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An HIV Symptom Management Intervention for African-American mothers - Essay Example

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The latest statistical information clearly shows that the HIV infection has become a worldwide epidemic. The fact that this epidemic has reached the four corners of the world and the effect it has on human existence, has prompted a worldwide effort not only to discover a treatment for the infection, but also to improve the lives of the many unfortunate ones that have been infected…
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An HIV Symptom Management Intervention for African-American mothers
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Critique of a quantitative study Running head: CRITIQUE OF A QUANTITATIVE STUDY Critique of a quantitative study: "An HIV Symptom Management Intervention for African-American mothers"
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The latest statistical information clearly shows that the HIV infection has become a worldwide epidemic. The fact that this epidemic has reached the four corners of the world and the effect it has on human existence, has prompted a worldwide effort not only to discover a treatment for the infection, but also to improve the lives of the many unfortunate ones that have been infected. This study is oriented towards the improvement of life and attitude of the infected towards the infection, particularly in the population that bears the brunt of the infection, such as the women in childbearing years, which are in unfavorable social and economic position.
The main purpose of this study was to "determine the efficacy of an HIV self-care symptom management intervention in reducing emotional distress and improving health among low income African American mothers with HIV." The study was based on the Maternal HIV Self-Care Symptom Management framework. The framework was adapted from the University of California-San Francisco model for symptom management as well as the current literature and studies on African-American women with HIV.
As in most studies, a control and an intervention group were formed. In both groups, the HIV infected African-American women reported low income and were mothers of at least one child under the age of 9. 17 grandmothers were also involved in this study, 8 of which were placed in the intervention group. In the intervention group, the implemented procedures regarding the Maternal HIV Self-Care Symptom Management framework were the same for all subjects. The procedures regarding data collection were also the same. Data was collected during 3 data collection points: once during the enrollment of the patients in the clinics, and twice primarily in their homes. Between data collection points, the mothers were telephoned twice, in order to help with retention. Telephone numbers of neighbors and relatives were also taken to help keep track of the mothers that might move or in any way impair the ability to come into contact with them, but nevertheless, the researchers state that because of the mothers' secrecy about their HIV infection, as well as other complex social problems, in the end it was impossible to keep in touch with some of the HIV infected women.
Respective clinics and agencies have approved the methods used to collect and classify the data. For measuring emotional distress, several methods were implemented. Such are the Center for Epidemiological Studies Depression scale, the Profile of Mood States scale, the Demi HIV Stigma scale and the HIV Worry scale. Regarding health and health quality, self-reporting with the Health Questionnaire and the Medical Outcomes Survey-HIV were used.
Data collectors in this study were specifically trained and followed a data collection protocol. They were also unaware of the woman's status, as to avoid unpleasant social side effects, primarily stigma.
Although approved by a variety of respective clinics and agencies, the researchers themselves explain that certain methods were insufficient in adequately presenting the effects of the HIV self-care program in the intervention group. They consider the methods used to evaluate emotional distress as sufficient, but they believe that the methods used to study the impact of the HIV self-care program on the mother's health were inadequate. The reasons for that are the facts that the number of infections, such as pulmonary or gastrointestinal infections, during the study were self reported with the Health Questionnaire and the MOS-HIV measures only global aspects of health.
Another problem that this study faced is attrition. The reasons for attrition are not clear in this study, but it is believed that social factors, such as stigma and substance abuse had a major influence. The lack of an attention-only group is also considered another limitation. It is stated that it is impossible to determine the effect of the attention given by the nurses that came into contact with the mothers and the intervention as two separate factors. The results also change over time, since the statistical methods are based on the women who completed the study, but not on those who left it.
Nevertheless, it is concluded that this study "may lead future work with this at-risk population to reduce their health disparities in the context of HIV". It is also concluded that future interventions should focus more on mental health issues and that the maternal symptom management intervention "has potential as a case management or clinical intervention model for use by public health nurses visiting the home or by advance practice nurses who see HIV-infected women in primary care of specialty clinics." It also states that the this intervention can be used by other African-American women who have chronic diseases such as diabetes.

Reference:
1. Miles, Margaret Shandor; Davis, Diane Holditch; Eron, Joseph; Black, Beth Perry; Pedersen, Cort; Harris, Donna A.; "An HIV Symptom Management Intervention for African-American mothers"; Nursing research, November/December 2003 Vol. 52, No.6 Read More
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