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INTRODUCTION
BACKGROUND OF THE STUDY
Since the beginning of the epidemic, almost 70 million people have
been infected with the HIV virus and about 35 million people have died of
AIDS. Globally, 34.0 million [31.435.9 million] people were living with HIV at
the end of 2011. An estimated 0.8% of adults aged 15-49 years worldwide
are living with HIV, although the burden of the epidemic continues to vary
considerably between countries and regions. Sub-Saharan Africa remains
most severely affected, with nearly 1 in every 20 adults (4.9%) living with HIV
and accounting for 69% of the people living with HIV worldwide.
Officially, the Philippines is a low-HIV-prevalence country, with less
than 0.1 percent of the adult population estimated to be HIV-positive. As of
January 2013, the Department of Health (DOH) AIDS Registry in the
Philippines reported 10,514 people living with HIV/AIDS, (Department of
Health, January 2013).
Several factors put the Philippines in danger of a broader HIV/AIDS
epidemic. They include increasing population mobility within and outside of
the Philippine islands; a conservative culture, adverse to publicly discussing
issues of a sexual nature; rising levels of sex work, casual sex, unsafe sex,
and injecting drug use.
There is also high STI prevalence and poor health-seeking behaviors
among at-risk groups; gender inequality; weak integration of HIV/AIDS
responses in local government activities; shortcomings in prevention
campaigns; inadequate social and behavioral research and monitoring; and
the persistence of stigma and discrimination. Lack of knowledge about HIV
among the Filipino population is troubling. Approximately two-thirds of young
women lack comprehensive knowledge on HIV transmission, and 90 percent
of the population of reproductive age believe you can contract HIV by sharing
a meal with someone, ("Health Profile: Philippines"-United States Agency for
International Development, March 2008).
In the institution, there is an increase in number of patients admitted
with HIV for the past three years. This statistics is quite alarming that entails
an extensive awareness of the health care providers in the care of HIV/AIDS
patients both to render quality care and to protect them in the possible cross
contamination of the disease.
The researcher believes that the care of HIV/AIDS patients in the birds
eye view should not be feared nor labelled. Awareness on this disease would
alleviate stigma and hindrances in the provision of care. This serves as a
leverage to conduct this study of assessing the level of awareness of the
hospital staff on HIV/Aids and use it as a basis in developing structured staff
1
be
taken
into
consideration
to
ensure
continuous
quality
Assessment
of the
awareness of
hospital staff
on HIV/AIDS.
Structured
Staff
Education
Program
program will serve as an outcome of the study after a deliberate and careful
understanding of the findings though such scientific undertakings.
DEFINITION OF TERMS
Medical
Technologist,
Respiratory
Therapist,
Cardio
CHAPTER II
REVIEW OF LITERATURES AND STUDIES
HIV and AIDS have been studied by other researchers over time. A
search and review of the existing literature on the topic of HIV/AIDS was
done. Numerous articles were obtained regarding the HIV/AIDS. The
researcher gathered some of these related studies and literature to support
this study.
This chapter deals with the related literatures, related studies and
synthesis that are relevant to the study. This chapter summarizes the ideas
and concepts on the significant variables presented herein.
HIV CASES IN PHILIPPINES
HIV/AIDS incidence is the Philippines is quite alarming. This situation
calls for the determination of the awareness of those who are involved in the
provision of care and determine an education program that will equip them
with necessary concepts to increase patient outcome.
Since 1984 to present, there were 14,025 cases reported. More than
half (6,549) came from the National Capital Region. Thirteen percent (1,643)
came from region 4A, followed by 8% (1,077) from Region 3, 9% (1,115) from
Region 7, 6% (765) from Region 11 and the rest of the country comprises
13% (1,740) of all the cases.
AIDS Cases (1984-2013)
Of the 2,323 HIV positive cases in 2013, one hundred twenty were
reported as AIDS cases. Of these, 112 were males and 8 were females. Ages
ranged from 17-59 years. Ninety-eight percent (118) acquired the infection
through sexual contact (60 homosexual, 26 bisexual and 32 heterosexual)
and 2% (2) through injecting drug use.
From 1984 to 2013, there were 1,289 AIDS cases reported. Seventynine percent (1,013) were males. Median age is 34 years (age range: 1-81
years). Sexual contact was the most common mode of HIV transmission,
accounting for 95% (1,220) of all reported AIDS cases. Almost half of sexual
transmission
was
through
heterosexual
contact
(540),
followed
by
time of reporting. In June 2013, the bulk of new HIV cases came from NCR,
Region 7, Region 4A, Region 3, and Region 11. The three highest reporting
regions were NCR, 7 and 4A.
Ninety-five percent of the 2,323 cases in 2013 were males (2,212).
Ages ranged from 4 to 79 years old (median 28 years). The 20-29 year old
age group had the most (58%) number of cases for 2013. For the male age
group, the most number of cases were found among the 20-24 years old
(25%), 25-29 years old (34%), and 30-34 years old (21%).
From 1984 to 2013, there were 14,025 HIV Ab sero-positive cases
reported, of which 12,736 (91%) were asymptomatic and 1,289 (9%) were
AIDS cases. There is a significant difference in the number of male and
female cases reported. Eighty-eight percent (12,288) were males. Ages
ranged from 1-81 years (median 29 years). The age groups with the most
number of cases were: 20-24 years (22%), 25-29 (30%), and 30-34 years
(19%).
ADMISSION
A clear definition about HIV/AIDS should be determined in order to
define a course of treatment for this disease condition. AIDS is a chronic,
potentially life-threatening condition caused by the human immunodeficiency
virus (HIV). By damaging your immune system, HIV interferes with your
body's ability to fight the organisms that cause disease, (Mayo Clinic, 2012).
According to Wikipedia, Human immunodeficiency virus infection /
acquired immunodeficiency syndrome (HIV/AIDS) is a disease of the human
immune system caused by infection with human immunodeficiency virus
(HIV). During the initial infection, a person may experience a brief period of
influenza-like illness. This is typically followed by a prolonged period without
symptoms. As the illness progresses, it interferes more and more with the
immune system, making the person much more likely to get infections,
including opportunistic infections and tumors that do not usually affect
people who have working immune systems.
Awareness on the disease process is also pivotal in this matter. Primary
focus of treatment in HIV/AIDS patients are focused on the prevention of
secondary infections and complications. According to Jung A. And Pauaw,
D.S., Risk of many HIV-related disease varies with the patient's degree of
immunosuppression. CD4 count, CD4 percentage, quantitative HIV-1 RNA
(viral load), neopterin level, and p-24 antigenemia have all been proposed as
surrogate markers of immune function. Among these, CD4 counts and
quantitative HIV-1 RNA levels are used most commonly. Quantitative HIV-1
RNA is a more reliable surrogate marker for progression to AIDS and death
than CD4 counts. However, HIV-1 RNA levels can vary up to fourfold during
7
acute infections, and there is no defined relation between HIV-1 RNA levels
and risk of opportunistic infections. Consequently, the CD4 count remains the
most useful test for estimating risk of many HIV-related diseases.
The advent of combination antiretroviral therapy using protease
inhibitors, nucleoside analogues, and nonnucleoside reverse transcriptase
inhibitors has led to substantial increases in CD4 counts in some patients.
Whether these increased CD4 counts alter patients' risk of opportunistic
infections is uncertain. Until studies clarify this issue, it is prudent to base
patients' management on their CD4 counts before initiation of antiretroviral
therapy.
Technical
and
physiologic
variability
contributes
to
the
overall
(opt-in testing) or are informed that they will be tested as part of routine
procedures unless they refuse (opt-out testing), is increasingly advocated.
This is different from routinely conducting tests in medical settings without
informing patients or seeking their consent. The terminology reflects ongoing
debates about consent, as well as the tension between safeguarding
individual rights and protecting public health: should testing be universal,
routinely practiced, routinely offered, or only performed at an individuals
request and where indicated for individual cases? Is voluntary counseling and
testing the only way to ensure consent?
In an effort to avoid the potential confusion of earlier terminology, the
World Health Organization (WHO) has recently proposed a formulation that
distinguishes between 2 types of HIV testing, both voluntary: client-initiated
testing, corresponding to what is usually referred to as voluntary counseling
and testing, and provider-initiated testing. The latter is conducted at health
facilities as part of clinical care to diagnose patients who present with signs
and
symptoms
suggestive
of
HIV
or
to
aid
in
providing
care
to
In 2004, WHO and the Joint United Nations Program on AIDS (UNAIDS)
had recommended the routine offer of testing with the choice to opt out; in
2007, they issued a Guidance for Provider-Initiated Testing and Counseling in
Health Facilities. In 2006, the Centers for Disease Control and Prevention
(CDC) called for routinely testing people aged 13 to 64 years and for
simplifying the process of obtaining consent. Recommendations to expand
testing raise numerous questions about the application of the policy and its
consequences in different settings. These questions relate to the feasibility of
providing the needed referral, treatment, and prevention services related to
HIV testing; the protection of individuals identified through testing; whether it
is truly possible to opt out of testing; ensuring consent and confidentiality;
and the extent to which routine testing encourages prevention, reduces
stigma, and promotes behavior change.
The evidence needed to inform debates about the best way to
implement testing and counseling programs is patchy. Although statistics are
increasingly available, and there have been comparative studies of the
effectiveness of voluntary counselling and testing, less is known about the
factors that influence utilization in different settings, with some studies
casting doubt on the notion that the positive effects observed in small studies
are necessarily replicated as testing expands. Nor do we understand the
reasons for differential use, even though discussions often refer to gender,
stigma, or poverty as obstacles to the utilization of testing. The issue of HIV
testing is often addressed as if all HIV tests were conducted for the same
purposes and under the same circumstances.
There
are,
however,
important
differences
between
voluntary
counselling and testing, testing conducted for diagnostic purposes among ill
patients, routinely offered testing at health facilities, testing for purposes of
surveillance among healthy populations, and mandatory testing that is
carried out when required by laweach of which may require different
information and different standards to ascertain consent and ensure
confidentiality. The epidemiological context in which testing is conducted also
makes
differencehigh-
or
low-prevalence
settings
have
different
depends in large part on the extent to which fears of testing are overcome,
adverse consequences of disclosure are avoided, and providers can connect
clients to appropriate treatment and prevention services. This, in turn,
requires an understanding of the contextual factors that facilitate or hinder
testing, both within health facilities and elsewhere.
According to Fournier P.O. ,et., al., With the rapid development (and
complex prescribing patterns) of drugs for HIV/AIDS care, it is challenging for
physicians to keep current. We conducted a follow-up study to a 1994 cohort
study to see how care and referral patterns have changed over the last
decade. In this study, we examined how family physicians in Massachusetts
were caring for their HIV-infected patients, and to see whether FPs were
referring more patients to specialists for care compared with a decade ago.
They utilized a cross-sectional survey as an 11-year follow-up to a
previous study. It was mailed in 2005 to the active membership of the
Massachusetts Academy of Family Physicians. They found out that compared
with the cohort of 1994, the number of HIV+ patients in individual practices
remained about the same, but the number of practices with no AIDS patients
was significantly higher. 85.3% of FPs noted that they were more likely to
refer HIV/AIDS patients immediately compared with their own practice
patterns a decade ago. In this study, 39.0% of current respondents referred
HIV+ patients immediately, 57.0% co-managed patients, and 4.1% managed
these patients alone (the data for the 1994 cohort was 7.0%, 45.8%, and
47.2%, respectively; P<.0001). Similar changes were seen in regard to care
patterns for AIDS patients. Among the current cohort, 61.7% reported that
they referred patients immediately, compared with only 18.3% in 1994;
36.8% noted that they co-managed these patients (vs 74.3% in 1994); and
only 1.5% reported that they managed these patients alone (vs 7.4% in 1994;
P<.0001).
With their study, they concluded significant shift amongst FPs with regard to
their referral patterns for patients with HIV/AIDS has occurred over the last
decade. The community health center has emerged as a resource for patients
with HIV/AIDS. Funding for specific training programs on HIV/AIDS care should
be targeted to community health centers.
Narhari Timilshina, et., al. stated that without protective practices such
as antiseptic hand washing, the use of sterile/surgical gloves, safe needles,
sterile equipment, and safe instrument and waste disposal procedures
outlined in universal precaution guidelines, basic health workers (BHWs) are
at substantial risk of blood-borne infections.
DISEASE PROCESS
11
Many people view HIV and AIDS in the same light, and therefore have
the underlying prejudice that someone who is HIV-positive could die
tomorrow.
AIDS.
A virus is a very small germ. HIV is not one virus, but a family of
similar viruses. HIV 1 is found in most countries of the world while HIV 2 is
found mainly in West Africa. AIDS is a medical diagnosis for a combination of
illnesses which results from weakness of the immune system due to infection
with HIV. The immune system defends the body against infections and
diseases. The word AIDS is an abbreviation for the following:
Our blood contains white and red blood cells. Normally the white cells
fight off and kill any germs which enter our bodies. They do this by eating up
the germs and by producing chemicals called antibodies which kill them. In
this way our bodies fight off many different germs and we stay healthy.
Sometimes we have symptoms of illness when our white cells are
fighting the germs, but usually the white cells win and we get better.
HIV weakens the immune system by entering and destroying our white
cells. As more and more white cells are killed, the body becomes less and less
able to fight off the many different germs which live around and in our bodies
all the time. After many years the white cells are so damaged that these
germs, which normally do not cause problems, can cause deadly diseases.
People with AIDS eventually die from one of these diseases which their bodies
cannot resist.
Immediately after a person is infected with HIV, the virus rapidly starts
to multiply using the bodys white blood cells. After about two to six weeks
most people infected with HIV produce antibodies against the virus. These
antibodies can contain a number of HI viruses, but they are not able to kill
HIV because it hides in the white cells. A blood test generally used can detect
these antibodies, which will show that the person has been infected with HIV.
The period from the time a person is infected until these antibodies appear is
called the window period.
antibodies present in the blood, and if a person would be tested during this
time a person therefore tests negative, although the virus is already in the
blood.
Around the time of infection some people have a short illness similar to
glandular fever. This could be associated with a short spell of night sweats,
swollen glands and some flu-like symptoms.
normally disappear within a few days.
12
After this, most people remain healthy with no signs of illness for many
years. However, HIV is still present in the body and the person can infect
others without either partner knowing it.
The longer a person is infected with HIV, the more white blood cells get
destroyed and the weaker the persons immune system become. This will
initially cause the person to begin to show some minor signs of illness.
Finally so much of the immune system is destroyed that the person is
attacked by rare and serious infections which eventually kill him or her. These
diseased are called opportunistic infections since they use opportunity of a
weakened immune system to make attack the body. The diseases vary in
different countries, depending on which viruses, bacteria, fungus and
protozoal infections are around.
Nobody should be
forced to go for testing. The testing should be accompanied by pre- and posttest counselling. This is called voluntary counselling and testing (VCT).
If you are worried, do not walk around being worried the whole time. Go
to any clinic, doctor or local hospital, and ask to be tested for HIV. All test
results will be kept confidential. People are very often afraid of hearing that
they are HIV infected, which is understandable, but it is definitely better for
you to know your HIV status, than not to know. If you know you are infected
you can start to look after your own health, start to investigate different
treatment options, make plans for the future, adapt your lifestyle and make
sure that you do not infect anyone else, get support, accept your HIV status
and start to live again.
On average, people infected with HIV develop AIDS after eight to twelve
years if they receive no treatment. This however has started to change as
new antiretroviral drugs are constantly developed. The prices of these drugs
may still be out of reach of many people, but thanks to global advocacy
efforts most governments now have programs to make antiretroviral drugs
more available for free or at reduced prices.
If an infected person uses these medications correctly and can tolerate
the possible side-effects of these drugs, HIV infection can now become a
13
These antiretroviral
suspected for some years that both these strains of the virus might have an
animal, specifically a simian or primate specie, origin. Very often the green
monkey got the blame. Whether it was a green monkey is not important.
What is important is that since the beginning of 1999 scientists have
provided sound evidence to show for certain that HIV1 the virulent and
widely spread strain of the virus originated in the chimpanzee sub-specie,
while HIV2 the less virulent and more contained strain of the virus
originated from the sooty mangaby monkey.
A particular kind of chimpanzee is known to carry a virus quite similar
in structure to the human AIDS virus. This chimpanzee virus (SIV) is a great
deal older than the HI virus. In certain areas of Africa, the monkey and
chimpanzee is considered a luxury food. Possibly the first human was infected
by eating some uncooked organs, or through an accidental cut while
preparing a carcass. The disease may have begun in this simple, quiet
manner, spreading to others from this point through sexual intercourse and
later through shared needle use.
Many African government representatives are sensitive about this view.
Understandably so, as it is often phrased in a way that seems to blame Africa
15
for the appearance of the virus. While scientific events are not themselves
racist, observations and reporting of them may be so. It is important to
remember that no one person, nation or population is responsible for the
development of HIV/AIDS.
further spread of the virus and care for those who are infected with HIV. No
one is to blame for the appearance of HIV. But now that we know it is there,
we must not be accused of failing to create the kind of responsible and caring
society which will make it possible to prevent AIDS.
CARE MANAGEMENT
The management of HIV/AIDS normally includes the use of multiple
antiretroviral drugs in an attempt to control HIV infection. There are several
classes of antiretroviral agents that act on different stages of the HIV lifecycle. The use of multiple drugs that act on different viral targets is known as
highly active antiretroviral therapy (HAART). HAART decreases the patient's
total burden of HIV, maintains function of the immune system, and prevents
opportunistic infections that often lead to death.
The American National Institutes of Health and other organizations
recommend offering antiretroviral treatment to all patients with AIDS.
Because of the complexity of selecting and following a regimen, the severity
of the side-effects, and the importance of compliance to prevent viral
resistance, such organizations emphasize the importance of involving
patients in therapy choices and recommend analyzing the risks and the
potential benefits to patients with low viral loads.
Sarah Chippindale and lesley French stated that ounselling in HIV and
AIDS has become a core element in a holistic model of health care, in which
psychological issues are recognised as integral to patient management. HIV
and AIDS counselling has two general aims: (1) the prevention of HIV
transmission and (2) the support of those affected directly and indirectly by
HIV. It is vital that HIV counselling should have these dual aims because the
spread of HIV can be prevented by changes in behaviour. One to one
prevention counselling has a particular contribution in that it enables frank
discussion of sensitive aspects of a patient's lifesuch discussion may be
hampered in other settings by the patient's concern for confidentiality or
anxiety about a judgmental response. Also, when patients know that they
have HIV infection or disease, they may suffer great psychosocial and
psychological stresses through a fear of rejection, social stigma, disease
progression, and the uncertainties associated with future management of HIV.
Good clinical management requires that such issues be managed with
consistency
and
professionalism,
and
16
counselling
can
both
minimise
morbidity and reduce its occurrence. All counsellors in this field should have
formal counselling training and receive regular clinical supervision as part of
adherence to good standards of clinical practice.
WHO recent Consolidated guidelines on the use of antiretroviral drugs
for treating and preventing HIV infection: recommendations for a public
health approach recommends a preferred treatment regimen based on
tenofovir (TDF) in combination with lamivudine and efavirenz (TLE), or TDF
with efavirenz and emtricitabine (TEE). In addition, WHO recommends that
countries should discontinue stavudine (d4T) use in first-line regimens. The
implementation of these recommendations implies transition of nearly 1
million patients on d4T-based regimens and a gradual shift of between
2,000,000 and 3,800,000 patients on zidovudine (AZT) regimens to TLE or
TEE. As has been seen with previous regimen changes, any major transition
of patients is a significant undertaking that requires careful procurement and
supply chain management planning.
The recommendations in support of Option B+ in the prevention of
mother-to-child transmission, and adult treatment initiation at a CD4 count
500 cells/mm or lower will also increase the demand for antiretroviral (ARV)
medicines. Programs should plan carefully and discuss with their suppliers
the pace at which increased quantities of TDF-based product can be made
available. This will require a graduated process of transition. In order to
ensure that supply is available to meet anticipated demand, a phased
programme is highly recommended.
POLICIES AND STAFF EDUCATION PROGRAM
The establishment of a clear policy on HIV/AIDS in every healthcare
institution is very important in determining course of actions to consider. This
policy should be clearly understood by the personnel involved in the care of
HIV/AIDS patients. Likewise the policy should always be congruent with the
national policy for HIV/AIDS. In this regard, the researcher included the
Philippine law as part of the literatures to be cited in this study.
PHILIPPINE REPUBLIC ACT 8504 is an act promulgating policies and
procedures for the prevention and control of HIV/AIDS in the Philippines,
instituting a nationwide HIV/AIDS information and educational program,
establishing a comprehensive HIV/AIDS monitoring system and strengthening
the Philippine National AIDS Council and for other purposes
Acquired Immune Deficiency Syndrome (AIDS) is a disease that
recognizes no territorial, social, political and economic boundaries for which
there is no known cure. The gravity of the AIDS threat demands strong State
action today, thus: (a) The State shall promote public awareness about the
causes, modes of transmission, consequences, means of prevention and
17
campaign
organized
and
conducted
by
the
State.
Such
individuals
in
propagating
vital
information
and
educational
messages about HIV/AIDS and shall utilize their experience to warn the public
about the disease.
Sec. 4 states that the Department of Education, Culture and Sports
(DECS), the Commission on Higher Education (CHED), and the Technical
Education
consultation with parents who must agree to the thrust and content of the
instruction materials.
All teachers and instructors of said HIV/AIDS courses shall be required
to undergo a seminar or training on HIV/AIDS prevention and control to be
supervised by DECS, CHED and TESDA, in coordination with the Department
of Health (DOH), before they are allowed to teach on the subject.
states
about HIV/AIDS
education
for
Filipinos
going
abroad The State shall ensure that all overseas Filipino workers and
diplomatic, military, trade, and labor officials and personnel to be assigned
overseas shall undergo or attend a seminar on the cause, prevention and
consequences of HIV/AIDS before certification for overseas assignment. The
Department of Labor and Employment or the Department of Foreign Affairs,
the Department of Tourism and the Department of Justice through the Bureau
of Immigration, as the case may be, in collaboration with the Department of
Health (DOH), shall oversee the implementation of this Section.
19
11
states
about Penalties
for
misleading
information
blood, tissue, or organ testing positive for HIV may be accepted for research
purposes only, and subject to strict sanitary disposal requirements.
Section 13 states about Guidelines on surgical and similar procedures.
The Department of Health (DOH), in consultation and in coordination with
concerned professional organizations and hospital associations, shall issue
guidelines on precautions against HIV transmission during surgical, dental,
embalming, tattooing or similar procedures. The DOH shall likewise issue
guidelines on the handling and disposition of cadavers, body fluids or wastes
of persons known or believed to be HIV-positive. The necessary protective
equipment such as gloves, goggles and gowns, shall be made available to all
physicians and health care providers and similarly exposed personnel at all
times.
Section
14
states
about
Penalties
for
unsafe
practices
and
testing
for
individuals
with
high
risk
for
contracting
HIV: Provided, That written informed consent must first be obtained. Such
consent shall be obtained from the person concerned if he/she is of legal age
or from the parents or legal guardian in the case of a minor or a mentally
incapacitated individual. Lawful consent to HIV testing of a donated human
body, organ, tissue, or blood shall be considered as having been given when:
(a) A person volunteers or freely agrees to donate his/her blood, organ, or
tissue for transfusion, transplantation, or research; (b) A person has executed
a legacy in accordance with Sec. 3 of Republic Act No. 7170, also known as
the Organ Donation Act of 1991";
(c)
donation
is
executed
in
27
states
about Monitoring
program
comprehensive
remain confidential and classified, and can only be used for statistical and
monitoring purposes and not as basis or qualification for any employment,
school attendance, freedom of abode, or travel.
Section
30
states
about Medical
confidentiality
All
health
24
39 states
about
Exclusion
from
credit
and
insurance
services All credit and loan services, including health, accident and life
insurance shall not be denied to a person on the basis of his/her actual,
perceived or suspected HIV status: Provided, That the person with HIV has not
concealed or misrepresented the fact to the insurance company upon
application. Extension and continuation of credit and loan shall likewise not
be denied solely on the basis of said health condition.
Section
40 states
about
Discrimination
in
hospitals
and
health
government
and
non-government
agencies
cooperate
foreign
involved
in
the
Coordinate
and
with
and
international
(5)
The
Secretary
of
the
Department
of
Labor
and
professionals;
(19)
Six
(6)
representatives
from
non-
professional
groups
and
the
six
(6)
non-government
organizations, they shall serve for a term of two (2) years, renewable upon
recommendation of the Council.
Section 46 Reports The Council shall submit to the President and to both
Houses of Congress comprehensive annual reports on the activities and
accomplishments
of
the
Council.
Such
27
annual
reports
shall
contain
SYNTHESIS
HIV/AIDS is a communicable disease which carries a social stigma in
our community. The prevalence of such disease is quite alarming and the
growing number of cases both globally and locally requires prompt attention.
Healthcare workers involved in the care of these patients must be aware of
the know-hows to provide the best, safe, effective and quality care. On the
other hand, this awareness is a good avenue to conduct a study. The
awareness of the healthcare providers should be taken into consideration for
designing an education program that would dynamically respond to their
learning needs. Likewise this would also be a leverage of a continuous
support on the learning and growth of the employees.
The study is similar to other studies done. It focused on assessing the
level of awareness of the hospital staff on HIV/AIDS and utilizing it as basis for
determining appropriate education program. The milieu of the study also so
make it similar with other studies since it was conducted in a hospital setting
since the primary concern are the health care providers in a caring institution.
The core aspect of the research conduct makes it different from other
studies. The initiative to assess the level of awareness as a basis for staff
education program makes it unique because it is institution based. And of
course the integration of concepts of different studies, theories and
literatures that made the researcher decided to pursue this study.
28
CHAPTER III
METHOD
This chapter presents the process and totality of procedures
through which this study was established. This part covered the discussion on
the research design utilized in this study. The sampling technique and the
research instruments used, the data gathering procedure and statistical
treatment.
RESEARCH DESIGN
The study used descriptive quantitative correlational research
design. In this type of research, the subjects are usually measured once and
it establishes only associations between variables. The design was conducted
to assess the level of awareness of hospital staff on HIV/AIDS.
PARTICIPANTS
The participants of the study are professionals involve in the care
of HIV/AIDS patients. These include medical consultants and residents,
Nurses, Nurse Assistants, Medical Technologist, Respiratory Therapist, Cardio
technicians, physical therapists, pharmacist, dieticians and other personnel
involved in the provision of care. The respondents were chosen using a non
probability purposive sampling technique.
SETTING
29
30
CHAPTER IV
RESULTS AND DISCUSSION
This chapter contains a thorough discussion of the findings of the
present study, which includes an in-depth analysis of the presented results
through the researchers observation, which are further supported by related
studies and readings.
SUB PROBLEM NO 1: DEMOGRAPHIC PROFILE OF THE RESPONDENTS
Table1: Age Distribution
AGE
20-30
31-40
41-50
51-60
years old
years old
years old
years
PERCENTAGE
51.40%
26.40%
18.00%
4.20%
31
of 51.40%
belong to the age bracket of 20-30 years old and the lowest percentage of
4.2% belong to the age group of 51-60 years of age. Data suggested that the
age group of the working population is well represented. Age of the
respondents may be one of the factors to consider in assessing their level of
awareness. We can therefore speculate that the ability to attend to important
information will also change with their age due to changes in the cognitive
ability and these will be more apparent as task complexity increases,
(Bolstad, 2001).
Analyzing
further,
the
highest
percentage
of
51.40%
are
the
respondents who belong to the age group of 20-30 years old. It can be
construed that most of the respondents are infants in professional practices
since the working age in our country starts at 20 years old and above
depending on their degree. Being young in professional practice, it may imply
that they may have lesser experience in the care of HIV/AIDS patients that
may limit their awareness in the said condition. Though the respondents have
foundational knowledge about HIV/AIDS during the completion of their
degree, it is different when you encounter these concepts in the practice.
On the other hand, the age group that garnered the lowest percentage
of 4.2% is 50-60 years old. This age group is said to be near retiring stage.
This may imply two things. First is that this age group may have lesser
updates on the current trends and practice on the care of HIV/AIDS patients
and second is, this age group may be experienced in the care of HIV/AIDS
patients since they are the elders of practice. These two implications may or
may not affect the level of their awareness on HIV/AIDS based on the criteria
identified by the researcher.
PERCENTAGE
5.6%
4.2%
13.9%
33.3%
6.9%
8.3%
2.8%
11.1%
5.6%
6.9%
1.4%
PERCENTAGE
59.7%
20.8%
19.5%
33
MEAN
INTERPRETAT
SCORE
2.22
ION
Moderate
Awareness
2.72
Awareness
2.67
Extensive
Awareness
2.69
Extensive
Extensive
Awareness
2.71
Extensive
Awareness
course of treatment
TOTAL
2.60
Extensive
MEAN
Awareness
Legend: 1.0-1.66= partial awareness; 1.67-2.33= Moderate Awareness; 2.343.00=Extensive Awareness.
symptoms and is suspected with HIV or AIDS for screening. Based on the
findings, it may be construed that the respondents have an awareness of the
importance of screening patients with presenting signs and symptoms. Early
detection of HIV/AIDS is very important in the course of treatment. HIV
Testing is voluntary, confidential and anonymous, with pre and post-test
counselling, (PNAC, 2013). It can also be deduced that the respondents have
an awareness of the responsibility of the physicians to request for screening
on suspected patients upon their consent. Studies have shown that most of
the diagnosed cases of HIV/AIDS are detected in healthcare institutions where
patients infected by the virus sought for treatment.
On the other hand, the specific item that obtained the lowest mean of
2.22 with an interpretation of moderate awareness is Patient with CD4 T cell
count less than 350 and has developed complications shall be admitted in a
health care institution. The data suggested that though it garnered the lowest
mean still respondents have a moderate awareness on it. CD4 cells are type
of white blood cell that fights infection. It is one of the important parameters
that indicates the stage of HIV disease, guides treatment, and predicts how
the disease may progress. It is through keeping the CD4 count high can
reduce complications of HIV disease and extend your life (WebMD, 2013).
Based on the findings, the respondents are aware about the relevance of
determining CD4 count in the progression of HIV/AIDS, has a background on
its normal value and how this value is important in determining admission of
patients. In this manner, it implies that as healthcare workers their awareness
on CD4 counts relevance to HIV/AIDS could contribute for the provision of
effective and quality care.
Moreover,
admission
awareness
on
HIV/AIDS
is
necessary
in
determining the course of care and treatment for the infected patients.
MEAN
INTERPRETAT
SCOR
ION
E
2.11
Moderate
Awareness
2.50
Extensive
Awareness
35
2.64
Extensive
Awareness
2.56
Extensive
be immunocompromised
There is no cure for HIV and AIDS but Anti retroviral
2.56
Awareness
Extensive
Awareness
2.47
Extensive
MEAN
Awareness
Legend: 1.0-1.66= partial awareness; 1.67-2.33= Moderate Awareness; 2.343.00=Extensive Awareness.
Table 5 presents the mean and interpretation of the level of awareness
of the respondents on HIV/AIDS based on disease process. As shown in the
table, the obtained general mean is 2.47 with an interpretation of extensive
awareness. Data suggest that the respondents are aware of the definition,
mode of transmission, condition and the treatment options of HIV/AIDS. It
implies that the respondents are able to provide safe and effective care to the
patients. Also, the social stigma and fear of contact with infected patients
could be alleviated by this awareness of the respondents on the disease
process.
Analyzing further, the specific item under Disease process that
garnered the highest mean of 2.64 with an interpretation of extensive
awareness is the mode of transmission of the HIV/AIDS. HIV is transmitted in
human body fluids by three major routes: (1) sexual intercourse through
vaginal, rectal, or penile tissues; (2) direct injection with HIV-contaminated
drugs, needles, syringes, blood or blood products; and (3) from HIV-infected
mother to fetus in utero, through intrapartum inoculation from mother to
infant or during breast-feeding (Stine 155). According to the CDC, HIV is not
spread by tears, sweat, coughing or sneezing. Nor it is transmitted via a an
infected person's clothes, phone, driking glasses, eating utensils or other
objects that HIV- infected people have used that are free of blood (AISD.gov,
2012). Awareness on the mode of transmission of HIV/AIDS is very important
in the provision of safe and effective care. Cross contamination from the
patient to healthcare providers will be prevented. Likewise, hesitation on
patient contact as a barrier in providing quality care among the infected
patients is alleviated. Data is suggestive of the extensive awareness of the
respondents on the mode of transmission of the disease, which may imply
practice of transmission based precaution in the care of the infected patient.
On the other hand, the item that obtained the lowest mean of 2.11
with an interpretation of moderate awareness is AIDS is defined in any
diagnosed individual with CDU T Cell Count of <350 u/L based on DOH
36
Guidelines though it garnered the lowest mean still, the respondents rated it
with moderate awareness. This implies that the respondents are aware about
the definition of AIDS and how it differs from HIV. Since AIDS and HIV are not
interchangeable terms. In order for a disease to be understood, a clear
definition and defining characteristics must be known. In this matter, the
respondents are aware of the diseases definition which may give them clear
concept about the disease.
Moreover, the definition of AIDS should be clearly understood and the
difference of it from HIV should be determined.
Table 6: Level of Awareness on Care Management
CARE MANAGEMENT
MEAN
INTERPRETAT
SCOR
ION
E
2.62
Extensive
workers
shall
observe
reverse
Awareness
2.48
Extensive
Awareness
2.56
Extensive
Awareness
2.47
Extensive
2.53
Awareness
Extensive
spiritual
counselling
are
Awareness
2.53
Extensive
2.29
Awareness
Moderate
2.50
Awareness
Extensive
MEAN
Awareness
Legend: 1.0-1.66= partial awareness; 1.67-2.33= Moderate Awareness; 2.343.00=Extensive Awareness.
the care provision. It implies that through this awareness the respondents
may render effective management to the HIV/AIDS patients
Analyzing further the specific item that obtained the highest mean of
2.62 with an interpretation of extensive awareness is Prevention of
infection/complication is one of the primary concerns of treatment in HIV and
AIDS patient. Patients with human immunodeficiency virus (HIV) infection
often develop multiple complications and comorbidities. Opportunistic
infections should always be considered in the evaluation of symptomatic
patients with advanced HIV/AIDS, although the overall incidence of these
infections has decreased, (Chu, Carolyn, et.al. 2011). HIV/AIDS is an
immunologic disorder which attacks the CD4 T helper cells in the body which
fight against infection. The decrease in CD4 T helper cells places the
individual to be susceptible to infection and opportunistic diseases. The
awareness on managing the disease through prevention of infection warrants
alleviation of further complications. This awareness implies the provision of
care to give emphasis on the preventive aspect thus precautionary measures
could be determined and established.
On the other hand, the specific item under management that obtained
the lowest mean of 2.29 with an interpretation of moderate awareness is All
patient died with AIDS related complications shall be securely covered with
specialized identification tag though this item obtained the lowest mean still
the respondents have moderate awareness on it. As part of immediate
postmortem
care,
deceased
persons
should
be
identified
and
that
38
MEAN
INTERPRETAT
SCORE
2.25
ION
Moderate
2.53
Awareness
Extensive
Awareness
management.
All healthcare workers shall observe the right of
2.61
Extensive
2.67
Awareness
Extensive
Awareness
2.40
Extensive
2.49
Awareness
Extensive
be done.
TOTAL
MEAN
Awareness
Legend: 1.0-1.66= partial awareness; 1.67-2.33= Moderate Awareness; 2.343.00=Extensive Awareness.
Table 7 presents the mean distribution and interpretation of awareness
of the respondents on HIV/AIDS based on the institutional policy. As shown in
the table, the obtained general mean is 2.49 with an interpretation of
extensive awareness. Data suggest that the respondents have an awareness
on the existing institutional policy on HIV/AIDS. Thus observance of this
framework of provision of care shall be ensured.
Analyzing further, the item which obtained the highest mean of 2.67
with an interpretation of extensive awareness is Needle stick injury and body
fluid exposure incidents from patients with HIV/AIDS shall be reported
immediately to Infection Control Staff. This implies that the respondents
have extensive awareness of their responsibility to report needle stick injuries
to determine future course of actions. In this matter cross contamination to
the health care providers could be prevented. Because of the environment in
which they work, many health care workers are at an increased risk of
accidental needle stick injuries (NSI). As a result, these workers are at risk of
occupational acquisition of blood borne pathogens such as HIV, hepatitis B
and C, and other diseases, (Sharma, R.,et., al., 2010). The most common
cross contamination of HIV/AIDS from patient to health care providers is
through needle stick injuries. Therefore, it is necessary to report the
occurrence of this injury to Infection Control Staff to determine course of
action and monitoring of the health care providers who have been afflicted
with injuries should be done.
39
On the other hand the specific item which obtained the lowest mean of
2.25 with an interpretation of moderate awareness is Mary Johnston Hospital
is capable in taking care of patients with HIV or AIDS. Data suggest that the
respondents considered the institutional limitations as per Mary Johnston
Hospital is not a specialty institution dealing with said diseases. Though it
gained the lowest mean, still the respondents have a moderate awareness
about this matter. It is deem important in considering facilities, staff
knowledge, skills and capabilities in taking care of person infected with
HIV/AIDS in this sense, the institution, as an accredited tertiary and training
hospital has the capacities to render care for HIV/AIDS patients but the
referral system to the specialty institutions for communicable diseases should
be observed.
Table 8: Summary of the Level of Awareness of the Respondents on
HIV/AIDS
LEVEL OF AWARENESS
MEAN
INTERPRETATI
Admission
SCORE
2.60
ON
Extensive
Disease Process
2.47
Awareness
Extensive
Management
2.50
Awareness
Extensive
2.49
Awareness
Extensive
2.52
Awareness
Extensive
GRAND
MEAN
Awareness
Legend: 1.0-1.66= partial awareness; 1.67-2.33= Moderate Awareness; 2.343.00=Extensive Awareness.
Table 8 presents the awareness of the respondents on HIV/AIDS based
on admission, disease process, care management and institutional policy as
identified by the researcher. As shown in the table, the grand mean obtained
is 2.52 with an interpretation of extensive awareness. This awareness of
health care providers on HIV/AIDS is pivotal in provision of care. It is also
relevant to the development of staff education program that will broaden
their understanding of the disease and strengthen their foundation in such
dealings and undertaking.
Analyzing further, admission gathered the highest mean of 2.60 with
an interpretation of extensive awareness. Data suggest that the respondents
identified their roles and responsibilities as frontline healthcare providers on
patient diagnosed with HIVAIDS. Understanding of the know-hows of
40
Admission
Disease Process
Management
Age
-.005
-.044
-.050
Int.
No or
Nature
Int.
Length
of
of
Work
Servic
-.233
e
-.112
weak
Int.
No or
negligibl
negative
negligible
relations
relations
relations
hip
hip
hip
No or
-.173
No or
-.134
No or
negligibl
negligibl
negligible
relations
relations
relations
hip
hip
No or
hip
No or
-.185
negligibl
negligibl
41
-.184
No or
negligible
Policies and
-.002
Procedures
relations
relations
relations
hip
hip
No or
-.237
hip
weak
-.174
No or
negligibl
negative
negligible
relations
relations
relations
hip
hip
hip
Table 9 presents the relationship between the Demographic profile of
the respondents and their level of awareness on HIV/AIDS. In general, all
variable identified are not significantly correlated.
On the Age, the obtained values, admission (p= -0.0005), Disease
Process (p= -0.044), Care Management (p= -0.50) and Institutional Policy (p=
-0.002) suggest that there are no significant relationship between age and
the level of awareness of the respondents on HIV/AIDS. Based on the findings,
age is not a determinant of the level of awareness of the respondents. It can
be attributed to the fact that it is through encounter that a person becomes
aware of the underlying concepts. It can be construed, that age is an
independent variable which does not create relationship or impact on the
level of awareness.
On the Nature of Work, the obtained values of Admission (p= -0.233),
Disease Process (p= -0.173), Case Management (p= -0.185) and Institutional
Policy (p= -0.237) suggest that nature of work is not significantly related to
the level of awareness of the respondents on HIV/AIDS. It is a fact that the
respondents represent different personnel who are involved in the care of
HIV/AIDIS patient. They vary from the nature of work and educational degree
and even to the training they have. One common denominator these
respondents have is that they render care to patients. The results of the
study imply that the level of awareness is not related or is not affected by the
Nature of work the respondents have. Though, there is a variation on it, still it
shows no correlation. This result may be strength of this study because it
delineates no biases in the selection of the respondents.
On the length of experience, the obtained values of Admission (p=
-0112), Disease Process (p= -0.134), Case Management (p= -0.184) and
Institutional Policy (p= -0.174) suggest that nature of work is not significantly
related to the level of awareness of the respondents on HIV/AIDS. Though the
respondents vary in their years of experience, it did not affect the level of
their awareness about AIDS. It implies that experience is not a contributory
factor to their level of awareness thus the variations in experience is not a
determinant. In the same way, the results of the study delineate experience
as a separate entity in the level of awareness of the hospital staff. Thus, an
42
Staff Education
Admissi
on
Disease
process
Care
Managem
ent
Institutio
nal
Policy
Program
43
To update with the latest trends and practice in the care of HIV/AIDS
patients.
Participants
All hospital staff involved in the care of HIV/AIDS patients.
Disease
Care
Institutional
Process
Management
Policy
Admission criteria
Causative
Holistic care of
Guidelines and
for HIV/AIDS
agent of
HIV/AIDS patient
procedures
patient
HIV/AIDS
Precautions and
Role of institution in
Screening and
Mode of
infection control
the case of
procedures for
transmission
practices
HIV/AIDS patients
Health education
Referral system of
and HIV/AIDS
HIV/AIDS patients
Counselling and
HIV/AIDS
Health care
Signs and
specialty
symptoms
institution for
HIV/AIDS
Complications
HIV/AIDS
44
of HIV/AIDS
Post mortem care
Treatment of
of HIV/AIDS
HIV/AIDS
Ethical issues of
HIV/AIDS
Materials Needed
1. Venue
2. Handouts
3. Technical needs
45
Person Responsible
1. HAC (HIV AIDS Committee)
2. Lecturer of each topic
3. Coordination with the Infection Control Committee
SAMPLE PROGRAM
DAY 1
TIME
7:30
8:00
8:15
8:30
9:00
8:00
8:15
8:30
9:00
12:00
12:00 1:00
1:00 5:00
DAY 2
7:30 8:00
8:00 12:00
TOPIC
Registration
Invocation
National Anthem
Opening Remarks
1. Admisison
a. Admission
criteria
for
HIV/AIDS patient
b. Screening and procedures
for HIV/AIDS
c. Health
care
specialty
institution for HIV/AIDS
Cofee Break
2. Disease Process
a. Causative
agent
of
HIV/AIDS
b. Mode of transmission
c. Signs and symptoms
d. Complications of HIV/AIDS
LECTURER
MROD
Dr. E.Caparro
MJH Choir
Dr. E. Duran
Dr. G.Pingol
Registration
3. Care Management
a. Holistic care of HIV/AIDS
MROD
Dr. C. Pasco
46
Dr.
Evangelista
T.
12:00 1:00
1:00 4:00
4:00 4:30
patients
b. Precautions and infection
control practices
c. Heatlh
education
and
HIV/AIDS
d. Counselling and HIV/AIDS
e. Post
mortem
care
of
HIV/AIDS
f. Ethical issues of HIV/AIDS
Lunch Break
4. Institutional Policies
Mr. Lester Naval
a. Guidelines and procedures
b. Role of the institution in
the
case
of
HIV/AIDS
patients
c. Referral
system
of
HIV/AIDS patients
Closing Remarks
Dr. D. Menorca
CHAPTER V
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
SUMMARY
The study aimed to assess the level of awareness of the hospital staff
on HIV/AIDS. It sought to answer the following problems. (1) What is the
demographic profile of the respondents when grouped according to age,
nature of work, length of experience? (2) What is the level of awareness of
the respondents on HIV/AIDS based on admission, disease process, care
management and institutional Policy? (3) Is there a significant relationship
between the demographic profile and the level of awareness of the
respondents on HIV/AIDS? (4) Based on the findings, what staff education
program can be proposed?
A descriptive quantitative correlational research design was utilized in
this study. In this type of research, the subjects are usually measured once
and it establishes only associations between variables. These include medical
consultants and residents, Nurses, Nurse Assistants, Medical Technologist,
47
average
mean
obtained
for
admission
is
2.60
with
an
reported immediately to the infection control staff. While the item that
obtained the lowest mean of 2.25 with an interpretation of Moderate
awareness was Mary Johnston Hospital is capable of taking care of patients
with HIV/AIDS.
The grand mean obtained for the level of awareness of the
respondents on HIV/AIDS is 2.51 with an interpretation of extensive
awareness.
CONCLUSIONS
The grand mean garnered on the level of awareness of the hospital
staff on HIV/AIDS is 2.51 which is interpreted as extensive awareness and
may imply provision of safe, effective and quality of care.
There are no significant relationships between the demographic profile
and level of awareness of the respondents which indicates acceptance of the
null hypothesis.
RECOMMENDATION
Based on the findings of the study and conclusions, the researcher
recommends the following
1. Adaptation of the proposed Staff Education Program for the institution
that will not only support the learning and growth perspective but also
ensuing quality, safe and effective care is rendered.
2. Inclusion of the non-medical staff in the education program.
3. Education program for Delphi Method to be a reference for further
studies.
4. Revising and reviewing of the Staff Education Program by the people
involved in implementation every year.
REFERENCES
Bolstard, C. A (2001) Situiation Analysis: Does it Change with Age?
Chu, C., et. Al., (2011). Complications of HIV/AIDS Infection: A system based
Approach. New York Albert Einstein College of Medicine, Yeshiva University
Fournier, PO,et., al. (2010). A Shift in Referring Patients for HIV/AIDS.
University of Massachussettes Medical School.
49
Jung, A. et.,al. (2010). Diagnosing HIV Related Diseases using CD4 Count as a
Guide
Khaido, J,A. Et., al. (2012). HIV/AIDS and Admission to Intensive Care Units: A
comparison of India, Brazil and South Africa. Southern African Journal of HIV
Medicine, vol 14, 110-203
Notsouldi, A. (2012). Clinical Guidelines for the Management of HIV/AIDS in
Aduly and Adolescent. Natinal Department of Health, South Africa
Obermeyer, SM and Osborn, M. (2007). The Utilization of Testing and
Counselling for HIV: A Review of Social and Behavioral Evidence. American
Journal of Public Health, 97(10), 1762-1774.
Sharma, R. et, al. (2010). A Study on the Prevalence and Response to NSI
among Healthcare Workers in a Tertiary Hospital in New Delhi India. Indian
Journal of Community Medicine,74-77
Tamilshima, N,et.,al. (2011). Risk of Infection Among Primary Health Workers
in the Western Development Region, Nepal: Knowledge and Compliance,
College of Health and Medical Science, AAI-DU India.
On line
www.google.com
www.yahoo.com
www.pubmed.com
Others
Republic Act 8504: Philippine AIDS Prevention and Control Act of 1998."
Philippine National AIDS Council: HIV/AIDS 101 Handout
G E R A L D O S O L O M O N P I N G O L , P T R P, M D
165-A
C.Dela
Paz
Pasig City, 1606
Street,
Caniogan,
jeremiah8330@yahoo.com
(+63922) 874-6465 / (02) 267-0029
50
CAREER OBJECTIVE:
To further develop the skills and knowledge that I have gained during my
educations, in the hope of being able to practice my chosen profession to the
best of my ability, in order to be a productive and beneficent person to the
environment, society, organization or institution I may involve myself in.
EDUCATION:
RESIDENCY:
Department of Medicine
Mary Johnston Hospital
1221 J. Nolasco St., Tondo, Manila
November 2010 November 2013
POST GRADUATE
Post-Graduate Internship
Ospital Ng Maynila Medical Center
Roxas Blvd. cor Quirino Ave., Manila
May 2006 May 2007
Doctor of Medicine
Pamantasan ng Lungsod ng Maynila
Intramuros, Manila
Graduated April 2006
TERTIARY
Bachelor of Science in Physical Therapy
Far Eastern University Dr. Nicanor Reyes Medical
Foundation
Nicanor Reyes St., Morayta, Manila
Graduated April 1999
SECONDARY
Arellano Univesity Andres Bonifacio High School
Pag-asa St., Caniogan, Pasig City
Graduated April 1994
PRIMARY
Caniogan Elementary School
Kalinangan St., Caniogan, Pasig City
Graduated April 1990
EXAMINATION:
51
WORK EXPERIENCE:
November 2008 to June 2009
Ortigas
Ave.,
Greenhills
East,
Mandaluyong City
Position Held: Administrative Clerk
Dr.
Geraldo
S.Pingol
APPENDIX A
RESEARCH QUESTIONNAIRE
Name(optional):______________________________
Date:_____________________
Dear Respondent,
52
DEMOGRAPHIC PROFILE
Age:
[ 20-30
[
Nature of Work:
[
Assistant
31-40
41-50
Consultant
51-60
Resident
Nurse
Respi Therapist
Pharmacist
Nurse
Med Tech
Rad Tech
Dietician
Physical Therapist
Others
please specify_____________
Length of Experience:
1-5years
5-10 years
more
than 10 YEARS
II. AWARENESS ON HIV/AIDS
Use this legend to answer the following questions
3- Extensive Awareness- full knowledge on the concept presented
about HIV/AIDS
2- Moderate Awareness- average knowledge on the concept presented
about HIV/AIDS
1- Partial Awareness- minimal knowledge on the concept presented
about HIV/AIDS
53
INDICATORS
A. ADMISSION
Patient with CD4 T cell count less than 350 and has
developed complications shall be admitted in a health care
institution
Attending physician shall advise patients with signs and
symptoms and is suspected with HIV or AIDS for screening
Patient diagnosed (with laboratory result) with HIV or AIDS
shall be referred to specialized healthcare institution
Patient diagnosed with HIV or AIDS shall receive appropriate
precautionary
measures
based
on
the
condition
and
primarily
by
unprotected/penetrative
sexual
room
APPENDIX B
LETTER OF VALIDATION
55
Respectfully yours;
___________________________
Geraldo S. Pingol, MD
Medical Resident, MJH
Researcher
September 10, 2013
Nurse Educator
Mary Johnston Hospital
Respectfully yours;
___________________________
Geraldo S. Pingol, MD
Medical Resident, MJH
Researcher
September 10 2013
Administrative Aide VI
Philippine National AIDS Council Secretariat
Department of Health- Manila
Respectfully yours;
___________________________
Geraldo S. Pingol, MD
Medical Resident, MJH
Researcher
APPENDIX C
INFORMED CONSENT FOR THE PARTICIPANTS
58
Date_________________
I,
Mr./Ms./Mrs.______________________________
am
allowing
the
APPENDIX D
MEAN COMPUTATION
59
Descriptive Statistics
N Min Ma Mean
x
Patient with CD4 T cell count less than 350 and has
developed complications shall be admitted in a health
care institution
Attending physician shall advise patients with signs and
symptoms and is suspected with HIV or AIDS for
screening
Patient diagnosed (with laboratory result) with HIV or
AIDS shall be referred to specialized healthcare
institution
Patient diagnosed with HIV or AIDS shall receive
appropriate precautionary measures based on the
condition and presenting signs and symptoms
Patient diagnosed with HIV and AIDS shall receive non
discriminatory care and confidentiality during course of
treatment
AIDS is defined in any diagnosed individual with CD4 T
cell count of <350 u/l based on DOH Guidelines.
Human Immunodeficiency Virus is the causative agent of
AIDS
Transmitted primarily by unprotected/penetrative sexual
intercourse, infected blood and other blood products and
infected mother to child transmission.
All patients diagnosed with HIV or AIDS are
immunocompromised
There is no cure for HIV and AIDS but Anti retroviral
therapy suppresses multiplication of virus and prolongs
life of a person with HIV or AIDS.
Prevention of infection/complication is one of the primary
concerns of treatment in HIV and AIDS patient
All healthcare workers shall observe reverse isolation and
Standard Precaution all the time in taking care of patient
diagnosed with HIV or AIDS
Wearing of Personal Protective Equipment such as
gloves, gown and protective eyewear shall be the first
line of defense against direct blood exposure from
infected patient
Meticulous terminal cleaning shall be done to room
evacuated by HIV/AIDS patient
Health education shall be provided to relative/s or
significant others who are taking care of patient with
HIV/AIDS.
Psychological and spiritual counselling are essential to
patient with HIV/AIDS patients
All patient died AIDS related complications shall be
securely covered with specialized identification tag.
Mary Johnston Hospital is capable in taking care of
patients with HIV or AIDS.
Patients diagnosed with HIV or AIDS shall receive nondiscriminatory
Medical-Surgical
and
nursing
management.
All healthcare workers shall observe the right of
confidentiality of patient with HIV or AIDS
Needle stick injury and body fluid exposure incidents
from patients with HIV or AIDS shall be reported
immediately to Infection Control Staff
Post exposure prophylaxis and management shall be
done.
60
1.0
0
1.0
0
3.0
0
3.0
0
2.111
1
2.500
0
1.0
0
1.0
0
1.0
0
3.0
0
3.0
0
3.0
0
2.527
8
2.291
7
2.250
0
7
2
Valid N (listwise)
APPENDIX E.
61
of