A systematic review of the knowledge, attitudes and practice of trained nurses towards patients with HIV/AIDS

Abstract

Background Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a global health problem. Stigmatization and blame which are associated with the disease have made efforts to control the pandemic challenging. With discoveries of anti-retroviral drugs, HIV/AIDS patients are expected to live longer. Therefore, nurses being frontline workers are expected to nurse them in different clinical settings. Some studies have found that nurses hold discriminatory attitudes when caring for HIV/AIDS patients, have gaps in their knowledge and differing practices Objective The objective of this review was to synthesize the evidence on the knowledge, attitudes and practice of trained nurses towards HIV/AIDS patients. Inclusion Criteria Types of participants Studies that included trained nurses, specifically Registered Nurses (RN) and Enrolled nurses (EN). Types of interventions Studies that evaluated knowledge, attitudes and practice of trained nurses towards HIV/AIDS patients. Types of measured outcomes Studies that included outcome measures of knowledge, attitudes or practices of trained nurses towards HIV/AIDS patients. Types of studies Cohort studies, cross-sectional studies, case control studies and descriptive studies were considered for inclusion Search strategy A three-step search strategy was utilised. Search was limited to English language studies published between January 1990 till December 2010. Assessment of methodological quality The reviewers used the JBI Critical AppraisalChecklists to assess methodological quality. Data extraction Data were extracted using the JBI Data Extraction Form for experimental/observational studies. Data synthesis Meta-analyses was not performed. Findings are presented in a narrative summary. Results Thirty-three studies were included for this systematic review. All studies were descriptive studies. The results showed that the knowledge, attitude and practices of nurses varied. In general studies showed that: nurses’ knowledge of HIV/AIDS was satisfactory but knowledge deficits are prevalent in certain areas; nurses also had positive attitudes, but still held fears; nurse showed more prejudice towards HIV/AIDS patients in the high risk groups; practiced of universal precaution was irregular; and nurses also changed their practice behaviours after knowing the patient is HIV positive. Conclusion Knowledge, attitude and practices of nurses varied worldwide. The level of knowledge is satisfactory but gaps in knowledge exist. Nurses have positive attitudes but is affected by the ways which a person acquired HIV/AIDS. Strong stigmatization is still prevalent towards high risk groups. The use of universal precaution also needs to be address. More well established questionnaire should be used to measure practice towards HIV/AIDS patients.