Critical Care Nursing Commons^™

Differentiation And Treatment Of Anemia In Hiv Disease, Kenneth D. Phillips, M Groer

Faculty Publications and Other Works -- Nursing

Anemia is a frequent complication of HIV disease that contributes to decreased quality of life and increased morbidity and mortality. The three major categories of anemia in HIV disease are anemia due to impaired red blood cell production, anemia due to increased red blood cell destruction, and anemia due to increased red blood cell loss. Although anemia of chronic illness is the most common type of anemia in HIV disease, other classifications of anemia may be encountered. Understanding the pathophysiology of anemia and laboratory tests that are frequently used to establish the differential diagnosis of anemia helps to ensure that …

Incidence And Correlates Of Violence Among Hiv-Infected Women At Risk For Pregnancy In The Southeastern United States, R.L. Sowell, Kenneth D. Phillips, B. Seals, C. Murdaugh, C. Rush

Faculty Publications and Other Works -- Nursing

To identify the incidence and correlates of physical and sexual violence among HIV-infected women at risk for pregnancy, a cross-sectional examination was conducted within a longitudinal study of reproductive decision making. Participants consisted of 275 HIVinfected women 17 to 49 years of age (mean = 30.1 years).Women were predominantly African American (87%) and single (82%), with annual incomes of $10,000 or less (66%). Overall, 68% of the women reported experiencing lifetime physical and/or sexual violence. Before becoming HIV infected, 65% of the women reported having been physically or sexually abused. After HIV diagnosis, 33% of the women reported experiencing physical …

Differentiation And Treatment Of Anemia In Hiv Disease, Kenneth D. Phillips, M Groer

Kenneth D. Phillips

Anemia is a frequent complication of HIV disease that contributes to decreased quality of life and increased morbidity and mortality. The three major categories of anemia in HIV disease are anemia due to impaired red blood cell production, anemia due to increased red blood cell destruction, and anemia due to increased red blood cell loss. Although anemia of chronic illness is the most common type of anemia in HIV disease, other classifications of anemia may be encountered. Understanding the pathophysiology of anemia and laboratory tests that are frequently used to establish the differential diagnosis of anemia helps to ensure that …

Incidence And Correlates Of Violence Among Hiv-Infected Women At Risk For Pregnancy In The Southeastern United States, R.L. Sowell, Kenneth D. Phillips, B. Seals, C. Murdaugh, C. Rush

Kenneth D. Phillips

To identify the incidence and correlates of physical and sexual violence among HIV-infected women at risk for pregnancy, a cross-sectional examination was conducted within a longitudinal study of reproductive decision making. Participants consisted of 275 HIVinfected women 17 to 49 years of age (mean = 30.1 years).Women were predominantly African American (87%) and single (82%), with annual incomes of $10,000 or less (66%). Overall, 68% of the women reported experiencing lifetime physical and/or sexual violence. Before becoming HIV infected, 65% of the women reported having been physically or sexually abused. After HIV diagnosis, 33% of the women reported experiencing physical …

Family Functioning And Motivation For Childbearing Among Hiv-Infected Women At Increased Risk For Pregnancy, B.C. Latham, R.L. Sowell, Kenneth D. Phillips

Faculty Publications and Other Works -- Nursing

This study examined family composition and functioning in a cohort of HIVinfected women of reproductive age living in the southern United States. Participants were predominantly single (82.2%), African American women (86.7%) with annual incomes of less than $10,000 (65.5%), with a mean age of 31.2 years. Using the Family Apgar Scale as a measure of perceived family functioning, women reported that their families functioned moderately well. Multiple regression analysis showed that level of education, life satisfaction, and coping through avoidance and coping by seeking social support were positively associated with family functioning. In contrast, a history of interpersonal verbal violence …

Psychosocial And Physiologic Correlates Of Perceived Health Among Hiv-Infected Women, Kenneth D. Phillips, R.L. Sowell, C.J. Rush, C.L. Murdaugh

Faculty Publications and Other Works -- Nursing

The purpose of this study was to identify factors related to perception of physical health in a cohort of HIV-infected women. A descriptive correlational design was used to identify factors influencing perceived physical health in a sample of 275 HIV-infected women in Georgia, South Carolina, and North Carolina. Participants were predominantly single African-American women with household incomes of less than $10,000 per year.

Using Spearman’s rho, statistically significant positive correlations (p < .05) were found between perceived physical health and T helper cell count, hope, present life satisfaction, education, and income. Statistically significant positive correlations (p <.05) were observed between perceived physical health and three HIV-specific active coping styles (managing the illness, focusing on others, and positive thinking). Inverse relationships were observed between perceived physical health and HIVrelated symptoms, stage of illness, depression, physical and sexual violence experienced since becoming HIV-infected, history of drug use since becoming HIV-infected, and age. Using backward stepwise selection, 9 of 14 variables were retained in the final model that explained 60% of the variance in physical health at the p < .10 level of significance (R2 = .60). Variables that demonstrated a significant relationship with perceived physical health were HIV-related symptoms, depression, present life satisfaction, age, education, coping by managing the illness, coping through positive thinking, and coping by focusing on the present. These findings support the need to address the psychosocial as well as the physiologic factors associated with HIV/AIDS in developing comprehensive plans of nursing care.

Effects Of Individualized Acupuncture On Sleep Quality In Hiv Disease, Kenneth D. Phillips, W.D. Skelton

Faculty Publications and Other Works -- Nursing

Although it may begin at any point, sleep disturbance often appears early in HIV disease and contributes to decreased quality of life during the course of the illness. Relatively few studies have explored the complex nature of poor sleep quality in HIV disease or tested interventions to improve sleep quality. The purpose of this study was threefold: explore the nature of sleep quality in HIV disease, test the relationship between pain and sleep quality, and test the effectiveness of acupuncture delivered in a group setting for improving sleep quality in those who are HIV infected. A pretest, post-test, pre-experimental design …

Family Functioning And Motivation For Childbearing Among Hiv-Infected Women At Increased Risk For Pregnancy, B.C. Latham, R.L. Sowell, Kenneth D. Phillips

Kenneth D. Phillips

This study examined family composition and functioning in a cohort of HIVinfected women of reproductive age living in the southern United States. Participants were predominantly single (82.2%), African American women (86.7%) with annual incomes of less than $10,000 (65.5%), with a mean age of 31.2 years. Using the Family Apgar Scale as a measure of perceived family functioning, women reported that their families functioned moderately well. Multiple regression analysis showed that level of education, life satisfaction, and coping through avoidance and coping by seeking social support were positively associated with family functioning. In contrast, a history of interpersonal verbal violence …

Psychosocial And Physiologic Correlates Of Perceived Health Among Hiv-Infected Women, Kenneth D. Phillips, R.L. Sowell, C.J. Rush, C.L. Murdaugh

Kenneth D. Phillips

The purpose of this study was to identify factors related to perception of physical health in a cohort of HIV-infected women. A descriptive correlational design was used to identify factors influencing perceived physical health in a sample of 275 HIV-infected women in Georgia, South Carolina, and North Carolina. Participants were predominantly single African-American women with household incomes of less than $10,000 per year.

Using Spearman’s rho, statistically significant positive correlations (p < .05) were found between perceived physical health and T helper cell count, hope, present life satisfaction, education, and income. Statistically significant positive correlations (p <.05) were observed between perceived physical health and three HIV-specific active coping styles (managing the illness, focusing on others, and positive thinking). Inverse relationships were observed between perceived physical health and HIVrelated symptoms, stage of illness, depression, physical and sexual violence experienced since becoming HIV-infected, history of drug use since becoming HIV-infected, and age. Using backward stepwise selection, 9 of 14 variables were retained in the final model that explained 60% of the variance in physical health at the p < .10 level of significance (R2 = .60). Variables that demonstrated a significant relationship with perceived physical health were HIV-related symptoms, depression, present life satisfaction, age, education, coping by managing the illness, coping through positive thinking, and coping by focusing on the present. These findings support the need to address the psychosocial as well as the physiologic factors associated with HIV/AIDS in developing comprehensive plans of nursing care.

Effects Of Individualized Acupuncture On Sleep Quality In Hiv Disease, Kenneth D. Phillips, W.D. Skelton

Kenneth D. Phillips

Although it may begin at any point, sleep disturbance often appears early in HIV disease and contributes to decreased quality of life during the course of the illness. Relatively few studies have explored the complex nature of poor sleep quality in HIV disease or tested interventions to improve sleep quality. The purpose of this study was threefold: explore the nature of sleep quality in HIV disease, test the relationship between pain and sleep quality, and test the effectiveness of acupuncture delivered in a group setting for improving sleep quality in those who are HIV infected. A pretest, post-test, pre-experimental design …

Hiv-Infected Women And Motivation To Add Children To Their Families, R.L. Sowell, Kenneth D. Phillips, T.R. Misener

Faculty Publications and Other Works -- Nursing

The purpose of this descriptive study was to identify how susceptible women perceived their babies to be to perinatal transmission of HIV and to examine factors that influence a woman’s motivation to have a baby. The sample consisted of 45 African American women living in South Carolina and Georgia. Data were collected during face-to-face interviews. A researcher-developed scale, Motivation for Childbearing in HIV-Positive Women, provided reliable and valid data on factors that motivated or deterred a woman’s decision to have a baby. This study supported prior findings that HIV status is not the most important influence on a woman’s reproductive …

Health Care Provider's Influence On Hiv-Infected Women's Belief And Intentions Related To Azt Therapy, R.L. Sowell, Kenneth D. Phillips, C. Murdaugh, A. Tavakoli

Faculty Publications and Other Works -- Nursing

This study examined how women’s relationship with their primary health care provider (PHP) and their perceptions about how effective their PHPs believe zidovudine (AZT) to be in decreasing perinatal transmission related to women’s AZT beliefs and intentions. It used a cross-sectional design to collect data from 59 HIV-infected African American women. Almost half the women (45%) had given birth since HIV diagnosis. Most of the babies born to HIV-infected mothers (87%) were seronegative. Data analysis with Pearson’s r indicated that the quality of the women’s relationship with their PHP was positively correlated to how important the PHP would be in …

Hiv-Infected Women And Motivation To Add Children To Their Families, R.L. Sowell, Kenneth D. Phillips, T.R. Misener

Kenneth D. Phillips

The purpose of this descriptive study was to identify how susceptible women perceived their babies to be to perinatal transmission of HIV and to examine factors that influence a woman’s motivation to have a baby. The sample consisted of 45 African American women living in South Carolina and Georgia. Data were collected during face-to-face interviews. A researcher-developed scale, Motivation for Childbearing in HIV-Positive Women, provided reliable and valid data on factors that motivated or deterred a woman’s decision to have a baby. This study supported prior findings that HIV status is not the most important influence on a woman’s reproductive …

Health Care Provider's Influence On Hiv-Infected Women's Belief And Intentions Related To Azt Therapy, R.L. Sowell, Kenneth D. Phillips, C. Murdaugh, A. Tavakoli

Kenneth D. Phillips

This study examined how women’s relationship with their primary health care provider (PHP) and their perceptions about how effective their PHPs believe zidovudine (AZT) to be in decreasing perinatal transmission related to women’s AZT beliefs and intentions. It used a cross-sectional design to collect data from 59 HIV-infected African American women. Almost half the women (45%) had given birth since HIV diagnosis. Most of the babies born to HIV-infected mothers (87%) were seronegative. Data analysis with Pearson’s r indicated that the quality of the women’s relationship with their PHP was positively correlated to how important the PHP would be in …

Nursing Management Of Anxiety In Hiv Infection, Kenneth D. Phillips, J. Morrow

Faculty Publications and Other Works -- Nursing

Anxiety is a universal problem for individuals with AIDS because the disease creates uncertainty and disruptions in every aspect of their lives. Nurses have a wide variety of holistic interventions to help persons living with AIDS (PLWAs) manage anxiety. Orem’s self-care theory of nursing provides a framework for assessing, diagnosing, planning, implementing, and evaluating nursing care for an HIV-infected person experiencing anxiety. This article presents an overview of anxiety, the nature of anxiety in HIV-infected individuals, and psychological, pharmacological, and holistic interventions to assist the client in self-care of anxiety.

Nursing Management Of Anxiety In Hiv Infection, Kenneth D. Phillips, J. Morrow

Kenneth D. Phillips

Anxiety is a universal problem for individuals with AIDS because the disease creates uncertainty and disruptions in every aspect of their lives. Nurses have a wide variety of holistic interventions to help persons living with AIDS (PLWAs) manage anxiety. Orem’s self-care theory of nursing provides a framework for assessing, diagnosing, planning, implementing, and evaluating nursing care for an HIV-infected person experiencing anxiety. This article presents an overview of anxiety, the nature of anxiety in HIV-infected individuals, and psychological, pharmacological, and holistic interventions to assist the client in self-care of anxiety.

Sexual Orientation: A Cultural Diversity Issue For Nursing, Tr Misener, Rl Sowell, Kenneth D. Phillips, C.M. Harris

Faculty Publications and Other Works -- Nursing

Traditional approaches to cultural diversity and the development of a culturally aware workforce have consistently ignored the importance of gender role orientation and sexual orientation as sources of potential conflict in the work environment. To maintain its integrity as a caring profession, nursing must take steps to end personal and professional discrimination on the basis of sexual orientation.

Sexual Orientation: A Cultural Diversity Issue For Nursing, Tr Misener, Rl Sowell, Kenneth D. Phillips, C.M. Harris

Kenneth D. Phillips

Traditional approaches to cultural diversity and the development of a culturally aware workforce have consistently ignored the importance of gender role orientation and sexual orientation as sources of potential conflict in the work environment. To maintain its integrity as a caring profession, nursing must take steps to end personal and professional discrimination on the basis of sexual orientation.

Extrapunitive And Intropunitive Anger Of Hiv Caregivers: Nursing Implications, Kenneth D. Phillips, S.P. Thomas

Faculty Publications and Other Works -- Nursing

The purpose of this qualitative study was to investigate the anger of individuals who have provided direct patient care to loved ones who are living with or who have died from AIDS. The sample consisted of eight individuals who are currently involved in an AIDS service organization in northeast Tennessee. Data were collected using semistructured taped interviews. At the beginning of the study, two group interviews were conducted. Subsequently, each of the participants was interviewed privately. Extrapunitive and intropunitive anger were predominant themes in each of the interviews. Participants also reported ways of coping with their anger. Nurses can suggest …

Knowledge Of Risk Behaviors Of Persons Seeking Hiv Antibody Testing At A Community Site, R.L. Sowell, B. Seals, Kenneth D. Phillips

Faculty Publications and Other Works -- Nursing

People seeking HIV antibody testing at a community-based AIDS service organization (N = 342) were asked to complete a self- report questionnaire to determine knowledge of HIV transmission, source(s) of HIV-related knowledge, and recent risk behaviors. The overall knowledge level of risk for transmitting HIV associated with 16 related behaviors was relatively high. Yet, 69% of the participants reported engaging in unsafe sex during the previous six months. Poorly informed subjects tended to overestimate their level of knowledge. In a multiple regression analysis, knowledge, age, and gender were the only significant predictors of engaging in unsafe sex in this cohort. …

Protease Inhibitors: A New Weapon And A New Strategy Against Hiv, Kenneth D. Phillips

Faculty Publications and Other Works -- Nursing

Until recently, reverse transcriptase inhibitors have been the mainstay for treating HIV infection. Now, three protease inhibitors have been approved. Early evidence suggests that triple therapy delays the progression of HIV infection. An understanding of these new drugs and treatment strategies is imperative for clinicians. This article (1) reviews HIV's structure and replication process, (2) discusses currently approved reverse transcriptase and protease inhibitors, (3) describes the antiretroviral drugs" modes of action, (4) discusses important nursing implications for monitoring clients on these drugs, and (5) presents current scientific evidence regarding the effectiveness of combination therapy strategies.

Knowledge Of Risk Behaviors Of Persons Seeking Hiv Antibody Testing At A Community Site, R.L. Sowell, B. Seals, Kenneth D. Phillips

Kenneth D. Phillips

People seeking HIV antibody testing at a community-based AIDS service organization (N = 342) were asked to complete a self- report questionnaire to determine knowledge of HIV transmission, source(s) of HIV-related knowledge, and recent risk behaviors. The overall knowledge level of risk for transmitting HIV associated with 16 related behaviors was relatively high. Yet, 69% of the participants reported engaging in unsafe sex during the previous six months. Poorly informed subjects tended to overestimate their level of knowledge. In a multiple regression analysis, knowledge, age, and gender were the only significant predictors of engaging in unsafe sex in this cohort. …

Extrapunitive And Intropunitive Anger Of Hiv Caregivers: Nursing Implications, Kenneth D. Phillips, S.P. Thomas

Kenneth D. Phillips

The purpose of this qualitative study was to investigate the anger of individuals who have provided direct patient care to loved ones who are living with or who have died from AIDS. The sample consisted of eight individuals who are currently involved in an AIDS service organization in northeast Tennessee. Data were collected using semistructured taped interviews. At the beginning of the study, two group interviews were conducted. Subsequently, each of the participants was interviewed privately. Extrapunitive and intropunitive anger were predominant themes in each of the interviews. Participants also reported ways of coping with their anger. Nurses can suggest …

Protease Inhibitors: A New Weapon And A New Strategy Against Hiv, Kenneth D. Phillips

Kenneth D. Phillips

Until recently, reverse transcriptase inhibitors have been the mainstay for treating HIV infection. Now, three protease inhibitors have been approved. Early evidence suggests that triple therapy delays the progression of HIV infection. An understanding of these new drugs and treatment strategies is imperative for clinicians. This article (1) reviews HIV's structure and replication process, (2) discusses currently approved reverse transcriptase and protease inhibitors, (3) describes the antiretroviral drugs" modes of action, (4) discusses important nursing implications for monitoring clients on these drugs, and (5) presents current scientific evidence regarding the effectiveness of combination therapy strategies.