Adele Webb

Level of cancer pain knowledge among baccalaureate student nurses

Inadequate nursing education is a major impediment to effective pain relief for cancer patients throughout the world. This study was conducted to identify the level of cancer pain knowledge among baccalaureate student nurses and to determine whether specific activities affect this level of knowledge. Two questionnaires were administered to 82 baccalaureate student nurses in the final course of their program. Although the students displayed a realistic perspective about the severity and prevalence of cancer pain and psychological dependence, specific knowledge deficits and negative attitudes suggest the possibility of inadequate pain management. Specifically, the students believed that (a) maximal analgesic therapy should be delayed until the patients prognosis was less than 12 months; (b) the proportion of patients whose pain can be controlled by appropriate therapy is less than is possible; (c) increasing pain is related to tolerance rather than to progression of the disease; (d) the preferred route of administration is intravenous rather than oral; and (e) the degree of respiratory depression, rather than constipation, does not decrease with repeated administration. Significant positive correlations (P < or = 0.05) were found between age and cancer pain knowledge and between attendance at seminars/workshops and time spent reading professional journal articles. Of the 30% of the participants who perceived a particular person to be a source for obtaining information about cancer pain management, 52% specified a practicing registered nurse. Seminars and workshops were chosen by 59% of the students as the most effective way for nurses to increase their knowledge.(ABSTRACT TRUNCATED AT 250 WORDS)

Essential nursing competencies related to HIV and AIDS.

With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug–drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of task-shifting, task-sharing, and scope of nursing practices. This is an online Supplement to the Journal of the Association of Nurses in AIDS Care. Visit www.nursesinaidscarejournal.org for easy navigation. A Supplement Preview was published in the January/February 2011 issue, Volume 22, Number 1. The Supplement Preview and Online Supplement are supported by grant number U92HA07230 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, funded by the Presidents Emergency Plan for AIDS Relief.

Family health and mental health six years after economic stress and unemployment.

This study is a follow-up of 39 working class couples who were interviewed after suffering economic stress or unemployment and again six years later. Repeated measures related to economics, stress, family functioning, anxiety, and depression were collected and analyzed for couples and for husbands and wives separately. A model of long-term coping was suggested for future testing. Initially stressed families appeared to grow stronger. Mental health correlated negatively to family problems. Depressed wives seemed to maintain their depression over time if they perceived family life as stressful. Irrespective of marital problems, husbands were less likely to stay depressed.

Every nurse is an HIV nurse.

Overview: The evolution of HIV infection into a chronic disease has implications across all clinical care settings. Every nurse should be knowledgeable about the prevention, testing, treatment, and chronicity of the disease in order to provide high-quality care to people with or at risk for HIV. Its important, therefore, to have an understanding of the changing epidemiology of the disease, the most recent testing recommendations, developments in screening technology, the implications of aging with HIV infection, and the nursing implications of the ongoing epidemic.

Essential core competencies related to HIV and AIDS are critically needed in nursing.

Michael V. Relf, PhD, RN, ACNS-BC, AACRN, FAAN Julia Mekwa, PhD, RN, RM Cynthia Chasokela, PhD(c), MEd, BScN, SRN, RMN, SCM Christina Booth, BA Lisa Deng, Student R. Kevin Mallinson, PhD, RN, AACRN, FAAN Keabitsa Ramantele, BSEd, RN, RM Elizabeth Letsie, BSEd, RN, RM Jasintha Mtengezo, MPH, BScN, UCM, DipN Winnie Nhlengethwa, PhD, RN, SRM, FNP, SRH Dorothy Powell, EdD, RN, FAAN Adele Webb, PhD, RN, AACRN, FAAN Tony Diesel, BA Cur (Admin & Education), Dipl (Gen Nursing), Dipl (Psychiatric Nursing), RN Amanda Liddle, DrPH, RN, FAAN Michael V. Relf, PhD, RN, ACNS-BC, AACRN, FAAN, is an associate professor and assistant dean for Undergraduate Education, Duke University School of Nursing, Durham, NC. Julia Mekwa, PhD, RN, RM, Head of Department, Department of Nursing Science, University of Zululand, Republic of South Africa. Cynthia Chasokela, PhD(c), MEd, BScN, SRN, RMN, SCM, Director of Nursing Services/Chief Nursing Officer, Ministry of Health and Child Welfare, Zimbabwe. Christina Booth, BA, Duke University, Durham, NC. Lisa Deng, Student, Duke University, Durham, NC. R. Kevin Mallinson, PhD, RN, AACRN, FAAN, Assistant Professor, Department of Nursing, Georgetown University School of Nursing & Health Studies, Washington, DC. Keabitsa Ramantele, BSEd, RN, RM, President, Botswana Nurses Association, Botswana. Elizabeth Letsie, BSEd, RN, RM, Chairperson, Lesotho Nursing Council, Lesotho. Jasintha Mtengezo, MPH, BScN, UCM, DipN, Director of Education Programs, Nurses and Midwives Council of Malawi, Malawi. Winnie Nhlengethwa, PhD, RN, SRM, FNP, SRH, Rector, Nazarene Higher Education Consortium & Principal, Nazarene College of Nursing, Swaziland. Dorothy Powell, EdD, RN, FAAN, Associate Dean, Global and Community Health Initiatives, Duke University School of Nursing, Durham, NC. Adele Webb, PhD, RN, AACRN, FAAN, Executive Director, Association of Nurses in AIDS Care, Akron, OH. Tony Diesel, BA Cur (Admin & Education), Dipl (Gen Nursing), Dipl (Psychiatric Nursing), RN, Regional Director, Nurses SOAR! Durban, Republic of South Africa. Amanda Liddle, DrPH, RN, FAAN, Project Director, Nurses SOAR! Georgetown University, School of Nursing and Health Studies, Washington, DC.

Essential nursing competencies related to HIV and AIDS: Executive summary.

With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug-drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of taskshifting, task-sharing, and scope of nursing practices.

HIV care provider shortages highlighted in national meeting.

HIV Care Provider Shortages Highlighted in National Meeting Last week, several ANAC members were invited to attend the HIV/AIDS Workforce Stakeholder Meeting, convened by Deborah Parham Hopson, associate administrator for HIV/AIDS Health Resources and Services Administration (HRSA)/U.S. Department of Health and Human Services and a longtime ANAC member, and led by Dr. Laura Cheever, chief medical officer and deputy director of the HRSA’s HIV/AIDS Bureau. The purpose of this important stakeholder meeting was to explore and discuss workforce issues related to HIV care and to describe major factors affecting the workforce supply. An additional goal was to explore promising practices and policies to increase recruitment and retention of HIV care providers. Stakeholders were identified mainly as dentists, nurses, nurse practitioners, pharmacists, physicians, and physician assistants. With the privilege of being part of this groundbreaking group, several thoughts became increasingly clear. The fact is, as nurses and ANAC members, we have an obligation to contribute individually and as a group to an overall model for addressing the continuing shortage of health care providers in the area of HIV. According to an American Association of Colleges of Nursing (2008) report, nursing schools in the United States turned away 40,285 qualified applicants from baccalaureate and graduate nursing programs in 2007 because of an insufficient number of faculty, clinical sites, and classrooms. This fact is disturbing because predictions estimate the number of new nurses needed by 2010 will exceed 1.1 million (Center for Nursing Advocacy, 2008). During a national conference of nursing workforce leaders in June, 2008, it was announced that in addition to the lack of licensed nurses, many of those who are licensed have either moved out of clinical positions or have left nursing altogether (Florida Center for Nursing, 2008). Factors related to this flight of li-

Endorsement of New Competencies

The rollout of care and treatment services of HIV disease in sub-Saharan Africa has brought great promise to families and is ensuring the future of many nations. The nursing community has been at the forefront of these endeavors and has worked tirelessly to insure that quality care is delivered. Support is needed not only for these efforts, but also for the nurses who work diligently to bring the treatment programs to fruition. The Journal of the Association of Nurses in AIDS Care (JANAC), along with the Association of Nurses in AIDS Care (ANAC), is pleased to present the Essential Nursing Competencies related toHIVandAIDS, which form a framework for curriculum development and present indicators that measure the quality of nursing care. This has been a monumental effort with leadership of many nurses. Dr. Michael Relf spearheaded the effort through the Nurses SOAR! Program. Nurses SOAR! was a U.S. Government (HRSA) funded project implemented through Georgetown University. Key nursing leaders in Botswana, Lesotho, Malawi, South Africa, Swaziland, and Zimbabwe contributed to the development of the competencies. Funding for this important project came from the U.S. government, which was budgeted with input from the host countries. The process to identify the competencies has been a long one, and one that must be continued. HIV nursing is an evolving science and the competencies will need to reflect changes in HIV care and treatment that occur over time. In addition, further work needs to occur around the issue of pediatric care and treatment as well as prevention of mother to child transmission (PMTCT). For instance, the new World Health