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Nursing research improves care locally and around the world Yale AIDS researchers from the School of Nursing can be found interviewing sex workers in Thai brothels and drug users in Poland, conducting clinical trials to prevent gynecologic complications in New Haven women infected with HIV, and teaching AIDS treatment and prevention to nurses in China and Vietnam. “What became apparent from the earliest days of the epidemic,” says Ann Williams, M.S.N. '81, “was that nursing care made a huge difference. In the beginning–and it's still true for most of the world–exquisite nursing care was all we had to offer people with HIV. Now, with the promise of long-term survival on the horizon for many, our focus is shifting from acute symptom management to interventions directed at the problems raised by living with a chronic condition.” Professor Williams is principle investigator for the School of Nursing-based GRACE project, or Gynecologic Regimens Addressing Candida Events. GRACE was funded by the National Institute for Nursing Research to examine the efficacy of three nursing interventions to prevent Candida vaginitis, a common and distressing problem for women with AIDS. “Now that the study is complete,” she says, “we are turning our attention to new challenges such as strategies to improve medication adherence and screening for anal cancer. Neither of these issues were on our radar screen earlier, when our goal was limited to helping people feel better and live as long as possible.” Professor Williams, who also serves as an advisor for School of Medicine students, was pleased that the dissertation research for the nursing school's first doctoral graduate, Wantana Limkulpong, D.N.Sc. '98, was a study of safer-sex practices among commercial sex workers in Thailand. Ms. Limkulpong discovered that although knowledge levels were high, financial pressures and lack of self-confidence prevented many women from initiating condom use. Limkulpong is returning to a faculty post at Mahidol University in Bangkok, where she will continue her research. The Nursing School's global reach is extended by its collaborations with the Yale-China Association. Under one such project, Jane Burgess, director of the YSN-based Connecticut AIDS Education and Training Center, traveled to Hunan Province in May. In a program supported by the World AIDS Foundation, Ms. Burgess and Professor Williams, along with Nancy Angoff, M.P.H. '81, M.D. '90, are conducting a series of workshops to prepare Chinese nurses to respond to the growing threat of an HIV epidemic in the world's most populous country. In association with the workshops, Professor Williams and Dr. Angoff will study HIV seroprevalence in a storefront STD clinic in Changsha. Although HIV testing is not widely available, a skyrocketing incidence of anogenital HPV infections and genital ulcer disease suggests that the risk is extremely high. Closer to home, Professor Williams and Dr.
Angoff are looking at strategies to improve patient-provider communication about
end of life care and advance directives. The range of AIDS nursing research under
way at the School of Nursing illustrates the global challenge posed by this epidemic
and the importance of strong interdisciplinary collaborations. |
