The HIV/AIDS epidemic in Indonesia: Does primary health care as a prevention and intervention strategy work?

Ibrahim K, Songwathana P, Boonyasopun U, Francis K. International Journal of Nursing Practice 2010; 16 : 87–91
The HIV/AIDS epidemic in Indonesia: Does primary health care as a prevention and intervention strategy work? The continuing increase in the number of people living with HIV/AIDS (PLWHA) in Indonesia is impacting on society. Various policies and strategies have been adopted and implemented to tackle this epidemic including primary health‐care (PHC) initiatives. This paper describes the current HIV/AIDS epidemic in Indonesia and highlights a range of prevention and intervention initiatives introduced to limit the spread and impact of this disease factors, such as the characteristics of high‐risk groups, the decentralization policy in the health sector, and the lack of skilled human resources and supplies in health centres have been identified as influencing access to health‐care services among high‐risk groups. Revitalization of a PHC approach coupled with adequate fiscal, infrastructure and human resources if addressed will increase of PLWHA and other risk groups to health care.     

International relocation: Womens’ coping methods

This article focuses on how corporate and military wives cope with international relocation. Specifically, the coping behaviors of women who exhibited signs of depression and anxiety and those women who did not in a convenience sample of 28 military and corporate women were studied. Six instruments were used: (a) the Relocation Survey, (b) the Beck Depression Inventory, (c) the Multiple Affect Adjective Check List, (d) the CAGE Questionnaire, (e) the Sarason Life Experience Survey, and (f) the Coping Questionnaire. Coping and adaption formed the conceptual framework. The findings revealed that women who coped well used active coping behaviors and women who coped poorly used more passive coping behaviors. This study offers some direction for health care providers who may use anticipatory guidance and counseling for women prior to international moves.     

Inadequacy of nutrients intake among pregnant women in the Deep South of Thailand

Background  

The deep south of Thailand is an area which has been affected by violence since 2004, yet the concurrent coverage of antenatal care has remained at over 90%. Our study aimed to describe the prevalence of nutrient inadequacy among pregnant women who attended antenatal care clinics in hospitals in the study area and assess factors associated with nutrient inadequacy.     

Evaluation of a clinical nursing practice guideline for preventing deep vein thrombosis in critically ill trauma patients

Deep vein thrombosis (DVT) is the third leading cause of morbidity in critically ill trauma patients but it can be prevented by performing appropriate risk assessment and preventive strategies. The purpose of this study was to evaluate of implementing a clinical nursing practice guideline (CNPG) for preventing DVT in critically trauma patients at Songklanagarind Hospital. The CNPG content with 37 items initially developed from evidence-based knowledge related to DVT and its prevention was validated and approved by the consensus of an expert panel. The ‘expert panel’ consisted of a clinical (critical surgical patients) nurse specialist, a trauma surgeon, a medical doctor who experts in developing CNPG, and two surgical care nurse educators. The revised 30 from 37 items were tested for reliability thereafter and yielded of 0.90 and 1.00, respectively. Forty-two nurses participated in this study. The effectiveness of this CNPG was evaluated in terms of (1) feasibility and difficulty of using the CNPG, (2) nurse's satisfaction in implementation of CNPG, and (3) the patient's femoral blood flow velocity before and after 7 days. Results have shown that 23 items were performed by more than 90% of nurses and there were 7 items performed at rates lower than 90%. 79% of nurses rated their satisfaction at high (M = 8.06, SD = 0.96). There were no differences in femoral venous blood flow velocity before and after 7 days and without signs of DVT. The findings indicated that the use of evidence-based clinical practice guidelines for deep vein thrombosis prevention could enhance the quality of care in terms of early detection for DVT and maintaining blood flow velocity in those patients who are at risk. Further study could be explored to confirm its effectiveness with the large sample size.     

Weighing Distress: Decision-Making Surrounding Management of the Pregnancy Experience Among HIV-Infected Thai Women

The researchers conducted this grounded theory study in order to describe the decision making surrounding management of the pregnancy experience of 38 pregnant, HIV-infected Thai women. Data were collected using in-depth interviews and an open-ended questionnaire, and they were analyzed using constant comparative analysis. We found that “weighing distress” was the core category of the decision-making process. The supporting categories were being ambivalent about continuing the pregnancy, exploring alternative options, and selecting the appropriate choice. Health care providers should encourage family members to participate and be involved in the women's decision-making processes.