My research interests are in advanced nursing practice, specifically advanced nurse practitioners. Nurse practitioners are Advanced Nursing Practice Registered Nurses (APRNs) with additional responsibilities in patient care management than Registered Nurses (RNs). Prescription of medication, examination of patients, identification of ailments, and provision of therapy are examples of such roles. In some states, nurse practitioners are not required to work under the supervision of a doctor. The professional experience of a nurse practitioner instills in them unique approaches to palliative care, while their level of medical education allows them to fulfill activities that were previously reserved for physicians. The chosen problem for the proposed research is the prevalence of HIV/AIDS and STIs among homosexual males in Europe. This selection is informed by an observation by Pharris Spiteri, Noori, and Amato-Gauci (2014) that all countries in the European Union (EU) and European Economic Area exhibit disproportionately high rates of HIV and STI infections including chlamydia, the two types of hepatitis, gonorrhea, and syphilis. Annual medical reports from some of the nations in these regions demonstrate increasing occurrences of infections among male homosexuals. For instance, the European Centre for Disease Prevention and Control cites that in the year 2013, a majority of the 29 157 new cases of HIV infections involved men who have sex with men. This shift was a 33% increase in new infections among this population compared to data collected between over the previous ten years (Beyrer, Sullivan, Sanchez, Dowdy, Altman, Trapence,... & Mayer, 2012).
According to Burke, Calabrese, Dovidio, Levina, Uusküla, Niccolai,... and Heimer (2015), the fact that homosexual males in this region have been consistently hesitant to disclose their HIV status for fear of stigmatization complicates the issue. As more and more are placed under the care of health care providers such as nurses, their refusal to share information about the condition of their health as they perceive it only further complicates the provision of health care (Lorimer, Kidd, Lawrence, McPherson, Cayless, & Cornish, 2013). The challenge to determine their actual health condition is hence automatically becoming the responsibility of the nurse who has to rely on previous experience with MSM (men who have sex with men) patients. The problem becomes even worse when the nurse responsible for the patient limits the extent to which they provide personal care. Should this scenario persist, the health of a considerable number of MSM HIV/AIDs patients is potentially bound to deteriorate.
Significance to Advanced Nursing Practice
The quality of life for people living with HIV/AIDs in developed regions such as the European Union has improved significantly ever since the development of antiretroviral drugs and therapy. While stakeholders in the healthcare sector should receive due credit for this progress, quality of life alone is an overgeneralization that conceals deep-lying issues regarding the management of the epidemic. This problem is of particular importance not only for stakeholders in the broader health care sectors but also for nurses. Foremost, Mayer, Bekker, Stall, Grulich, Colfax, and Lama (2012) observe that the delivery of health care has become more scientific but with the parallel challenge of also becoming less personalized. Health providers and especially nurses are neglecting the imperative to also comfort, care, and console patients. This scenario has important implications for the well-being of patients and especially those homosexual men who have HIV/AIDS. This group is particularly vulnerable considering allusions by Nöstlinger, Rojas Castro, Platteau, Dias, and Le Gall (2014) to a societal climate that has harbored negative attitude towards homosexual men. Nurses themselves may also perceive homosexual men in a negative light, and this dynamic has the potential to complicate the delivery of quality health care for such patients. It is hence crucial that certain steps be taken to alleviate the situation for both homosexual HIV/AIDS male patients and nurse practitioners involved in their management.
Preliminary PICOT Question
The context of the above description of the problem area necessitates the formulation of an initial PICOT question to guide the research necessary for gaining a deeper understanding of the proposal of feasible solutions. The preliminary PICOT question is framed as follows: should nurse practitioners engage more personalized care for MSM HIV/AIDS patients versus or maintain traditional clinical health care provision strategies for the same patients?
Population: the target population comprises homosexuals in Europe.
Intervention: engage more personalized care for MSM HIV/AIDS patients.
Control: maintain traditional clinical health care provision strategies.
Outcome(s): the possible results of which the researcher may be interested include:
Occurrences of diseases or symptoms related to the HIV.
Ratio of death related to HIV in the target population
Incidents of illness or symptoms related to sexually transmitted infections (STIs)
Rate of mortality associated with STIs
Possible changes in the quality of life
Time: The research will be conducted over a period of one year
Research Questions and Feasibility Analysis
Possible research questions regarding the role of nurse practitioners in the provision of health care for homosexual males living with HIV/AIDS will seek to put the problem into context. The questions will purpose to examine the role of both patients and nurses, establish the interrelationship between personalized care and health outcomes, and examine contemporary literature to determine the potential effects of increasing personalized care. The possible research questions for the proposed research include the following:
To what extent are MSM HIV/AIDS patients willing to disclose personal information regarding their health status?
What is the relationship between personalized nursing care and health outcomes for MSM HIV/AIDS patients?
How can nurse practitioners affect the delivery of personalized nursing care for MSM patients?
What are the effects of increasing personalized nursing care for this category of patients?
What does current literature recommend regarding the treatment of MSM HIV/AIDS patients?
Keywords (10) Relevant to Literature Search and Rationale
The possible keywords relevant to researching the PICOT questions include: males having sex with men (MSM), homosexual male sex, HIV in Europe, nursing and HIV, nursing interventions for MSM, STIs, antiretroviral, anonymous counseling, and safer sex. Their typical application in research involving HIV/AIDS informs the selection of these keywords which are expected to yield publications that could be relevant to the research.
Conclusion
In summary, the provision of personalized care for MSM patients is a direct concern for nurse practitioners. Preliminary research indicates that these patients are not receiving enough care for fear of stigmatization. This scenario presents a research opportunity to determine the effectiveness of increased personalized care as a possible intervention.
References
Beyrer, C., Sullivan, P. S., Sanchez, J., Dowdy, D., Altman, D., Trapence, G., ... & Mayer, K. H. (2012). A call to action for comprehensive HIV services for men who have sex with men. The Lancet, 380(9839), 424-438.
Burke, S. E., Calabrese, S. K., Dovidio, J. F., Levina, O. S., Uusküla, A., Niccolai, L. M., ... & Heimer, R. (2015). A tale of two cities: stigma and health outcomes among people with HIV who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia. Social Science & Medicine, 130, 154-161.
Lorimer, K., Kidd, L., Lawrence, M., McPherson, K., Cayless, S., & Cornish, F. (2013). Systematic review of reviews of behavioral HIV prevention interventions among men who have sex with men. AIDS Care, 25(2), 133-150.
Mayer, K. H., Bekker, L. G., Stall, R., Grulich, A. E., Colfax, G., & Lama, J. R. (2012). Comprehensive clinical care for men who have sex with men: an integrated approach. The Lancet, 380(9839), 378-387.
Nöstlinger, C., Rojas Castro, D., Platteau, T., Dias, S., & Le Gall, J. (2014). HIV-related discrimination in European health care settings. AIDS Patient Care and STDs, 28(3), 155-161.
Pharris, A., Spiteri, G., Noori, T., & Amato-Gauci, A. J. (2014). Ten years after Dublin: Principal trends in HIV surveillance in the EU/EEA, 2004 to 2013. Euro Surveill, 19(47), 20968.
