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Biomedical subjects

A Nyamathi

Publications and source records attributed to A Nyamathi.

34 records · Page 2Linked to original sources
PubMed1989

AIDS-related heart disease: a review of the literature.

Heart disease related to the acquired immunodeficiency syndrome (AIDS) encompasses a number of pathologic findings that may or may not be associated with specific cardiac signs and symptoms. A review of 30 reports revealed that cardiac disorders were apparent in 424 (74%) of 574 AIDS patients. Neoplasms and opportunistic infections each were reported in 46 (8%) patients. The area of the heart most commonly affected was the myocardium. Pericardial disease as a single disorder was apparent in 14 patients, the etiologic bases of which were Mycobacterium tuberculosis. Cryptococcus neoformans infection, and unspecified fibrinous pericarditis. Endocardial disease was histologically evident in 18 patients with nonbacterial thrombotic endocarditis, and one patient was found to have Nocardia asteroides endocarditis. Although cardiac symptoms (dyspnea and chest pains); signs (pulsus paradoxus and murmurs); or ECG, roentgenogram, or echocardiographic manifestations of AIDS may be significant, they are not generally helpful in establishing a clinical diagnosis. Echocardiograms and a heightened degree of clinical suspicion have proven useful in detecting cardiac dysfunction and life-threatening cardiac tamponade.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Comprehensive health seeking and coping paradigm.

While scholars in nursing are charged with the responsibility of advancing and structuring a body of knowledge for application in nursing practice, many of the currently utilized theories have been borrowed from other disciplines. Until such knowledge is redefined and synthesized according to the perspective of nursing, borrowed knowledge cannot be adequately understood. The purpose of this paper is to present a comprehensive client-orientated health seeking and coping paradigm. This paradigm is theorized to be a function of 12 factors which include: clients' situational and personal factors, resources, sociodemographic characteristics, cognitive appraisal, health goals, health seeking and coping behaviours, nursing goals and strategies, clients' perceived compliance, clients' perceived coping effectiveness, and immediate and long-term health outcome. The Lazarus Schema of Coping and Adaptation and the Schlotfeldt Health Seeking and Coping Paradigm were the parent conceptualizations from which the Comprehensive Health Seeking and Coping Paradigm (CHSCP) was derived. As a nursing-orientated multidimensional framework, the CHSCP will provide a useful framework for nurses interested in altering, enhancing or promoting the health seeking and coping of clients. By providing an intellectual focus for the initial and ongoing assessment of a multitude of variables which influence health seeking and coping, the specification of appropriate strategies can be developed and enhanced.

Adaptation, Psychological↗
PubMed1989

Maladaptive coping in the critically ill population with acquired immunodeficiency syndrome: nursing assessment and treatment.

A diagnosis of the acquired immunodeficiency syndrome (AIDS) is a devastating experience, placing those with the syndrome at high risk for ineffective coping. During the acute stage of illness, when the patient is admitted to a critical care setting, a crisis can ensue and precipitate intense anxiety, anger, denial, depression, and even suicidal ideation. Although it is imperative that critical care nurses become proficient in accurately assessing, diagnosing, and treating the disease in individuals who have an increased risk of maladaptive coping, there is no systematic basis for assessing the coping of patients with AIDS. Our purpose is to present a theoretically based explanation of the coping experience of persons with AIDS and to delineate nursing interventions designed to deal with maladaptive responses. The early and deliberate assessment, diagnosis, and treatment of such responses by means of a full range of psychosocial interventions are needed to enhance the coping efforts of the patients and optimize their psychosocial adjustment.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Factors affecting prescribed medication compliance of the urban homeless adult.

Compliance with medical treatment may constitute an impenetrable barrier to homeless persons experiencing significant physiological and psychosocial limitations. The purpose of this study was to describe the perceived factors that enhance or diminish prescribed medication compliance of homeless adults. A retrospective descriptive study of 61 urban homeless adults sheltered at the Union Rescue Mission in downtown Los Angeles were interviewed with a compliance questionnaire. Findings revealed that more than two-thirds of the sample reported their health status to be fair to poor. Nearly one-third reported compliance rates ranging from none of the time to half of the time. Deterrents to compliance included structural variables such as availability of drugs and lack of privacy and storage space. Factors enhancing compliance included carrying the medications, being close to the health clinic and understanding the need for the medication. Many of the factors reported to enhance or diminish compliance are within the realm of professional practice.

Adult↗
PubMed1989

Effectiveness of an AIDS education program on knowledge, attitudes, and practices of state employees.

While the number of companies employing HIV infected workers has more than tripled since 1985, only 10% of American corporations have policies for dealing with persons infected with HIV. The occupational health nurse is in a unique position to influence the attitudes, knowledge, and behaviors of workers in promoting a safe and productive work environment and reducing high risk activities. While the number of all individuals with AIDS has increased 4,000% in the last 6 years, there has been no reported increase in the percentage of HIV infected health care workers as compared with other occupations. An evaluation of an AIDS educational program revealed that while knowledge base was fairly high, statistically significant improvements were noted from pretest to retest in specific knowledge, attitude, and practice items.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Emotional distress in women with symptomatic HIV disease.

This article describes emotional distress in 44 women with Human Immunodeficiency Virus (HIV) symptomatic disease. Measures of self-reported symptoms of anxiety and depression revealed that emotional distress was prevalent in this group and may be sufficiently robust to warrant clinical diagnoses. Limits to functioning and disruptions in physical well-being were found to be associated with both anxiety and depression. Additionally, level of optimism was inversely related to anxiety and depression, and social support was inversely related to anxiety. These findings indicate that emotional distress in women with HIV disease is associated with, and could be ameliorated by, interventions targeted at functional status, social support, and level of optimism.

Activities of Daily Living↗
PubMedDate not supplied

HIV-risk behaviors and mental health characteristics among homeless or drug-recovering women and their closest sources of social support.

This article describes risky drug and sexual behavior and mental health characteristics in a sample of 240 homeless or drug-recovering women and their most immediate sources of social support. Women and their closest support sources both reported a great deal of recent noninjection drug use (56% and 52%, respectively) and lesser, though similar amounts of recent injection drug use (12% and 14%, respectively). More than one third of both groups reported a history of sexually transmitted disease and sexual activity with multiple partners. Fifty-one percent of the women and 31% of their support sources had Center for Epidemiological Studies Depression Scale (CES-D) scores of 27 or greater, suggesting a high level of depressive disorders in both samples. Similarly, 76% of the women and 59% of their support sources had psychological well-being scores below a standard clinical cutoff point. These data suggest that homeless and impoverished women turn to individuals who are themselves at high risk for emotional distress and risky behaviors as their main sources of support.

Adult↗
PubMedDate not supplied

Type of social support among homeless women: its impact on psychosocial resources, health and health behaviors, and use of health services.

BACKGROUND: Information about whether specific types of support are associated with poor psychosocial profiles, health behaviors, and positive use of medical care is critical for identifying homeless women at highest risk for negative outcomes. OBJECTIVES: This study aimed to examine the impact that various levels of support from substance users and nonusers have on homeless women's psychosocial profiles, health and health behaviors, and use of health services. METHODS: This cross-sectional survey used a sample of 1,302 sheltered homeless women. Using controls for potential confounders, outcomes were compared across four mutually exclusive subgroups of women reporting support from substance users only (n = 58), substance nonusers only (n = 439), both users and nonusers (n = 136), and no one (n = 669). Structured and psychometrically sound instruments measured social support, substance use, self-esteem, coping, and psychological symptoms. Additional instruments measured sociodemographic characteristics, sexual risk behavior, health status, and use of health services. RESULTS: As compared with those who have little or no support, women whose support included substance nonusers reported better psychosocial profiles and somewhat greater use of health services. Support from substance nonusers only was associated with better health behaviors and greater use of health services. Support from substance users only was essentially equivalent to not having support. CONCLUSION: Modifying the social networks of homeless women appears to be associated with improved mental health outcomes, less risky health behaviors, and greater use of health services.

Adaptation, Psychological↗
PubMedDate not supplied

Reliability of homeless women's reports: concordance between hair assay and self report of cocaine use.

BACKGROUND: To assess the concordance of homeless women's self-reported drug use with objective data. OBJECTIVE: To determine whether objective data (e.g., hair assays) are necessary supplements to self reports in assessing homeless women's cocaine use. METHOD: Self reports of cocaine use by 1,037 homeless women were compared to objective data based on radioimmunoassay of hair; independent correlates of cocaine use and underreporting were assessed using logistic regression. RESULTS: Forty-two percent of the women self-reported cocaine use in the past 6 months, whereas 49% had positive hair assays. Over 25% underreported cocaine use; however, underreporting decreased as hair cocaine levels increased. Predictors of underreporting included being Latino, younger and living primarily in shelters. Nevertheless, independent predictors of self-reported cocaine use and positive hair assays were identical. CONCLUSION: Homeless women's self-reports of cocaine use are fairly accurate. Objective data are particularly critical for assessing cocaine use among subgroups who are fearful of sanctions or use cocaine relatively infrequently or in smaller amounts.

Adult↗