This research project examined the changing expectations and knowledge of Managers in the Department of Health who attended the Sexual Health Counselling Project offered by Rhodes University, East London, South Africa. These managers came from contexts in which the hierarchical medical model is firmly entrenched. The Sexual Health Counselling Project, drawing on theoretical principles from Narrative and other theories,presented a challenge to the standard management practices used by the managers. It also challenged how they dealt with clients. This research explored changes in expectations and knowledge prior to and during a two- week training course that the managers attended. A personal awareness and shift in knowledge occurred for many managers who examined their current practices. Some managers, who were firmly entrenched in the hierarchical model,found it difficult to change their ways of working.

Health information exchange (HIE) has the potential to improve care quality through improved information sharing and coordination of care. In Phase 1, a sociotechnical analysis was conducted at one HIV clinic to explore the interrelated factors that affect the consent of persons living with HIV (PLWH) to electronically share their protected health information (PHI) through a HIE. The findings of the sociotechnical analysis revealed that there is not a single solution that can adequately address the complex, interrelated issues that affect PLWH decision to electronically share PHI. Improvement in the consent process was selected as the target of intervention for Phase 2, which focused on designing and pilot testing a prototype HIE eConsent iPad app at the HIV clinic. A one-group post-test design examined if HIV clinic patients preferred the eConsent or the paper consent. Semi-structured interviews were used to assess overall comprehension of HIE after reading both consents. Over half of the participants favored eConsent as compared to paper consent. The proportion of participants who were able to verbalize essential components of HIE were as follows: more than one component – 35%, one component - 20%, and no component – 45%. While racially and ethnically diverse, the sample was well-educated (50% with a college degree); however, the low comprehension levels suggested that educational attainment was insufficient for HIE comprehension. A hybrid approach that integrates discussion with knowledgeable personnel and multimedia usage may be useful to convey complex information and facilitate HIE comprehension.

Human Immunodeficiency Virus (HIV) and Acquired Immuno-Deficiency Syndrome (AIDS) have brought about a global epidemic far more extensive than was predicted even a decade ago (van Rensburg, 2002:1). South Africa has one of the highest HIV prevalence rates in the world (South African Department of Health, 2000: 5), it still increase yearly. Before a vaccine and/or effective treatment become available, effective education and information campaigns are necessary for preventing the spreading of HIV and AIDS (WHO (the World Health Organization), 1988:21). According to WHO and ICN (International Council of Nurses) (1988:12), Nurses can play a pivotal role in the education of patients, their families and friends with regard to the prevention of HIV and AIDS transmission, so as to control the spread of this disease. In South Africa, more than 60 percent of the healthcare human resources comprise professional nursing practitioners (Muller, 2002: 95). Therefore, the education and training of nurses is one of the effective methods to preventing further spread of HIV and AIDS infection in South Africa. Accordingly, nurses need to reduce both personal and occupational risk of becoming infected with HIV themselves, as well as provide education to patients and their families. Before effective and efficient in-service education guidelines on the prevention of HIV and AIDS transmission can be developed, any knowledge deficit and negative attitudes of registered nurses regarding the prevention of HIV and AIDS transmission should be identified. Thus, it is important to survey the knowledge and attitudes of nurses in healthcare institutions related to the prevention of HIV and AIDS transmission. The main goal of the study was to explore and describe the knowledge and attitudes of registered nurses in public hospitals related to the prevention of HIV and AIDS transmission. The secondary objective was to develop in-service education guidelines for registered nurses in public hospitals to optimise both personal and occupational prevention measures relating to HIV and AIDS transmission. The research was conducted using a quantitative, explorative, descriptive and contextual design. The purposive sampling method was used to select the participants and a self-administered questionnaire was used to collect data. This data was analysed by inferential statistics and descriptive statistics and areas of deficits concerning knowledge and negative attitudes were identified. In this study there were deficits concerning the knowledge and negative attitudes regarding the prevention of HIV and AIDS transmission to a greater or lesser degree in all the subgroups of the questionnaire. In general, the registered nurses with the attendance of HIV and AIDS training program, experience in caring for HIV and AIDS patients made the level of certain knowledge related to the prevention of HIV and AIDS transmission different; Working experience as a registered nurses and the attendance of HIV and AIDS training programmes did not make attitudes towards the prevention of HIV and AIDS transmission significantly different. The registered nurses with experience of caring for HIV and AIDS patients had more positive attitudes than those without the experience. This information was used to compile in-service education guidelines for registered nurses concerning the prevention of HIV and AIDS transmission. The in-service education guidelines will be given to clinical facilitators at public hospitals. It is envisaged that this will guide them as to what to include in their in-service education programmes concerning the prevention of HIV and AIDS transmission for registered nurses.

Submitted in fulfillment of the requirements for the Degree of Master of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2015. / Abstract The HIV pandemic continues to intensify in most countries, especially in Sub­ Saharan Africa, with 1.8 million new people becoming infected with the disease in 2011. Sub- Saharan Africa is the world's worst HIV and AIDS affected region. The intensity of the AIDS pandemic in South Africa creates additional challenges for health workers. Apart from the fact that they could be infected, they have to deal with an increasing number of people who suffer from a fatal disease for which no cure has been found. Nurses are expected to give all the necessary care to these patients. The HIV and AIDS epidemic in South Africa poses challenges for an overburdened health care system. There is limited knowledge about health care perceptions and emotional experiences of providing HIV and AIDS related care and support. It is against this backdrop that the researcher has chosen to explore the experiences of first-year student nurses, caring for HIV and AIDS patients. Aim of the study The purpose of the study was to explore the lived experiences of first-year student nurses, nursing HIV and AIDS patients. Methodology A descriptive phenomenological research design was used to explore the experiences of first-year student nurses, caring for HIV and AIDS patients. The research setting was two colleges of nursing in the uMgungundlovu District that offer the four-year nursing diploma programme. The type of purposeful sampling that was used was criterion sampling, which entailed studying cases which met pre-set criteria. In-depth interviews with the first-year student nurses, who had experienced nursing HIV and AIDS patients, were conducted. The data was analysed manually and put into categories and sub-categories as they emerged. Results The findings revealed that the participants had positive and negative experiences when they provided nursing care to HIV positive patients. The positive experiences were that the participants did not fear meeting HIV positive patients and they were not traumatized. These participants nursed HIV positive patients like any other patient. The participants expressed their feelings as sad and bad. Participants who had negative experiences were shocked, scared and cried when they met HIV positive patients. Six participants reported that they did not know of any facilities available for debriefing and sharing of experiences. The remaining participants identified the group lecturer, group mates, the psychologist and registered nurse in the ward. There was a lesson in class that was dedicated to debriefing and the sharing of experiences. The majority of the participants (n=10) stated that HIV and AIDS was transmitted through contact with infected body fluids and blood. The participants identified similar methods of transmission, which were unprotected sexual intercourse, needle-stick injuries, use of contaminated needles and mother- to- child transmission of HIV and AIDS. The participants were able to correctly identify the modes of transmission, except for one participant who was not sure if HIV and AIDS was transmitted through breast-feeding, due to a lack of knowledge of the modes of transmission. Six participants identified voluntary counselling and testing (VCT) as a support service available for nurses exposed to HIV and AIDS. Three participants verbalised that they did not know of any services available to student nurses. Some participants were not sure if the services were available and accessible and had no idea if the services were available and accessible to the student nurses. There were various problems that were encountered by the participants with regards to accessing the services. These included a lack of privacy, fear of giving information to colleagues, early closure of the clinic and unavailability of the counsellor when needed. Recommendations were made concerning the need for adequate preparation of student nurses in their early training, with regard to VCT, PMTCT, home- based care and support groups. The stigma for HIV and AIDS needs to be adequately addressed. Support for student nurses needs to be provided when dealing with death of HIV and AIDS patients, as a large majority voiced not being able to cope. Conclusion Student nurses who shared their experiences nursing HIV and AIDS patients had positive and negative experiences when they provided nursing care to HIV positive patients. The participants needed the relevant support and counselling to be available when needed. Stigma still exists, even though HIV and AIDS has existed for at least thirty years. / PDF copy unavailable. please refer to hard copy for full text information / M

Studies on knowledge, attitudes and practices among healthcare workers involved in HIV and AIDS care have often revealed the lack of knowledge about HIV and AIDS. Nurses‘ knowledge may compromise the quality of care and attitudes towards patients living with HIV/AIDS. Special nursing knowledge and skills have been suggested as a prerequisite for taking care of patients with HIV. The purpose of this study was to assess nurses‘ knowledge, attitudes and practices towards patients with HIV and AIDS in Kumasi, Ghana. A quantitative cross-sectional study was conducted among 247 nurses at five selected health facilities in Kumasi. Data was collected by means of a structured self-administered questionnaire and analysed using SPSS version 23.0. Results were presented using charts and tables. Knowledge of HIV and AIDS was satisfactory but some of the nurses still hold erroneous beliefs and misconception about HIV transmission. A majority demonstrated favourable attitudes. Nurses had fears of contracting the virus, which resulted in the display of negative attitudes by some. Their practice of universal precautions was satisfactory; however, there was evidence of noncompliance among some of them. More studies should be conducted throughout the country to further assess nurses‘ knowledge, attitude and practices towards HIV and AIDS / Health Studies / M.A. (Nursing Science)