1. Prepare for Final Paper
Topic: Ethical Conduct of Research (Outcomes 1,6): 20 hours
- Select a healthcare related research study. Identify the sample population. Analyze and critique the study to identify if sampling method reflects ethical principles including consent, conditions of the participants, study approved by IRB,
- Minimum 20 pages excluding title and reference page.
- APA format
Final paper will be submitted through TURNIT in™.
Papers MAY NOT show evidence of similarity beyond 17% excluding reference pages!
Papers that reflect over 17% SIMILARITIES will be assigned a ZERO. There is NO opportunity for late or re-submitted work!
MINIMUN 6 REFERENCES, from 2014 to 2019
YOU WANT ADDED MORE CRITIQUE QUESTION IF YOU WANT TO COMPLET THE 20 PAGES
FOLLOW THE TERM TEMPLATE APA PAPER TEMPLATE 6th
Title in Upper and Lower Case
Your Name
Miami Regional College
MSN 5300: Advanced Nursing Inquiry and Evidence Based Practice
Title of Paper in Upper and Lower Case (Centered, Not Bold)
Paragraph one is the introduction to the paper. It should begin with something that will grab the reader’s attention and provide a citation to support your opening sentence (Norwood, 2002). Next, support that opening sentence with discussion or explanation with one or multiple sentences which will make up the body of the introductory paragraph. The last sentence of the introduction should highlight areas to be covered in the paper. APA success requires knowledge of the format and skill in concise, clear written communication.
Research Study Overview
This section is where you provide a summary of the research study being critiqued? What were the goals of the research? What health care related issue was addressed? Is it a good/feasible study to apply in clinical practice? Was a practical study, from a financial aspect? Use as many paragraphs as needed to cover the content appropriately.
Ethical Issues in Research
Use this paragraph to provide feedback/history on ethical issues on research.
Protection of Human Rights
What are the five human rights that must be protected during research/investigation? What do they stand for? How do they relate to this research study? Were any/all of the human rights protected in the duration of the research study in question? Use as many paragraphs as needed to cover the content appropriately. Ladkjfasdojfadfoasidfjaod. Aff fasdfjasod faosdijfaosdjfaodjfasdjdklfljkadf
Adpapsdufas dfoaidfoakds. Lijaofijasdijfalsd adifasdiufa osdifuaosdfaisdufad fjsdif asdoif. Poiofapdfiasdpfoi asdpf poifpadofiadf ;lskdm;vokmae ;obvkmse;rokmgageo sivjnseariun v;osdr g;I s;bnofnb;o aiermf ;sokdfmb;osiermg oskmfbopvsidfm b;mseoribgmseoribg nbsodfjbvs;ervjnnbs;odrkmfbv;oaerkmv sodbmsnoe;rif nvpsoeonvrsep.
Sampling Method
What was the sampling method used, how did the researchers choose the subjects for participation? What other sampling methods could have worked better, provided better results? Does the sampling method used reflect ethical principles, was it a fair process? Is the population in question a vulnerable population, and if so were there special considerations taken? Use as many paragraphs as needed to cover the content appropriately.
Ina;osif;oaiwe mfasodifmaow vmoadifmgo ;aodifgi ;aodfvmao vma;o nvaoejjngfpsoinfv bnaeornfgvpesunfvpasjnvpadjfnvpajnvpoadf vpoasjdfnv[oiadsno[cv afnvpainfvpaw9unfvpasdj avmaojf;oaskdjfoaskdmv;lkamdsfovmewpoigfnasdock apovmaporingrpaio
Informed Consent
What is an informed consent? In regards to this research study, was it obtained, if appropriate? If a consent was part of the study, was it obtained properly? Did the participants assent? If participants unable to consent, were they not competent, did a caregiver consent? Were participants provided full/complete detailed information or was it a short version? What components did it include? Use as many paragraphs as needed to cover the content appropriately.
Mv;aoskdkjfngaogna;o aosngfva;osing; aodkfkngvo;sdjfnv ngvsoerphngea;oi aojgnjvspdofinv;sdjfvn;sdozjfvns; vnaoeriengpa9eru vnapesring[earoi vnaeroinmg[eaoirm vna[eroimgfaoskmf;szlkmf ngae[iorng[awekmf mvaoeor[imges’aripom d;mokgm ae
Ethical Scientific Integrity
What are the credentials of the researchers? Did the researchers fabricate data, publish errors/ publish correction? Is there evidence of plagiarism? Use as many paragraphs as needed to cover the content appropriately. Ifnagw;oeifnaw;eo vo;ianener;ai nvzodsianvaei;or nag;oekermf naipeieufn ;aoidfvim; ;aodkzkfnv;azdfskjvn.
IRB
This section is where you will discuss all the information available (or lack thereof) regarding the IRB. Was the research study approved by an institutional review board? If not, why not? Was a research proposal submitted for approval by an IRB? Use as many paragraphs as needed to cover the content appropriately Adkjfasdojfa dfoasidfjaod. Aff fasdfjasod faosdijfaosdjfaodjfasdjdklfljkadf.
Adpapsdufas dfoaidfoakds. Lijaofijasdijfalsd adifasdiufa osdifuaosdfaisdufad fjsdif asdoif. Poiofapdfiasdpfoi asdpf poifpadofiadf.
HIPPA
What is HIPPA and how does it apply to a research study? Was the research conducted using database information, and if so, was the health information protected? How was it protected? Was any data de-identified? Were participants provided pseudonyms or assigned numbers? Use as many paragraphs as needed to cover the content appropriately.
Benefit to Risk Ratio
Discuss if a benefit to risk ratio was calculated and how? Did it provide am honest estimation? What is your opinion about the outcome of the study and the potential benefits? Can it have a positive impact on the individual, how about in the community? Use as many paragraphs as needed to cover the content appropriately. Ladkjfasdojfadfoasidfjaod. Aff fasdfjasod faosdijfaosdjfaodjfasdjdklfljkadf
Adpapsdufas dfoaidfoakds. Lijaofijasdijfalsd adifasdiufa osdifuaosdfaisdufad fjsdif asdoif. Poiofapdfiasdpfoi asdpf poifpadofiadf.
Conclusion
Most papers should end with a conclusion or summary, which consists a short description of the key points of the paper. It should be concise and contain little or no detail. No matter how much space is left on the page, the References are always on the next page.
References (centered, not bold)
American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.
You next reference.
Appendix A(centered, not bold)
This is the article to analyze, and critique
Resilience of people living with HIV/AIDS in Indonesia: a phenomenological study Kumboyono Kumboyono, Cathrine T Sukotjo, Yulia C Lestari, Dini P Wijayanti Faculty of Medicine, Brawijaya University, Malang City, Indonesia
Abstract Background: HIV/AIDS is one of the most continuously developing communicable diseases in the world. The number of people diagnosed with HIV/AIDS is currently increasing worldwide, including in Indonesia. People living with HIV/AIDS (PLWHA) fall into a state of crisis, which signifies the difficulties of living with chronic pathological conditions. Resilience is one unique phenomenon observed among PLWHA in Indonesia, which further reveals the results of current health management and expectations of PLWHA for better health programmes. Objective: This study aims to explore the mechanism of resilience in Indonesian PLWHA and the factors affecting that particular mechanism. Method: This is a qualitative phenomenological study. Twenty-seven PLWHA were selected from a primary healthcare centre in Malang City, East Java, Indonesia. Participants were selected from various economic, social, and diverse sexual orientation backgrounds. Participants were informed about the conduct of the research and consented to take part in the interview. Results: Diagnosis of HIV/AIDS signifies the beginning of psychological and social distress, the spiritual reaction after being diagnosed is a state of crisis, and the coping mechanism and understanding of life by PLWHA is a definite sign of resilience. Conclusion: HIV/AIDS is a chronic progressive disease and induces the distinct mechanism of resilience in Indonesian society. Future healthcare and management of PLWHA will be required to support and motivate this mechanism to guide PLWHA into a more comfortable and healthy lifestyle.
Keywords: HIV/AIDS, healthcare, meaning of life, resilience, spiritual
Introduction HIV/AIDS is one of the most continuously developing communicable diseases in the world among other communicable diseases, such as tuberculosis, affecting people diagnosed with immunocompromised conditions. The number of people living with HIV/AIDS (PLWHA) worldwide is currently increasing with a significant incline among Asian countries, especially the Asia and Pacific region [1]. In Indonesia, the number of PLWHA is in synergy with the increasing pattern of an Asian epidemic, with 300,000 estimated new infections in 2015 [2]. Having been diagnosed HIV-positive, novel psychological and social disturbances are certainly experienced by PLWHA in general. As reported by Dahlui [3], PLWHA are a vulnerable community experiencing a psychosocial burden, together with physical discomforts. Another study from India also reported the effects of stress and the psychosocial burden suffered by people diagnosed with HIV/AIDS [4]. Although there is a mechanism of resilience to chronic diseases, this group of people are still under enormous pressure to survive the harmful pathological progress of HIV/AIDS and the opportunistic infections that follow. A lack of psychosocial support from family, for example, loss of parents and caregivers at an early age, adds to this pressure [5]. Biological mechanisms of survival under the duress of chronic diseases, such as HIV/AIDS or tuberculosis, can result in two outcomes. People living with the chronic disease will experience the entire physical
andpsychologicaldisturbancesafterperseveringunder similar clinical manifestations for a long period of time. One outcome results in depression and loss of spiritual motivation that may lead to mortality [6,7]. The other is the mechanism of resilience, the most distinct phenomenon will eventually lead to survival while experiencing deteriorations of physical and psychological well-being [8,9]. Qualitative phenomenological studies exploring the mechanism of resilience in PLWHA and its other factors have not been the focus of researches in Indonesia. The purpose of this study is to explore the nature of resilience amongpeoplediagnosedwithHIV/AIDS.Themeaning of experiencing an HIV/AIDS burden, physically and psychologically, and also the social responses of PLWHA were recorded and reported in this study. This research is important as it will allow health professionals to identify the support required by PLWHA.
Method Design of study This study is a classical phenomenological study with an analytic descriptive approach. This approach is used to understand the meaning of the patient’s life after being diagnosed with HIV/AIDS. This study obtained an ethical health licence from the Ethical, Health, and Research Commission of Medical Faculty, Brawijaya University, Malang City (Ref: 261/EC/KEPK/04/2014) and was upheld according to the Helsinki Declaration of 1975.
HIV Nursing; 2018: 18(1): 4–7 Research
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Population and sample For this study 27 PLWHA were selected by snowball sampling from Malang City, Indonesia. Criteria for selection were that participants had been diagnosed with HIV/AIDS for at least 1 year and be aged 18–40 years. The benefit to participants in this research was anincreaseinawarenessoftheimportanceofaccepting a diagnosis of HIV/AIDS in order to remain productive. They were selected according to achieved saturation of data [10]. Participants consisted of 13 men and 14 womendiagnosedwithHIV/AIDSacquiredfromvarious modes of transmission, such as, multiple sexual partners: 17 participants; men who have sex with men: four participants; and injectable drug users: six participants. Participants were aged 25–34 years and lived in the areas of Malang city, Batu city, and Blitar municipality. The educational background of participants ranged from primary school, junior high school, senior high school, and vocational school. The marriagestatusofparticipantsvariedfrombeingsingle, married, and widowed. The occupational backgrounds of participants were freelancers, private-organisation workers, and homemakers.
Data collection Instrumentsusedtoanalysethedataweretheinterview process and the participative observation of researchers. Data were collected at the participants’ homes through private interviews and there were no repeat interviews. Data were recorded in the form of audio files (MP3) and the duration of interviews was 28–42 minutes. A community health nursing specialist who is a registered practitioner and a lecturer at Brawijaya University conducted the interviews
Data analysis Analysis of qualitative data was accomplished by creating a transcript of interview recordings and notes during the interview. Manual analysis of the data was carried out according to the Colaizzi method [11]. Analysing qualitative data manually provides more precise results because the data contain information on attitudes, values, and feelings that cannot be detected by software The procedure was as follows: 1. Read all transcribed verbatim to gain a whole sense of the resilience experience; 2. review each transcript and extract significant statements; 3. explain the meaning of each significant statement; 4. organise the formulated meanings into clusters of themes; 5. integrate results into an exhaustive description of the phenomenon under study; 6. formulate an exhaustive description of the phenomenon in uniquivocal statements of identification as far as possible; and 7. ask participants about the findings thus far as a final validating step. The results of the analysis were based on keywords, categories, and themes and subthemes of qualitative
variables of the study. There were two themes (phases) in this research and two subthemes from each.
Results According to the results of qualitative analysis of data, the mechanism of resilience of PLWHA in Malang city can be divided into two phases: crisis phase and survival phase. The crisis phase can be described by examining the psychological and social stresses of a lifestyle acquired by PLWHA. Meanwhile, the survival phase is explored by asking about the changes in the spiritual pattern and future arrangements of PLWHA. Each theme is discussed thoroughly and described qualitatively according to specific subthemes. Crisis phase of people living with HIV/AIDS The crisis phase of PLWHA is described through two subthemes: psychological and social stress. Psychological stress: the psychological response of PLWHA after being diagnosed with HIV/AIDS can be illustrated by anxiety and anger conditions. Anxiety aroseinparticipantsconsideringtheuncertaintyoftheir lives, which could end in morbidities and mortalities. Anger is also one of the psychological responses after participants pass the initial shock of being diagnosed with HIV/AIDS. Some of them accuse God for their sickness and acquire deep enmity against those who they perceive as responsible for transmitting the disease: Now I am afraid, anxious, worried that my sickness will result in me being sick all my whole life or I might die someday.IthinkGodnolongerlovesme,Ihadthisperiod of being angry with God, but now I realised and widely opened my heart … I’m open to taking the advantages of my situation …, God is the almighty, God will be the one who heals me. (Patient [P] 5, male, 25 years) Social stress: Feeling isolated from the social environment is perceived by participants to be due to social stigma. Social stigma arises as an impact of incorrect perceptions of society about PLWHA and HIV transmission, in the forms of societal embarrassment, labeling, prejudice, social isolation, fear of being isolated and being shunned by society. Whereas some participants suffered from discrimination, several others admitted that they also received acceptance from people living around them, depending on the openness and educational level of their communities: People gossip about me … both my own family and the society … many say that it’s the burden I have to bear alone as a consequence of what I did. If I want to work, Iwillmostsurelyberejectedbecauseofthedisease.But luckily, now there’s no pressure from society, in this area, it’s no longer a taboo subject. (P21, female, 28 years) Survival phase of life of people living with HIV/AIDS The survival phase of PLWHA can be divided into these following two subthemes: changes of spiritual pattern and future arrangements. Changes to spiritual pattern: changes of spiritual meaning experienced by participants occur in the form
Research HIV Nursing; 2018: 18(1): 4–7
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of spiritual closeness to God through surrendering all to God, repentance, diligence of prayers, and worship: I don’t want to grief for too long … because everything that’shappeningrightnowisGod’swill,ifGodgivesme the disease, God will be the one giving me medicine. Now I’m diligently reciting prayers, before my illness, I rarely do it. I can now read the Quran which I was to unable before. (P16, female, 30 years). Futurearrangement: Planningforthefutureistheform ofPLWHA’sawarenessinlearninglifelessonsfromtheir personal experiences by maintaining health and future arrangements for their family. Maintaining health is a method used by participants to support their declining immune system through behaviour changes and beliefs leading to a more healthy lifestyle. I want to show that though I am diagnosed with HIV positive, I can live a healthy lifestyle without medical problems. I will change my lifestyle, change all of them. … All the bad behavior of my past I have left, such as drinking, doing drugs, multiple sex partners, I have left all of it. (P23, male, 32 years). Future hope for the family is a participants’ wishes for the security of their family, the future of their children, and happiness of their parents and relatives to redeem their previous deeds. This phenomenon can be observed through this following comment: What I fear is; it is acceptable if it is only me who suffer the disease … what about my kids, who will take care of them if I die … I have to stay healthy for my children. Besides, I want to get work again; I want to please my parents. … My parents need more attention now. (P25, female, 29 years).
Discussion The results of this study indicate that resilience is the participants’ ability to bounce back to psychological and social norms after facing adversity owing to a positive HIV/AIDS diagnosis. The nature of resilience among people diagnosed with chronic diseases can be categorised into the crisis and survival phase. The former is signified by the beginning of a psychological and physical struggle immediately after having been diagnosed with a certain critical disease, such as HIV/AIDS. Individuals acquiring one particular severe disease enter the crisis phase, which is also the beginning of their mental and physical experiences as people under the pathological burden of chronic and worsening physical manifestations [12]. Under the duress of discomfort and pain over a long period,togetherwiththeheavyburdenofpsychological and social pressures, individuals will finally arrive at certain destinations. One likely destination is morbidities and irreversibly deteriorating psychological conditions, which eventually lead to mortality. The other destination is an interesting phenomena to behold in itself, in which PLWHA and others suffering from chronic progressive disorders can persevere and acquire the physical resistance needed to counter the destructive progression of the disease. This phenomenon is called resilience and is a distinctive topic that may be discussed based on the results of this study.
According to the interview results, all the participants agree with the notion of having suffered great negative psychological changes regarding their diagnosis of HIV/AIDS. Participants admitted that some of them were hardly able to control the anger and hatred they had after first being informed about their actual clinical conditions. They perceived people in their close acquaintance as ones who were responsible for their clinical conditions, and this understanding led to justifying their motivation to harm innocent individuals and the perceived bad deeds of others in transmitting the virus. Other participants reacted in a different way by expressing great sadness, anxiety, and depression regarding their bleak future and low rate of survival under the rapid progressive manifestation of the disease. Based on these results of psychological and social reactions of the participants, it can be inferred that one significant negative event relating to their well-being can deflate the positive perceptions that participants’ acquire about themselves. The psychological and physical stress they receive after being diagnosed with HIV/AIDS signify the beginning of their long struggle andjourneyinreachingthecriticalphasethatallpeople with chronic disease will eventually reach. Those participants proceed both physically and mentally through the discomforts and the state of being constantly uncomfortable with themselves, which is specifically induced by the harmful particular stressor that is HIV/AIDS. Having been diagnosed with HIV/AIDS, initially, participants revealed a great distrust and absolutely blamed God and other spiritual systems of belief in their society, according to their upbringing. As most Indonesians consider that spiritual devotedness to God is the absolute duty in their private and public lifestyle, itisgenerallyperceivedasawrongdoingtoblameGod for the disease and discomfort the participants have to pass through in life. PLWHA in this study had a difficult time reconciling their sufferings with the goodness and righteousness of religious beliefs. This alsoaddedtotheirpsychologicalandphysicalburdens, whichfurtherledtoanxietyanddepression.Thismental stateofPLWHAisadistinctivepointinthecriticalphase of suffering from a chronic disease, and also has the role as a determining factor of the final destinations of the participants’ well-being. The final destinations of people with a chronic disease, as mentioned above, can manifest in mortalities owing to an individuals’ inability to cope with a long and strenuous psychological and physical burden. However, an interesting phenomenon called resilience to chronic disease can also exist and be presented in the final stages of an individuals’ struggle. According to this study, all participants reacted in a positive way regarding their experiences and meanings of life acquired by contracting HIV/AIDS. Most participants agreed to repent and improve their spiritual lifestyle by being more vigilant in prayers to God. Participants also admitted that they behaved more carefully after being diagnosed with HIV/AIDS to preserve their HIV Nursing; 2018: 18(1): 4–7 Research 6
remaining years and also to prepare economically and psychologically for their families. These are positive signs in the final destinations of PLWHA and can be further categorised into the resilience expected to be found in people with chronic disease. The resilience phenomena of PLWHA found in this study are in conjunction with the results of other previous studies of PLWHA. According to one study held in a Haitian children’s community diagnosed with HIV/AIDS [13], the participants admitted that they suffered great stress/depressive symptoms of being diagnosed with HIV/AIDS owing to a lack of social support, stigma, and discrimination; which agrees with the initial process of HIV/AIDS for participants of this study. Similarly, PLWHA in Brazil, Iran, and USA also revealedthepsychologicalandsocialstruggleofhaving negative social stigma from the environment, which is worsened with the struggle of coping with all the negative perceptions without their caregivers or family to support them [14,15,16]. AnHIV/AIDSdiagnosismaymakeanindividualstressed and impart a sense of grief. Therefore, a nurse has a veryimportantroleinhelpingpatientsthroughdisbelief of their fate and to be able to adapt to the condition oftheillness.Nursescanactascounsellorsbyproviding individual and group counselling and educators by providing accurate information about HIV/AIDS to the patient, family and community. The role of nurses as educators and counsellors is corroborated by research findings that reveal nurses have a role in providing access to knowledge and counselling for newly diagnosed HIV patients to help them in dealing with stigma and disclosure. The National HIV/AIDS Strategy of United States reveals that advanced and innovative education strategies are necessary to provide care that is free from stigma and discrimination [17,18]. An HIV/AIDS nursing education strategy involving PLHWA and experts in the field could help nurses reduce HIV/AIDS stigma in society. Conclusion PLWHAhaveachronicprogressivediseasethatinduces the distinct mechanism of resilience in Indonesian society. Future health care and management of PLWHA should socially support and motivate this mechanism to guide PLWHA into more comfortable and healthy lifestyles. The role of nurses as counsellors and educators can assist the adaptation of PLWHA in facing adversity after being diagnosed with HIV/AIDS.
Acknowledgements Conflicts of interests The authors declare there are no conflicts of interests regarding the funding and publication of this article. Funding The author is grateful for the support of the Directorate General of Higher Education, Ministry of Culture and Education, Republic of Indonesia in funding
this community health nursing research (Ref: 023.04.2.414989/2014). References 1. UNAIDS DATA 2017. Available at: www.unaids.org/sites/ default/files/media_asset/20170720_Data_book_2017_ en.pdf (accessed January 2018). 2. UNAIDS. Global AIDS update, 2016. Available at: www.unaids.org/en/resources/publications/all/ (accessed January 2018). 3. Dahlui M, Azahar N, Bulgiba A et al. HIV/AIDS related stigma and discrimination against PLWHA in Nigerian population. Plos One 2015; 10: e0143749. 4. Kumar S, Mohanraj R, Rao D et al. Positive coping strategiesandHIV-relatedstigmainSouthIndia. AIDSPatient Care STDS 2015; 29: 157–163. 5. Dejman M, Ardakani HM, Malekafzali B et al. Psychological, social, and familial problems of people living withHIV/AIDSinIran:aqualitativestudy. IntJPrevMed 2015; 6: 126. 6. SakiM,KermansashiSMK,MohammadiEetal.Perception ofpatientswithHIV/AIDSfromstigmaanddiscrimination. Iran Red Crescent Med J 2015; 17: e23638. 7. AmiyaRM,PoudelKC,Poudel-TandukarK etal. Perceived family support, depression, and suicidal ideation among people living with HIV/AIDS: a cross-sectional study in the Kathmandu Valley, Nepal. Plos One 2014: 9: e90959. 8. Kanez S. Depression and coping mechanism among HIV/AIDS patients under anti-retroviral therapy. Indian J Soc Psychiatry. 2016. 32: 149–153. 9. Sun W, Wu M, Qu P et al. Quality of life of people living withHIV/AIDSunderthenewepidemiccharacteristicsinChina and the associated factors. Plos One 2014; 8: e64562. 10. GentlesSJ,CharlesC,PloegJ,McKibbonKA.Sampling in qualitative research: Insights from an overview of the methods literature. Qualitative Report 2015; 20: 1772–1789. 11. Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative, 2nd edn. Philadelphia: Lipincott Williams & Wilkins, 1999. 12. Arrey AE, Bilsen J, Lacor P Deschepper R. Spirituality/ Religiosity: A cultural and psychological resource among sub-SaharanAfricanmigrantwomenwithHIV/AIDSinBelgium. Plos One 2016; 11: e0159488. 13. SurkanaPJ,MukherjeebJS,WilliamsdDRetal.Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti. AIDS Care 2010; 22: 803–815. 14. daSilvaLMS,TavaresJSK.Thefamily’sroleasasupport network for people living with HIV/AIDS: a review of Brazilian research into the theme. Cien Saúde Colet 2015; 20: 1109– 1118. 15. Forouzan AS, Jorjoran Shustari Z et al. Social support networkamongpeoplelivingwithHIV/AIDSinIran. AIDSRes Treat 2013; 2013: 715381. 16. Peterson JL, Rintamaki LS, Brashers DE et al. The forms and functions of peer social support for people living with HIV. J Assoc Nurses AIDS Care 2012; 23: 294–305. 17. Wei-Ti C, Shiu CS, Simoni J et al. Optimizing HIV care by expanding the nursing role: patient and provider perspectives. J Adv Nurs 2009; 49: 1841–1850. 18. FrainJA.PreparingeverynursetobecomeanHIVnurse. Nurse Educ Today 2017; 48: 129–33.
Correspondence: Kumboyono Kumboyono Email: [email protected] / [email protected]
Research HIV Nursing; 2018: 18(1): 4–7
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Ethical And Spiritual Decision Making In Health Care Topic 3 Dq 2
/in Uncategorized /by developerWhat do the four parts of the Christian biblical narrative (i.e., creation, fall, redemption, and restoration) say about the nature of God and of reality in relation to the reality of sickness and disease? From where would one find comfort and hope in the light of illness according to this narrative? Explain in detail each part of the narrative above and analyze the implications.
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Ethical And Spiritual Decision Making In Health Care Topic 4 Dq 2
/in Uncategorized /by developerReflect on the analysis of the sin of suicide and, thus, euthanasia from the topic readings. Do you agree? Why or why not? Refer to the lecture and topic readings in your response
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Ethical And Spiritual Decision Making In Health Care
/in Uncategorized /by developerAssignmentsCase Study on Moral Status
Write a 750-1000 word analysis of “Case Study: Fetal Abnormality.” Be sure to address the following questions:
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
150.0
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Ethical And Spiritual Decision Making In Healthcare 19328169
/in Uncategorized /by developerWhat do the four parts of the Christian biblical narrative (i.e., creation, fall, redemption, and restoration) say about the nature of God and of reality in relation to the reality of sickness and disease? From where would one find comfort and hope in the light of illness according to this narrative? Explain in detail each part of the narrative above and analyze the implications.
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Ethical Case Studies
/in Uncategorized /by developerEthical Case Studies
Consider the ethical dilemma the health care professional faces in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).
Note: The case study may not supply all of the information you may need for the assignment. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make.
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Open and Close Icon Reducing Hospital Readmissions
Caleb Powell was preparing the agenda for the upcoming executive leadership meeting and he shook his head ruefully. As chief executive officer for Virginia County Regional Hospital (VCRH), Caleb believes that a key piece of VCRH’s future success lies in reducing readmission rates, not only in the areas identified by federal guidelines, but across the board. A few weeks ago, he read a piece from the National Institutes of Health discussing strategies associated with reduction in readmission rates. He decided that he wanted to discuss the issue in detail with his leadership team.
Caleb’s goal is to align the hospital’s strategic planning with the goal of reducing readmissions. The stakes are high; under provisions of the Affordable Care Act, hospitals with higher than expected 30 day readmission rates for heart failure, heart attack and pneumonia are penalized with reduced payments. Historically, hospitals (including VCRH) have struggled to avoid the penalties, but Caleb believes that believes that a focused approach will allow them to be successful. He also believes that reducing readmission rates will improve patient satisfaction, which has become a key metric in measuring hospital quality.
Caleb’s initial research into this issue revealed that while many facilities were incurring the Centers for Medicare and Medicaid Services (CMS) penalties, there was still significant variability in terms of hospitals implementing successful strategies for reducing their readmission rates. However, several themes have emerged. Hospitals that established partnerships with physicians, physician groups and other local hospitals have had greater success. In addition, a clear discharge planning process and nurse driven medication reconciliation have also been associated with reducing the risk of readmissions.
At the same time, Caleb is concerned that an aggressive policy to avoid readmissions could be construed as too focused on the hospital’s bottom line and indifferent to patient needs. The last thing he wants is to create a policy that prevents patients from seeking or receiving care. Caleb hopes that this meeting will begin a productive discussion around developing strategies to improve VCRH’s performance in this area.
Caleb’s email to the executive leadership team with the agenda for the meeting included the following note:
“As we research the readmission rate issue for improvement, we need to be aware that we cannot add additional days to the patient’s initial stay. It’s a balancing act. We also cannot hinder a patient from coming back into the hospital for a readmission. I’ll be asking for your input about whether we should create a system to profile health care providers whose patients have high readmission rates.”
Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.
For this assessment, you will develop a solution to a specific ethical dilemma faced by a health care professional. Read each portion of the assessment carefully and use the suggested resources to help you complete the assessment. This assessment provides an opportunity to consider ethical principles and how they can be applied in health care situations.
Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed.
For this assessment, you will develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:
Example Assessment: You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.
Additional Requirements
Note: Read the Applying Ethical Principles Scoring Guide to fully understand how your paper will be graded.
Submit your paper for evaluation by clicking on the assessment title and uploading the paper as a Word document.
If you would like assistance in organizing your assessment, or if you simply have a question about your assessment, please do not hesitate to ask your courseroom instructor or the teaching assistants in the NHS Learner Success Lab for guidance and suggestions.
Ethics for Health Care
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Ethical Concerns With Deeming A Patient As Incompetent
/in Uncategorized /by developerTake a moment to consider some ethical concerns with deeming a patient as incompetent. Now imagine that the patient who is being evaluated at your facility is a family member. How would your ethical concerns be affected in determining his or her competence? Would your ethical concerns differ if the patient were a stranger? Why, or why not?
Your entry must be at least 200 words.
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Ethical Conduct Of Research 19292041
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10 Pages (2750 Words)
Deadline July 18, 2019
NO PLAGIARISM
SAMPLE PAPER WILL BE PROVIDED
Select a healthcare related research study .
Identify the sample population.
Analyze and critique the study to identify if sampling method reflects ethical principles including consent, conditions of the participants, study approved by IRB.
Minimum 12 pages excluding title and reference page.
Introduction
Paragraph one is the introduction to the paper. It should begin with something that will grab the reader’s attention and provide a citation to support your opening sentence (Norwood, 2002). Next, support that opening sentence with discussion or explanation with one or multiple sentences which will make up the body of the introductory paragraph. The last sentence of the introduction should highlight areas to be covered in the paper. APA success requires knowledge of the format and skill in concise, clear written communication.
Research Study Overview
This section is where you provide a summary of the research study being critiqued? What were the goals of the research? What health care related issue was addressed? Is it a good/feasible study to apply in clinical practice? Was a practical study, from a financial aspect? Use as many paragraphs as needed to cover the content appropriately.
Ethical Issues in Research
Use this paragraph to provide feedback/history on ethical issues on research.
Protection of Human Rights
What are the five human rights that must be protected during research/investigation? What do they stand for? How do they relate to this research study? Were any/all of the human rights protected in the duration of the research study in question? Use as many paragraphs as needed to cover the content appropriately.
Sampling Method
What was the sampling method used, how did the researchers choose the subjects for participation? What other sampling methods could have worked better, provided better results? Does the sampling method used reflect ethical principles, was it a fair process? Is the population in question a vulnerable population, and if so were there special considerations taken? Use as many paragraphs as needed to cover the content appropriately.
Informed Consent
What is an informed consent? In regards to this research study, was it obtained, if appropriate? If a consent was part of the study, was it obtained properly? Did the participants assent? If participants unable to consent, were they not competent, did a caregiver consent? Were participants provided full/complete detailed information or was it a short version? What components did it include? Use as many paragraphs as needed to cover the content appropriately.
Ethical Scientific Integrity
What are the credentials of the researchers? Did the researchers fabricate data, publish errors/ publish correction? Is there evidence of plagiarism? Use as many paragraphs as needed to cover the content appropriately.
IRB
This section is where you will discuss all the information available (or lack thereof) regarding the IRB. Was the research study approved by an institutional review board? If not, why not? Was a research proposal submitted for approval by an IRB? Use as many paragraphs as needed to cover the content appropriately
HIPPA
What is HIPPA and how does it apply to a research study? Was the research conducted using database information, and if so, was the health information protected? How was it protected? Was any data de-identified? Were participants provided pseudonyms or assigned numbers? Use as many paragraphs as needed to cover the content appropriately.
Benefit to Risk Ratio
Discuss if a benefit to risk ratio was calculated and how? Did it provide am honest estimation? What is your opinion about the outcome of the study and the potential benefits? Can it have a positive impact on the individual, how about in the community? Use as many paragraphs as needed to cover the content appropriately.
Conclusion
Most papers should end with a conclusion or summary, which consists a short description of the key points of the paper. It should be concise and contain little or no detail. No matter how much space is left on the page, the References are always on the next page.
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informed consent should be sought in all forms of human subjects studies
/in Uncategorized /by developerranging from diagnostics and therapeutic investigations
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Ethical Conduct Of Research Infections Disease A Global Perspective
/in Uncategorized /by developerEthical Conduct of Research
power point from this document, 15 slides
Introduction
Depending on the context of the study, researchers often encounter ethical dilemmas that are associated with respect for privacy, establishment of honest and open interactions, and avoidance of misrepresentation. From an ethical standpoint, such challenging circumstances may surface if researchers are grappling with conflicting issues and have to choose between different methodological approaches in complex circumstances. In such circumstances, disagreements among different components including participants, researchers, researchers’ disciplines, the financing organization, and the society might be inevitable. Therefore, there are numerous ethical concerns that should be taken into account when undertaking studies that deal with human subjects. Understanding ethical principles can guide researchers to conduct studies that safeguard the wellbeing of human subjects.
Overview of the Research
In a research work titled Resilience of People Living with HIV/AIDS in Indonesia: a Phenomenological Study, Kumboyono et al. (2018) observe that HIV/ AIDS is among the most prevalent and expanding communicable diseases on the planet. The number of individuals who are diagnosed with HIV/AIDS continues to skyrocket every year in Indonesia and other parts of the world. According to Kumboyono et al. (2018), individuals who suffer from HIV/AIDS often plunge themselves into a series of crises, which indicate the challenges of living with the chronic pathological condition. As such, resilience is one distinct phenomenon that is common among persons living with the diseases Indonesia, a pattern that indicates the results of current health management and expectations of HIV/AIDS patients for better and improved health outcomes. In light of this concern, Kumboyono et al. (2018) undertook a study that sought to examine the mechanism of resilience in Indonesian people living with HIV/AIDS and the factors that influence their specific mechanisms.
Using qualitative phenomenological design, the researchers sampled a total of 27 people living with HIV/AIDS from a primary health care institution in Malang City, East Java, Indonesia. The participants were selected from different socioeconomic, gender, and sexual orientations. The researchers informed participants about the conduct and processes involved in the study, resulting in their consent to participate in the interview process. The findings of the study indicated that the diagnosis of HIV/AIDS reflects the onset of psychological and social distress. Moreover, Kumbomoyo et al. (2018) found that the spiritual response that follows diagnosis is a state that is characterized by crises. As a consequence, the coping strategies and understanding of life by HIV patients is a definite sign on resilience. Based on these findings, Kumbomoyo et al. (2018) infer that HIV/AIDS is a chronic infection that has the potential to induce the unique mechanism of resilience within the Indonesian social system. Therefore, future health and management of persons living with HIV/ AIDS will be needed to enhance and encourage this strategy to guide persons living with HIV into a more comfortable and healthy way of life.
Ethical Issues in Research
The relationships and interactions established between the researcher and participants in a study can potentially generate a wide range of varying ethical issues. While ethical codes, policies and principles are highly significant and beneficial, like any set of norms, they do not cater for all situations. Thus, they often have a high potentiality of conflicting. Nonetheless, the vast majority of decisions often entail the straightforward application of ethical codes and practices. Ethics is one of the most important issues that are commonly mentioned by educators in the scientific community. Ethical misconducts most commonly stem from environmental and individual causes. For instance, when people who are morally weak or unaware of the rules participate in research, ethical violations are bound to occur. Thus, many significant forms of the ethical deviations that are observed in many scientific studies are attributed to the fact that some researchers are oblivious of the ethical norms of scientific research.
Protection of Human Rights
The most important ethical principles in research focus on protecting human rights when dealing with human subjects. Principles of protection of human rights during research emerged out of a dark history that was littered with accounts of abuses undertaken in the name of medical research. One of the most dreadful of these atrocities were undertaken by the Nazi physicians who utilized convicts for human experimentation (Avasthi et al. 2013). The unearthing of these experiments sent ripples of shock across the world, a situation that resulted in the development of the Nuremberg Code to deter recurrence of similar episodes. The Nuremberg Code was the first international code of ethics in clinical research that laid down the guidelines for research dealing with human subjects. This policy made laid down principles, guidelines and standards to be followed by researchers and make voluntary consent essential, allowed subjects withdraw from the experimentation at any time, banned experiments that could lead to major injuries or fatalities of the subjects, and made it mandatory to have preclinical data prior to the experimentation of humans. However, the Nuremberg Code failed to end unethical practices conducted by certain researchers (Avasthi et al. 2013). As a consequence, a collection of guidelines was developed by the 18th World Medical Association General Assembly, also referred to as the Declaration of Helsinki.
The Helsinki Declaration had a collection of principles, which emphasize on informed consent, confidentiality of data, vulnerable populations, and requirements of a protocol, including the scientific justifications for the study. All researches had to be reviewed based on these standards by the ethics committee for a research to be declared as ethically fit (Avasthi et al. 2013). However, it is during the time of the Helsinki Declaration that other major scandals continued such as the Tuskegee Syphilis Experiment in the United States. This malpractice raised concerns in the ethics community, thereby resulting in the establishment of the Belmont Report in 1979. The Belmont Report established the modern regulations and human rights principles associated with research dealing with human subjects in the United States and other parts of the world (Avasthi et al. 2013). Nonetheless, with the growing interest in pharmaceutical, health, and psychological research in the developing and the underdeveloped nations, the Council for International Organization of Medical Sciences, in collaboration with the World Health Organization (WHO) and other health researchers designed the International Ethical Guidelines for Biomedical Research Involving Human Subjects in 1982 (Avasthi et al. 2013). Thereafter, other professional research organizations such as the American Psychological Organization (APA), have designed similar standards that relate to protection of human rights in studies that deal with human subjects.
The Five Human Rights that Must Be Protected
There are five cardinal ethical principles that reflect the five human rights that must be protected during research. These principles include: nonmaleficence, beneficence, respect for autonomy, justice, as well as right to self-determination. The principle of nonmaleficence states that the researcher has an obligation to avoid infliction of harm on human subjects in a study. This principle is closely interlinked with the maxim primum non nocere (‘first do no harm’). The principle of nonmaleficence prohibits killing, causing pain or suffering, incapacitating, and causing an offense on the human subject during research. Therefore, this principle encourages researchers to act in ways that do not cause physical or mental harm on the research participants. More precisely, the principle states that researchers should not cause avoidable or intentional harm. This should incorporate avoidance of any possible risks associated with harm (Jahn, 2013). Researchers should avoid intentional and unintentional violations of this ethical principle. For instance, a researcher does not necessarily intend to harm in order to violate this principle. As a matter of fact, knowingly or unknowingly subjecting a research participant to unnecessary risk amounts to violation of the principle of nonmaleficense.
The principle of nonmaleficense has been applied to this study in many ways. One of the primary focuses of the study was to investigate the coping skills of people living with HIV/AIDS. Thus, when analyzing these coping skills and strategies, the researcher must engage in a one-on-one interview with the participants (Jahn, 2013). In the process, questions that trigger psychological and emotional pain might be asked unknowingly. Such situations are likely to occur in the study, especially when dealing with participants who suffer from HIV/AIDS. In almost all parts of the world, HIV/AIDS patients often witness numerous cases of social stigma. These negative experiences may interfere with the manner in which they respond to interview questions. Therefore, it is the task of the researcher to develop strategies that can help to minimize any possible mental and emotional paint that the persons living with HIV are likely o experience as a result of the data gathering and interview questions. Many studies on nonmaleficense often narrow down to physical harm (Chagani, 2014). However, the concept of harm is broad and dynamic, incorporating all dimensions of human life, including the mental and physical realms. In this particular study, there is no serious physical interaction with the participants that might cause physical pain, harm or death.
The concept of harm is broad and takes many forms. They range from physical and emotional injuries to deprivation of property or violations of human rights. Within the research context, the primary emphasis of harm is often linked to a narrower definition, such as pain, disability, or death (Chagani, 2014). Within these standards, the research has observed avoidance of harm since all the participants who took part in the study did not die, sustain any physical injury or disability stemming from the research. However, harm can be strongly within the eye of the beholder, and a wider definition of harm is often required during ethical considerations. In light of the above, more than one level of harm may come into play in a situation. For instance, the researchers are more likely to inflict mental pain and suffering in the participants by asking questions related to the way in which they responded to the news that they had been diagnosed with HIV/AIDS. However, in such a situation, the researchers have imposed one harm in order to avoid a greater harm. Nonetheless, in all situations, researchers should be prohibited from acting in ways that are likely to generate undue risks or needless harm to participants.
The principle of beneficence is a moral obligation to act for the benefit of others. In this respect, any research work that observes this principle should be designed in a way that is meant to promote societal good and wellbeing (Jahn, 2013). There are various ways in which this principle comes into play. For instance, the principle suggests that researchers should act in a manner that provides benefits to the society, and balances benefits with risks or harms. The principle of beneficence is broad and multifaceted. It includes protecting and defending the rights of others, preventing harm from occurring to others, removing conditions that will cause harm, and supporting persons with disabilities. Furthermore, this principle advocates for rescuing persons in danger during and after research. In furtherance of these ethical standards advocated by beneficence, there are various ways in which the study can be assessed. For instance, the outcomes of the study seeks to improve health professionals’ understanding of HIV/AIDS patients’ coping skills and strategies and the psychological pain that they undergo in the process of coping. As a result, it provides health professionals and psychological researchers with insights into ways of developing interventions that are meant to address mental health problems that affect HIV patients.
The study encourages researchers to design interventions that are meant to enable HIV patients to bounce back to their normal psychological and social norms after receiving adversities as a consequence of HIV/AIDS diagnosis. Indeed, the nature of resilience among individuals who are diagnosed with chronic infections can be grouped into the crisis and survival stages. The former is characterized by the onset of a psychological and physical struggle that follows after diagnosis with several struggles. This study can inform future evidence-based practices that seek to design cognitive and counseling strategies for improving the quality of life of persons living with HIV/ AIDS. As such, the study fulfills the ethical principle of benefiting the participants and the society at large by promoting greater good and wellbeing for persons living with HIV/AIDS.
The ethical principles of beneficence and nonmaleficense are multidimensional and intertwined. These dimensions include positivity and utility. Positivity can be described as the benefits that are gained after undertaking the research, which outweighs its costs. For instance, timely understanding of the mental and pain that HIV patients undergo after diagnosis can help to reduce major depression and help to cope will with the disease. On the other hand, utility refers to the benefits of undertaking an action that balances its costs. For instance, in a clinical research that explores psychological pain that patients undergo, the patient control group may only receive psychological treatment-as-usual instead of the experimental treatment that could generate extra gains. Beneficence and nonmaleficence are fundamental ethical principles that are essential in guiding the clinical practice and research in both psychology and healthcare. Beneficence encourages the researcher to exercise responsibility of promoting the wellbeing of the patients, especially participants in clinical trials, often by researching and administering therapeutic interventions with the highest possibility of positive patient responsivity. One of the biggest ethical dilemmas that psychologists confront is the need to strike a balance between beneficence and nonmaleficence. This balance may sometimes entail weighing the possible benefits and limitations or net risks associated with a specific research. In all jurisdictions, researchers are required by law to inform their participants or patients of the possible risks and gains of a research, procedure, or testy. This move allows the study participants to make an informed decision, with theirs being the burden to assess the potential costs and benefits of the available alternatives.
Autonomy and self-determination are other fundamental human right that the participants should be granted during a research. Thus, respect for autonomy is a practice that obligates the researcher to respect the decisions of adults who have the capacity to make their own decisions. There are three conditions that must be existent for an action by the research subject to be regarded as autonomous. They include: intentionality, understanding, as well as complete absence of controlling influences that determine the subject’s decisions. In order to meet the ethical obligation of autonomy, there are several moral standards or guidelines that can be used. They include: telling the truth, respecting the privacy of others, protecting the confidentiality of information, as well s seeking consent from the participant before commencing the data gathering process. Respect for autonomy represents an obligation to the researcher to respect the decision making capabilities of the participants. It also denotes the provision of choices and alternatives to the subject so that they can practice self-determination. In this study, the participants’ rights to autonomy were observed by providing them with all the relevant information about the study and giving them the opportunity to decide whether or not to participate in the research. This process was primarily exercised through issuance of informed consent forms to the subjects.
Within the context of this study, the subjects’ autonomy were respected by first giving them all sufficient information that are necessary for the research and then giving them the opportunity to consent or reject proposals to participate in it. Based on this practice, it is the responsibility of the researcher to ensure that the subject is sufficiently competent to practice autonomy. By competency, a research subject should be not only conscious, but also possess the sufficient knowledge and understanding to gain and maintain the information offered to take relevant decisions. Along with this view, the principle also requires the researcher to offer complete information to the participant and not hide anything so that the patient may seek to meet an obligation or can desire to spend some valuable time with family members and friends. The subject, after knowing the truth, may desire to do a hobby with which he or she desired to do. The participant may also seek to select other options of the research that may not be available or provided by the researchers. However, it is the right of human beings to be treated in a way that does not cause pain and anguish. Therefore, the researcher should go by the data gathering method in which the participants are comfortable with in order to avoid restraining the subject from exercising autonomy. In addition, in many jurisdictions, going ahead with a research against patients’ rights and decisions even if it is meant for their goodwill, is considered as an illegal decision. Therefore, a comprehensive justification on legal is often needed to undertake a research involving subjects who are patients against their knowledge and will. The principle of beneficence supports the autonomy of the patients as in the case of telling the truth to the research subject and respecting the subject’s autonomy can go a long way in generating the desired benefits to the participants, who will feel more confident in determining their course of life.
Further, self-determination is a human right that is also relevant and interrelated to the right to autonomy. Self-determination is a right and principle that plays a critical role in the contemporary research ethics associated with human subject. Put simply, this principle suggests that ultimately, it is the participant who should make the final decision as to whether or not to accept a proposed research process (Lindberg, Johansson & Broström, 2019). While this principle is widely discussed in many academic works, one of its most significant elements has often been overlooked- the fact that real-world decision making is temporarily extended. In this respect, decision-making is a process that broadly takes a significant period of time from the time at which the researcher determines that there is a need for the subject to participate in the clinical research and that there is a decision that should be made. Moreover, the participant should be able to make it to the point at which they are actually asked for their views. The principle of self-determination is broadly viewed as the center of research ethics and trials in the health sector (Lindberg, Johansson & Broström, 2019). It is a principle that is commonly codified in legal frameworks and standards across different parts of the world, and has had a major effect on researchers’ understanding of ways of dealing with several legal and ethical issues associated with handling human subjects in research.
There are several accounts of the content and implications of the principle that have been put into use within the context of this study. For instance, in all stages of the study, the patients were given the liberty to opt out of the research. Through the issuance of informed consent documents and explaining to them the conduct and content of the study, they were sufficiently empowered to determine whether or not they would like to chat their own path by either remaining or opting out of the research. In view of this phenomenon, it would be deduced that it is the research subject who ultimately, following evaluation of all relevant information offered by the researchers, has the authority to decide whether or not to consent to the research. The principle of self-determination raises many fundamental questions. One such question revolves around who should self-determination be applicable to. In this study, the main subjects of self determination are the participants of the research. They are the HIV/AIDS patients who were interviewed on their psychological coping skills. Since a right to self-determination is often traditionally ascribed only to people with sufficient decision-making capabilities, one major issue that confronts many researchers is what it takes for a patient to be above the recommended threshold. Based on this standard, it is not clear in this study whether or not the HIV patient populations that were sampled were above the recommended normal mental threshold that is required of them to make informed decision on whether or not they should take part in the research. However, it can still be implied that they were mentally upright at the time of decision-making based on the nature of the data that have been gathered.
When it comes to self-determination, real-world decision-making capabilities can be temporarily extended in that it broadly takes some significant period of time from the point at which the researcher determines that there is a consent decision that should be made, and that the patient is mentally fit or able to make it (Lindberg, Johansson & Broström, 2019). Moreover, such a situation should extent to the point at which the subject is asked about their views. Such a temporal element of decision-making raises normative questions. For instance, it may not be clear under what situations and length of time the researcher should wait in order to get the feedback from the subject on the decisions that they have made regarding participation in the research.
Finally, the principle of justice in research can also be used to analyze the ethical standards that were used in the study. The right to justice requires the researcher to exercise equity in the distribution of the benefits of the research. These include the benefits, costs, and resources. The key justice principles in a study include: promotion of equal share, giving each person in accordance with heir efforts, rewarding each individual according to their contributions, and issuing gains made out of the research according to merits (Silver, Ventura & Castro, 2016). In almost all forms, clinical trials require the active participation of human subjects and entail clinical interventions that are comprised of various procedures. However, this study only engaged human subjects in the interviewing process alone. Still, the performance of a study involving human subject can be beneficial to the economy and the whole society, especially the participating country, thereby generating employment opportunities and promoting local scientific and technological progress through the scientific data found and studied in collaboration with many research centers (Silver, Ventura & Castro, 2016). The financial and economic gains of this particular study have not yet been determined. However, its insights can be used to develop interventions that help to promote psychological wellbeing of persons living with HIV/AIDS. In so doing, the study can immensely improve their quality of life.
Ethical Scientific Integrity
The credibility of a researcher or author is very critical in assessing the authenticity and quality of a specific research work. The personal details of the authors who developed this research work have not been provided in the journal article. However, there are other standards that can still be used to determine the credibility and level of suitability of the researchers to undertake the above study. For instance, the authors have revealed at the end of the article that their study was funded by the Directorate General of Higher Education, Ministry of Culture and Education in the Republic of Indonesia. Based on this standard alone, it can be deduced that the authors have the necessary academic credentials and intellectual acumen or capacity to undertake such a study. In addition, the mere fact that the study was approved by these higher educational bodies raises the credibility of the authors. Another factor that raises the credibility of this particular study is that its findings were assessed and later published by the Research HIV Nursing, which is a widely known reputable international journal that publishes studies on HIV research.
Plagiarism is one of the ethical issues in research that are hardly ever mentioned. However, its violations can have far-reaching consequences on the credibility and authenticity of a specific body of knowledge. Plagiarism can be defined as the unethical practice of stealing and passing off ideas or group of words as one’s own (Ben-Yehuda & Oliver-Lumerman, 2017). Plagiarism is also the act of utilizing someone’s ideas and works and pretending to be one’s own. In light of the above, there are various ways in which plagiarism manifests itself in research. For instance, many researchers often fail to recognize the originators of their collection of words. However, this specific study can be said to have passed plagiarism test. First, the body section of the study has various in-text citations, indicating that the authors acknowledged the sources or originators of the ideas that were sued in the study (Ben-Yehuda & Oliver-Lumerman, 2017). In addition, all the in-text citations have their corresponding bibliographic citations. As such, the authors do not have a case of plagiarism or copyright violation.
Fabrication and falsification are some of the cardinal malpractices ion research conduct. They are commonly regarded as the key concerns in averting research misconduct. Any deviation or departure from such standards often undermines the integrity of a specific body of research for an individual or organization as a whole (Ben-Yehuda & Oliver-Lumerman, 2017). Falsification can be described as the practice of altering or omitting research findings to support certain claims, hypotheses, as well as other data. This can include the act of manipulating study instrumentation, materials, or procedures. Usually, manipulations of images or representations in a way that distorts the figures or data or reads too much between the lines can also be regarded as an act of falsification (Ben-Yehuda & Oliver-Lumerman, 2017). The process of identifying a case of falsification or fabrication is often a complex one. As such, it was not possible for this specific study to detect any case of falsification. This is because the main data that were being explored were primarily qualitative and they were derived from the interview responses. In the same way, it was not easy to detect any case of outright fabrication. Fabrication is the development of or inclusion of data, observations, or characterizations that never took place during the collection of data. Fabrications are likely to take place during the process of filling out the entire of an experiment runs (Ben-Yehuda & Oliver-Lumerman, 2017). Moreover, the researchers might come up with claims on the basis of incomplete or presumed findings, which are regarded as outright forms of fabrication.
Institutional Review Board
Details on the Institutional Review Board (IRB) pertaining to this study have not been written in the article. However, the researchers indicate that they passed through the due process of informed consent and other ethical standards before they were approved to participate in the study. In addition, the study was approved by the Ministry of Higher Education, although such a ministry may or may not develop an IRB to assess the ethical suitability of the researchers. Therefore, it is not easy to determine whether or not the above study was approved by IRB. However, the researchers’ use of human subjects was not experimental in nature. Rather, use of human subjects in this study was minimized to data collection process through interviews.
The absence of details regarding the IRB in this study calls for the need for future researchers to report as to whether or not their studies were approved by an ethics body. All individual organizations or sponsors may demand that all studies, irrespective of their sources of funding, be assessed and approved by an IRB (Whitney, 2015). An IRB has the specific power and authority over the nature of the research within its jurisdiction. For instance, no clinical research may be approved to stat enrolling participants until it has been given the green light by the IRB. The IRB primarily has the authority to approve, dismiss, or halt all research activities that fall within its jurisdictions in accordance with the relevant government regulations and institutional standards and procedures. The IRB also ensures that a given research meets the needed ethical standards by demanding for modifications in processes, protocols as well as previously approved studies (Whitney, 2015). Furthermore, the IRB has the power and authority to demand that participants in a specific research be granted any extra information that will enable them to make informed decisions to participate in the study.
One of the most important documentations that the IRB may require is the informed consent form. While researchers who indicate that they provided participants with informed consent might have gone through the IRB, it might not be the case in all situations. All institutions that take part in the research process that engage human subjects are often tasked with the responsibility of identifying an IRB to assess and approve such studies (Whitney, 2015). The IRB is charged with the responsibility of adhering to the requirements and standards recommended by the Office for Human Research Protections. Many study sites may be under the jurisdiction of more than one IRB. Then IRB plays a significant role in safeguarding the rights, safety, and wellbeing of all human study participants. The IRB meets this responsibility by assessing the full research plan for a specific research study in order to ensure that it meets the standards that have been recommended by local and international codes of research ethics (Whitney, 2015). Moreover, the IRB undertakes a confirmation and approval that the study plan does not expose human subjects to unreasonable risks. In this particular study, human subjects are not exposed to unreasonable risks because their role in the research is to simply explain how they psychologically cope with the news of their diagnosis with HIV/ AIDS.
Informed Consent
Informed consent is the main ethical practice that has been extensively observed by the researchers in this study. For instance, after selecting the populations to participate in the study, the participants were informed regarding the conduct of the research. Thereafter, the researchers report that the participants consented to the proposals to participate in the interview. The researchers also indicate that the study participants were given the opportunity to opt out of the research at any stage if they so wished. Therefore, it can be deduced that the study adhered to the recommended informed consent procedures and standards.
Informed consent can be described as the voluntary acceptance by a study s
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Ethical Conduct Of Research
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YOU WANT ADDED MORE CRITIQUE QUESTION IF YOU WANT TO COMPLET THE 20 PAGES
FOLLOW THE TERM TEMPLATE APA PAPER TEMPLATE 6th
Title in Upper and Lower Case
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Miami Regional College
MSN 5300: Advanced Nursing Inquiry and Evidence Based Practice
Title of Paper in Upper and Lower Case (Centered, Not Bold)
Paragraph one is the introduction to the paper. It should begin with something that will grab the reader’s attention and provide a citation to support your opening sentence (Norwood, 2002). Next, support that opening sentence with discussion or explanation with one or multiple sentences which will make up the body of the introductory paragraph. The last sentence of the introduction should highlight areas to be covered in the paper. APA success requires knowledge of the format and skill in concise, clear written communication.
Research Study Overview
This section is where you provide a summary of the research study being critiqued? What were the goals of the research? What health care related issue was addressed? Is it a good/feasible study to apply in clinical practice? Was a practical study, from a financial aspect? Use as many paragraphs as needed to cover the content appropriately.
Ethical Issues in Research
Use this paragraph to provide feedback/history on ethical issues on research.
Protection of Human Rights
What are the five human rights that must be protected during research/investigation? What do they stand for? How do they relate to this research study? Were any/all of the human rights protected in the duration of the research study in question? Use as many paragraphs as needed to cover the content appropriately. Ladkjfasdojfadfoasidfjaod. Aff fasdfjasod faosdijfaosdjfaodjfasdjdklfljkadf
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Sampling Method
What was the sampling method used, how did the researchers choose the subjects for participation? What other sampling methods could have worked better, provided better results? Does the sampling method used reflect ethical principles, was it a fair process? Is the population in question a vulnerable population, and if so were there special considerations taken? Use as many paragraphs as needed to cover the content appropriately.
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Informed Consent
What is an informed consent? In regards to this research study, was it obtained, if appropriate? If a consent was part of the study, was it obtained properly? Did the participants assent? If participants unable to consent, were they not competent, did a caregiver consent? Were participants provided full/complete detailed information or was it a short version? What components did it include? Use as many paragraphs as needed to cover the content appropriately.
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Ethical Scientific Integrity
What are the credentials of the researchers? Did the researchers fabricate data, publish errors/ publish correction? Is there evidence of plagiarism? Use as many paragraphs as needed to cover the content appropriately. Ifnagw;oeifnaw;eo vo;ianener;ai nvzodsianvaei;or nag;oekermf naipeieufn ;aoidfvim; ;aodkzkfnv;azdfskjvn.
IRB
This section is where you will discuss all the information available (or lack thereof) regarding the IRB. Was the research study approved by an institutional review board? If not, why not? Was a research proposal submitted for approval by an IRB? Use as many paragraphs as needed to cover the content appropriately Adkjfasdojfa dfoasidfjaod. Aff fasdfjasod faosdijfaosdjfaodjfasdjdklfljkadf.
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HIPPA
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Benefit to Risk Ratio
Discuss if a benefit to risk ratio was calculated and how? Did it provide am honest estimation? What is your opinion about the outcome of the study and the potential benefits? Can it have a positive impact on the individual, how about in the community? Use as many paragraphs as needed to cover the content appropriately. Ladkjfasdojfadfoasidfjaod. Aff fasdfjasod faosdijfaosdjfaodjfasdjdklfljkadf
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Conclusion
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American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.). Washington, DC: Author.
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Appendix A(centered, not bold)
This is the article to analyze, and critique
Resilience of people living with HIV/AIDS in Indonesia: a phenomenological study Kumboyono Kumboyono, Cathrine T Sukotjo, Yulia C Lestari, Dini P Wijayanti Faculty of Medicine, Brawijaya University, Malang City, Indonesia
Abstract Background: HIV/AIDS is one of the most continuously developing communicable diseases in the world. The number of people diagnosed with HIV/AIDS is currently increasing worldwide, including in Indonesia. People living with HIV/AIDS (PLWHA) fall into a state of crisis, which signifies the difficulties of living with chronic pathological conditions. Resilience is one unique phenomenon observed among PLWHA in Indonesia, which further reveals the results of current health management and expectations of PLWHA for better health programmes. Objective: This study aims to explore the mechanism of resilience in Indonesian PLWHA and the factors affecting that particular mechanism. Method: This is a qualitative phenomenological study. Twenty-seven PLWHA were selected from a primary healthcare centre in Malang City, East Java, Indonesia. Participants were selected from various economic, social, and diverse sexual orientation backgrounds. Participants were informed about the conduct of the research and consented to take part in the interview. Results: Diagnosis of HIV/AIDS signifies the beginning of psychological and social distress, the spiritual reaction after being diagnosed is a state of crisis, and the coping mechanism and understanding of life by PLWHA is a definite sign of resilience. Conclusion: HIV/AIDS is a chronic progressive disease and induces the distinct mechanism of resilience in Indonesian society. Future healthcare and management of PLWHA will be required to support and motivate this mechanism to guide PLWHA into a more comfortable and healthy lifestyle.
Keywords: HIV/AIDS, healthcare, meaning of life, resilience, spiritual
Introduction HIV/AIDS is one of the most continuously developing communicable diseases in the world among other communicable diseases, such as tuberculosis, affecting people diagnosed with immunocompromised conditions. The number of people living with HIV/AIDS (PLWHA) worldwide is currently increasing with a significant incline among Asian countries, especially the Asia and Pacific region [1]. In Indonesia, the number of PLWHA is in synergy with the increasing pattern of an Asian epidemic, with 300,000 estimated new infections in 2015 [2]. Having been diagnosed HIV-positive, novel psychological and social disturbances are certainly experienced by PLWHA in general. As reported by Dahlui [3], PLWHA are a vulnerable community experiencing a psychosocial burden, together with physical discomforts. Another study from India also reported the effects of stress and the psychosocial burden suffered by people diagnosed with HIV/AIDS [4]. Although there is a mechanism of resilience to chronic diseases, this group of people are still under enormous pressure to survive the harmful pathological progress of HIV/AIDS and the opportunistic infections that follow. A lack of psychosocial support from family, for example, loss of parents and caregivers at an early age, adds to this pressure [5]. Biological mechanisms of survival under the duress of chronic diseases, such as HIV/AIDS or tuberculosis, can result in two outcomes. People living with the chronic disease will experience the entire physical
andpsychologicaldisturbancesafterperseveringunder similar clinical manifestations for a long period of time. One outcome results in depression and loss of spiritual motivation that may lead to mortality [6,7]. The other is the mechanism of resilience, the most distinct phenomenon will eventually lead to survival while experiencing deteriorations of physical and psychological well-being [8,9]. Qualitative phenomenological studies exploring the mechanism of resilience in PLWHA and its other factors have not been the focus of researches in Indonesia. The purpose of this study is to explore the nature of resilience amongpeoplediagnosedwithHIV/AIDS.Themeaning of experiencing an HIV/AIDS burden, physically and psychologically, and also the social responses of PLWHA were recorded and reported in this study. This research is important as it will allow health professionals to identify the support required by PLWHA.
Method Design of study This study is a classical phenomenological study with an analytic descriptive approach. This approach is used to understand the meaning of the patient’s life after being diagnosed with HIV/AIDS. This study obtained an ethical health licence from the Ethical, Health, and Research Commission of Medical Faculty, Brawijaya University, Malang City (Ref: 261/EC/KEPK/04/2014) and was upheld according to the Helsinki Declaration of 1975.
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Population and sample For this study 27 PLWHA were selected by snowball sampling from Malang City, Indonesia. Criteria for selection were that participants had been diagnosed with HIV/AIDS for at least 1 year and be aged 18–40 years. The benefit to participants in this research was anincreaseinawarenessoftheimportanceofaccepting a diagnosis of HIV/AIDS in order to remain productive. They were selected according to achieved saturation of data [10]. Participants consisted of 13 men and 14 womendiagnosedwithHIV/AIDSacquiredfromvarious modes of transmission, such as, multiple sexual partners: 17 participants; men who have sex with men: four participants; and injectable drug users: six participants. Participants were aged 25–34 years and lived in the areas of Malang city, Batu city, and Blitar municipality. The educational background of participants ranged from primary school, junior high school, senior high school, and vocational school. The marriagestatusofparticipantsvariedfrombeingsingle, married, and widowed. The occupational backgrounds of participants were freelancers, private-organisation workers, and homemakers.
Data collection Instrumentsusedtoanalysethedataweretheinterview process and the participative observation of researchers. Data were collected at the participants’ homes through private interviews and there were no repeat interviews. Data were recorded in the form of audio files (MP3) and the duration of interviews was 28–42 minutes. A community health nursing specialist who is a registered practitioner and a lecturer at Brawijaya University conducted the interviews
Data analysis Analysis of qualitative data was accomplished by creating a transcript of interview recordings and notes during the interview. Manual analysis of the data was carried out according to the Colaizzi method [11]. Analysing qualitative data manually provides more precise results because the data contain information on attitudes, values, and feelings that cannot be detected by software The procedure was as follows: 1. Read all transcribed verbatim to gain a whole sense of the resilience experience; 2. review each transcript and extract significant statements; 3. explain the meaning of each significant statement; 4. organise the formulated meanings into clusters of themes; 5. integrate results into an exhaustive description of the phenomenon under study; 6. formulate an exhaustive description of the phenomenon in uniquivocal statements of identification as far as possible; and 7. ask participants about the findings thus far as a final validating step. The results of the analysis were based on keywords, categories, and themes and subthemes of qualitative
variables of the study. There were two themes (phases) in this research and two subthemes from each.
Results According to the results of qualitative analysis of data, the mechanism of resilience of PLWHA in Malang city can be divided into two phases: crisis phase and survival phase. The crisis phase can be described by examining the psychological and social stresses of a lifestyle acquired by PLWHA. Meanwhile, the survival phase is explored by asking about the changes in the spiritual pattern and future arrangements of PLWHA. Each theme is discussed thoroughly and described qualitatively according to specific subthemes. Crisis phase of people living with HIV/AIDS The crisis phase of PLWHA is described through two subthemes: psychological and social stress. Psychological stress: the psychological response of PLWHA after being diagnosed with HIV/AIDS can be illustrated by anxiety and anger conditions. Anxiety aroseinparticipantsconsideringtheuncertaintyoftheir lives, which could end in morbidities and mortalities. Anger is also one of the psychological responses after participants pass the initial shock of being diagnosed with HIV/AIDS. Some of them accuse God for their sickness and acquire deep enmity against those who they perceive as responsible for transmitting the disease: Now I am afraid, anxious, worried that my sickness will result in me being sick all my whole life or I might die someday.IthinkGodnolongerlovesme,Ihadthisperiod of being angry with God, but now I realised and widely opened my heart … I’m open to taking the advantages of my situation …, God is the almighty, God will be the one who heals me. (Patient [P] 5, male, 25 years) Social stress: Feeling isolated from the social environment is perceived by participants to be due to social stigma. Social stigma arises as an impact of incorrect perceptions of society about PLWHA and HIV transmission, in the forms of societal embarrassment, labeling, prejudice, social isolation, fear of being isolated and being shunned by society. Whereas some participants suffered from discrimination, several others admitted that they also received acceptance from people living around them, depending on the openness and educational level of their communities: People gossip about me … both my own family and the society … many say that it’s the burden I have to bear alone as a consequence of what I did. If I want to work, Iwillmostsurelyberejectedbecauseofthedisease.But luckily, now there’s no pressure from society, in this area, it’s no longer a taboo subject. (P21, female, 28 years) Survival phase of life of people living with HIV/AIDS The survival phase of PLWHA can be divided into these following two subthemes: changes of spiritual pattern and future arrangements. Changes to spiritual pattern: changes of spiritual meaning experienced by participants occur in the form
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of spiritual closeness to God through surrendering all to God, repentance, diligence of prayers, and worship: I don’t want to grief for too long … because everything that’shappeningrightnowisGod’swill,ifGodgivesme the disease, God will be the one giving me medicine. Now I’m diligently reciting prayers, before my illness, I rarely do it. I can now read the Quran which I was to unable before. (P16, female, 30 years). Futurearrangement: Planningforthefutureistheform ofPLWHA’sawarenessinlearninglifelessonsfromtheir personal experiences by maintaining health and future arrangements for their family. Maintaining health is a method used by participants to support their declining immune system through behaviour changes and beliefs leading to a more healthy lifestyle. I want to show that though I am diagnosed with HIV positive, I can live a healthy lifestyle without medical problems. I will change my lifestyle, change all of them. … All the bad behavior of my past I have left, such as drinking, doing drugs, multiple sex partners, I have left all of it. (P23, male, 32 years). Future hope for the family is a participants’ wishes for the security of their family, the future of their children, and happiness of their parents and relatives to redeem their previous deeds. This phenomenon can be observed through this following comment: What I fear is; it is acceptable if it is only me who suffer the disease … what about my kids, who will take care of them if I die … I have to stay healthy for my children. Besides, I want to get work again; I want to please my parents. … My parents need more attention now. (P25, female, 29 years).
Discussion The results of this study indicate that resilience is the participants’ ability to bounce back to psychological and social norms after facing adversity owing to a positive HIV/AIDS diagnosis. The nature of resilience among people diagnosed with chronic diseases can be categorised into the crisis and survival phase. The former is signified by the beginning of a psychological and physical struggle immediately after having been diagnosed with a certain critical disease, such as HIV/AIDS. Individuals acquiring one particular severe disease enter the crisis phase, which is also the beginning of their mental and physical experiences as people under the pathological burden of chronic and worsening physical manifestations [12]. Under the duress of discomfort and pain over a long period,togetherwiththeheavyburdenofpsychological and social pressures, individuals will finally arrive at certain destinations. One likely destination is morbidities and irreversibly deteriorating psychological conditions, which eventually lead to mortality. The other destination is an interesting phenomena to behold in itself, in which PLWHA and others suffering from chronic progressive disorders can persevere and acquire the physical resistance needed to counter the destructive progression of the disease. This phenomenon is called resilience and is a distinctive topic that may be discussed based on the results of this study.
According to the interview results, all the participants agree with the notion of having suffered great negative psychological changes regarding their diagnosis of HIV/AIDS. Participants admitted that some of them were hardly able to control the anger and hatred they had after first being informed about their actual clinical conditions. They perceived people in their close acquaintance as ones who were responsible for their clinical conditions, and this understanding led to justifying their motivation to harm innocent individuals and the perceived bad deeds of others in transmitting the virus. Other participants reacted in a different way by expressing great sadness, anxiety, and depression regarding their bleak future and low rate of survival under the rapid progressive manifestation of the disease. Based on these results of psychological and social reactions of the participants, it can be inferred that one significant negative event relating to their well-being can deflate the positive perceptions that participants’ acquire about themselves. The psychological and physical stress they receive after being diagnosed with HIV/AIDS signify the beginning of their long struggle andjourneyinreachingthecriticalphasethatallpeople with chronic disease will eventually reach. Those participants proceed both physically and mentally through the discomforts and the state of being constantly uncomfortable with themselves, which is specifically induced by the harmful particular stressor that is HIV/AIDS. Having been diagnosed with HIV/AIDS, initially, participants revealed a great distrust and absolutely blamed God and other spiritual systems of belief in their society, according to their upbringing. As most Indonesians consider that spiritual devotedness to God is the absolute duty in their private and public lifestyle, itisgenerallyperceivedasawrongdoingtoblameGod for the disease and discomfort the participants have to pass through in life. PLWHA in this study had a difficult time reconciling their sufferings with the goodness and righteousness of religious beliefs. This alsoaddedtotheirpsychologicalandphysicalburdens, whichfurtherledtoanxietyanddepression.Thismental stateofPLWHAisadistinctivepointinthecriticalphase of suffering from a chronic disease, and also has the role as a determining factor of the final destinations of the participants’ well-being. The final destinations of people with a chronic disease, as mentioned above, can manifest in mortalities owing to an individuals’ inability to cope with a long and strenuous psychological and physical burden. However, an interesting phenomenon called resilience to chronic disease can also exist and be presented in the final stages of an individuals’ struggle. According to this study, all participants reacted in a positive way regarding their experiences and meanings of life acquired by contracting HIV/AIDS. Most participants agreed to repent and improve their spiritual lifestyle by being more vigilant in prayers to God. Participants also admitted that they behaved more carefully after being diagnosed with HIV/AIDS to preserve their HIV Nursing; 2018: 18(1): 4–7 Research 6
remaining years and also to prepare economically and psychologically for their families. These are positive signs in the final destinations of PLWHA and can be further categorised into the resilience expected to be found in people with chronic disease. The resilience phenomena of PLWHA found in this study are in conjunction with the results of other previous studies of PLWHA. According to one study held in a Haitian children’s community diagnosed with HIV/AIDS [13], the participants admitted that they suffered great stress/depressive symptoms of being diagnosed with HIV/AIDS owing to a lack of social support, stigma, and discrimination; which agrees with the initial process of HIV/AIDS for participants of this study. Similarly, PLWHA in Brazil, Iran, and USA also revealedthepsychologicalandsocialstruggleofhaving negative social stigma from the environment, which is worsened with the struggle of coping with all the negative perceptions without their caregivers or family to support them [14,15,16]. AnHIV/AIDSdiagnosismaymakeanindividualstressed and impart a sense of grief. Therefore, a nurse has a veryimportantroleinhelpingpatientsthroughdisbelief of their fate and to be able to adapt to the condition oftheillness.Nursescanactascounsellorsbyproviding individual and group counselling and educators by providing accurate information about HIV/AIDS to the patient, family and community. The role of nurses as educators and counsellors is corroborated by research findings that reveal nurses have a role in providing access to knowledge and counselling for newly diagnosed HIV patients to help them in dealing with stigma and disclosure. The National HIV/AIDS Strategy of United States reveals that advanced and innovative education strategies are necessary to provide care that is free from stigma and discrimination [17,18]. An HIV/AIDS nursing education strategy involving PLHWA and experts in the field could help nurses reduce HIV/AIDS stigma in society. Conclusion PLWHAhaveachronicprogressivediseasethatinduces the distinct mechanism of resilience in Indonesian society. Future health care and management of PLWHA should socially support and motivate this mechanism to guide PLWHA into more comfortable and healthy lifestyles. The role of nurses as counsellors and educators can assist the adaptation of PLWHA in facing adversity after being diagnosed with HIV/AIDS.
Acknowledgements Conflicts of interests The authors declare there are no conflicts of interests regarding the funding and publication of this article. Funding The author is grateful for the support of the Directorate General of Higher Education, Ministry of Culture and Education, Republic of Indonesia in funding
this community health nursing research (Ref: 023.04.2.414989/2014). References 1. UNAIDS DATA 2017. Available at: www.unaids.org/sites/ default/files/media_asset/20170720_Data_book_2017_ en.pdf (accessed January 2018). 2. UNAIDS. Global AIDS update, 2016. Available at: www.unaids.org/en/resources/publications/all/ (accessed January 2018). 3. Dahlui M, Azahar N, Bulgiba A et al. HIV/AIDS related stigma and discrimination against PLWHA in Nigerian population. Plos One 2015; 10: e0143749. 4. Kumar S, Mohanraj R, Rao D et al. Positive coping strategiesandHIV-relatedstigmainSouthIndia. AIDSPatient Care STDS 2015; 29: 157–163. 5. Dejman M, Ardakani HM, Malekafzali B et al. Psychological, social, and familial problems of people living withHIV/AIDSinIran:aqualitativestudy. IntJPrevMed 2015; 6: 126. 6. SakiM,KermansashiSMK,MohammadiEetal.Perception ofpatientswithHIV/AIDSfromstigmaanddiscrimination. Iran Red Crescent Med J 2015; 17: e23638. 7. AmiyaRM,PoudelKC,Poudel-TandukarK etal. Perceived family support, depression, and suicidal ideation among people living with HIV/AIDS: a cross-sectional study in the Kathmandu Valley, Nepal. Plos One 2014: 9: e90959. 8. Kanez S. Depression and coping mechanism among HIV/AIDS patients under anti-retroviral therapy. Indian J Soc Psychiatry. 2016. 32: 149–153. 9. Sun W, Wu M, Qu P et al. Quality of life of people living withHIV/AIDSunderthenewepidemiccharacteristicsinChina and the associated factors. Plos One 2014; 8: e64562. 10. GentlesSJ,CharlesC,PloegJ,McKibbonKA.Sampling in qualitative research: Insights from an overview of the methods literature. Qualitative Report 2015; 20: 1772–1789. 11. Streubert HJ, Carpenter DR. Qualitative research in nursing: Advancing the humanistic imperative, 2nd edn. Philadelphia: Lipincott Williams & Wilkins, 1999. 12. Arrey AE, Bilsen J, Lacor P Deschepper R. Spirituality/ Religiosity: A cultural and psychological resource among sub-SaharanAfricanmigrantwomenwithHIV/AIDSinBelgium. Plos One 2016; 11: e0159488. 13. SurkanaPJ,MukherjeebJS,WilliamsdDRetal.Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti. AIDS Care 2010; 22: 803–815. 14. daSilvaLMS,TavaresJSK.Thefamily’sroleasasupport network for people living with HIV/AIDS: a review of Brazilian research into the theme. Cien Saúde Colet 2015; 20: 1109– 1118. 15. Forouzan AS, Jorjoran Shustari Z et al. Social support networkamongpeoplelivingwithHIV/AIDSinIran. AIDSRes Treat 2013; 2013: 715381. 16. Peterson JL, Rintamaki LS, Brashers DE et al. The forms and functions of peer social support for people living with HIV. J Assoc Nurses AIDS Care 2012; 23: 294–305. 17. Wei-Ti C, Shiu CS, Simoni J et al. Optimizing HIV care by expanding the nursing role: patient and provider perspectives. J Adv Nurs 2009; 49: 1841–1850. 18. FrainJA.PreparingeverynursetobecomeanHIVnurse. Nurse Educ Today 2017; 48: 129–33.
Correspondence: Kumboyono Kumboyono Email: [email protected] / [email protected]
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