The role of people living with HIV as patient instructors - reducing stigma and improving interest around HIV care among medical students
The role of people living with HIV as patient instructors - reducing stigma and improving interest around HIV care among medical students
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DOI：
10.1080/09540121.2016.1224314
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发表时间：
2017-01-01
影响因子：
1.7
通讯作者：
Rachlis, Anita
中科院分区：
文献类型：
--
作者：
Jaworsky, Denise;Gardner, Sandra;Rachlis, Anita
艾滋病毒/艾滋病感染者（PHAs）越来越多地被认为是艾滋病毒及其自身健康方面的专家。我们开发了一个模拟的临床遭遇（SCE），医学生提供艾滋病毒检测前和检测后的咨询和护理点艾滋病毒检测的PHAs作为病人的导师（PHA-PI）在临床导师的监督。该研究评估了这一教学工具的可接受性，重点是评估对医学生中艾滋病毒相关污名化的影响。多伦多大学见习医学生参加了一系列由16名PHA-PI和22名临床导师主持的SCE。SCE前和SCE后的学生完成了验证的卫生保健提供者艾滋病毒/艾滋病污名量表（HPASS）。HPASS测量总体耻辱，以及艾滋病毒耻辱的三个领域：陈规定型观念，歧视和偏见。分数越高，耻辱感越重。另一份调查问卷测量了提供艾滋病毒相关护理的舒适度。列出了平均评分和配对t检验结果。SCE后，学生（n = 62）表现出整体耻辱感下降（68.74 vs. 61.81，p < .001）以及每个领域内的耻辱感下降。SCE后，学生（n = 67）报告提供HIV相关护理的舒适度增加（10.24 vs. 18.06，p <0.001）。让PHA-PI参与减少了医学生中与艾滋病毒有关的耻辱感，并增加了提供艾滋病毒相关护理的舒适度。
People living with HIV/AIDS (PHAs) are increasingly recognized as experts in HIV and their own health. We developed a simulated clinical encounter (SCE) in which medical students provided HIV pre-and post-test counselling and point-of-care HIV testing for PHAs as patient instructors (PHA-PIs) under clinical preceptor supervision. The study assessed the acceptability of this teaching tool with a focus on assessing impact on HIV-related stigma among medical students. University of Toronto pre-clerkship medical students participated in a series of SCEs facilitated by 16 PHA-PIs and 22 clinical preceptors. Pre-and post-SCE students completed the validated Health Care Provider HIV/AIDS Stigma Scale (HPASS). HPASS measures overall stigma, as well as three domains within HIV stigma: stereotyping, discrimination, and prejudice. Higher scores represented higher levels of stigma. An additional questionnaire measured comfort in providing HIV-related care. Mean scores and results of paired t-tests are presented. Post-SCE, students (n = 62) demonstrated decreased overall stigma (68.74 vs. 61.81, p < .001) as well as decreased stigma within each domain. Post-SCE, students (n = 67) reported increased comfort in providing HIVrelated care (10.24 vs. 18.06, p < .001). Involving PHA-PIs reduced HIV-related stigma among medical students and increased comfort in providing HIV-related care.