Nurses' self-evaluations of human immunodeficiency virus (HIV) staff education programs

www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 Published by Sciedu P ess 51 ORIGINAL RESEARCH Nu ses’ sel -e alua ions o human immunode iciency i us (HIV) s a educa ional p og ams Vida Mockienė¹, Ta ja Suominen², Ma i a Valimaki³, A u as Razbadauskas¹, A ydas Ma inkenas¹, Ma ija T ush¹ 1. Facul y o Heal h Sciences, Uni e si y o Klaipeda, Li huania. 2. School o Heal h Sciences, Nu sing Science, Uni e si y o Tampe e, Finland. 3. Depa men o Nu sing Science, Uni e si y o Tu ku, Finland. Co espondence: Ta ja Suominen. Add ess: School o Heal h Sciences, Nu sing Science, Uni e si y o Tampe e, Finland. Email: a ja.suominen@u a. i Recei ed: Feb ua y 7, 2014 Accep ed: July 7, 2014 Online Published: Augus 5, 2014 DOI: 10.5430/jnep. 4n10p51 URL: h p://dx.doi.o g/10.5430/jnep. 4n10p51 Abs ac This s udy looks o desc ibe nu ses’ sel -e alua ions o s a educa ion p og ams ela ing o HIV and acqui ed immune de iciency synd ome (AIDS). Two di e en educa ion p og ams we e employed in h ee Li huanian hospi als: a 2-day wo kshop and he dis ibu ion o w i en ma e ials we e used in one hospi al, and only he dis ibu ion o w i en ma e ials in ano he . A hi d hospi al was chosen o con ol pu poses. A desc ip i e and compa ison s udy was unde aken wi h wo expe imen al g oups ( i s g oup, n = 63, second g oup, n = 63), and one con ol g oup (n = 59). Nu ses in he i s g oup we e mo e sa is ied wi h he p og am me hods (p < .001), du a ion (p < .001), and also he alue o hem (p = .010). The nu ses’ sa is ac ion wi h he educa ion p og am ela ed o hei backg ound ac o s was mos ly ela ed o he nu ses’ wo king a ea. Nu ses om he i s g oup who wo ked in a gynecological wa d we e mo e sa is ied wi h he in o ma ion hey ecei ed on HIV ansmission han hose d awn om a p ima y heal h ca e cen e , (p = .038), hey we e also mo e sa is ied wi h he p og am’s du a ion han nu ses om medical wa d (p = .003). P og am e alua ion ( om 0 o 10) was a ec ed by he nu ses’ wo king a eas. The nu ses in he i s g oup who wo ked in he gynecological wa d e alua ed he p og am wi h he highe ma k han he nu ses om he su gical wa d. The esul was s a is ically signi ican (p = .004). Nu ses om he second g oup (p o ided wi h only w i en ma e ial) who wo ked in a p ima y heal h ca e cen e we e mo e sa is ied wi h he HIV and AIDS disease con en , han nu ses who wo ked in he gynecological wa d (p = .033). The compa ison be ween he wo educa ion g oups e alua ing he educa ion p og am abou HIV and AIDS in he in e al scale om 0 o 10 was s a is ically signi ican (p = .016). The nu ses o he i s g oup e alua ed he educa ion p og am e y highly. Mos sugges ions conce ned p og am me hods and p og am du a ion when asked he ways o u he de eloped educa ion p og ams. The nu ses o he i s g oup (2-day wo kshop and he p o ision o w i en ma e ials) indica ed ha hey would like o ha e cou ses wi h lec u es using mo e isual means o p esen ing ma e ial, mo e discussions, and ha he cou ses should be longe . We can conclude ha special cou ses a e needed o nu ses o imp o e hei knowledge o HIV and AIDS. Key wo ds Educa ion in e en ion, E alua ion, Nu se, HIV, Sa is ac ion www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 ISSN 1925-4040 E-ISSN 1925-4059 52 1 In oduc ion Al hough nu sing li e a u e has s essed he impo ance o con inuing educa ion since he beginnings o he p o ession [1], he impo ance o ongoing con inuing educa ion and p o essional de elopmen o nu ses is inc easingly ecognized [2]. The cu en and p ojec ed demands o nu ses and nu sing se ices wo ldwide, coupled wi h d ama ic changes in he deli e y o heal h ca e, equi e nu ses wi h g ea e le els o knowledge, educa ion and skills [3]. Con inuing educa ion has been no iced o ha e an impac on di e en issues such as nu sing p ac ice [1, 4-7], pa ien ou comes [1, 8], nu ses’ knowledge le els [1, 7, 9] and p o essional g ow h [10, 11]. Educa ional mee ings a e one o he mos common ypes o con inuing educa ion o heal h p o essionals, and an impo an aim o con inuing educa ion is o in luence p o essional p ac ice [4]. I is he e o e necessa y o nu ses o pe cei e a clea ela ionship as exis ing be ween con inuing educa ion, imp o ed clien ca e and nu sing p ac ice. The li e a u e is abundan wi h calls o a cu iculum e o m in nu sing educa ion, ad oca ing cu icula ha a e esponsi e o changes in he heal h ca e deli e y sys em, a e esea ch-based and collabo a i e, and apply pedagogical inno a ion [13]. Many esea che s [6, 14] ha e indica ed ha aining should head in new di ec ions, some o which include pe sonal expe ience, g oup suppo , g and ounds, hospi al-wide con inuing educa ion p og ams, p o essional o ganiza ion-based con inuing educa ion p og ams, on-line educa ional p og ams, and jou nal clubs. Such ini ia i es a e use ul in ha hey allow pa icipan s o assis each o he in unde s anding ma e ial and help lea ne s unde s and how he hings hey lea n can be applied o he wo kplace. In oday’s socie y, hospi al inpa ien s a e mo e acu ely ill and p esen wi h mul i ace ed and complex heal h p oblems ha necessi a e ongoing high-quali y nu se educa ion [17]. Educa ion is essen ial in he a ea o nu sing pa ien s li ing wi h HIV o AIDS, because nu ses o m he on line o hei ca e, p e en ion and ad ocacy, so educing he isk o HIV in ec ion among hei clien s and con ibu ing o he imp o emen and quali y o ca e deli e ed [21]. The e ec i e educa ion o nu ses ela ing o HIV and ca e o People Li ing wi h AIDS (PLWA) has no been ex ensi ely esea ched and he e is s ill a need o de elop nu se educa ion so ha hey could unde ake oles such as HIV p e en ion leade s. The ba ie s which inhibi indi idual heal h wo ke s om becoming in ol ed in HIV p e en ion ha e been iden i ied in p e ious esea ch [24, 25]. These include knowledge de ici , HIV and AIDS s igma izing a i udes, and a eluc ance o discuss HIV, AIDS, sexuali y, and aspec s o isky beha iou in he clien ’s pe sonal li e. Thus, i is impo an o unde s and he iews o heal h ca e p o essionals and hei pe spec i e on educa ion ela ed o HIV and AIDS. This s udy he e o e places a special emphasis on he sel -e alua ion o HIV and AIDS ela ed s a educa ional p og ams. 2 Pu pose and esea ch ques ions The pu pose o his s udy is o desc ibe nu ses’ sel -e alua ions o HIV and AIDS ela ed educa ion p og ams. The speci ic esea ch ques ions we e: 1) How should such educa ion be o ganized? a) Wha is he bes sou ce o in o ma ion abou HIV and AIDS? b) Wha is he bes du a ion o his ype o educa ion p og am? 2) How sa is ied we e nu ses wi h hese educa ion p og ams? 3) How was nu se sa is ac ion ela ed o backg ound ac o s? 4) How should educa ion p og ams be u he de eloped? www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 Published by Sciedu P ess 53 3 Ma e ials and me hods 3.1 Educa ion p og am Two di e en educa ion p og ams we e used: a 2-day wo kshop including he dis ibu ion o w i en ma e ials was used in one hospi al, and only he dis ibu ion o w i en ma e ials was used in ano he hospi al. An addi ional hospi al was used o con ol pu poses. The educa ion session p o ided o he i s g oup consis ed o a 2-day wo kshop and he p o ision o w i en ma e ials. The wo kshops las ed 13 hou s in o al, including 1 hou o an in oduc ion o he esea ch and ins uc ions on how o comple e he ques ionnai e. The augh elemen s included: lec u es, g oup discussions, a con e sa ion wi h people li ing wi h HIV, a ilm “Heal h ca e wo ke s and HIV and AIDS”, lec u e handou s and he dis ibu ion o w i en ma e ials. The ilm was based on he educa ional aspec o how o a oid con amina ion a wo k. The ilm las ed o abou 60 minu es and was o iginally c ea ed in Finland. I was made a ailable in he Li huanian language by he Li huanian AIDS Cen e. The con en a eas we e: HIV epidemiology and his o y, p e en ion, ansmission, HIV ea men , counseling and e hical conside a ions. The w i en ma e ials consis ed o academic jou nal a icles on he p og am’s con en a ea opics (20 pages). The in e en ion ecei ed by he second g oup consis ed o he same academic jou nal a icles (20 pages) ha we e p o ided o he i s g oup nu ses. Addi ionally, he lec u e handou s om he i s g oup we e also p o ided o he second g oup (2 pages p o iding new s a is ics o he HIV si ua ion Li huanian and global con ex s). In o al he second g oup pa icipan s ecei ed 22 pages o w i en ma e ial. The con ol g oup o nu ses ecei ed no lec u es o w i en ma e ials. The pa icipan s om he i s and second g oups we e also p o ided wi h con inuing educa ion c edi s as an incen i e o pa icipa e. 3.2 Pa icipan s and se ings The pa icipan s we e nu ses egis e ed in Li huanian who wo ked in he su gical, medical, o gynecology wa ds o h ee o he la ges hospi als in Li huania, and in p ima y heal h ca e cen e s a ached o he hospi als. The nu ses we e andomized in o s udy g oups om pools o abou 300 nu ses a each hospi al. The minimum numbe o pa icipan s equi ed pe g oup was 55, howe e , his was inc eased o 80 pe g oup (as he esponse a e was 68.8%), so as o allow a mo e obus explo a ion o be conduc ed. A o al o 240 nu ses we e in i ed o pa icipa e in he s udy. The s udy u ilized a desc ip i e and compa ison design, wi h p e- es e alua ion and a h ee-mon h epea ed ollow-up e alua ion. The baseline sample con ained 206 pa icipan s (15% o he in i ed nu ses declined o pa icipa e in he s udy). The ollow-up sample con ained 185 pa icipan s (10% o nu ses wi hd ew om he s udy). 3.3 Da a collec ion me hods The baseline ques ionnai e consis ed o backg ound ac o s and ques ions ela ed o he sou ces o nu ses’ iews on who could bes p o ide in o ma ion abou HIV in ec ion and/o AIDS. The backg ound ac o s asked we e demog aphic: age, sex, mo he - ongue, ma i al s a us, whe he he esponden had child en o no , and he highes le el o educa ion held. Wo k ela ed backg ound ac o s such as wo k expe ience in heal h ca e, cu en wo k place, wo k a ea and wo k expe ience in hei p esen wa d we e also ga he ed. The nu ses’ need o in o ma ion was assessed using a 5 poin Like -scale. The ollow-up ques ionnai e consis ed o a ew backg ound ques ions ha con i med nu ses’ cu en wo kplace, wo k a ea and wo k expe ience in hei p esen wa d. In ega d o he ques ions ela ed o hei in o ma ion abou HIV and AIDS, he esponden s needed o e alua e how well hey ela ed o he sou ces o in o ma ion which we e made a ailable o hei s udy g oup. Thei sa is ac ion wi h he chosen p og am was e alua ed using a 5-poin Like scale. Sa is ac ion was measu ed ela ed o he con en , me hods and du a ion o he p og am. Addi ionally, he esponden s ga e hei opinion o www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 ISSN 1925-4040 E-ISSN 1925-4059 54 he p og am on he in e al scale om 0 o 10, and an open-ended ques ion was p o ided we e esponden s could w i e any sugges ions o an HIV and AIDS educa ion p og am o nu ses. 3.4 E hical issues and limi a ions Following a posi i e s a emen by he esea ch e hics boa d o Uni e si y o Klaipeda, in Li huania, pe mission o conduc he s udy was ob ained di ec ly om he hospi als in ol ed. The s a was in o med abou he pu pose o he s udy and he na u e o olun a y and con iden ial pa icipa ion. W i en consen was ob ained om all pa icipan s. The comple ed ques ionnai es we e e u ned in sealed en elopes di ec ly o he esea che s based on e hical p inciples [27]. As limi a ion he e we e some s a is ically signi ican di e ences be ween he g oups, and also a change in he sample size be ween he baseline and ollow-up da a. 3.5 Analysis A quan i a i e analysis app oach was used o e alua e and in e p e he nume ical da a. S a is ical analysis was pe o med by using he SPSS 12.0 so wa e package. The nu ses' demog aphic a iables and i ems conce ning hei e alua ion o he educa ion p og am we e examined using desc ip i e analysis. A e es ing o no mali y, pa ame ic and nonpa ame ic c i e ia we e used o compa e wo o mo e g oups (ANOVA, Tukey’s HSD, Mann–Whi ney and K uskal–Wallis es s). P obabili y alues o less han .05 we e in e p e ed as being s a is ically signi ican . C onbach’s alpha coe icien was used o e alua e whe he he i ems wi hin a scale e lec ed o measu ed he same concep [26]. Two ac o s we e de ec ed in he esul s ( he con en and he alue o pa icipan s) o he pa icipan s o he wo g oups. In he i s g oup, he C onbach’s alpha coe icien in sa is ac ion wi h he con en was 0.923 and 0.938 o alue. In he second g oup i was 0.922 o con en and 0.856 o alue. Nu ses’ sugges ions o he u he de elopmen o educa ion p og ams we e e alua ed using he con en analysis me hod. The analysis s a ed wi h sea ching he s a emen s p o ided which co esponded o he ques ions [27]. Con en analysis can help e alua o s lea n mo e abou he p og ams and issues in ol ed due o i s sys ema ic app oach, and has s uc u ed o ms ha allow he ex ac ion o ele an in o ma ion mo e consis en ly han i he same in o ma ion we e ead only casually. 4 Resul s 4.1 Sample cha ac e is ics All pa icipa ing nu ses we e emale and he majo i y was ma ied and had child en. The nu ses a ied in age om 23 o 67 yea s, hei mean age being 43.1 (SD = 8.8). The le el o wo k expe ience was long and abou he same numbe s o nu ses we e d awn om su gical, medical, and gynecological uni s and p ima y heal h ca e cen e s a ached o he hospi als. The e we e some s a is ically signi ican di e ences be ween he g oups: he pa icipan s in he i s g oup we e younges (p = .016), held a highe le el o uni e si y educa ion (p = .001) and had he leas wo k expe ience (p = .051) and had ewe child en (p = .46). 4.2 O ganiza ion o he educa ion Fo bo h g oups, he bes means o ga he ing in o ma ion on HIV o /and AIDS ela ed in o ma ion was epo ed o be h ough a special cou se (see Table 1), de e mined bo h a baseline enqui y and ollow-up. Also, he majo i y o nu ses om bo h g oups hough ha he bes in o ma ion sou ce was an academic a icle (see Table 1). I is impo an o highligh ha be o e he educa ion p og am, up o 42% o nu ses o he i s g oup belie ed ha he bes in o ma ion sou ce was om mass media, bu ollowing he educa ion p og am only 23.8% o nu ses held he same iew. www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 Published by Sciedu P ess 55 Table 1. The bes in o ma ion sou ce abou HIV/AIDS, as iden i ied a baseline (n = 206) and ollow-up (n = 185) be ween g oups To ally ag ee (%) Ag ee (%) Pa ly ag ee pa ly disag ee (%) Disag ee (%) To ally disag ee (%) P Baseline and ollow-up Baseline and ollow-up Baseline and ollow-up Baseline and ollow-up Baseline and ollow-up Mass media Fi s g oup 42.0/23.8 23.2/33.3 23.2/33.3 13.0/9.5 4.3/1.6 .076 Second g oup 24.3/33.3 32.9/33.3 32.9/33.3 8.6/3.2 - .435 Con ol g oup 28.6/30.5 33.3/44.1 21.4/15.9 11.9/6.8 4.8/1.7 .643 Scien i ic a icle Fi s g oup 65.2/63.5 29.0/27.0 5.8/7.9 - 0.0/1.6 .711 Second g oup 63.8/71.4 29.0/20.6 2.9/7.9 2.9/0.0 1.4/0.0 .238 Con ol g oup 60.5/57.6 39.5/28.8 0.0/10.2 0.0/1.7 0.0/1.7 .151 Popula li e a u e Fi s g oup 34.8/22.2 30.4/34.9 18.8/28.6 15.9/12.7 0.0/1.6 .323 Second g oup 18.6/34.9 37.1/25.4 20.0/27.0 21.4/11.1 2.9/1.6 .096 Con ol g oup 23.3/32.2 37.2/33.9 18.6/23.7 16.3/10.2 4.7/0.0 .336 Special Cou se Fi s g oup 73.9/73.0 24.6/15.9 1.4/6.3 0.0/3.2 0.0/1.6 .158 Second g oup 84.3/73.0 15.7/27.0 - - - .111 Con ol g oup 74.4/78.0 20.9/18.6 2.3/1.7 2.3/1.7 - .976 No e. Fi s g oup (2-day wo kshop and w i en ma e ial); second g oup (w i en ma e ial). K uskal Wallis Tes - he mean di e ence is signi ican a he le el o p < .05. A e he educa ion p og am he i s g oup o nu ses e alua ed he bes possible p og am du a ion o be 2-5 days (mean = 3.30, median = 3.00, SD = 1.15). The second g oup o nu ses epo ed i o be mo e han 1 week (mean = 3.98, median = 4.00, SD = 1.55). The con ol g oup epo ed he bes possible du a ion o be 2-5 days (mean = 3.56, median = 3.00, SD = 1.18). The di e ence be ween he i s and he second g oup was s a is ically signi ican (p = .005). 4.3 Nu ses’ sa is ac ion wi h he educa ion p og am A e he educa ion p og am, he nu ses o he i s g oup assessed he educa ion p og am con en (see Table 2). They we e mo e sa is ied wi h he con en a eas o isk con ac (61.9%), ea men and ca e (61.9%), HIV ansmission (57.1%) explana ion, and disclosu e and con iden iali y (57.1%). Howe e , he nu ses o his g oup we e no sa is ied co e age o he law egula ing he wo k wi h HIV-posi i e pa ien s (38.1%), he explana ion o e hical p oblems (34.9%) o he du a ion o he p og am (41.3%). The nu ses we e e y sa is ied wi h all o he me hods used in he p og am: ilm, g oup discussion, g oup discussion wi h an HIV posi i e pe son, lec u es and he p o ision o w i en ma e ials. They we e leas sa is ied wi h du a ion o he educa ion p og am, bu we e e y sa is ied wi h he alue i p o ided. The nu ses o he second g oup we e mo e sa is ied wi h he con en in o ma ion ela ed o HIV ansmission (68.3%), ea men and ca e (66.7%), HIV and AIDS disease (58.7%), isk con ac (58.7%) and ea and con agion (57.1%). They we e leas sa is ied wi h he me hods (20.6%) and du a ion o he p og am (20.6%), bu ga e a high e alua ion o he p og am om he poin o iew o he in o ma ion hey had gained (see Table 2). 4.4 Associa ion o nu ses’ backg ound ac o s o hei sa is ac ion wi h he educa ion p og am The nu ses’ sa is ac ion wi h he educa ion p og am ela ed o hei backg ound ac o s was mos ly ela ed o he nu ses’ wo king a ea. In assessing he educa ion p og am con en , nu ses om he i s g oup who wo ked in a gynecological wa d we e mo e sa is ied wi h he in o ma ion hey ecei ed on HIV ansmission (81.3%) whe eas wi h hose d awn om a www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 ISSN 1925-4040 E-ISSN 1925-4059 56 p ima y heal h ca e cen e , his d opped o only 31.3% (s a is ically signi ican , p = .038). The nu ses om he gyneco- logical wa d we e also mo e sa is ied wi h he p og am’s du a ion han nu ses om medical wa d (p = .003) (see Table 3). The e alua ion o he educa ional p og am ( om 0 o 10) among he nu ses o he i s g oup was no s a is ically signi ican as a as he du a ion was conce ned. P og am e alua ion ( om 0 o 10) was a ec ed by he nu ses’ wo king a eas: 68.8% o he nu ses in he i s g oup who wo ked in he gynecological wa d e alua ed he p og am wi h he highes ma k (10), while only 6.7% o he nu ses om he su gical wa d e alua ed he p og am wi h he highes ma k (10). The esul was s a is ically signi ican p = .004. Table 2. Sa is ac ion wi h he educa ion p og am a ollow-up P oposi ion (%) Ve y sa is ied Sa is ied Pa ly sa is ied pa ly dissa is ied Dissa is ied Ve y dissa is ied P Fi s /second Fi s /second Fi s /second Fi s /second Fi s /second The con en : 39.7/46.0 60.3/54.0 .473 HIV epidemiology and his o y 41.3/54.0 55.6/38.1 3.2/7.9 .301 Legisla ion 38.1/44.4 52.4/34.9 7.9/17.5 1.6/1.6 0/1.6 .905 HIV/AIDS disease 47.6/58.7 52.4/39.2 0/1.6 .251 HIV ansmission 57.1/68.3 42.9/31.7 .199 Co-In ec ion 41.3/52/4 54.0/36.5 4.8/11.1 .459 T ea men and ca e 61.9/66.7 34.9/33.3 1.6/0 1.6/0 .499 HIV es 47.6/47.6 46.0/44.4 6.3/6.3 0/1.6 .920 Risk con ac 61.9/58.7 34.9/34.9 3.2/6.3 .629 Pos -exposi ion p ophylaxis 46.0/46.0 42.9/34.9 11.1/19.0 .651 Disclosu e/con iden iali y 57.1/47.6 41.3/42.9 1.6/9.5 .162 S igma/disc imina ion 49.2/44.4 38.1/36.5 11.1/12.7 1.6/3.2 0/3.2 .403 Fea o con agion 57.1/57.1 31.7/36.5 9.5/3.2 1.6/3.2 .844 Mo al issues 44.4/47.6 46.0/38.1 7.9/12.7 1.6/1.6 .974 E hical issues 34.9/46.1 57.1/38.1 6.3/14.3 1.6/1.6 .580 The me hods: 69.8/20.6 28.6/52.4 1.6/27.0 < .001 Lec u es 63.5 36.5 G oup discussions 66.7 27.0 6.3 Film abou HIV demons a ion 71.4 28.6 G oup discussions wi h HIV posi i e 71.4 20.6 4.8 3.2 W i en ma e ial 61.9/27.0 33.3/63.5 4.8/7.9 0/1.6 <.001 The du a ion o he p og am 41.3/20.6 27.0/15.9 30.2/17.5 1.6/25.4 0/20.6 <.001 The alue o me: 73.0/49.2 23.8/49.2 3.2/1.6 .010 Bene icial now 71.4/37.1 27.0/41.3 1.6/1.6 .102 Bene icial o u u e 65.1/52.4 33.3/44.4 1.6/3.2 .141 P omo e c i ical hinking 63.5/47.6 34.9/46.0 1.6/4.8 0/1.6 .055 No e. Fi s g oup (2-day wo kshop and w i en ma e ial); second g oup (w i en ma e ial). K uskal Wallis Tes - he mean di e ence is signi ican a he le el o p < .05. Nu ses om he second g oup (p o ided wi h only w i en ma e ial) who wo ked in a p ima y heal h ca e cen e we e mo e sa is ied wi h he HIV and AIDS disease con en , han nu ses who wo ked in he gynecological wa d (p = .033). Howe e , nu ses who wo ked in he gynecological wa d we e no a all sa is ied wi h he p og am du a ion, whe eas 43.8% o nu ses om he medical wa d we e sa is ied wi h he du a ion o he p og am. The compa ison be ween he wo g oups e alua ing he educa ion p og am abou HIV and AIDS in he in e al scale om 0 o 10 was s a is ically signi ican (p = .016). The nu ses o he i s g oup e alua ed he educa ion p og am e y highly (see Table 3). www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 Published by Sciedu P ess 57 Table 3. The compa ison be ween he wo g oups in e alua ing he educa ion p og am on an in e al scale om 0-10 (%) 4 5 6 7 8 9 10 P Fi s g oup 0 1.6 1.6 6.3 27.9 28.6 34.9 .016 Second g oup 1.6 11.1 1.6 15.9 22.2 23.8 23.8 No e. Fi s g oup (2-day wo kshop and he w i en ma e ial); Second g oup ( he w i en ma e ial). The mean di e ence is signi ican a he le el o p < .05. 4.5 Nu ses’ sugges ions o u u e de elopmen o he educa ion p og ams In o al, o 185 pa icipan s om he ollow-up ques ionnai e, 25 nu ses epo ed ways in which educa ion p og ams may be u he de eloped (see Table 4), ecei ed om all he pa icipa ing g oups. Mos sugges ions conce ned p og am me hods and p og am du a ion. The nu ses o he i s g oup (2-day wo kshop and he p o ision o w i en ma e ials) indica ed ha hey would like o ha e cou ses wi h lec u es using mo e isual means o p esen ing ma e ial, mo e discussions, and ha he cou ses should be longe . The nu ses o he second g oup (p o ision o w i en ma e ials only) indica ed ha he cou ses should be p o ided egula ly (2-3 imes pe yea ) and ha he dis ibu ion o ma e ials should be made easie and in a mo e imagina i e manne . They also wan ed o ha e longe - e m cou ses. Simila sugges ions we e highligh ed by he nu ses o he con ol g oup ( ega ding he educa ion p og am me hod and du a ion). Table 4. Nu ses’ sugges ions ega ding he u u e de elopmen o educa ion p og am Me hods: Fi s g oup (N*) Second g oup (N*) Con ol g oup (N*) Lec u es 3 8 2 Discussion 1 - - Visual (e.g. ilm) 1 - - Dis ibu ion ma e ial - 2 - P og am du a ion 2 2 5 No e. Fi s g oup (2-day wo kshop and he w i en ma e ial); Second g oup ( he w i en ma e ial). *N – he numbe o answe s 5 Discussion The bes in o ma ion sou ce o HIV o /and AIDS ela ed in o ma ion in he p esen s udy was epo ed o be a special cou se. This was exp essed by bo h g oups in he su eys conduc ed be o e and a e he educa ion p og am. The inding coincides wi h s udies by Pisal e al. [28] Williams e al. [29] and Endaco e al. [30]. The s udy by Timmins [2] indica ed ha nu ses ga e p io i y o con e ences and nu sing jou nals in he p ocess o enewing hei knowledge. The nu ses o he i s g oup e alua ed he bes possible du a ion o an HIV and AIDS educa ion p og am o be 2-5 days and he second g oup – mo e han 1 week. This inding is simila o ha o , e.g. Pisal e al. [28] Williams e al. [29] Cha uluxananan e al. [31] and B une o e al. [32] who e iewed he educa ional p og ams in nu sing ound ha s a is ically signi ican esul s we e e iden om he sho e du a ion s udies o 11 hou s, wi h he longes p og am o 105 hou s showing only end imp o emen . Following he educa ion p og am, he nu ses o he i s g oup we e mo e sa is ied wi h he con en a eas o isk con ac and ea men and ca e. The nu ses o he second g oup we e mo e sa is ied wi h HIV ansmission and ea men , and ca e explana ion hey ead om he pos ed ma e ial. The sa is ac ion di e ences among nu ses om di e en clinical a eas challenges he manage s. I is ob ious he nu ses’ knowledge le el should be added, bu how o do ha in app op ia e way. The gene al cou se like in his s udy a e mo e economic, bu a he same ime can’ each all as well nu ses wo king in www.sciedu.ca/jnep Jou nal o Nu sing Educa ion and P ac ice, 2014, Vol. 4, No. 10 ISSN 1925-4040 E-ISSN 1925-4059 58 su gical, medical, o gynecology wa ds and p ima y heal h ca e cen e s. The eason o ha e hese nu ses in ou s udy was based on he knowledge hey mos o en mee HIV-in ec ed people and a e in on line o ecei e addi ional educa ion also in a coun y whe e he opic has been no o in e es ea lie so much in con inuing educa ion and lacks heal h ca e de elopmen money. Nu ses om di e en clinical a eas ha e speci ic educa ion needs conce ned hei e e yday nu sing p ac ice. Realis ic way is no hough ha e a special cou se o all clinical a eas, bu some combina ion o gene al pa and mo e speci ic pa o he con en a eas based on clinical a eas would be welcomed in coun ies wi h low economic si ua ion. The i s and second g oup opinions we e e y di e en when assessing he educa ion p og am me hods, ye bo h g oups highly a ed he inpu hey ecei ed du ing he educa ional p og ams. In p e ious li e a u e, esea che s who desc ibed in e en ion s udies in a simila con ex [28, 29] did no examine he le els o nu ses’ sa is ac ion wi h, o example, he p og am me hods o con en . S a is ically, nu ses’ sa is ac ion wi h he educa ional p og am was mos ly ela ed o he backg ound ac o s ha associa ed wi h he nu se’s wo king a ea. Howe e , when o e ing ideas abou he u u e de elopmen o educa ional p og ams, nu ses emphasized he impo ance o p og am me hods and du a ion, bu did no o e mo e de ailed in o ma ion which kind o con en addi ions hey wan ed in he p og am. 6 Conclusions The p esen s udy indica ed ha he bes in o ma ion sou ce o HIV o /and AIDS ela ed in o ma ion was epo ed o be a special cou se, and he bes possible du a ion o HIV and AIDS - ela ed educa ion p og am o be 2-5 days, o mo e han 1 week. In u u e s udies esea ches should examine no only he e ec i eness o he p og ams in changing knowledge, a i udes and willingness o ca e in he sho e m, bu also he nu ses’ sa is ac ion wi h he p og am. In doing so, i may be possible o iden i y obs acles which nu ses encoun e in local educa ional p og ams and gi e ise o he de elopmen o e ec i e s a egies by which hey may be o e come. Acknowledgemen s The esea che s would like o hank he Finnish Nu sing Educa ion Founda ion o hei inancial suppo . 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