Anna Karani

Where Will This Illness Take Me? Reactions to HIV Diagnosis From Women Living With HIV in Kenya

The purpose of our study was to develop an in-depth understanding of the reactions of 40 urban and rural HIV-infected Kenyan women to HIV diagnosis. We employed narrative inquiry principles to guide this qualitative cross-sectional study. We conducted individual in-depth interviews using open-ended questions in April and May 2006. In this article we focus on womens reactions to HIV diagnosis, under which four subthemes emerged: immediate intense emotions; keeping HIV status secret; acceptance of HIV diagnosis; and finding liberation in disclosure. We offer important implications for health care professionals serving women in sub-Saharan Africa from the findings of our study.

Grappling With HIV Transmission Risks: Narratives of Rural Women in Eastern Kenya Living With HIV

&NA; As people live longer and more productively with HIV infection, issues of agency in reducing HIV risk are particularly important for HIV‐infected women living in high prevalence, underresourced countries such as Kenya. Because of their gendered lives, in that being masculine is associated with dominance and being feminine is associated with passiveness, women in rural Kenya must cope with continued HIV transmission risk even after knowing they are infected with HIV. In this narrative interview study, informed by theories of gender and postcolonial feminism, we examined personal accounts of HIV risk and risk reduction of 20 rural women in eastern Kenya who were living with HIV. From our analysis of the womens narratives, two major themes emerged: gender‐based obstacles even in the context of a known HIV diagnosis, and struggles with economic pressures amid HIV risks. Implications for policy, programs, and research are discussed.

Missed opportunities for early HIV diagnosis: critical insights from the stories of Kenyan women living with HIV

Early HIV testing is critical for prevention and timely treatment. Missed opportunities for HIV diagnosis can result in unnecessary deaths at a time when access to antiretroviral treatment proves lifesaving. While HIV prevention and treatment research has increased, less research exists on womens experiences with HIV diagnosis, despite the fact that women are most affected. Insights from local women are critical in designing culturally meaningful interventions that thwart missed opportunities for early HIV diagnosis. The purpose of our study was to uncover steps women took to know their HIV diagnosis. Using narrative inquiry methodology informed by postcolonial feminism, we interviewed 40 HIV-positive women in Kenya. Five themes emerged related to uptake of HIV testing for women: (1) spouses critical illness or death; (2) years of suffering from HIV-related symptoms; (3) sick children; (4) prenatal testing; and (5) personal desire to know ones HIV status. These findings centered on women experiences provide an important basis for health promotion interventions related to HIV prevention, earlier detection, and treatment.

Explore Best Practices in Family Nursing in Kenya: Empathy as a Value in Caring

Objective: The arterial needle placement in arteriovenous fistula (AVF) can either be antegrade (in the direction of blood flow or pointing towards the heart) or retrograde (against the direction of blood flow) while venous needle placement should always be in the same direction as the blood flow. This study determined the effects of arterial needle placement in the arteriovenous fistula on dialysis adequacy of End-Stage Renal Disease (ESRD) patients undergoing maintenance hemodialysis in United Candelaria Doctors Hospital Nephro Synergies Inc. (UCDHNSI) Hemodialysis Center. Methods: A randomized controlled trial design was used in the study. A total of 20 non-diabetic, non-cardiac patients on maintenance hemodialysis for more than 6 months were randomized either to the intervention group (patients’ AVF were cannulated in a retrograde manner) or the control group (patients’ AVF were cannulated in an antegrade manner). Urea reduction ratio (URR) and Kt/V as well as access recirculation percentage were used to determine dialysis adequacy. Pre-dialysis, in the first 30 minutes of dialysis initiation and post-dialysis blood samples were obtained in each patient in 6 succeeding hemodialysis considering dialyzer reuse up to fifth reuse. Means were compared by independent t-test. Results: The findings of the study revealed that the mean URR and Kt/V of the subjects cannulated in retrograde manner and antegrade manner were 69.35% and 1.45, and 74.65% and 1.70, respectively. The mean access recirculation percentage of the subjects was 4.65% in the intervention group and 3.02% in the control group. There was a significant difference on URR and Kt/V of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. There was no significant difference on access recirculation percentage of the subjects using retrograde and antegrade arterial needle placement in 6 succeeding hemodialysis sessions. Conclusions: Antegrade arterial needle placement provides more adequate hemodialysis than retrograde arterial needle placement in terms of URR and Kt/V values among non-diabetic, non-cardiac patients undergoing maintenance hemodialysis in 6 succeeding hemodialysis sessions. The directions of the arterial needle either retrograde and antegrade did not have significant effects on access recirculation. United Candelaria Doctors Hospital – Nephro Synergies Inc. Hemodialysis Center Candelaria, Quezon, Philippines *Corresponding author Oscar R Reyes II, Nursing Care Coordinator, United Candelaria Doctors Hospital Nephro Synergies Inc. Hemodialysis CenterCandelaria, Quezon, Philippines; Tel: +639162751291; E-mail: oscarreyesii@yahoo.com Submitted: 19 Oct 2016; Accepted: 04 Nov 2016; Published: 08 Nov 2016BackgroudPatients going through surgery in local anesthesia often have a sense of anxiety and stress and thus need support to relax. Different distracting intervention is known to reduce the anxiet ...Methods: In Taiwan, any operations of ICD-9-CM primary surgical procedure codes are 53.00-53.05, 53.21, and 53.29 are reimbursed as IHR under the Tw-DRGs. With the 2010-2011 data of three hospitals of different ownership extracted from the NHI claim database, retrospective study was applied to analyze the age, sex, length of stay (LoS), diagnosis and surgical procedure code and the change in the financial risk of medical costs on IHR cases after Tw-DRGs practice. The study adopted the corresponding cost calculated with the Tw-DRGs payment principles and compared it with estimated inpatient medical cost calculated based on the fee-for-service policy.Introduction: Empathy is an affective-cognitive concept that has a rationally mediated set of responses. Family forms the basis of societal identity, kinships and survival. Through families the basis of caring, socialisation and identity for individuals is established. Family empathy ensures that family members care for one another as a shared responsibility. This study aimed at describing empathy characteristic values in caring. Methodology: An explanatory sequential design was used to conduct a qualitative research at Kenyatta National Hospital. A purposive sample of thirty-two nurses was randomly assigned to three focused groups for discussions. Data collection was by verbatim notes and recorded tapes. Data analysis was by correspondence and thematic analysis. Findings: Empathy involves displaying kindness and concern for others while caring is the state of being aware or informed about needs and intervening to meet that need. The relationship between empathy and caring was significant (p=0.000; p=0.05). Empathy as a value in caring was characterized by kindness, tolerance, listening, understanding and being available to intervene in patient needs. Caring was viewed as ability to achieve patient healthcare satisfaction, boost self-image and esteem for nurses, professional pride, and encouraging social cohesion and fosters national unity. Conclusion: Empathy has its values in family and social structure. A functional family structure prepares individuals to embrace values of empathy and care for others as a personal responsibility. Caring nature of nurses has benefits for both nurses and patients. 1School of Nursing, University of Embu, Kenya 2School of Nursing, University of Nairobi, Kenya *Corresponding author Gitonga G Pius, School of Nursing, University of Embu, Kenya, E-mail: piusgvg@gmail.com. Submitted: 04 Dec 2016; Accepted: 28 Dec 2016; Published: 04 Jan 2017