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    Intimate partner violence and HIV treatment adherence in urban South Africa: mediating role of perinatal common mental disorders
    (Elsevier, 2022) Hatcher, Abigail M.; Stöckl, Heidi; Woollett, Nataly; García-Moreno, Claudía M.; Christofides, Nicola Joan; N/A; Turan, Janet Molzan; Other; School of Medicine; N/A
    Background: Antiretroviral therapy (ART) has potential to eliminate perinatal HIV infections, but adherence to ART in late pregnancy and postpartum is often suboptimal. Intimate partner violence (IPV) may influence non-adherence among perinatal women living with HIV (WWH), but few quantitative studies have examined this over time or explored mechanisms for this association. Methods: We used secondary data from a parent trial in Johannesburg comprising WWH from the control arm (n=63) and WWH ineligible for the trial (n=133). Trained nurse researchers administered questionnaires at first antenatal visit on past-year psychological, physical, and/or sexual IPV (WHO instrument), socio-demographics (age, food security, education), and perinatal common mental symptoms of depression (Hospital Anxiety and Depression Screener-d); anxiety (HADS-a); post-traumatic stress disorder (PTSD; Harvard Trauma Questionnaire). At endline visit 2-4 months postpartum, nurse researchers assessed self-reported ART adherence using a visual analog scale (with ≥95% considered “good”). We fitted structural equation models (SEM) in MPlus to explore direct and indirect effects of IPV on ART adherence. Results: Of 196 perinatal WWH, 53.1% reported IPV exposure at baseline. The majority of participants (85.7%) had good perinatal ART adherence. In adjusted models, IPV at baseline was associated with halved odds of good adherence (aOR=0.51, 95%CI=0.20-0.96). IPV was associated with higher adjusted odds of probable depression (aOR=4.64), anxiety (aOR=2.85), and PTSD (aOR=3.42). In SEM, IPV had a direct (standardized coef=-0.22) and indirect effect (coef=-0.05) on ART via common mental disorders. The total effect of IPV on perinatal adherence was of moderate size (coef= -0.27) and the model had good fit (CFI=0.972; TLI=0.969; RMSEA=0.045; SRMR=0.076). Conclusion: IPV was longitudinally associated with perinatal ART non-adherence in part due to its relationship with mental health symptomology. Addressing IPV within clinical care has potential to improve perinatal mental health, maternal HIV outcomes, and HIV-free infant survival.
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    PublicationOpen Access
    The profile of psychiatric nurses in Turkey: academic field
    (Kare Yayıncılık, 2020) Yılmaz, Sevil; Boyacıoğlu, Nur Elçin; Sukut, Özge; Doğan, Nareg; Oflaz, Fahriye; Faculty Member; School of Nursing; 185160
    Objectives: there is no current data on the number and qualifications of the academic nursing work force in the mental health and psychiatric field in Turkey. The purpose of this research, therefore, is to construct a profile of academics who are working in the field of mental health and psychiatric nursing in Turkey. Methods: this descriptive and cross-sectional study was conducted between January–May 2018 via a digital questionnaire form. Of the 227 teaching staff with internet access who were invited to participate in the study, 177 filled out the questionnaires. The questionnaire consists of 42 questions about personal and professional experience. Descriptive statistics were used in the analysis of the data. Results: among the participants, 5.6% were professors; 16.9% were associate professors; 31.3% were doctoral faculty members, 14.6% were faculty members and 31.6% were research assistants. The percentage of those with master of science degrees in Mental Health and Psychiatric Nursing was 73.4%, while those with a doctorate in this field was 55.4%. It was further found that 89.8% of the participants worked full time, 34.5% had 1–5 years of academic experience, 45.2% taught outside the field of mental health, 20.9% had clinical experience in the field of mental health and 12.4% had never worked in a clinical area before. Finally, 34.5% stated that they had visited or studied in an institution abroad and 63.8% had participated in congresses abroad, with the mean number of international congresses attended being 3.92 (Max:43). Conclusion: the fact that about one-third of the academics were at the beginning of their academic experience and that half had no doctorate degree can be seen as characteristics posing possible risks to reaching goals. In contrast, the high number of those with clinical experience in the field of mental health can be viewed as a strong quality of the academic profile. / Amaç: ülkemizde, ruh sağlığı ve psikiyatri hemşireliği insan gücünü yetiştiren öğretim elemanlarının sayı ve niteliklerine ilişkin güncel veri bulunmamaktadır. Bu bağlamda araştırmanın amacı, Türkiye’de ruh sağlığı ve psikiyatri hemşireliği alanında görev yapmakta olan akademisyenlerin profilini ortaya koymaktır. Gereç ve yöntem: tanımlayıcı-kesitsel nitelikteki çalışmada veriler, Ocak–Mayıs 2018 tarihlerinde, dijital anket formu aracılığı ile toplanmıştır. İnternet erişimi olan 227 öğretim elemanı çalışmaya davet edilmiş olup, anketleri dolduran 177 kişi ile çalışma tamamlanmıştır. Anket formu, kişisel ve mesleki deneyime ilişkin 42 sorudan oluşmaktadır. Verilerin analizinde tanımlayıcı istatistikler kullanılmıştır. Bulgular: katılımcıların %5.6’sı profesör; %16.9’u doçent; %31.3’ü doktor öğretim üyesi, %14.6’sı öğretim ve %31.6’sı araştırma görevlisidir. Ruh Sağlığı ve Psikiyatri Hemşireliği yüksek lisans mezunu olanların oranı %73.4 olup, bu alanda doktora yapmış olma oranı %55.4’dür. Katılımcıların %89.8’i tam zamanlı çalışmaktadır, %34.5’i 1-5 yıl arası akademik deneyime sahiptir ve %45.2’si ruh sağlığı alanı dışında da ders vermektedir. Katılımcıların %20.9’unun ruh sağlığı alanında klinik deneyimi olduğu, %12.4’ünün ise daha önce herhangi bir klinik alanda çalışmadığı bulunmuştur. Akademisyenlerin %34.5’i yurtdışında bir kurumda çalışma ya da gözlem yapmak için bulunmuş olup, %63.8’i yurt dışında kongreye katılmıştır. Yurt dışı kongreye katılım sayısı ortalaması 3.92’dir (max. 43). Sonuç: psikiyatri hemşireliği akademisyenlerinin yaklaşık olarak üçte birinin akademik deneyiminin başında olması ve yarısının doktora derecesine henüz sahip olmaması hedeflere ulaşmada risk yaratabilecek bir özellik olarak değerlendirmiştir. Ruh sağlığı alanında klinik deneyimi olanların sayısının yüksek olması ise güçlü bir özelliktir.