Challenges in care management threaten health outcomes in persons living with HIV (PLWH), who also have other medical and psychiatric diagnoses, substance use problems, or adjustment issues (comorbid PLWH). Integrated primary care programs have been developed to address multiple care needs in comorbid PLWH. The effectiveness of these models has not been shown empirically, in part because of multidisciplinary approaches to care. Adherence and its relationship to social support are key factors in favorable outcomes in HIV. The authors measured social support and adherence among clients in AIDS day health care, an integrated primary care program for comorbid PLWH. The level of social support among AIDS day health care clients who were adherent to their antiretroviral therapy was reported to be significantly higher than social support among those who were nonadherent. Implications of the differences in social support and adherence in the population are explored and discussed. Implications for nursing practice and future research are also addressed.
It is evident that the hospital did not use patient complaints as a source of learning that could have promoted higher standards of care. The case study reveals some of the constraints and identifies requirements for appropriate use of information and feedback from patients. The study raises some issues requiring further research to ensure more appropriate use of patient complaints to improve quality of care.
This study explored perceptions, experiences and opportunities for the occupational safety and health professional (OSHP) as a result of COVID-19. Using qualitative methods, interviews took place with OSHPs in two organisations to understand how their role developed during the pandemic. Additionally, seven focus groups were organised and met virtually, using the Zoom platform, each addressing a different topic identified by the researchers. Participants (n = 45) from 10 different countries were distributed among the focus groups. Topics were separated into four themes: impact on the workplace; the psychosocial dynamic; medical and health issues and occupational safety and health (OSH) issues. Results were subsequently divided into seven action categories and compared with the findings from the organisational interviews. Comparison pointed to an expanded role for the OSHP including business continuity, resilience and wellbeing in addition to assessing and controlling risks emerging during the pandemic. There is also the need for a means to adequately disseminate trustworthy information. Results indicated that there was no single ‘average’ role of the OSHP, demonstrating essential contributions as a member of the management team. Results also stressed that the pandemic carried three health-related co-morbidities, stress, Post-Traumatic Stress Disorder and burnout. Directions for future research included: the education of the OSHP to support a move away from compliance towards risk management; determining how mental health issues in organisations should be managed; expanded roles for OSHPs within business; and implications for professional bodies, membership institutions and academia in supporting the above-mentioned emerging roles.
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