The attitudes of nurses towards HIV positive patients

Abstract

AIDS is increasing in South Africa at an alarming rate. Registered nurses consequently have more frequent contact with HIV positive patients. During this contact the nurses' behaviour are influenced by their attitudes. Negative attitudes may influence the quality of nursing care. In the light of this problem, the aim of this study was to investigate the attitudes of nurses towards HIV positive patients and to set guidelines for potentially changing these attitudes, in an attempt to improve the quality of care rendered to HIV positive persons. A qualitative design was used. An interview schedule was compiled after a literature study of the construct attitude, the components of attitude, differences between values and attitudes, the purpose of attitudes and the way in which attitudes can be changed. Nurses were identified for participation through purposive, voluntary sampling. Semi-structured interviews were conducted. The interviews were transcribed verbatim. The researcher and a co-coder analysed the data using a combination of Giorgi and Kerlinger's methods of coding. Consensus on the main categories was reached after discussion with the co-coder. The conclusion was made that the attitudes of nurses towards the HIV positive patient are mostly negative. Conflict between the personal and professional value systems of nurses exists. Nurses cope with the resulting discomfort by using defence and coping mechanisms, which hamper the development of a therapeutic relationship between them and HIV positive patients. Nurses entertain a biased view of their own risks, considering risks only from occupational exposure. According to these findings, general and specific guidelines for changing attitudes were set.


VIGS neem drasties toe in Suid-Afrika. Geregistreerde verpleegkundiges het gevolglik meer gereelde kontak met MIV-positiewe pasiënte. Gedurende hierdie kontak word verpleegkundiges se optrede beïnvloed deur hulle houdings. Negatiewe houdings mag die kwaliteit van verpleging beïnvloed. In die lig hiervan, was daar in die navorsing gepoog om die houdings van verpleegkundiges teenoor MIV-positiewe pasiënte te bepaal en om riglyne daar te stel wat potensiële houdingsveranderinge by die verpleegkundiges teweeg sal bring en sodoende die kwaliteit van verpleging van MIV-positiewe persone te verbeter. 'n Kwalitatiewe ontwerp is gebruik. 'n Onderhoudskedule is na 'n literatuurstudie van die konstruk-houding, die komponente van houdings, verskille tussen waardes en houdings, die doel van houdings en die wyse waarop houdings verander kan word, saamgestel. Verpleegkundiges is deur middel van 'n doelgerigte, vrywillige steekproef as deelnemers geïdentifiseer. Semigestruktureerde onderhoude is daarna gevoer. Die onderhoude is woordeliks getranskribeer. Die navorser en 'n mede-kodeerder het die data geanaliseer volgens 'n kombinasie van Kerlinger en Giorgi se metodes van kodering. Konsensus oor die kategorieë in die data was bereik na gesprek met die mede-kodeerder. Dit blyk dat die houdings van verpleegkundiges teenoor MIV-positiewe pasiënte oorwegend negatief is. Daar bestaan konflik tussen die persoonlike en professionele waardesisteme van die verpleegkundiges. Die verdedigings- en hanteringsmeganismes van verpleegkundiges om die gevolglike interne ongemak te verminder, belemmer die opbou van 'n terapeutiese verhouding tussen hulle en MIV-positiewe pasiënte. Verpleegkundiges handhaaf 'n eensydige siening van die risiko om MIV-positief te raak deur slegs die moontlikheid van infektering deur hulle werk te oorweeg. Hierdie gevolgtrekkings het gelei tot die stel van algemene en spesifieke riglyne om houdingsverandering by verpleegkundiges teweeg te bring.


Key words: Attitudes, Nursing, Nurse, Human Immune Deficiency Virus, HIV, Acquired Immune Deficiency Syndrome, AIDS


(Health SA Gesondheid: 2003 8(2): 23-33)