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Past research evidence has not been heeded

In this issue of Journal of Advanced Nursing we publish a paper by Pickles et al. (2009, pp. 2262–2273) reporting their thematic review of studies published over the past decade concerning nursing students’ knowledge and attitudes towards HIV/AIDS. This paper attracted my attention because I have researched this subject in the past. Indeed, passing reference is made to the literature review I published in 1995 in Journal of Clinical Nursing and, in turn, that refers to the national survey of HIV/AIDS knowledge and attitudes among community nurses that I co-ordinated in the late 1980s for the government health department in Scotland. Neither of these studies was included in Pickles et al.’s review because that was confined deliberately to more recent research. So, I was hopeful that this new JAN review would reveal a much more enlightened picture than had been the case in the earlier years of HIV/AIDS. Alas, the main messages to emerge from Pickles et al.’s review are depressingly similar to recommendations that have been made time and again in the past. This suggests, conclude Pickles et al. themselves (p. 2271), that ‘past research evidence has not been heeded’.

Past research, including my own review, has pointed out repeatedly that nursing students lack knowledge about HIV/AIDS. Accordingly, research recommendations have emphasized the vital importance of HIV/AIDs education in the nursing curriculum. So how is it possible for this recent review to find that nursing students still can be so poorly educated about HIV/AIDS that their fear of contracting the virus makes them reluctant to care for people carrying the disease? And how can any student nurse of today possibly be so ignorant as to believe that HIV/AIDS can be transmitted by sharing food utensils or sitting on a WC, or by a mosquito bite or even a fish hook?! But, sadly, this is what this review by Pickles et al. reveals, and it draws on studies from eleven countries in very different regions of the world.

Why has the past research evidence apparently not been heeded? It really is hard to understand this, especially as there also is evidence from research to show that positive improvement generally results from educational intervention. Surely there cannot now be any undergraduate/RN curriculum anywhere in the world that is without at least some HIV/AIDS education. Pickles et al. point out (p. 2271), however, that educational programmes need to be geared to local needs and cultures and, crucially, that their impact on students’ knowledge and attitudes must be systematically evaluated. How to properly evaluate the impact of HIV/AIDS education on knowledge and attitudes is still in need of further research. There also is a need for a more standardized approach to evaluation in order to allow more meaningful international comparison. And we definitely need new research that will help us to understand more about the circumstances and factors that shape nursing students’ knowledge and attitudes to HIV/AIDS.

What we do not need are more surveys that simply repeat what we already know, as summarized in Pickles et al.’s paper. Nurse educators and nursing schools worldwide should take note of this review. It does not provide all of the answers, but it clearly flags up an ongoing problem that should no longer be allowed to be tolerated or ignored.

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