Rural nurses' responses to providing nursing care to persons with HIV/AIDS and their family caregivers

Nurses in rural areas have limited contact with patients with HIV/AIDS and therefore may not have the skills necessary to provide care to these patients and their families. The purpose of this study was to investigate rural nurses' experiences providing nursing care to persons with HIV/AIDS and their family caregivers. Relationships among demographic variables, experiences caregiving to persons with HIV/AIDS and their family caregivers, satisfaction with caregiving, stress of caregiving, courtesy stigma, fear of AIDS, safe nursing practices, and proficiency in AIDS care were assessed to determine which variables best predict proficiency in providing caregiving. In addition the responses of rural nurses working in rural settings were compared with rural nurses working in urban settings on proficiency in AIDS care. Benner's Model of the five levels of proficiency provided conceptual model for the study. A descriptive correlational design was used. Instruments included a demographic data questionnaire and standardized instruments. A modified Dillman method was used for the survey. Data analysis included descriptive statistics, correlational analysis, multiple regression, ANOVA, and MANOVA. A convenience sample of 204 registered nurses who had rural mailing zip codes participated in the study. Hypothesis 1 was partially supported by findings indicating that nurses who reported more proficiency in caring for PWAs and their family caregivers had less fear of AIDS and more satisfaction with caregiving. The second hypothesis was not supported. There were no differences between the responses of nurses who worked in urban settings and nurses who worked in rural settings for the variables safe nursing practices, courtesy stigma, fear of AIDS, and proficiency in caring for PWAs and their family caregivers. Nurses working in urban settings reported greater contact with PWAs than nurses working in rural settings. AIDS contact and how many PWAs the nurse has cared for in the past 5 years were predictors of proficiency in AIDS Caregiving. Future research should consider other predictors of expertise for rural nurses. Findings indicate a need for more classroom theoretical content and clinical experiences in AIDS care in basic nursing education and in continuing education programs for practicing nurses.