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Biomedical subjects

D W Sherman

Publications and source records attributed to D W Sherman.

At least 19 recordsLinked to original sources
PubMed2000

Experiences of AIDS-dedicated nurses in alleviating the stress of AIDS caregiving.

From the beginning of the AIDS epidemic, there have been individuals dedicated to the care of patients with AIDS. However, there has been little research regarding their perceptions and experiences of AIDS caregiving and the strategies they use to alleviate the stress and promote their willingness to care. Based on the experiences of 12 nurses at one hospital, who had chosen to work on an AIDS-dedicated unit, this exploratory study, conducted in 1998, explored the following: the physical, emotional or spiritual risks and stresses associated with AIDS caregiving; factors that provide resistance to the stresses of AIDS caregiving and promote a willingness to care; and strategies recommended by AIDS-dedicated nurses in caring for patients with AIDS. The data reveal important themes related to the physical stress of AIDS caregiving, specifically being aware of risks, but not paralysed by fear, and bombardment of the senses. The coping strategies of nurses included taking the risk in their stride, reframing the risk, and protecting oneself. The emotional stress of AIDS caregiving included witnessing suffering, experiencing unresolved grief, accepting diversity, being emotionally connected, distress from the dismantling of the AIDS unit and work demands, and declining team spirit. Coping strategies included balancing personal and professional life, releasing pain, respecting yet controlling feelings, managing demands, and asking for help. Nurses maintained their spiritual perspective. They experienced through AIDS caregiving a greater sense of shared humanity and a new perspective of life. Findings indicate that AIDS-dedicated nurses use many coping strategies. The experiences of these nurses can assist clinicians, educators and administrators in supporting nurses' caregiving and promoting the quality of care offered to patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed2000

AIDS-dedicated nurses: what can be learned from their perceptions and experiences.

Throughout the history of the AIDS epidemic, the theoretical and empirical literature have emphasized the stressors related to the care of patients with AIDS and the reluctance of health professionals to provide AIDS care. Since the beginning, however, there have been individuals who dedicated themselves to the care of patients with AIDS. This descriptive, qualitative study explored the perceptions and experiences of nurses who have chosen to work on an AIDS-dedicated unit in a New York City medical center, with regard to both their patients and their own personal and professional responses to caring for patients with AIDS. In addition to presenting the interview data of 12 AIDS-dedicated nurses, included are researcher observations, based on 4 months of participatory observation on an AIDS unit. These findings provide insight into the development of the relationship between nurses and their patients with HIV/AIDS and lessons in supporting and enriching those caregiving relationships.

Acquired Immunodeficiency Syndrome↗
PubMed2000

Physicians reflect on their lived experiences in long-term AIDS care.

Throughout the history of the acquired immunodeficiency syndrome (AIDS) epidemic, the theoretical and empirical literature has emphasized the stressors related to the care of patients with AIDS, and the reluctance of health professionals, including physicians, to provide care to patients with AIDS. However, from the beginning, there have been individuals who have dedicated themselves to the care of patients with AIDS. This descriptive, qualitative study explores the perceptions and experiences of five physicians, specializing in AIDS care, within a large medical center in New York City. Using principles of qualitative data analyses set forth by Carini, the data reveal important themes related to how they became involved in AIDS care; the stresses associated with AIDS caregiving and ways of coping; the rewards of AIDS care; aspects of the physician-AIDS patient relationship and patient characteristics that promote their willingness to care; and recommendations to fellow physicians in caring for patients with AIDS. From what they have said, and not said, palliative care clinicians, educators, and administrators can learn ways of promoting physicians' caregiving potential, and understand the value and intimacy of the physician-patient relationship, particularly within the context of life-threatening illness. This has further implications in promoting the quality of care offered to patients with AIDS and to all patients with an incurable illness, as well as insuring "safe passage" for patients and for the physicians committed to their care.

Journal Article↗
PubMed1999

The experience of relapse to unsafe sexual behavior among HIV-positive, heterosexual, minority men.

The purpose of this qualitative study was to examine the phenomenon of relapse to unsafe sexual behavior in human immunodeficiency virus (HIV)-positive, heterosexual, minority men. In-depth interviews were conducted by using a purposive sample of 18 HIV-positive, heterosexual, minority men who were recruited from an outpatient acquired immunodeficiency syndrome (AIDS) clinic in upstate New York and a community-based HIV/AIDS service organization in New York City. All participants expressed concern about the seriousness and health threat of unsafe sexual behaviors. The perceived benefits and barriers to unsafe sexual practices were identified. Content analysis revealed the following themes related to relapse to unsafe sexual behavior: drug and alcohol use, state of mind, "looking good" and "helping" fallacies, male-female relationship issues, influence of friends, weighing the risks, sexual preparation, uncontrollable sexual urges, and the symbolic meaning of condoms. Clinical implications related to health assessment, interventions, and health education and prevention programs for HIV-positive heterosexual, minority men and their sexual partners are presented.

Adult↗
PubMed1999

End-of-life care: challenges and opportunities for health care professionals.

The failings of the American Health Care System in meeting the comprehensive needs of the seriously and terminally ill have led to both professional and public efforts to improve end-of-life care. Following a discussion of the shortcomings of end-of-life in America, this article describes the goals and philosophy of palliative care, while highlighting current innovative programs in end-of-life needs and insure quality of life for patients and families experiencing incurable, progressive illness. Health care professionals are called to respond to the challenges and opportunities of end-of-life care as individual health care providers, as members of professions, and as members of interdisciplinary teams committed to improving the care of the dying in America.

Family↗
PubMed1999

Moving beyond fear: lessons learned through a longitudinal review of the literature regarding health care providers and the care of people with HIV/AIDS.

This article examines the literature regarding the health care provider/AIDS patient relationship for a 14 year period from 1984 through 1998. For each of the four time periods (1984-1989, 1990-1992, 1992-1995, 1996-1998), we present the general themes and concerns of the literature at that time. We begin the review of each time period with a depiction of what was happening in biomedical circles and in the broader society around HIV/AIDS. To provide a closer look at the setting for the work completed within each time period, we draw on research interviews conducted by the first author with nurses involved in AIDS care since the early days of the epidemic. Nurses'retrospective comments on what it was like to do the work at various times reveal the local reality and provide an important rationale for the work that we review. Each time period closes with a discussion of the lessons learned and suggestions of new possibilities for future efforts to enhance the well-being of both health care providers and patients with HIV/AIDS.

Attitude of Health Personnel↗
PubMed1999

Palliative care: pain and symptom management in persons with HIV/AIDS.

As patients with HIV/AIDS are living longer with the illness, pain and symptom management are increasingly important health issues. This article will discuss the assessment and management of such common problems as pain, fatigue and weakness, dyspnea and cough, anorexia and weight-loss, nausea and vomiting, sleep disorders, dry mouth, diarrhea, itching, and fever and night sweats.

HIV Infections↗
PubMed1998

Reciprocal suffering: the need to improve family caregivers' quality of life through palliative care.

There is growing recognition of the reciprocity of suffering by patients and families experiencing terminal illness and the need to improve the quality of their lives as the patient's illness progresses. Research is presented that addresses the importance of a dyadic perspective in recognizing patients' and families' stress and adjustment and the related physical, emotional, social, spiritual and financial needs at the end-of-life. These aspects of quality of life are specifically addressed by palliative care. The philosophy and goals of palliative care are described, as is its role in promoting the best possible quality of life for patients and their families experiencing terminal illness. This article addresses the importance of assessing the dynamics of the family caregiving system and potential palliative care interventions to enhance the quality of life of family caregivers. Implications for research are also discussed.

Journal Article↗
PubMed1997

Developing quality assurance programs in ambulatory surgery.

Cost and efficiency are only two outcomes considered in evaluating surgical ambulatory services. More important, quality of care and the patient's physical and emotional health and well-being must be evaluated. Nurse practitioners play a key role in initiating and implementing quality assurance programs to meet these outcomes.

Ambulatory Surgical Procedures↗
PubMed1996

Nurses' willingness to care for AIDS patients and spirituality, social support, and death anxiety.

OBJECTIVE: Use Rogers' (1992) framework of the science of unitary human beings to examine relationships among spirituality, perceived social support, death anxiety, and nurses' willingness to care for AIDS patients. DESIGN: Descriptive, correlational. POPULATION, SAMPLE, SETTING: Population, female RNs in the New York City Metropolitan area who care for patients with AIDS. Convenience sample of 220 RNs who worked in eight hospitals either on AIDS-dedicated units (n = 88), or medical-surgical scatterbed units (n = 132) with a daily AIDS patient census of between 5% to 50%. Data were collected in 1992. MEASURES: Spiritual Orientation Inventory, the Personal Resource Questionnaire-85, the Templer Death Anxiety Scale, and the Willingness to Care for AIDS Patients Instrument. METHODS: Pearson product-moment correlations and hierarchical multiple regression analyses to test hypotheses. FINDINGS: Willingness to care for AIDS patients was positively correlated with spirituality and perceived social support, and negatively correlated with death anxiety. Death anxiety moderated the relationship between spirituality and willingness to care. In total, 17% of the variance in nurses' willingness to care for AIDS patients was explained. Additional regression analyses indicated that group membership as either an AIDS-dedicated nurse or medical-surgical nurse did not moderate or change hypothesized relationships. CONCLUSION: Because group membership explained 22% of the variance in willingness to care, the data indicate that group culture or professional identity should be further examined as predictors of nurses' willingness to care for AIDS patients. CLINICAL IMPLICATIONS: Social support at work from administrators and colleagues, as well as the support from patients themselves is important to nurses and should be fostered.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Taking the fear out of AIDS nursing: voices from the field.

This paper discusses the findings of a quantitative study of nurses' willingness to care for patients with AIDS. It identifies several factors that enable nurses to confront the fear of AIDS nursing and to turn fear into compassion, and negative attitudes into positive ones. These factors include professional values, organizational support, group identity, patients' responses, spirituality, family and friends with AIDS, knowledge about AIDS, and the importance of personal choice. The value of these factors are further supported through personal statements made by nurses on AIDS-dedicated units as they express their feelings, thoughts, and positive experiences and expectations regarding AIDS nursing.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Acute head injury.

Explore the source record for details and available documents.

Craniocerebral Trauma↗
PubMedDate not supplied

Patients tell of their images, expectations, and experiences with physicians and nurses on an AIDS-designated unit.

Throughout the 1980s and 1990s, there were only a few studies addressing the relationship of health care professionals and patients with AIDS from the patient's viewpoint. This descriptive, qualitative study explored patients' perceptions and experiences with physicians and nurses on an AIDS-designated unit in New York City. The data reveal patients' physical and emotional images and expectations of physicians and nurses. In meeting their needs, patients expect physicians and nurses to attend to their physical needs as the priority but do not expect them to address their emotional and social needs. Although patients appreciate recognition of their spiritual needs, they attempt to avoid discussions about religion. Patients characterized "special" and "difficult" physicians and nurses. Patients emphasized the importance of establishing a caring relationship through the professionals' therapeutic use of self. With knowledge of what is valued by patients in their relationship with physicians and nurses, health professionals have an opportunity to reflect on their own caregiving experiences and learn ways of enriching and supporting those relationships with the intent of improving the quality of care.

Adult↗