The Effect of Nursing Care Approach Model (NCAM = PAKAR) on the Increase of CD4 Cell Count for Patient with HIV Infection

The increase of the number of patient With HIV (PWH) Infection has become a great challenge to Indonesian nurses, confronting their values, practices and prejudices and many ethical dilemmas concerning autonomy, control and confidentiality. HIV diagnosis is perceived as a death sentence and the first reaction often include denial and shock. The purpose of the study was to examine NCAM, that focused on on coping strategy and social support (nurse, family, and peer groups). This may result in positive cognitive response and to increase Biological responses. Psychoneuroimmunology paradigm was used in this study. Quasy-experimental pre-post test non randomized control group design was used in this study. Forty (40) PWH infections in Intermediate Department Care for Infection Disease (UPIPI) Dr. Soetomo hospital in Surabaya were selected and non-randomized assignment divided into 2 groups. Instruments, in vitro- test were used to measure biological response change: CD4 and IFN-γ and questionnaires, in depth interview and Focus Group Discussion were used to measure the cognitive responses; spiritual, social, and selfacceptance. A multivariate analysis was used to evaluate the data of biological response, while non-parametric test: Wilcoxon and Mann Whitney were used to measure cognitive response. The finding indicated that NCAM model is able to treat positive cognitive response that leads to induce immune response modulation that showed by the increase of CD4 cell count.

keywords : Nursing Care Approach Model (PAKAR), cognitive adaptive responses, and biological responses

writer : Nursalam, School of Nursing, Airlangga University School of Medicine, Surabaya

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