Responses Of Health Care Professionals Research Articles

Safe sex and student nurses in rural Australia: Nurses’ knowledge and practices (Part 1)

This article is the first of a two-part series on a research study investigating student nurses’ knowledge and attitudes to safe sex in a rural university in Australia. The article begins with a discussion of HIV/AIDS, particularly the current incidence and a discussion of the associated epidemiological data. Health care professionals responses to the disease and examples from relevant Australian literature are briefly explored. The authors then discuss the need for this current research study, reveal the associated ethical process, outline the instrument used and the sample population. The article concludes with a discussion of reliability and validity.

Privacy of medical records

Increasingly, medical records are being stored in computer databases that allow for efficiencies in providing treatment and in the processing of clinical and financial services. Computerization of medical records has also diminished patient privacy and, in particular, has increased the potential for misuse, especially in the form of nonconsensual secondary use of personally identifiable records. Organizations that store and use medical records have had to establish security measures, prompted partially by an inconsistent patchwork of legal standards that vary from state to state. There is widespread appreciation among policy makers regarding the need for legal reform. The Health Information and Portability Accountability Act of 1996 mandated that the Administration develop regulations regarding the control of medical records. The Administration has offered regulations from the Department of Health and Human Services (Standards for Privacy of Individually Identifiable Health Information; Proposed Rule 45 CFR Parts 160 through 164). Survey data reveal what healthcare professionals who have access to sensitive medical records believe are the greatest threats to patients' privacy. The overlap between Administration proposals and the responses of healthcare professionals is striking.

Care of the Woman Who Has Been Raped

There is an escalating epidemic of rape in the United States. All victims have psychological injury, and over half sustain physical injury in the assault. The response of health care professionals to these women demands sensitivity and expertise. A focused history and well-documented physical examination are crucial. Consistency among the history and physical findings, objective findings of recent trauma, and evidence of recent sexual activity are critical. Compliance with forensic protocols ensures that this information will be available for criminal proceedings. Long-term follow-up care and psychological support are necessary for the woman to make the transition from victim to survivor.

Patient control over dying: Responses of health care professionals

Decisions concerning how, when and where patients should die have traditionally been the exclusive domain of health care professionals. More recently, patients and their families are demanding increasing control over these decisions. This paper reports on the responses of 20 physicians and 20 nurses in a major teaching hospital regarding the desire of patients to exert more control over the circumstances of their dying. The findings, based on in-depth, semi-structured interviews, suggest that while health care professionals are generally in favour of the principle of patient control over dying, they have reservations about accommodating patients' wishes in actual clinical situations. Key factors that underly their ambivalence on this point are: (1) specific patient circumstances, such as age, severity of illness and mental competence; (2) moral and legal concerns; and (3) the type of intervention requested by patient. The results indicate that patient control over dying represents a challenge to the clinical judgement of health care professionals; that it runs counter to their perception of their role as healers and supporters; that it raises crucial concerns about their personal ethics and legal liability and that it poses a challenge to their professional autonomy and power. It is likely that health care practitioners will increasingly be pressured to concede their autonomy and enter into a partnership with patients in the decision-making process.

Responses of health care professionals to proposed mandatory HIV testing.

to survey active health professionals to assess the response to and impact of a mandatory human immunodeficiency virus (HIV) testing policy on health care providers and the communities in which they practice. Anonymous four-page survey of active health professionals at 13 hospitals in northern and central New Jersey. 1557 physicians and nurses responded to the survey. Response rate was approximately 41%. Hypothetical intervention. Responses to a series of questions relating to a hypothetical mandatory HIV testing policy for health professionals. Approximately three fourths of all surveyed health professionals stated that a mandatory testing policy would persuade individuals in their profession not to work in high-prevalence areas. Among those who currently work in high-prevalence HIV/acquired immunodeficiency syndrome (AIDS) areas, only 51% said that they would definitely or probably remain in that area should such a policy be instituted. Among those practicing surgery or performing invasive procedures, 7% currently avoid HIV-positive patients, and an additional 34% said that they would do so under the proposed testing policy. Finally, 4% of these professionals currently advice others to stop working in high-prevalence areas, and an additional 22% state that they would definitely do so if the proposed policy were instituted. If physicians and nurses behaved in accordance with their survey responses, institution of a mandatory HIV testing policy would create a shortage of physicians and nurses in high-prevalence HIV/AIDS areas.

Postlaryngectomy quality-of-life dimensions identified by patients and health care professionals

We compared the quality-of-life (QOL) dimensions after laryngectomy in patients with advanced larynx or pharynx cancer that were elicited from 20 consecutive laryngectomy patients and 20 health care professionals working in the Regional Head and Neck Oncology Service. Subjects in both groups were asked to identify important QOL items after recovery from laryngectomy and to rank and rate each on a vertical visual analogue scale. Health care professionals ranked impaired communication and self-image/self-esteem as the two most important QOL dimensions, whereas patients ranked the physical consequences of surgery, e.g., tracheal mucous production, and interference with social activities as the two most important items. The results indicate that the responses of health care professionals do not fully correlate with patient priorities. These findings are relevant to researchers developing treatment-specific QOL measures and to health care professionals when presenting treatment options to patients.