Rev. Enferm. UFSM - REUFSM
Santa Maria, RS, v. 9, e29, p. 1-17, 2019
DOI: 10.5902/2179769235114
ISSN 2179-7692
Submission: 09/10/2018 Acceptance: 04/07/2019 Publication: 25/09/2019
Original Article
Nursing academic production on the topics of HIV and aids: a historical-social study
Produção acadêmica da enfermagem acerca dos temas HIV e aids: um estudo histórico-social
Producción académica de enfermería sobre los temas VIH y sida: un estudio histórico-social
Stéfany PetryI
Maria Itayra PadilhaII
Ana Rosete MaiaIII
Gabriela Beims GapskiIV
I Nurse. Student of the Master Degree by the Postgraduate Program in Nursing of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
E-mail: stefanypetry@hotmail.com. Orcid: https://orcid.org/0000-0001-9713-247X
II Nurse. Professor Doctor by the Postgraduate Program in Nursing of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
E-mail: itayra.padilha@ufsc.br. Orcid: https://orcid.org/0000-0001-9695-640X
III Nurse. Professor Doctor by the Postgraduate Program in Nursing of the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
E-mail: anamaia8@hotmail.com. Orcid: https://orcid.org/0000-0002-3353-1225
IV Student of the Undergraduate Nursing Course by the Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
E-mail: Gabriela_beims@hotmail.com. Orcid: https://orcid.org/0000-0002-5627-8824
Abstract: Aim: to know the final undergraduate paper productions on HIV/AIDS in the Nursing Undergraduate Course of the Federal University of Santa Catarina from 1990 to 2017. Method: qualitative research, social-historical, of documented sources on the subject of HIV/AIDS in the Undergraduate Nursing Course of UFSC. Results: Of the 773 final undergraduate papers found, 25 (3.23%) were in the subject area. Studies aimed at the care of HIV patients, adolescent health promotion, and the risks of health professionals were identified. Final considerations: it was observed that the subject is still little investigated in final undergraduate papers, despite the increase in the last three years. It is necessary to carry out researches that contribute to the reduction of the disease’s social stigma and that can help in promoting and preventing the health of the population.
Descriptors: Students, Nursing; Nursing Research; Acquired Immunodeficiency Syndrome; Monograph
Resumo: Objetivo: conhecer os trabalhos de conclusão de curso sobre a temática HIV/aids no Curso de Graduação em Enfermagem da Universidade Federal de Santa Catarina no período de 1990 a 2017. Método: pesquisa qualitativa, histórico-social, de fontes documentais acerca da temática HIV/aids no Curso de Graduação em Enfermagem da UFSC. Resultados: foram levantados 773 trabalhos de conclusão do cursos, sendo que 25 (3,23%) se enquadravam na temática. Identificaram-se estudos voltados a assistência de pacientes com HIV, promoção à saúde de adolescentes, e os riscos dos profissionais da área da saúde. Considerações finais: observou-se que o tema ainda é pouco investigado nos trabalhos de conclusão de curso, apesar da ampliação nos últimos três anos, faz-se necessário a realização de pesquisas que contribuam para redução do estigma social da doença e também que possam auxiliar na promoção e prevenção da saúde da população.
Descritores: Estudantes de enfermagem; Pesquisa em enfermagem; Síndrome de Imunodeficiência Adquirida; Monografia
Resumen: Objetivo: conocer los trabajos finales de curso sobre VIH/SIDA, en el Curso de Enfermería, de la Universidad Federal de Santa Catarina (UFSC), entre 1990 y 2017. Método: investigación cualitativa, sociohistórica, a partir de fuentes documentales, específicamente, las monografías sobre el tema VIH/SIDA en el curso de enfermería de la UFSC. Resultados: fueron encontrados 773 trabajos finales de curso, 25 (3,23%) realizados sobre esa área temática. Identificamos estudios direccionados a la atención de los pacientes con VIH, a la promoción de la salud de los adolescentes y a los riesgos de los profesionales de la salud. Consideraciones finales: el tema aun es poco investigado en trabajos finales de curso, aunque el número de investigaciones aumentó en los últimos tres años, es necesario desarrollar más trabajos que contribuyan para la
Descriptores: Estudiantes de Enfermería; Investigación en Enfermería; Síndrome de Inmunodeficiencia Adquirida; Monografía
Introduction
The Undergraduate Nursing Course has as a profile the generalist, humanist, critical and thoughtful nurse training. This professional becomes qualified for the exercise of nursing when he has a scientific and intellectual basis based on ethical principles, for this reason, the course pedagogical program should offer complementary activities by means of study and independent practices face-to-face education and/or distance learning; monitoring and internships; scientific initiation programs; extension programs; complementary studies and courses conducted in other areas.1
When it concerns research, the early insertion of this student must be stimulated, however it can achieved in several moments, taking into account the curriculum structure provided by the course. Ensuring the link between teaching, research and extension/care and encourage performance of experiments and/or research projects to an evolution of the explicative models of the health-disease process. Since both during the training and in the conclusion, of course the researchers are essential.1
In our days, the research and the technology occupy a relevant place in the Brazilian universities. The graduate programs allied to incentive actions and resources allocated to research contribute to the increase of scientific productions within universities and facilitate undergraduate students´ access to the scientific community.2
In the light of the importance of the research in Nursing undergraduate courses, allied to the National Curriculum Guidelines (DCN), changes have been discussed in recent years to strengthen the integration between theory and practice, as well as the interdisciplinary training, participation of service nurses in practical activities and supervised curriculum internships, and establishing priority training areas which aim to meet population´s epidemiological picture and the principles of the Unified Health System.3
In accordance with these points, it is during the undergraduate course that the nursing students develop the final undergraduate paper (TCC), with the aid and orientation of a teacher. These studies called monographs and later TCC aim to know the thematic trends of the nursing students. It was found that the types of research more used by nursing students are field research, bibliographical research or theoretical review, documentary research and historical research. 4 The student learning with regard to the research also occurs by means of the integration of the student into research groups, by providing contact and learning with other undergraduate and graduate students at Masters and Doctoral levels. The extracurricular activity is also part of the nurses´ training process, being a mechanism assisting the course pedagogic proposal, the Teaching Institution and the scientific competence training. 5
It is important to integrate the nursing student into the research groups, by considering that the studies conducted by the groups, guided by researcher teachers promote the closeness of the act of investigating, bringing critical reflection regarding possible solutions to problems of care practice, managerial and teaching of the profession. These issues will promote future nursing professionals research opportunities for their practice both with regards to the search for answers to a health problem, with respect to the skill to make choice of studies with the best level of evidence.6 This process is necessary by understanding the teaching research in the undergraduate course, with the aim at training nurses increasingly qualified and strengthening profession as science under construction.7
In Federal University of Santa Catarina (UFSC), according to the curriculum established in 2011, the course has risen from eight to ten semesters, and in the last two phases of the course the student develops its final undergraduate paper, which can take place in two ways: as a research by following proceedings after approval by the Ethical Research Committee or diagnosis, resolution and evaluation grounded on the intention of finding solutions to the problems of care practice, educational and managerial.8
One of themes discussed in the TCC is related to HIV/aids, which was identified in 1982 and since its discovery carries a social stigma. It is important recognizing the disease as a public health problem and that the scientific community helps to spread information in order to contribute in construction of preventive measures. In order to change these conceptions, it is necessary to conduct researches that show the true meaning of the disease, and teaching institutions having an important role in the attribution of meanings and valorization of aspects concerning the theme and its appropriation by the future professional nurses.9
Taking into consideration that the HIV/aids remains a serious health problem in Brazil and all over the world, the nursing has a great participation in health promotion, prevention and care practice actions.10 It is worth pointing out that the HIV/aids is considered as a public health problem, because the same has an impact on the individual in terms of life-years lost, extension of incapacity, financial aspects related to treatment, pain and discomfort and impact on the family. As it also brings impacts on society linked to mortality, morbidity and financial costs with regard to treatment. Another relevant aspect as a criterion to list the disease as a public health problem is associated with its epidemic potential.11-12
In view of this evidence, this study aims to know the final undergraduate papers production on the HIV/aids in the Nursing Undergraduate Course of the UFSC from 1990 to 2017.
Method
This is an exploratory descriptive research of qualitative nature, historical-social of documentary type. The use of documents in the research provides the reach of objective information in the subjective context of the history. The documents appear as sources and can be contemporary or retrospective materials that contain oral or written substances, texts, books and other bibliographic materials. The historical research has as a method the documentation and presents choice processes, organization, analysis and synthesis. The documentary research techniques correspond to a set of collections operations, observation and information treatment, to convert facts into analyzable data. 13
The presentation of a TCC in the Nursing undergraduate course of the UFSC became a requirement in 1978, however the production data were obtained only from 1982 in a catalogue produced by the Nursing Department of the UFSC which includes the TCC from 1982 to 1997.14 The corresponding data from 1998 to 2017 were obtained by the available productions in the University Library of the UFSC and in its digital libraries (Pergamum), in the University Library of the University Hospital Professor Polydoro Ernani de São Thiago and in the archives of the Nursing Department of the UFSC. In addition to cooperation and dissemination of the works by teachers responsible for the disciplines linked to elaboration of the final undergraduate papers. From this survey, it was possible to find the TCC related to theme HIV/aids.
It is important to highlight that in 2011 a change has occurred in the course curriculum, in that the duration time has been extended from eight to ten semesters, which caused a time lag with respect to the classes that were being formed. That way, there are not TCC data regarding the first semester of 2015.
The data collect and organization took place during the period from May to August 2018. Seven hundred seventy three (773) TCCs were surveyed; all them were entered in a spreadsheet in Microsoft Excel and classified by title, author, advisor, theoretical reference and year. For an initial analysis all the titles and abstracts of the works was read, after this step, those that addressed the referring theme in their titles and abstracts using explicitly the term “HIV” or “aids”, or even, works that contained subjects such as: sexuality, reproductive health, sexual violence and biological accidents were separated. Subsequently a new reading of titles and abstracts of the selected results was conducted, and for classification and understanding, a reading of the methodology to achieve the result of the quantitative of TCCs to be analyzed was done.
After the selection of studies, a detailing of data about each research with respect to the year of publication, who were the advisors teachers and how the theme HIV or aids was being addressed in their different research fields and scenarios was conducted. Due to it is a documentary research with the use of public access data the approval of the Research Ethics Committee on human beings is not required.
Results
Seven hundred seventy three (773) TCCs were produced by students of the Nursing Undergraduate Course of the UFSC between 1982 and 2017. We noticed that although a period of 35 years of productions there were only 25 studies in the area of HIV/aids, which represents 3.23% of total production. In addition, the first study about the theme was conducted in 1990, after 8 years of the disease identification.
Not all studies found were framed or studied specifically the HIV/aids, however in any way were intrinsically associated with the theme.
Chart 1 – Nursing final undergraduate papers of the UFSC with the theme HIV/aids from 1990 to 2017, Florianopolis, 2018.
Order |
Title |
Year |
1 |
The Nursing care to the person with HIV and aids patients |
1990 |
2 |
Implementation of the nursing process in the care of clients from the attendance service to the psychosocial needs of the UFSC (SANPS) |
1993 |
3 |
Prevention of sexually transmitted diseases in adolescents in a Florianopolis state school |
1993 |
4 |
Nursing Care of persons with HIV/aids in hospital and domicile – a new care proposal |
1994 |
5 |
The nursing taking care of women/mother with HIV or aids through constructing a support relation |
1994 |
6 |
Nursing Care of persons with HIV/aids on the basis of the Basic Human Needs theory |
1996 |
7 |
Nursing Care of Persons with HIV/aids using the conceptual framework of stressors and confrontations |
1996 |
8 |
The Nursing interacting with the HIV/aids family in a pediatric hospital, in search for the objectives |
1996 |
9 |
Nursing Care of (together) persons with HIV/aids using the theoretical framework of Leininger |
1997 |
10 |
Prospective study about knowledge and use of contraceptive among patients with HIV/aids of an outpatient gynecology unit in an University Hospital |
1998 |
11 |
Sharing, through the Nursing Care, the knowledge in family planning, on searching to promote the self-care on health to individuals of childbearing age |
1999 |
12 |
Nursing care of persons with HIV/aids based on the Human basic needs |
2000 |
13 |
Care to the adolescent´s health : Reproductive Rights |
2003 |
14 |
Sexual Violence: the nursing promoting self-care through the education on health for victimized adolescents |
2003 |
15 |
Promoting autonomy to the humanized care of persons with HIV/aids on antiretroviral treatment based on Watson´s theory |
2004 |
16 |
The nursing practice as an educative process on health: the contribution of community agents in preventing early pregnancy and sexually transmitted diseases |
2005 |
17 |
The life history and the perceptions of patients living with aids |
2010 |
18 |
Profile of occupational accidents among nursing professionals exposed to biological material from 2005 to 2011: reality of a Hospital in southern Brazil |
2012 |
19 |
Managing the nursing care of adolescents living with HIV/aids by vertical transmission |
2012 |
20 |
The occupational accident repercussion on the professionals´life |
2013 |
21 |
The women living with HIV/aids and the (im)possibility of breastfeeding: an integrative review |
2014 |
22 |
Behavioral intentions presented by men before serological results of sexually transmitted diseases |
2014 |
23 |
Understanding the home care provided by HIV mothers to HIV-exposed children |
2016 |
24 |
Self-care knowledges and attitudes of nursing students before the sexually transmitted infections |
2017 |
25 |
Promotion of sexual and reproductive health: a conversation with adolescents about sexual and reproductive rights |
2017 |
Source: Own authors.
The TCC were classified with relation to the theme HIV/aids in different study areas: 09 production regarding the adults´ health (36%), 05 adolescents´ health (20%), 04 productions on women´s health (16%), 02 workers´ health (8%), 02 in public health (8%), 01 with emphasis on the management (4%), 01 in children´s health (4%), and 01 focused on the nursing students´ health (4%). The studies scenarios were: 12 studies occurred in the hospital (48%), 05 in schools (20%), 04 in the Primary Health Care (16%), 02 at home (8%), 01 Center for Testing and Counseling (CTA) (4%) and 01 in the university (4%).
When associated these production to advisors teachers, we observed that there were 10 teachers of the university concerned to develop researches with the theme during these 35 years. Standing out with orientation of 06 works the Prof. Dr. Maria Helena Bittencourt Westrupp, followed by the Prof. Dr. Maria Itayra Padilha with 04 orientations.
Discussion
Researching about some theme involves searching for the most recent knowledge about certain subject and the creation of questions to be answered in order to construct a project. The tasks necessary to develop a project are planned and carried out in accordance with the appropriate method, culminating in the discussion of results and elaboration of study conclusions.15
From identification of HIV/aids in 1982, the scientific studies were intensifying in order to increase the knowledge of the disease and develop a therapeutic intervention. Historically, the first case of aids notified in the Santa Catarina State was in August 1984. However, the first final undergraduate paper produced in the Nursing Undergraduate Course of the UFSC was in 1990, this pioneer study searched for informing what is this virus, how does its transmission occur, which are the signals and symptoms, how does the organism react to this virus, having as general objective the nursing care of the person with HIV/aids.16
The rise of the HIV/aids epidemic in Brazil occurred in 1982 almost simultaneously to the international scenario in that the health authorities detect the possibility of aids transmission through the sexual act, use of injectable drugs and exposition to blood and its by-products. The disease previously known with the provisional name of Disease of 5H: homosexuals, hemophiliacs, Haitians, heroin addicts (injectable heroin users) and prostitutes (hookers) it is now called the definitive name Acquired Immunodeficiency Syndrome (Sida, in Spanish, or Aids).17
It is important to point out that the HIV transmission among the Users of Injectable Drugs (UDI) is quite significant in the South and Southeast in Brazil. The greater economic infrastructure of the Southeast region allows the contact among people and supports the drug trafficking. The HIV infection among UDI in the state of São Paulo is associated with the low drug cost, which may lead to its spread among the municipalities and, also attracting even more the users.18
Considering the epidemiological profile of the Santa Catarina
region, the State takes the second highest rate of aids detection in the
country, according to the Ministry of Health, with 31.9/100.000 inhabitants.
In the first place, is the Rio Grande do Sul that presents a rate of 34.7/100.000
inhabitants. At national level, the aids detection rate is 19.1/100.000 inhabitants.
In the Santa Catarina State, 12 municipalities participate in an agreement
signed between the State Government and the Federal government to give priority
to prevention actions and greater coverage access to HIV/aids diagnosis,
because of presenting the highest detection rates in the state. Are they: Balneário Camboriú (63.2), Itajaí (61.9), São José
(57.7), Florianopolis (53.7), Palhoça (49.4), Lages (44.1), Criciúma (39.6),
Blumenau (39.5), Brusque (35.0), Joinville (30.6), Jaraguá do Sul (29.3) and
Chapecó (29.2).19
It is needed to take a complex look on factors such as the epidemiology, the prevention and the health programs in HIV/aids, contributing that way to a constant conceptual and scientific evolution that facilitate a step forward in understanding these factors and that is traduced in practices that may destabilize the stigma, as well as the repercussion of this on the management of care. 20
With regard to theme, it can also considered the nursing professionals´ occupational accidents through exposure to biological materials. The worker health and which are the conducts adopted in an occupational accident with biological material, as well as the professionals´ adherence to biosecurity measures is part of the daily work of nursing. The occupational accidents can understood as occupational diseases, and acquired by the function exerted by the worker in its work sector, and the commuting accidents, characterized as resulting from the travel between residence and work. 21
Nursing professionals occupy areas of care operation/ providing, such as emergency rooms, surgical rooms and laboratories, which place them in situations with greater risk of exposure, as well as cleaning professionals who collect and handle material containing contaminated .22 In Brazil, the occupational accidents with exposure to biological material are of compulsory declaration and must be recorded in the Information System on Diseases of Compulsory Declaration (SINAN).23 Health services has complex environments, which offer risks to health professionals, the needle stick injuries remain a problem with regards to contamination by biologically contaminated material, as they lead to the possibility of transmission of some pathogen agent through the blood, as in the cases of hepatitis B and C and HIV.24
Another area in that the TCCs had emphasized related to women health /mother with regard to HIV/aids by vertical transmission. The HIV transmission from mother to child may occur in the uterus, in the peripartum period or through breastfeeding .25 It becomes essential the access of pregnant women with positive HIV result to counselling, in order to begin the prevention of the HIV vertical transmission. Without the counselling and knowledge of serological status, the women care process is compromised. The counselling practice is complex and brings different challenges in the hearing and interaction with the patients. Communicating to the patient the serological result for the HIV, for example, is a delicate moment, specially, when the exam is carried out at the moment of birth.26 The diagnosis should be given as early as possible, in the prenatal period, once proved, the pregnant women may take some time to accept the situation and begin the prophylactic procedures to avoid the HIV vertical transmission. In this moment, the pregnant woman is confronted with the possibility that the disease may manifest in her or in her child, if prophylactic measures are inefficient. 26
Some TCCs addressed the sexuality theme, reproductive health with the adolescent population. These sexual behaviors and the sexual relations are an important and needed part of the human development. It is in adolescence that there is a progressive conquest of autonomy, projects elaboration, personal and social affirmation, and the searching for independence to reach adulthood. In this phase, socio-affective and sexual behaviors stood out.
The adolescents are increasingly earlier initiating their sexual life, even before they are 15 years old and without any educative information that can explain about issues of sexuality, body changes, issues about the vulnerability to Sexually Transmitted Infections (STI) and, mainly, the HIV. At this age, the naive awareness of the reality and the feeling of omnipotence added to the lack of information, lead to an unprotected sexual activity, which expose them to different risks. 27
The educational practices regarding the sexual education of adolescents is important in the actions within the school. In this sense, the nurse, in the development of the Health at School Program, must assume the role of educator in order to orient and inform the adolescents about the sexuality and the practice of the safe sex, free of diseases and contamination, by clarifying doubts and curiosities, and knocking down taboos. There are several factors involving the issue of the adolescents´ vulnerability to STI, among them: the beginning of early sexual life, lack of information about the performance of the sexual act, non-use of condom, inequality of gender, low income and social vulnerability.28
The theme has a great comprehensiveness due to the wide range of individuals who may be vulnerable to infection. It can be noted, that despite few TCCs with this theme, the studies permeate the historical context of the disease, in which there was an initial concern about the knowledge of disease identification, diagnosis and treatment addressed to the adult population that was the profile of the period, followed by studies focused on the contamination of pregnant women and the complex process of pregnancy and breastfeeding, and a more current way, studies related to high epidemiological indexes in the young population and the need of education and prevention.
Final considerations
The study shows the comprehensiveness of the researches conducted, focused not only on persons with the disease, but also in health promotion in different environments. The theme HIV/aids can approached in several ways, linked specifically to the women health field, the management, the students´ and health professionals´ health, as well as to drugs users.
Among the monographs of the nursing undergraduate course, there are still few studies addressing this theme. It is worth pointing out that due to be a problem that affects all population, of both sexes, it needed to increase the number of productions in order to provide actions for promoting and preventing the disease, as well as to broaden debates that may help in lowering the current epidemiological indexes, mainly with regard to Santa Catarina State. One considered that for being a theme wrapped in stigmas, fears and shame, these factors may influence the choice of the TCC theme, as well as the manner how is being addressed the thematic during the undergraduate course.
It is essential discussing the theme HIV/aids during the undergraduate course in a comprehensive way, not only its etiology and prognosis, but as an action of the health professional faced the patient. One can understood that this study can influence both in the choice of the thematic and in the possible study object for the production of other works, research and articles, as well as to highlight the need to place particular emphasis on developing studies and research about in order to increase and enhance the information about the disease, taking into account its academic and social relevance.
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Corresponding author
Stéfany Petry
E-mail: stefanypetry@hotmail.com
Address: Rua Aracuã, 34 – Pantanal, Florianópolis-SC, Brazil.
CEP: 88040310
Authorship Contributions
1 – Stéfany Petry
Conceptualization and planning of the research; obtaining, analysis and interpretation of data; critical writing and review.
2 – Maria Itayra Padilha
Conceptualization and planning of the research; analysis and interpretation of data; critical writing and review.
3 – Ana Rosete Maia
Critical writing and review.
4 – Gabriela Beims Gapski
Analysis and interpretation of data.
How to cite this article
Petry S, Padilha MI, Maia AR, Gapski GB. Nursing academic production on the topics of HIV and aids: a historical-social study. Rev. Enferm. UFSM. 2019 [Access at: 2019 jun 15];vol 9 ex:p1-p17. DOI:https://doi.org/10.5902/2179769235114