Reports of fear and psychological distress on the part of nurses caring for patients with acquired immunodeficiency syndrome (AIDS) have drawn attention to the quality of nursing care received by this seriously ill group of patients. Studies of health services provided for persons with AIDS (PWAs) have indicated that this patient population may receive less than adequate care. Despite much speculation and many isolated accounts of substandard care, systematic documentation of this phenomenon is lacking. Therefore, the overall purpose of this three year study is to describe and measure the quality of nursing care given to PWAs during hospitalization compared to the quality of nursing care given to a general population of inpatients. We will examine the relationship between the parameters of quality care, i.e. structure, process, and outcome. We will assess the relationship between nurse's fear of AIDS, stigma, nurse professionalism, perceptions of the work environment, and organization of nursing care delivery and quality of care, as well as between quality of care and both patient and nurse work satisfaction. This study will enroll 100 nurses and 100 PWAs and a comparison group of 100 patients from the nurses' caseloads. Data collection entails using the Quality of Patient Care Scale (QUALPACS), a tool with established validity and reliability which measures quality of nursing care through primarily direct observation using two nurse observers. Standard instruments to measure fear of AIDS stigma, nurse professionalism, perceptions of the work environment, and nurse work satisfaction will be administered to nurses after data collection with QUALPACS. A standard tool measuring patient satisfaction will be administered to both groups of patients. The need for research in this area is underscored by the lack of empirically based research describing the actual care provided by nurses to PWAs. Possibly exaggerated fears of the occupational risk of contracting AIDS among nurses does not compromise the quality of nursing care PWAs receive. Until claims of substandard care can be substantiated or refuted, health care agencies will be unable to plan appropriate educational and administrative interventions aimed at improving quality of nursing care for PWAs. Only when areas of strength and weakness in the delivery of nursing care are identified can planned change occur to improve the quality of that care.
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