing students (70/72) are willing to accept any job opportunity relating to caring for HIV/AIDS patients. Two students who expressed their reservation for accepting any job opportunity in regard to caring for HIV/AIDS patients argued that: 'I do not want to accept this sort of job because of personal hazards' 'In our country a large number of people are deprived from basic minimal health care facilities. So instead of serving HIV/AIDS patients I would prefer to work for the mass population'.

However, out of 70 willing students, about one third (34.3%) stated that they might encounter resistance from their family members in accepting any offer in regard to caring for HIV/AIDS patients.

Analysis of qualitative data revealed that social work, social stigma and misconceptions attached with the disease are some of the factors, which might cause family members to object in this regard. According to some of the nursing students:

'Parents might think if I accept any job opportunity for caring of HIV/AIDS patients it will affect our social network'

'Since social stigma is attached with this disease, my parents have a feeling that if I accept any such job they might find it difficulty to get a suitable groom for me'

'My parents might think that I will be at risk of getting the disease'

'My parents did not study much. Hence they might have some wrong perceptions about the disease'

On the other hand, the students who were of the view that they will not encounter any resistance from their family members given explanations in favour of their views.

'Because they know that as a nurse it is my duty to give care to all types of patients and also to give health education to the patients'

'As I know well about the disease, I'll try to make my parents understand'

'My parents are open minded and will give me full freedom in working in jobs like this'

'Because my family members are well educated and they know the value of this job so I think this job will be easily acceptable to them'

'My parents understand and believe that unless I am careless I will not be affected, and I can serve a lot'

It is believed that there is a positive correlation between knowledge, attitude and behaviour. Hence, an effort was made to understand the knowledge and perception of the nursing students about different aspects of HIV/ AIDS.

So far as knowledge of the nursing students about the full form of HIV/ AIDS is concerned, interestingly an overwhelming number of the respondents (84.3%) could state the full form of AIDS correctly while only 41.4% of them could state the full form of HIV. In case of pathogenecity of HIV/AIDS, 87.1% of them could correctly stated that HIV comes first.

Table I : Knowledge About Mode of Transmission of HIV/AIDS

Mode of Transmission Frequency N=70 (%)
A. Correct knowledge
Sexual transmission 64 (91.4)
Blood contact 62 (88.6)
Exchange of needles and syringes 29 (41.4)
Mother to baby during pregnancy 10 (14.2)
B. Misconceptions
Kissing 32 (45.7)
Sharing of utensils 9 (12.9)
Mosquitoes, flea or bedbug bite 9 (12.9)
Sharing toilets 7 (10.0)
Sharing clothes 3 (4.3)
Hugging 1 (1.4)
Base : Willing to care for HIV/AIDS patients

The nursing students are mostly aware of two modes of transmission i.e., sexual contact (91.4%) and blood transmission (88.6%). Regarding the other two modes of transmission i.e., sharing of needles and mother to baby, a large number of them are now aware. Surprisingly, it has also been observed that a large number of them possess misconceptions about that the mode of transmission. (Table I)

Regarding preventive methods, most of the nursing students were aware of safe sex (82.9%), followed by avoid using/sharing syringe (55.7%), and avoid using contaminated blood (35.7%). Only one subject mentioned of mother to baby.

For health professionals it is very essential to be familiar with the symptoms of any disease so that they can diagnose it properly. Surprisingly, the present study findings indicate that the majority of the nursing students were not familiar with the symptoms of the disease even after two/three years of attending nursing course (Table 2). The issue needs serious attention of the authorities of Nursing Colleges.

Regarding prognosis of the disease majority of the nursing students (81.9%) possessed correct perception while the rest had either misconceptions (8.3%) or no knowledge (9.7%) about this issue.

Table II: Knowledge About Major and Minor Symptoms

Knowledge about Symptoms Frequency N=70 (%)
A. Major Symptoms
Stated correctly one symptoms only 11 (15.7)
Stated correctly two symptoms 16 (22.9)
B. Minor Symptoms
Stated correctly one symptom only 7 (10.0)
Stated correctly two symptoms 6 (8.6)
Base : Willing to care for HIV/AIDS patients

Replying to a question whether they require additional information about the diseases, majority of them expressed their interest to know something more about the disease especially with regard to origin of the disease, mode of transmission, methods of prevention, counseling, latest research findings, signs and symptoms, personal protection and severity of the disease.

Discussion and Conclusion

Interestingly findings revealed that the majority of the nursing students have no reservation in accepting any offer in regard to caring for HIV/AIDS patients after completion of the study. However, few of them did foresee that they might encounter resistance from their family members in accepting this sort of job primarily because of social stigma attached with the issue and misconceptions. Further, they also viewed that they would be able to overcome the resistance, if offered this type of job in future. It shows the commitments of the nursing students towards their profession. Their attitude and outlook really deserve appreciation. However, previous researchers observed contradictory attitude of health care professionals in this regard (Klimes et al., 1989; Wormser, 1989; Mccam, 1999). In this regard, Siminoff et al., (1998) remarked on the basis of their study findings that psychological care solely depends upon attitude of the nurses. The present study findings contradict with the observation of two previous studies might be because of two reasons. The nursing students covered in the present study are yet to be exposed to real job situation. Secondly, while replying to this question perhaps a good number of them were guided by ideal self. In reality i.e., after completion of the course if they get a job in regard to caring for HIV/ AIDS patients what exactly they will do, it remains a question. However, if one fourth of them are really eager to serve the HIV/AIDS patients it would be a great help for the health centres dealing with HIV/AIDS patients.

So far as the knowledge of the nursing students about the issue is concerned, it was found that 100% of them are aware of HIV/AIDS. However, a large number of them had incomplete knowledge and misconceptions especially with regard to full form of HIV, pathogenecity of HIV/AIDS, mode of transmission, methods of prevention and signs and symptoms of the disease. The above observation corroborates with the findings of previous studies carried out among different categories of health care and management professionals in India (Kudbe et al., 1995; Dobe, 1995). However, this observation needs attention of the health policy makers and authorities of the Nursing Colleges.

An overwhelming number of the nursing students urged that they require latest information about the disease especially with regard to origin of the disease, mode of transmission, methods of prevention, counselling, latest research findings, signs and symptoms, personal protection and severity of the disease. Findings suggest that another study with larger sample should be carried out covering different categories of health care professionals including health workers in the rural areas so that needbased intervention programme can be designed accordingly.

It is apparent that many health care professionals like doctors and nurses feel they have inadequate clinical and counselling skills to deal with HIV and its implications. Thus, the training programmes for health care professionals like nurses, doctors and other categories of health workers should aim at increasing the confidence and skills so that they can cope with HIV issues. Improving counselling skills through training in respect of HIV infection should also become a part of the basic training of health care professionals (Fransman et al., 2000).

References

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Deptt. of Applied Psychology,
University of Calcutta, 92, A.P.C. Road, Kolkata - 700 009.
E-mail : [email protected]

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