Journal of the American Psychiatric Nurses Association

The presence of a psychiatric illness increases the risk of exposure to HIV and disease complications; however, effective treatments have substantially reduced mortality in adults with HIV. Despite such effective treatments, nearly half of adults with HIV experience neurocognitive deficits that can affect job-related and everyday tasks, thus reducing their quality of life. This article provides an overview of the context in which neurocognitive deficits occur in adults with HIV; it also includes implications for treatment and mitigation of such neurocognitive deficits. Understanding the underlying neurocognitive changes related to HIV can help psychiatric nurses provide better care to patients that may improve medication compliance and everyday functioning.

BACKGROUND: Inpatient psychiatric nurses are a large workforce, but their work is poorly articulated and thus poorly understood outside of the professional inpatient community. OBJECTIVE: To learn how inpatient psychiatric nurses depict their work, define important aspects of their role, and view the impact of the unit environment on their clinical practice. DESIGN: Metasynthesis of research that has focused on the ideas and perceptions of inpatient psychiatric nurses around their role and practice on inpatient psychiatric units. RESULTS: Three themes emerged from the analysis; the first was an umbrella for three important aspects of nursing work: the nurses’ efforts to forge engagement with patients; their activities which maintained the safety of the unit and interventions nurses viewed as educating/empowering patients. The second theme captures the conditions that enabled nurses to do this work such as a cohesive nursing team and their sense of self-direction in their role. The final theme centers on difficulties nurses encountered in enacting their role which included multiple responsibilities for patient care and management of the milieu; intense work often with low visibility and scant support within the organization. CONCLUSIONS: Nurses need to articulate their practice so they can assert for the staffing and resources needed to keep units safe and promote patients’ well-being, strive toward quality, and promote the development of the specialty.

BACKGROUND: Lifetime histories of sexual and physical abuse have been associated with increased HIV-risk sexual behavior, and some studies have identified other variables associated with these relationships. However, there is a dearth of literature that has critically examined abuse histories and HIV-risk sexual behavior in relation to these other variables. OBJECTIVES: Predictors of HIV-risk sexual behavior were analyzed among a sample of ex-offenders who were completing inpatient substance dependence treatment to identify factors related to increases in HIV-risk sexual behavior beyond that of abuse histories. DESIGN: Hierarchical linear regression was conducted to examine sociodemographic characteristics, recent substance use, and current psychiatric problem severity in addition to lifetime histories of sexual/physical abuse in a cross-sectional design. RESULTS: Gender, substance use, and psychiatric problem severity predicted increases in HIV-risk sexual behavior beyond what was predicted by abuse histories. Proportionately more women than men reported abuse histories. In addition, significantly more unprotected sexual than safer sexual practices were observed, but differences in these practices based on lifetime abuse histories and gender were not significant. CONCLUSIONS: Findings suggest recent substance use and current psychiatric problem severity are greater risk factors for HIV-risk sexual behavior than lifetime abuse histories among persons who have substance use disorders.