Midwives Towards Human Immunodeficiency Virus Health And Social Care Essay

An infective disease like HIV is continues to turn in developing states and worldwide. It is a major planetary public wellness issue, which puts a heavy load on wellness attention demands. Harmonizing to the World Health Organization planetary sum-up of the AIDS epidemic ( 2011 ) globally 30.4 million of people populating with HIV out of them prevalence of grownup is 30.7 million, prevalence of adult females is 16.7 million, whereas 30.7 million is the prevalence of kids & lt ; 15 old ages of age. Harmonizing to UNAIDS ( 2008 ) study in the Asia-Pacific, Pakistan is the state with high prevalence people infected with HIV among 11 states. Prevalence of HIV in Pakistan is about doubled from 11 % in 2005 to 21 % in 2008. Pakistan was ab initio considered as the low prevalence state. Harmonizing to Ilyas et al. , ( 2011 ) in Pakistan in immature people the contributing behaviou0rs to the spread of HIV infection are wonder of sex, drugs, negative equal force per unit area, and economic defeat. Besides, Pakistan is confronting HIV epidemic among high hazard populations like shooting drug users ( IDUs ) .

Nurses and Midwifes are at head in passing considerable clip taking attention of the HIV positive patients who are admitted to infirmaries. Midwifes are considered to play a polar function whose undertaking is to advance sexual and generative wellness and to forestall generative unwellnesss. Hence, it is of import to research the cognition of accoucheuses about HIV and their attitudes and willingness to take attention of them in order to better the quality of attention.

Aim/ Purpose

The intent of this paper is to compose an in-depth analysis and synthesis of current literature to depict accoucheuses perceptual experiences, explore cognition degrees related to symptoms and transmittal of HIV and their attitudes towards HIV positive patients. A systemic and comprehensive literature reappraisal would be presented in this paper in a thematic mode with debate and in-depth analysis. Furthermore, critical assessment and identified spread would be presented with the strengths, restrictions, and summarisation of the literature reappraisal.

Research Question

The research inquiry was formulated harmonizing to PICO scheme that represents population, intercession, comparing and result.

What is the cognition degree and attitude of accoucheuses towards HIV positive patients?

Key Research Questions

What is the degree of Midwives cognition sing HIV?

What sort of attitudes accoucheuses have sing HIV positive patients?

What sort of association is found between accoucheuses knowledge and their attitudes towards HIV?

Method/ Search Strategy

A comprehensive and systematic literature hunt was conducted to reexamine and analyse the bing literature on the topic. Initially, the hunt was started from cyberspace hunt engine, and Google bookman was selected. Key words used Knowledge, Attitude, Midwives, and HIV which gave 9,040 hits. The bounds were set for the twelvemonth 2000-2013 ; it gave 590 hits. Titles of the searched articles were reviewed ; 2 articles were found relevant to the subject.

A database hunt of Cumulative Index for Nursing and Allied Health Literature ( CINHAL ) , PubMed and MEDLINE was conducted utilizing the Medical Subject Heading ( MeSH ) footings Knowledge, Attitude, Midwives, and HIV. PubMed was searched foremost by uniting MeSH footings. Limits were set for journal articles, Year 2000-2013 and free full text articles. The rubrics and abstract were reviewed ; as a consequence, 3 articles were extracted on the selected subject. Another information based explored was CINHAL in which keywords with Boolean operator used were: Knowledge, Attitude, Midwives, and HIV. To hold more specific consequences the bounds were set for twelvemonth 2000-2013, diary articles, and full text. Titles were reviewed and 8 articles were selected. Out of all the hunt consequences, 5 articles were relevant and extracted. Almost all the surveies found were from West ; none of the surveies have been conducted for accoucheuses in Pakistani context. From MEDLINE one Pakistani survey was selected, 3 relevant articles were same as CINHAL. During literature hunt, I found an unpublished thesis on the relevant subject which is besides utilized in synthesis. In order for seeking more relevant surveies ancestry attack was followed and commendations from the searched articles were used to track down other surveies on the similar subject. The hunt scheme resulted in 13 surveies for reappraisal published over last 13 old ages.Each article was reviewed and organized harmonizing to the research inquiry.

Critical Review ( Analysis, Synthesis and Argumentation ) of the Literature

As HIV significantly impacts individualaa‚¬a„?s sexual and generative wellness, proviso of wellness for people populating with HIV is of import every bit good as entree to information on generative wellness is besides indispensable ( Nordkvist & A ; Allvin, n.d. ) . This would assist forestalling HIV transmittal and bettering the quality of life of people populating with HIV. Midwifes function is of import in the publicity of sexual and generative wellness, which needs clear perceptual experiences, positive attitude and equal degree of cognition among them. However, there is a deficiency of research peculiarly in the sphere of obstetrics therefore surveies researching cognition and attitude of nurses and medical pupils are besides included in order to place the spread. Following subjects were identified from critical analysis of literature reappraisal. All the surveies are quantitative largely cross sectional with the assortment of tools used for surveies.

Knowledge and Attitude of Nurses towards attention of HIV Positive Patients

Knowledge about HIV transmittal and bar is the most normally happening subject and was identified in about all of the surveies. Among Vietnam obstetrics pupils and Nigeria wellness workers, one of the major causes of negative attitudes, reluctance and fright to care for people with HIV was acknowledged as deficiency of instruction. ( Nordkvist & A ; Allvin, n.d. ; Reis et Al. 2005 ) . Besides in Pakistan a survey on medical pupils indicated really low cognition tonss with conformity to the indispensable symptoms of HIV ( Shaikh, Khan, Ross & A ; Grimes, 2007 ) . Similarly, a survey conducted by Khan, Unemo, Zaman and Lundborg ( 2009 ) revealed that Pakistani wellness attention professional of Lahore have low degree of cognition and patterns resulted in hapless attitude towards handling patients with HIV. On the other manus, Earl and Penny ( 2003 ) found that instruction and cognition of HIV resulted in more positive attitude towards caring for HIV positive patients.

These consequences contrast with the findings of survey conducted in Greece by Ouzoni and Nakakis ( 2012 ) they found out that overall the HIV cognition of the pupil nurses of Greece was reasonably good and they displayed positive attitudes towards HIV patients. Though, 76.7 % i.e. , bulk of participants stated that they hadnaa‚¬a„?t been taught about HIV in nursing schools. These findings of appropriate degree of cognition about HIV among wellness attention workers are supported by surveies conducted in rural India ( Kermode, Holmes, Langkham, Thomas & A ; Gifford, 2005 ) , South-east of England ( Veeramah, Bruneau, & A ; McNaught, 2008 ) and Southern Nigeria ( Umeh, Essien, Ezedinachi & A ; Ross, 2008 ) . Therefore it can be synthesized from literature that there is a demand to educate accoucheuses with biomedical cognition of HIV along with ethical and cultural issues environing HIV.

Fear of undertaking HIV

Health attention professionalaa‚¬a„?s frights of undertaking patients with HIV for whom they are caring was the other more repeatedly happening subject of the reviewed surveies, and was noted in surveies through different continents and civilizations. Study conducted in Greece by Ouzoni and Nakakis ( 2012 ) revealed that there are some transmission myths among wellness attention professionals as they believed that HIV can be contracted through mosquitoes, lavatory place, swimming pools, sharing coffin nails, caressing, and though coughing and sneeze. Besides 63 % of the wellness attention workers of rural India perceived high hazard of undertaking occupational infection patients and Among 266 nurses 91 % of participant said that they are at high hazard of occupational hurts ( Kermode, Holmes, Langkham, Thomas & A ; Gifford, 2005 ) . In the survey of Juan ( 2004 ) found that due to the deficiency of cognition and fright of undertaking HIV 19.3 % of Chinese nurses were go forthing nursing.

Nordkvist & A ; Allvin, ( n.d. ) in their survey concluded that 98.1 % of the obstetrics pupil in Vitenam knew that HIV can non be spread by agitating custodies and sharing spoons and home bases. These findings were supported by Veeramah, Bruneau, and McNaught ( 2008 ) who found out that nurse and accoucheuses in England have good cognition in respect to undertaking HIV. However, as HIV uninterrupted to raise accoucheuses and other wellness attention professionals need to hold in deepness cognition in order to avoid misconceptions.

Loath to care for people with HIV

The primary grounds identified from the literature reappraisal for the reluctance to care for patients with HIV were deficiency of cognition and fright of infection. In a survey conducted in Greece 43.7 % of the nurses were willing to care for people with HIV ( Ouzoni and Nakakis, 2012 ) . The similar findings were besides showed in a survey conducted in southern Nigeria that really low per centum of wellness attention professionals cared for HIV patients in last 12 months propose that they are loath to care for HIV patients ( Umeh, Essien, Ezedinachi & A ; Ross, 2008 ) . Rondal et al. , ( 2002 ) found that nurses showed empathic attitudes towards HIV patients and had less fright of contagious disease whereas, 37 % of nurses would hold refused to care for HIV patients. While Veeramah, Bruneau, and McNaught ( 2008 ) found out that 91 % of the nurses and accoucheuses in England were willing to care for HIV patients. Willingness to supply attention to HIV positive patients in rural India was extremely associated with holding antecedently cared for HIV ( Kermode, Holmes, Langkham, Thomas & A ; Gifford, 2005 ) . This can be anticipated from reviewed articles that due to the deficiency of cognition, fright and reluctant to care for HIV patients could impede in doing professional relationship with patients. This issue can be overcome through educational programmes as, Pisal et Al. ( 2007 ) in a survey established that 6 yearss developing programme on HIV significantly decreases fright of reaching with HIV positive patients.

Stigma associated with HIV

Stigma is defined by Germov ( 2005 ) as a societal concept which separates out a individual by virtuousness of physical or societal behavior which consequences in negative attitudes such as turning away and favoritism. Peoples with HIV faces stigma like homosexual, they are labelled as shooting drug users or commercial sex workers. More than one tierce of Midwifery pupils of Vitenam believed that they do non prefer to care for HIV positive patients due to stigma no affair 85 % of them are cognizant that wellness attention professionals are non suppose to know apart HIV positive patients ( Nordkvist & A ; Allvin, n.d. ) . Reis et al. , ( 2005 ) found out that 8 % of the wellness workers in Nigeria believed that it is the complete waste of resorts if handling person with HIV. This stigma and negative attitude is associated with the deficiency of equal cognition in HIV intervention and moralss. Rondahl et al. , concluded that HIV patients faced stigma as they are considered as homophiles and they donaa‚¬a„?t get quality of attention. Besides, stigmatisation of patients with HIV in a survey of Chan et al. , ( 2007 ) is statically major obstruction in proviso of attention in Thailand. However, in Thailand commercial sex is more tolerated and less stigmatized while shooting drug users are extremely stigmatized.

Critical assessment and Gaps

After in-depth critical reappraisal of literature it is identified that really limited research have been done on a peculiar subject in Asiatic or Pakistani context. Furthermore, there is a scant of research from Midwifery position. As Pakistan is a state in passage in footings that HIV instances increases twenty-four hours by twenty-four hours ; it is extremely important to carry on research on this subject. It is the responsibility of every wellness attention professional to supply attention without favoritism. Therefore, it is of import to acquire equal cognition and demo positive attitude towards HIV positive patients.

It is critical to cognize the cognition degree and attitudes of accoucheuses towards HIV positive patients so that the accoucheuses can be trained through specific HIV cognition to get the better of the fright and reduces stigma for HIV patients. Furthermore, educating pupils accoucheuses about HIV cognition of forestalling and bring arounding the disease and moralss will besides assist to get the better of the reluctance of taking attention for HIV patients.

Restatement of Research inquiry and philosophical underpinning

After reexamining the literature ; my research inquiry harmonizing to PICOT stretegy is: What are the perceptual experiences, cognition degree, and attitude of accoucheuses and factors act uponing these attitudes towards HIV positive patients in a third attention scene of Karachi, Pakistan? Hence, assorted method i.e. , quantitative and qualitative both can be utilized to derive in-depth cognition in which a questionnaire can be used to measure knowledge degree of accoucheuses and I would carry on an interview with accoucheuses to verbalise their attitude and perceptual experiences of how assorted factors are impacting their attention towards HIV positive patients.

Strengths and Restrictions

Review of international articles assist to widen a broader apprehension of the phenomena faced in the nursing universe. Light cognition of wellness attention professionals about HIV and negative attitude towards HIV positive patients needs pressing attending to include HIV instruction in obstetrics course of study. While each of the reviewed articles has certain failings like most of the surveies were carried out in one university or infirmary. Further restriction is that different methods and instrument were used which limits the generalizability of the findings. Further surveies on the subject with qualitative attack would accomplish a deeper cognition. Furthermore, as mentioned above there is a deficiency of research in midwifery context peculiarly in Asian and Pakistani context therefore, surveies researching cognition and attitude of nurses and medical pupils are besides included in order to place the spread.


This literature reappraisal revealed that there is a lack in the cognition and there are some false beliefs existed among accoucheuses and other wellness attention professionals about HIV resulted in negative attitudes. Therefore, Midwifes need to be knowing in generative and sexual wellness issues including HIV issues. This can be achieved by updated cognition in relation to HIV, get the better ofing their frights and attitudes, and edifice assurance for caring HIV patients. Furthermore, there is a demand to better the consciousness about HIV and HIV patient attention through preparation programme in order to unclutter the misconceptions of accoucheuses so that HIV positive patients can acquire compassionate attention without favoritism.

Furthermore, accoucheuses working in infirmaries need to be supported with cognition and should hold adequate supplies to take cosmopolitan safeguards while caring for HIV positive patients. Pisal et Al. ( 2007 ) proposed that it is expected that in context of low resources, the deficiency of proper medical supplies, deficiency of sufficient protection and unequal cognition about HIV will maintain on lending to prejudiced behaviors towards HIV positive patients.