title: Reluctance to care for patients with HIV or hepatitis B / C in Japan.
abstract: BACKGROUND
  Healthcare workers are faced with various professional dilemmas in the workplace, including at times, a reluctance to care for particular patients. This study investigated personal attitudes and factors influencing Japanese nurses' reluctance to care for patients infected with HIV, Hepatitis B Virus (HBV), or Hepatitis C Virus (HCV).
  
  
  METHODS
  Participants completed an anonymous online survey focusing on potential attitudes towards hypothetical patients, awareness of infection risk and their confidence in using precautions to prevent infection. Statistical associations were analyzed using Poisson regression models.
  
  
  RESULTS
  Regarding personal attitudes, 41% and 18% of nurses agreed or somewhat agreed that they would be reluctant to care for a hypothetical patient infected with HIV or HBV / HCV, respectively. Reluctance to care for patients with HIV or HBV / HCV was positively associated with prejudicial attitudes and negatively associated with confidence in personal safety precautions. Hypothetical reluctance to care for patients with HBV / HCV was negatively associated with actual previous experience caring for HBV / HCV patients. Older age among nurses (≥50 years) was positively associated with an increased reluctance to care for hypothetical patients with HIV.
  
  
  CONCLUSIONS
  Overall, this study suggests that anxiety arising from perceived infection risk and having a prejudicial attitude might affect the acceptance of infected patients, while personal confidence in universal precautions probably mitigates this situation. Improving nurses' confidence in using universal precautions therefore represents a positive measure that can help reduce prejudice and improve the quality of healthcare services in Japan, as elsewhere.
authors: Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan. kwada-sgy@umin.ac.jp.
authors: Koji
authors: K
authors: Wada
authors: School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Ourimbah, Australia. derek.smith@newcastle.edu.au.
authors: Derek R
authors: DR
authors: Smith
authors: Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand. ishimaru@med.uoeh-u.ac.jp.|Occupational Health Training Center, University of Occupational and Environmental Health, Kitakyushu, Japan. ishimaru@med.uoeh-u.ac.jp.
authors: Tomohiro
authors: T
authors: Ishimaru
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000451:nursing* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000451:nursing* / Q000523:psychology; D006526:Hepatitis C / Q000451:nursing* / Q000523:psychology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology*; D011287:Prejudice; D016079:Refusal to Treat; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D016635:Universal Precautions; D017132:Workplace / Q000523:psychology; D055815:Young Adult