Wounded Healers: Understanding the Socioecological Stressors Affecting HIV Positive Nurses in Sub-Saharan Africa

Thursday, 15 July 2010

Jackline Gloria Opollo, RN, MSN, MPH
School of Nursing, University of Texas at Arlington, Arlington, TX

Learning Objective 1: The learner will articulate the socioecological stressors affecting HIV positive nurses in Sub-Saharan Africa

Learning Objective 2: The learner will integrate concepts that can guide a theoretical framework for workplace health promotion research in Sub-Saharan Africa

Purpose: Despite the plethora of research exploring physical, emotional, or spiritual stressors associated with the Human-immune Deficiency Virus (HIV/AIDS) few studies have explored how these aspects specifically affect Africa’s “wounded healers”: the HIV positive nurse. Illness related to HIV/AIDS is a major cause of death among nurses in developing countries (Liese, 2004).The critical nursing shortage in Sub-Saharan Africa (SSA) could be attributable to escalated death rates related to AIDS rather than health worker migration (Hancock, 2006). HIV positive nurses must cope with direct effects of their illness, occupational hazards, as well as psychological effects of working in overburdened health systems. The purpose of this presentation is to propose an integrative research framework that will guide the understanding of socioecological stressors affecting HIV positive nurses working in SSA. Evaluating these stressors can ultimately guide relevant workplace health promotion and disease prevention interventions that can promote wellness for this vulnerable population.
Methods:   A systematic review of literature identifying critical socioecological concepts and the relationships among them for future workplace health promotion research in Sub-Saharan Africa.
Results: An integrative framework of Bronfenbrenner’s Socioecological Theory and Donabedian’s Structure, Process and Outcomes theory. This framework will guide identification of socioecological stressors, strategies to improve workplace structures and processes that promote access to care, equal opportunity policies, and workplace support programs. Desirable outcomes include improved access to care, improved workplace quality of life, and improved quality of life for HIV positive nurses, their dependents, and the populations they serve.
Conclusion:    Successful attainment of United Nations Millennium Development Goals (MDGs) depends on the availability of nurses to deliver care to People Living with HIV/AIDS. HIV positive nurses working in Sub-Saharan Africa are “wounded healers”. Any investment in research, policy, or practice strategies aimed at healing the wounded is a worthwhile global health effort.