1.1 Introduction
The HIV/AIDS infected patients can live healthy lives for longer if proper care and support is provided; their immune system can be strengthened by medical treatment, healthy food, regular exercise, rest, care and support. They need a compassionate multifaceted assistance and support which will enable them to find meaning to life, appraising their survival, taping new resources of psychic strength and courage. Some of the feelings the PLWHA experience include shock or anger at being positively diagnosed with HIV, fear over how the disease will progress, fear of isolation by family and friends and worries about infecting others. By bearing such a heavy burden, it is not surprising that depression is twice as common in PLWHA compared to general population (American Psychiatric Association, 2013).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Health care providers who are also members of the general community are likely to elicit similar prejudicial and fearful reactions to HIV/AIDS infected persons as members of the community. The resultant effect of such negative attitudes including poor patient management, with people being denied most needed treatment, are and support, this in turn could affect their morale, self-esteem and self determination to live quality lives devoid of stigma, fear, depression and discrimination (UNAIDS,2005). Furthermore, discriminatory, attitude and violations of international principles of medical ethics may serve to legitimize other forms of discrimination against people living with HIV/AIDS. Worldwide report suggests that health care professionals in Nigeria may engage in discriminatory attitude against people with HIV/AIDS (Alubo et al., 2004).
Maintaining the desired quality of life of people living with HIV/AIDS is possible mainly through extensive, competent and compassionate nursing care. Yet, the provision of their care raises health and occupational concerns for all levels of health providers (International council for Nurses, 2005).
There is therefore an urgent need for all health care providers particularly nurses who have direct contact and spend more time with patients to examine their personal attitudes towards people living with HIV/AIDS as this can compromise compassionate care. The number of health care workers per 10,000 increased from 29.2 in 2001 to 34.4 in 2008 (Ministry of health care Vietnam and health partnership group 2010). Despite this, there are limitations in quality and quality of health care providers which inhibit the expansion of quality practices in provincial and district levels. Inorder to alleviate some of the tensions caused by lack of proper training, the ministry of health workers quality should be achieved through investment in training facilities, improving quality of instructors and strengthening practice facilities (Ministry of Health, Vietnam, 2010).
Gostin (2009) reported that even specialist had difficulty remaining knowledgeable about virologicals, immunologicals, epidemiological, clinical and social behavioural aspect of the pandemic. Several studies reported higher knowledge among group of nurses who reported having receive HIV elated in service training compared to those not having receive any (brown, Rae, an Calder (2006).
With an estimated 3.5 million people with HIV/AIDS, Nigeria is home to one of every eleven (11) of the forty (49) million people with HIV/AIDS worldwide. The HIV Prevalence among adult in Nigeria has increase from 1.8% in 1991 to an estimated 5.8% in 2001 (joint united nations programme on AIDS 2006).Prevalence ranges from 2% to 4% in the country, according to official estimates Nigeria has an estimate 3.6 million people with HIV/AIDS and approximately 310,000 AIDS death this year and these numbers are protected to increase each year(joint united nation programme on HIVAIDS 2005).
Factors such as alcohol consumption before sex, unprotected sexual contact, intravenous drug use, and sharing HIV contaminated syringes needles are the major causes for HIV transmission (American Psychiatric Association, 2015). A lot of information about HIV/ AIDS prevention efforts and awareness campaigns against the spread of HIV infection is already abundantly available for PLWHA and for the general public. Despite the vast knowledge of how HIV is transmitted, many PLWHA still continue to engage in HIV/AIDS risky behaviors that also further places them to risks contracting secondary infections (e.g., syphilis, gonorrhea, herpesvirus-6) that may accelerate HIV/AIDS (Angelino, 2012).
Therefore, in Nigeria where the research was carried out, the activities that was conducted is to determine the level of knowledge and attitude of health care providers towards HIV/AIDS patients in Mary Sclessor Hospital Itu Local Government Area.
1.3 Statement of Problems
Investigation revealed that the problems of psychological implication on PLWHA. Despite advances in HIV care, PLWHA face numerous psychological challenges, HIV stigma has been defined as the social discrediting and devaluation of HIV infected persons. PLWHA are sometimes abandoned by their families and are forced to live in destitution which may lead to psychological devastation, inadequate family and community support may lead to poor drug adherence and non-disclosure of their disease status thus arising complications.
HIV/AIDS can lead to ostracism and social isolation, some children have a difficult time because of the interminable bullying and mockery at school and neighborhood which may lead to loneliness and low self esteem. Because of the stigma of HIV/AIDS, families are fearful of disclosing the diagnosis and have limited support systems from both inside and outside their family.
It is estimated that up to 50% of PLWHA suffer mental illness and substance abuse issues (Bing et al; 2009). Depression is noted to be often linked with major causes of HIV transmission, these include; unprotected sexual contact, intravenous drug use, alcohol consumption before sex and the sharing of HIV contaminated syringes and needles (Saylors & Daliparthy, 2010; Luber, 2012). Despite the prevalence of psychological distress experienced by PLWHA, the available body of evidence indicates that depression is frequently under diagnosed and goes untreated on a large scale. Hence, the intent of this study is to investigate the factors affecting psychological distress among people living with HIV/AIDS in Nigeria.
1.4 Aim and Objectives of Study
The aim of the study is to determine the level of knowledge and attitude of health care providers towards HIV/AIDS patients in Mary Slessor Itu Local Government Area. In achieving this aim, the following specific objectives were laid out as follows:
- To examine the level of awareness of health care providers towards HIV/AIDS patients
- To assess the attitude of health care providers towards HIV/AIDS patients
- To ascertain the causes and various forms of psychological problems against HIV patients
- To assess the coping mechanisms adopted by people living with HIV/AIDS to cope with social stigma and prevent depression, anxiety and substance abuse
- To investigate the psychological problems associated with HIV patients in Mary Slessor Itu Local Government Area
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of awareness of health care providers towards HIV/AIDS patients?
- What is the attitude of health care providers towards HIV/AIDS patients?
- What are the causes and various forms of psychological problems against HIV patients?
- How does people living with HIV/AIDS cope with social stigma and prevent depression, anxiety and substance abuse?
- Are there the psychological problems associated with HIV patients in Mary Slessor Itu Local Government Area?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: The health care workers have a low level of attitude and knowledge towards HIV/AIDS patients in Mary Slessor Itu Local Government Area
- H1: The health care workers has an high level of attitude and knowledge towards HIV/AIDS patients in Mary Slessor Itu Local Government Area
1.7 Significance of Study
A huge amount of research has been done around these psychological influences, yet it is felt that not all medical professionals and individuals working with HIV infected or the society they live in are aware of this body of knowledge. No one argues about the importance of following the numbers immune cell counts and levels of the virus in the blood nor should they but there is substantial and consistent evidence that depression, stressful life events and trauma accounts for some of the viability in HIV disease course.
It is necessary to investigate the biological and behavioral mediators of the relationships between psychological issues and the immune system also the types of intervention that could lessen the negative health impact of chronic depression and trauma.
Finally, the findings based on the outcome of this study will inform policy makers in the study area and the country as a whole on the psychological implications of HIV and also serve as a reference source to future researchers contributing to the existing body of literature on the subject matter.
1.8 Scope of Study
The scope of the research is focused on the knowledge and attitude of health care providers towards HIV/AIDS patients in Mary Slessor Itu Local Government Area, Akwa Ibom State.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Knowledge: To have information in one's mind as a result of experience or because you have learned or been told (Oxford Advanced Learner's Dictionary, 2005).
Attitude: The way one thinks feels or behaves about somebody or something (Oxford Advanced Learner's Dictionary, 2005).
