HIV Insight: Reluctance to Care for Patients with HIV or Hepatitis B/C in Japan

BACKGROUND:

Healthcare workers are faced with various professional dilemmas in the workplace, including at times, a reluctance to care for particular patients. This study investigated personal attitudes and factors influencing Japanese nurses' reluctance to care for patients infected with HIV, Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV).

METHODS:

Participants completed an anonymous online survey focusing on potential attitudes towards hypothetical patients, awareness of infection risk and their confidence in using precautions to prevent infection. Statistical associations were analyzed using Poisson regression models.

RESULTS:

Regarding personal attitudes, 41 % and 18 % of nurses agreed or somewhat agreed that they would be reluctant to care for a hypothetical patient infected with HIV or HBV / HCV, respectively. Reluctance to care for patients with HIV or HBV / HCV was positively associated with prejudicial attitudes and negatively associated with confidence in personal safety precautions. Hypothetical reluctance to care for patients with HBV / HCV was negatively associated with actual previous experience caring for HBV / HCV patients. Older age among nurses (≥50 years) was positively associated with an increased reluctance to care for hypothetical patients with HIV.

CONCLUSIONS:

Overall, this study suggests that anxiety arising from perceived infection risk and having a prejudicial attitude might affect the acceptance of infected patients, while personal confidence in universal precautions probably mitigates this situation. Improving nurses' confidence in using universal precautions therefore represents a positive measure that can help reduce prejudice and improve the quality of healthcare services in Japan, as elsewhere.

Distribution of responses by HIV or HBV / HCV status

	HIV		HBV/HCV
	n	(%)	n	(%)
Anxiety regarding the potential infection risk from patients with HIV or HBV / HCV
Agree	133	(13)	145	(15)
Somewhat agree	397	(40)	391	(39)
Somewhat disagree	254	(26)	303	(31)
Disagree	186	(19)	139	(14)
Do not know	22	(2)	14	(1)
Confident that I could protect myself from infection when caring for patients infected with HIV or HBV / HCV
Agree	125	(13)	179	(18)
Somewhat agree	359	(36)	403	(41)
Somewhat disagree	253	(26)	231	(23)
Disagree	143	(14)	84	(9)
Do not know	112	(11)	95	(10)
Have you cared for a patient infected with HIV or HBV/HCV during the past one year?
Yes	110	(11)	668	(67)
No	700	(71)	218	(22)
Do not know	182	(19)	106	(11)
Do you believe that a patient infected with HIV or HBV / HCV might be a homosexual, have multiple sexual partners or be a drug user?
Agree	93	(9)	31	(3)
Somewhat agree	294	(30)	99	(10)
Somewhat disagree	261	(26)	330	(33)
Disagree	304	(31)	512	(52)
Do not know	40	(4)	17	(2)
Would you be reluctant to care for a patient infected with HIV or HBV / HCV?
Agree	109	(11)	43	(4)
Somewhat agree	294	(30)	136	(14)
Somewhat disagree	266	(27)	325	(33)
Disagree	271	(27)	466	(47)
Do not know	52	(5)	22	(2)

HBV hepatitis B virus, HCV hepatitis C virus

Full article at: http://goo.gl/lomDOA

By: Wada K1, Smith DR2, Ishimaru T3,4.

1Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan. kwada-sgy@umin.ac.jp.
2School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Ourimbah, Australia. derek.smith@newcastle.edu.au.
3Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand. ishimaru@med.uoeh-u.ac.jp.
4Occupational Health Training Center, University of Occupational and Environmental Health, Kitakyushu, Japan. ishimaru@med.uoeh-u.ac.jp.
BMC Pregnancy Childbirth. 2016 Feb 5;16(1):31.