Dieleman Marjolein, Biemba Godfrey, Mphuka Simon, Sichinga-Sichali Karen, Sissolak Dagmar, van der Kwaak Anke, van der Wilt Gert-Jan
Royal Tropical Institute, Amsterdam, the Netherlands.
Health Policy Plan. 2007 May;22(3):139-48. doi: 10.1093/heapol/czm006. Epub 2007 Mar 30.
In countries with a high AIDS prevalence, the health workforce is affected by AIDS in several ways. In Zambia, which has a prevalence rate of 16.5%, a study was carried out in 2004 with the aim to: explore the impact of HIV/AIDS on health workers, describe their coping mechanisms and recommend supportive measures. The qualitative study was complemented by a survey using self-administered questionnaires in four selected health facilities in two rural districts in Zambia, Mpika and Mazabuka. It is one of the few studies to have explored the impact of HIV/AIDS from the perspective of health workers and managers in the region. Thirty-four in-depth interviews and five group discussions were conducted with health workers, managers and volunteers, and 82 self-administered questionnaires were filled out by health workers. In addition, burnout among 42 health workers was measured using the Maslach Burnout Inventory (MBI). The MBI measures three components that contribute to burnout: emotional exhaustion, depersonalization and personal accomplishment. The results show that in both districts, HIV/AIDS has had a negative impact on workload and has considerably changed or added tasks to already overburdened health workers. In Mpika, 76% of respondents (29/38), and in Mazabuka, 79% (34/44) of respondents, expressed fear of infection at the workplace. HIV-positive health workers remained 'in hiding', did not talk about their illness and suffered in silence. Despite the fact that health workers were still relatively motivated, emotional exhaustion occurred among 62% of the respondents (26/42). The interviews revealed that counsellors and nurses were especially at risk for emotional exhaustion. In each of the selected facilities, organizational support for health workers to deal with HIV/AIDS was either haphazardly in place or not in place at all. AIDS complicates the already difficult work environment. In addition to health workers, management also needs support in dealing with AIDS at the workplace.
在艾滋病高发国家，卫生人力在多个方面受到艾滋病的影响。在赞比亚，艾滋病患病率为16.5%，2004年开展了一项研究，旨在：探讨艾滋病毒/艾滋病对卫生工作者的影响，描述他们的应对机制并提出支持措施。这项定性研究辅以一项调查，在赞比亚两个农村地区姆皮卡和马扎布卡的四个选定卫生机构中使用自填式问卷。这是少数从该地区卫生工作者和管理人员角度探讨艾滋病毒/艾滋病影响的研究之一。对卫生工作者、管理人员和志愿者进行了34次深入访谈和5次小组讨论，卫生工作者填写了82份自填式问卷。此外，使用马氏职业倦怠量表（MBI）对42名卫生工作者的倦怠情况进行了测量。MBI测量导致倦怠的三个成分：情感耗竭、去个性化和个人成就感。结果表明，在这两个地区，艾滋病毒/艾滋病对工作量产生了负面影响，并极大地改变或增加了本已负担过重的卫生工作者的任务。在姆皮卡，76%的受访者（29/38），在马扎布卡，79%（34/44）的受访者表示担心在工作场所感染。艾滋病毒呈阳性的卫生工作者仍“躲起来”，不谈论自己的病情，默默承受痛苦。尽管卫生工作者仍有相对较高的积极性，但62%的受访者（26/42）出现了情感耗竭。访谈显示，咨询师和护士尤其面临情感耗竭的风险。在每个选定的机构中，对卫生工作者应对艾滋病毒/艾滋病的组织支持要么随意存在，要么根本不存在。艾滋病使本就艰难的工作环境更加复杂。除了卫生工作者，管理层在应对工作场所的艾滋病方面也需要支持。
