Academic literature on the topic 'AIDS (Disease), Palliative treatment. Rwanda'
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Journal articles on the topic "AIDS (Disease), Palliative treatment. Rwanda"
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May, Peter, Charles Normand, Egidio Del Fabbro, Robert L. Fine, R. Sean Morrison, Isabel Ottewill, Chessie Robinson, and J. Brian Cassel. "Economic Analysis of Hospital Palliative Care: Investigating Heterogeneity by Noncancer Diagnoses." MDM Policy & Practice 4, no. 2 (July 2019): 238146831986645. http://dx.doi.org/10.1177/2381468319866451.
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Background. Single-disease-focused treatment and hospital-centric care are poorly suited to meet complex needs in an era of multimorbidity. Understanding variation in palliative care’s association with treatment choices is essential to optimizing interdisciplinary decision making in care of complex patients. Aim. To estimate the association between palliative care and hospital costs by primary diagnosis and multimorbidity for adults with one of six life-limiting conditions: heart failure, chronic obstructive pulmonary disease (COPD), liver failure, kidney failure, neurodegenerative conditions including dementia, and HIV/AIDS. Methods. Data from four studies (2002–2015) were pooled to provide an analytic dataset of 73,304 participants with mean costs $10,483, of whom 5,348 (7%) received palliative care. We estimated average effect of palliative care on direct hospital costs among the treated, using propensity scores to control for observed confounding. Results. Palliative care was associated with a statistically significant reduction in total direct costs for heart failure (estimated treatment effect: −$2666; 95% confidence interval [CI]: −$3440 to −$1892), neurodegenerative conditions (−$3523; −$4394 to −$2651), COPD (−$1613; −$2217 to −$1009), kidney failure (−$3589; −$5132 to −$2045), and liver failure (−$7574; −$9232 to −$5916). The association for liver failure patients was statistically significantly larger than for any other disease group. Cost-saving associations were also statistically larger for patients with multimorbidity than single disease for two of the six groups: neurodegenerative and liver failure. Conclusions. Heterogeneity in treatment effect estimates was observable in assessing association between palliative care and hospital costs for adults with serious life-limiting illnesses other than cancer. The results illustrate the importance of careful definition of palliative care populations in research and practice, and raise further questions about the role of interdisciplinary decision making in treatment of complex medical illness.
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Adeyemi, Olukemi, Mary Lyons, Tsi Njim, Joseph Okebe, Josephine Birungi, Kevin Nana, Jean Claude Mbanya, et al. "Integration of non-communicable disease and HIV/AIDS management: a review of healthcare policies and plans in East Africa." BMJ Global Health 6, no. 5 (May 2021): e004669. http://dx.doi.org/10.1136/bmjgh-2020-004669.
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BackgroundLow-income and middle-income countries are struggling to manage growing numbers of patients with chronic non-communicable diseases (NCDs), while services for patients with HIV infection are well established. There have been calls for integration of HIV and NCD services to increase efficiency and improve coverage of NCD care, although evidence of effectiveness remains unclear. In this review, we assess the extent to which National HIV and NCD policies in East Africa reflect the calls for HIV-NCD service integration.MethodsBetween April 2018 and December 2020, we searched for policies, strategies and guidelines associated with HIV and NCDs programmes in Burundi, Kenya, Rwanda, South Sudan, Tanzania and Uganda. Documents were searched manually for plans for integration of HIV and NCD services. Data were analysed qualitatively using document analysis.ResultsThirty-one documents were screened, and 13 contained action plans for HIV and NCDs service integration. Integrated delivery of HIV and NCD care is recommended in high level health policies and treatment guidelines in four countries in the East African region; Kenya, Rwanda, Tanzania and Uganda, mostly relating to integrating NCD care into HIV programmes. The increasing burden of NCDs, as well as a move towards person-centred differentiated delivery of services for people living with HIV, is a factor in the recent adoption of integrated HIV and NCD service delivery plans. Both South Sudan and Burundi report a focus on building their healthcare infrastructure and improving coverage and quality of healthcare provision, with no reported plans for HIV and NCD care integration.ConclusionDespite the limited evidence of effectiveness, some East African countries have already taken steps towards HIV and NCD service integration. Close monitoring and evaluation of the integrated HIV and NCD programmes is necessary to provide insight into the associated benefits and risks, and to inform future service developments.
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Noor-Mahomed, S. B., L. Schlebusch, and B. A. Bosch. "Suicidal Behavior in Patients Diagnosed with Cancer of the Cervix." Crisis 24, no. 4 (July 2003): 168–72. http://dx.doi.org/10.1027//0227-5910.24.4.168.
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Summary: There is a paucity of literature on suicide and cancer, especially cancer of the cervix. This study reports on suicidal behavior in these patients. The sample consisted of adult, black, Zulu-speaking women from palliative and radical oncology treatment groups who volunteered for the study. There were more patients in the palliative group who were younger, and had a more significant delay between cancer symptom presentation and seeking oncology treatment. Patients experienced: significant depression, anxiety, stress, hopelessness/helplessness, anxious preoccupation about their disease, poor current or delayed social support, feelings of being a burden to their significant others, beliefs that they would be better off dead, perceptions that they were stigmatized by society or that their communities suspected them of being HIV-AIDS positive, and suppressed anger. More patients in the palliative, compared to the radical treatment, group were inclined toward suicidal ideation with serious intent. Overall, most patients coped inadequately with their disease and its management. These patients are a high risk group for suicidal behavior and should be identified in time for appropriate psychological intervention.
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Silva, Cristiano Domingues da, Carlos Alberto de Oliveira Magalhães Júnior, and Jaqueline Feltrin Inada. "Psicologia Social, Representações Sociais e AIDS." Revista de Ensino, Educação e Ciências Humanas 18, no. 4 (January 22, 2018): 458. http://dx.doi.org/10.17921/2447-8733.2017v18n4p458-463.
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Apesar das inúmeras campanhas de prevenção, a Síndrome da Imunodeficiência Adquirida (AIDS) ainda se constitui um grave problema de saúde pública. O presente trabalho teve como objetivo investigar as representações sociais do HIV/AIDS e, assim, contribuir para o tratamento psicológico desses pacientes. Foi realizada uma revisão da literatura, com levantamento bibliográfico, abordando as discussões de autores da psicologia social, entre outros, a respeito do HIV/AIDS. A AIDS é uma enfermidade que marca intensamente quem a vivencia, uma vez que afeta não apenas o corporal do sujeito, mas as demais esferas da sua vida, envolvendo, muitas vezes, sentimentos negativos, tais como: a tristeza, o desejo de morte, a angústia, entre outros, que refletem no seu bem-estar mental, físico, afetivo e social. A infecção pelo HIV estabelece uma cadeia de cuidados a serem desempenhados pelas pessoas portadoras, como consultas frequentes, realização de exames laboratoriais especiais, o uso de medicamentos e mudanças na vida social que, muitas vezes, causam dificuldades que propiciam e implicam cuidados especializados em saúde mental. Atualmente, não existe uma cura para essa doença, apenas tratamento paliativo como: uso de medicamentos, tratamento com psicólogo, tratamento com psiquiatra, entre outros.Palavras-chave: HIV/AIDS. Psicologia Social. Representação Social.AbstractDespite the several prevention campaigns, AIDS remains a serious public health problem. This study aims to investigate the social representations of HIV/AIDS and thereby contribute to the psychological treatment of these patients. A bibliographic review was performed showing the themes discussed about the social psychology according to the view of many authors, concerning the HIV/AIDS. The Acquired Immune Deficiency Syndrome (AIDS) is an illness that marks intensely those who experience it, since it affects not only the body of the individual, but the other spheres of his or her life, involving often negative feelings such as sadness, death desire , anguish, among others, reflecting on his or her mental, physical, emotional and social well-being. HIV infection establishes a chain of care to be taken by people with this illness, such as frequent consultations, conducting special laboratory tests, medication use and changes in social life that often cause difficulties that require mental health care specialist. Currently, there is no cure for this disease, only palliative treatment such as use of drugs, treatment with a psychologist, psychiatrist treatment, among others.Keywords: HIV/AIDS. Social Psychology. Social Representation.
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Koprowski, Christopher, Ej Johnson, Kenneth Trzepkowski, Karen Sites, and Nicholas J. Petrelli. "Introducing enhanced navigation and supportive care into the curative treatment of cancer (SCOOP pathway)." Journal of Clinical Oncology 36, no. 30_suppl (October 20, 2018): 142. http://dx.doi.org/10.1200/jco.2018.36.30_suppl.142.
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142 Background: We hypothesized that introducing supportive care management and enhanced electronic aids to nurse navigation in selective curative cases could result in cost savings and enhanced patient experience of the sort demonstrated in patients with advanced disease. Methods: To test this hypothesis, we introduced a clinical pathway in November 2016 called the Supportive Care of Oncology Patients (SCOOP) program. We limited the scope to patients receiving radiation and chemotherapy concurrently at the Helen F. Graham Cancer Center and diagnosed with potentially curable thoracic, colorectal or head and neck malignancies and seen in our mulitdisciplinary clinics (MDCs). 1. A nurse navigation check list was developed for nurse navigators in the Aerial information system to support standardization of care. The navigator has to opt out of ancillary service consults such as nutrition, behavioral health and social work. The check list includes other mandatory tasks that must be completed at various time points before, during and after the patient’s concurrent treatment. Examples include: Prescribed communication dates with the patient; capturing of scheduled consults; assessing additional/unmet needs before, during and after treatment phase. 2. A mandatory supportive and palliative care service screening during the MDC visit, and, if indicated, urgent or timely consultation. 3. Flags in the inpatient information system that alert in real time the supportive care service, the navigators and the oncologists whenever a patient is seen in the emergency room, admitted or discharged. Results: During the first year nurse navigation compliance increased from 94% to 99%.ED visits declined from 54% to 32% of SCOOP patients , admissions from 34% to 25% and readmissions from 32% to 20% . Opportunity cost savings were $1500.00 per patient. Conclusions: Much like the results observed in advanced disease, the early introduction of enhanced nurse navigation and palliative/supportive care in high acuity patients treated curatively improves the patient experience and reduces societal costs.
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Dzinamarira, Tafadzwa, Gashema Pierre, Elyse Jeanne Umuhire, Michael Habtu, and Rosemary Okova. "A Hospital Based Cross Sectional Study on Dietary Status and Associated Factors among People Living with HIV/AIDS in Kigali, Rwanda." Journal of Food Research 9, no. 1 (January 9, 2020): 50. http://dx.doi.org/10.5539/jfr.v9n1p50.
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Background
Good nutrition empowers PLWH with the ability to fight against infection ultimately slowing down disease progression. Consequently, nutrition management is a crucial component of HIV treatment, care, and support. This study aimed at assessing dietary status and associated factors among PLWH in Kigali, Rwanda.
Methods
We conducted a cross sectional study in three selected hospitals in Kigali from over a six-week period in July – August, 2019 to collect data from 204 HIV positive adults enrolled using systematic random sampling. Data was collected using an adapted, validated and pre-tested food frequency questionnaire (FFQ). Descriptive and multiple logistic regression analyses were performed using SPSS version 25 for windows.
Results
The proportion of participants with poor dietary status was 15% based on FFQ responses. The study found only three factors to be independently associated with dietary status. There was an association between dietary status and HIV status disclosure (AOR 2.5; CI 1.25 - 4.83; p=0.014). There was an association between dietary status and travel time to place of collection of ARVs (AOR 3.2; CI 1.7 - 5.8; p=0.006). There was an association between dietary status and BMI (AOR 10.2; CI 8.30 – 16.0; p<0.001).
Conclusions
Poor dietary status among PLWH remains a concern. The strong association between dietary status and BMI underlines the need for interventions that target PLWH to improve dietary status and ultimately nutrition status
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Shyirambere, Cyprien, Rebecca Deboer, Yvan Butera, Caitlin Driscoll, Jean Bosco Bigirimana, Francois Regis Uwizeye, Temidayo Fadelu, et al. "Report on the Treatment of Hodgkin Lymphoma with ABVD Chemotherapy at Two Rural District Hospitals in Rwanda." Blood 134, Supplement_1 (November 13, 2019): 4053. http://dx.doi.org/10.1182/blood-2019-130780.
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Background: While Hodgkin lymphoma (HL) is highly curable with standard chemotherapy in high-resource settings, there are few reports of HL treatment in low-resource settings. In Rwanda, a treatment protocol using six cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine, dacarbazine) without radiotherapy has been implemented at two rural district hospitals. Here we report on the feasibility of this approach, our patient characteristics, and outcomes. Methods: We conducted a retrospective cohort study of all patients with biopsy-confirmed HL seen at Butaro and Rwinkwavu hospitals between October 2009 and June 2018. Data were extracted from clinical charts and analyzed using descriptive statistics and Kaplan-Meier logrank testing. Results: Ninety HL patients were seen at Butaro (n=85) and Rwinkwavu (n=5); 58% male, median age 16 (IQR 10.6-30.5) with 54% under age 18. Eleven (12%) were HIV positive. Mean duration of presenting symptoms at the time of intake was 54 weeks; 70% had B symptoms. Nodular sclerosis was the predominant histological subtype (47%) followed by mixed cellularity (28%). Of 24 biopsy specimens evaluated for EBV, 14 (58%) were positive, 10 (42%) negative. Most patients were staged with chest x-ray (81%); fewer had abdominal ultrasound (34%), CT (21%), or bone marrow biopsy (20%). Resulting Ann Arbor stages were I (17%), II (28%), III (32%), IV (20%), and undetermined (3%). Median time from initial biopsy to first dose of ABVD was 6.1 weeks (IQR 3.6-11.9). Of 76 patients who started ABVD, 56 (74%) completed all 6 cycles; the leading reasons for discontinuation were loss to follow up (n=9) and death (n=7). Median time to completion of the 24-week ABVD regimen was 26.1 weeks; 51 patients (67%) experienced at least one treatment delay. Neutropenia, social factors, and infection were the most common reasons for delays. Dose reductions were rare. Mean dose intensity over 6 cycles was 87.2% calculated per Owadally, et al. 2010; <86% in 40% of patients, 86-97% in 32%, and >97% in 28%. Of the 76 patients started on ABVD, 34 (45%) are in clinical remission, 21 (28%) are deceased, 2 (3%) referred to palliative care, and 19 (25%) are lost to follow up at a median interval of 48 months from intake. Univariate analysis demonstrates that stage III-IV (p=0.0000), ECOG performance status 2-4 (p=0.0004), hemoglobin <10.5 g/dL (p=0.01), WBC > 15,000 mm3 (p=0.05), B symptoms (p=0.004), and extranodal disease (0.0004) were associated with worse survival. Conclusions: We observed a strikingly younger age distribution in our cohort compared to the classic bimodal distribution reported in high income countries, suggesting biologic differences that warrant further investigation. Treating HL with standard chemotherapy in a low-resource setting through international partnership is feasible, and nearly half of patients who complete treatment may experience a clinically significant remission with this approach. Late presentation, treatment delays, and loss to follow up are among major reasons to explain the discrepancy in survival compared to high income countries. Further efforts should tackle these identified barriers to achieve better survival outcomes. Figure Disclosures No relevant conflicts of interest to declare.
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Ochoa, Roberto Enrique, Christos Kyriakopoulos, and Judith Hurley. "Outcomes of 47 patients with human immunodeficiency virus infection treated for breast cancer: A 20-year experience." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 1071. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.1071.
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1071 Background: Patients (pts) with Human Immunodeficiency Virus (HIV) are living longer and non-AIDS defining malignancies have been increasingly reported in these patients. Methods: Retrospective review identified 47 pts with breast cancer (BC) and HIV who were seen at the University of Miami Sylvester Comprehensive Cancer Center/Jackson Memorial Hospital between January 1999 and June 2011. Results: Pt characteristics: 46 female, 1 male, mean age 46 years (range 31-65). Race: African American 79%, Caucasian 21%. Ethnic: Hispanics 14%, non-Hispanics 86%. Premenopausal 68% postmenopausal 32%. Tumor characteristics: Stage: Tis 4%, Stage I: 6 % , Stage II: 38%, Stage III: 38%, Stage IV: 9%. ER positive (50%) her-2 positive (15%), Triple negative (21%). HIV characteristics: 36 pts with HIV before or concurrent with the diagnosis of BC. 6 pts diagnosed with HIV within 1 year of BC diagnosis. HIV dx date unavailable in 5 pts. 27% had AIDS. CD4 counts (in cells/µL)were: > 500 (23%); 201-500 (37%), 51 – 200 (20%) < 50 (20%). 15 pts were diagnosed with BC in preHAART era. Of those dx with BC after 1996, 60% were on HAART. BC treatment: 43 pts had localized disease. 32 underwent modified radical mastectomy, 8 breast conservation and 3 pts refused surgery. 26 pts received curative or palliative chemotherapy. Complications of BC treatment: serious side effects were reported in 11 (42%) including neutropenic fever/sepsis (10 pts), ARDS (1 pt). Zoster infection was reported in 12% of the pts. 3 patients developed rapidly progressive and fatal AIDS within 6 months of completion of chemotherapy. Survival: See Table. Conclusions: BC in patients with HIV infection spans the spectrum of BC presentations. Hormonal therapy, surgery and radiation therapy were well tolerated. Infectious complications were common in patients treated with chemotherapy and routine use of growth factors and prophylactic acyclovir should be considered. [Table: see text]
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Chamberlain, M. C., and L. Dirr. "Involved-field radiotherapy and intra-Ommaya methotrexate/cytarabine in patients with AIDS-related lymphomatous meningitis." Journal of Clinical Oncology 11, no. 10 (October 1993): 1978–84. http://dx.doi.org/10.1200/jco.1993.11.10.1978.
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PURPOSE To evaluate combined limited-field radiotherapy and concentration times time (C X T) intra-CSF chemotherapy in patients with AIDS-related lymphomatous meningitis (LM). PATIENTS AND METHODS Fourteen men and one woman with AIDS had cytologically documented LM. Eleven patients had systemic non-Hodgkin's lymphoma (NHL) (all B-cell histology, including six immunoblastic, four large cell, one small cell) with leptomeningeal metastases and four patients had primary CNS lymphoma (PCNSL) (all B-cell histology, including two immunoblastic, two large cell) with CSF dissemination. Presenting neurologic examinations included cranial neuropathies (n = 7), normal (n = 4), abulia (n = 2), paraparesis (n = 2), ataxia (n = 1), hemiparesis (n = 1), and aphasia (n = 1). Standardized pretreatment evaluations included contrast cranial magnetic resonance/computed tomography (MR/CT), placement of an intraventricular reservoir, CT myelogram/contrast spine MR, ophthalmologic examination, and indium 111-pentetic acid (DTPA) CSF flow studies. Regions of bulky or symptomatic disease were treated with limited-field radiation therapy, which included whole brain in 10 patients combined with spinal cord irradiation in five patients. Concurrent systemic chemotherapy was administered in 12 patients. All patients were scheduled to receive intraventricular methotrexate (MTX) 2 mg/d for 5 consecutive days biweekly for 8 weeks (induction), followed in cytologically responding patients by MTX administered in a similar manner every 4 weeks (maintenance). In MTX-responsive and consenting patients with cytologic relapse, intraventricular cytarabine (ara-C) was administered, 25 mg/d for 3 consecutive days weekly for 4 weeks (induction), followed by ara-C administered in a similar manner every 4 weeks (maintenance). CSF cytology and neurologic examinations were performed biweekly. RESULTS In 13 assessable patients (two patients refused CNS directed therapy following standardized pretreatment evaluations), median time to tumor progression was 60 days (range, 3 to 260) and median survival duration was 125 days (range, 44 to 260). Response rate, determined clinically (four of 13 patients) and cytologically (nine of 13), was 69%. Complications included reservoir infection (n = 2) and myelosuppression (n = 11); the latter was felt to be a consequence of coadministered systemic chemotherapy. CONCLUSION There were no treatment-related deaths. We conclude that involved-field irradiation and intraventricular MTX/ara-C is effective palliative treatment of AIDS-related LM.
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Mathur, Prateek, Shruti Rawal, Bhoomika Patel, and Mayur M. Patel. "Oral Delivery of Anticancer Agents Using Nanoparticulate Drug Delivery System." Current Drug Metabolism 20, no. 14 (February 25, 2020): 1132–40. http://dx.doi.org/10.2174/1389200220666191007154017.
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Background: Conventionally, anti-cancer agents were administered through the intravenous route. The major drawbacks associated with the intravenous route of administration are: severe side effects, need of hospitalization, nursing care, and palliative treatment. In order to overcome the drawbacks associated with the intravenous route of administration, oral delivery of anti-cancer agents has gained tremendous interest among the scientific fraternity. Oral delivery of anti-cancer agents principally leads to a reduction in the overall cost of treatment, and aids in improving the quality of life of patients. Bioavailability of drugs and inter-subject variability are the major concerns with oral administration of anti-cancer agents. Factors viz. physicochemical and biological barriers (pre-systemic metabolism and transmembrane efflux of the drug) are accountable for hampering oral bioavailability of anti-cancer agents can be efficiently overcome by employing nanocarrier based drug delivery systems. Oral delivery of anticancer agents by employing these drug delivery systems will not only improve the quality of life of patients but will also provide pharmacoeconomic advantage and lead to a reduction in the overall cost of treatment of life-threatening disease like cancer. Objective: This article aims to familiarize the readers with some of the recent advancements in the field of nanobased drug delivery systems for oral delivery of anticancer agents. Conclusion: Advancement in the field of nanotechnology-based drug delivery systems has opened up gateways for the delivery of drugs that are difficult to administer orally. Oral delivery of anti-cancer agents by these drug delivery systems will not only improve the quality of life of patients but will also provide pharmacoeconomic advantage and lead to a reduction in the overall cost of treatment of life-threatening disease like cancer.
Dissertations / Theses on the topic "AIDS (Disease), Palliative treatment. Rwanda"
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Uwimana, Jeannine. "Met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda." Thesis, University of the Western Cape, 2005. http://etd.uwc.ac.za/index.php?module=etd&.
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The aim of this study was to investigate met and unmet palliative care needs for people living with HIV/AIDS in selected areas in Rwanda. The achieve this aim, the study, firstly, identified the palliative care needs of people living with HIV/AIDS, secondly, it identified the health care services available to meet these needs, and thirdly, it determined the extent to which palliative care needs were met.
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Garanganga, Eunice. "Palliative care needs of children suffering from AIDS, Zimbabwe." Thesis, [S.l. : s.n.], 2009. http://dk.cput.ac.za/cgi/viewcontent.cgi?article=1030&context=td_cput.
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Fourie, Linda. "Pain control in palliative care : a South African nursing perspective." Thesis, [S.l. : s.n.], 2008. http://dk.cput.ac.za/cgi/viewcontent.cgi?article=1029&context=td_cput.
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Jumah, Anne Mukeli. "The nature and extent of palliative care in the Nairobi Hospice." Diss., Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-11202008-163831.
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Moodley, Aneetha Devi. "A study into palliative care services for offenders with AIDS at Westville Prison." Thesis, 2006. http://hdl.handle.net/10413/2221.
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The study sought to determine what palliative care services were provided to offenders at Medium B correctional center, which is located at Durban Management Area. It identified the perceptions of offender-patients about the services they received. The study also identified challenges that staff and offender-volunteer caregivers faced in rendering services within a correctional context in South Africa. The sample consisted of three stakeholders, namely, offender-patients who were terminally ill with AIDS at the prison hospital, staff and offender volunteer caregivers. The methods of data collection comprised of content analysis, semi-structured interviews with offender-patients and focus group discussions with staff and offender volunteer caregivers. The study revealed that efforts were made by the Department of Correctional Services to provide services to terminally ill AIDS patients. Legislation and policy frameworks were consistently being developed by the Department to meet the needs of patients and to keep abreast with international best practices. Some services were in accordance with the theoretical framework of palliative care. However, many challenges were experienced because of the contextual constraints in which the services were being rendered. Recommendations to improve the delivery of services were made by all participants in the study. The study concludes with the recommendations by the researcher and suggestions for future research.Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2006.
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Shirinda-Mthombeni, Keit. "Psychosocial challenges and coping mechanisms of palliative care volunteer caregivers for people living with HIV and AIDS." Diss., 2014. http://hdl.handle.net/10500/18693.
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South African palliative care volunteer caregivers play a crucial role in caring for people living with HIV and Aids, but frequently do not receive the support and respect that they deserve. The current study explored the psychosocial challenges and coping mechanisms of palliative care volunteer caregivers for people living with HIV and Aids. The researcher conducted in-depth interviews with 24 participants who also filled in questionnaires. The aim was to explore their experiences, their challenges, and coping mechanisms. Although these volunteer caregivers shared many positive experiences, they also faced multiple challenges in the workplace, their personal lives, financial challenges as well as psychological and emotional ones. Despite these challenges, the caregivers showed only moderate levels of stress on the stress scale. Recommendations for overcoming these challenges were provided to caregivers, organisations and the Department of HealthPsychology
M. Sc. (Psychology)
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Bam, Nokwanda. "Exploring the lived experiences of nurses caring for the terminally ill patients with AIDS in selected wards in a level one district hospital in KwaZulu-Natal." Thesis, 2012. http://hdl.handle.net/10413/11118.
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Title: Exploring the lived experiences of nurses caring for the terminally ill patients with AIDS in selected wards in a level one district hospital.
Aim: The purpose of this study was to explore and describe the experiences of nurses caring for dying patients with AIDS in the context of palliative care.
Methodology: The study explored the meaning of caring and terminal illness and the lived experiences of nurses in the context of AIDS in palliative care. A constructivist paradigm underpinned this study. A qualitative research approach was used and Giorgi’s five steps of analysis were aligned to the Husserlian phenomenology method to make sense of the data. Individual in-depth interviews were conducted with ten of the operational nurses who were caring for patients suffering from AIDS in the palliative care wards of a level one state-aided district hospital. These included professional nurses, enrolled nurses and enrolled nursing assistants. The interviews were audio-taped.
Findings: The findings of the study were presented and discussed according to the two categories that emerged during the data analysis, namely, conceptualization of the core concepts of caring and terminal illness and the experiences of caring in the context of palliative care. Each of these categories had themes and sub-themes that were presented and discussed. The conceptualization of the core terms influenced the nurses’ actions, behaviors and opinions as they described their experiences of taking care of terminally ill patients who suffered from AIDS. The nurses’ lived experiences were conceptualized into three main themes: the social networking that enabled the nurses to collaborate with colleagues in the interdisciplinary teams and share knowledge, skills and support within the palliative care team to optimize patient outcomes; factors hindering the nurses abilities to provide quality care to their
patients and the internal and external mechanisms that enabled the nurses to provide care within palliative care contexts despite the encountered challenges.
Conclusion: Nurses are exposed to increasing work-load in the context of HIV/AIDS, particularly in the care of terminally ill patients suffering from AIDS as they deal with complex emotional aspects of the diseases. Routine exposure to suffering and death accustom the nurses to dealing with death, resulting in situations where they display lack of care and respect for the terminal patients. Therefore, the antecedents that alter the nurses’ level of caring augmented by the emotionally taxing contexts are an agenda that needs to be addressed in order to achieve emotional work through improved nurse-patient relationships.Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2012.
Books on the topic "AIDS (Disease), Palliative treatment. Rwanda"
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Seaton, Richard, and Joan Holloway. Palliative care in resource-constrained settings for people living with HIV/AIDS and other life-threatening illnesses: Presentations from the 14th International Congress on the Care of the Terminally Ill, Montreal, Canada, October 2002. Edited by International Congress on the Care of the Terminally Ill (2002 : Montréal, Québec). Rockville, MD: U.S. Dept. of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, 2003.
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Gordon, Hewitt, and Music Therapy Services of Metropolitan Toronto., eds. Last songs: AIDS and the music therapist. 2nd ed. Toronto: Music Therapy Services of Metropolitan Toronto, 1994.
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Federal Centre for AIDS (Canada). Expert Working Group on Integrated Palliative Care for Persons with AIDS. Caring together: The report of the Expert Working Group on Integrated Palliative Care for Persons with AIDS to Health and Welfare Canada, Federal Centre for AIDS. [Ottawa]: The Centre, 1989.
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Music at the edge: The music therapy experiences of a musician with AIDS. London: Routledge, 1996.
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O'Neill, Joseph F., Peter A. Selvyn, and Helen Schietinger. A clinical guide to supportive & palliative care for HIV/AIDS. 2nd ed. [Rockville, Md.]: U.S. Dept. of Health and Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, 2003.
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Lee, Colin. Music at the edge: Music therapy experiences of a musician with AIDS. London: Routledge, 1996.
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Woodruff, Roger. Palliative medicine: Symptomatic and supportive care for patients with advanced cancer and AIDS. 3rd ed. Oxford: Oxford University Press, 1999.
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Woodruff, Roger. Palliative medicine: Symptomatic and supportive care for patients with advanced cancer and AIDS. Melbourne: Asperula, 1993.
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Johnson, Andrew S. Living with dying, dying at home: An AIDS care team resource manual. Toronto: AIDS Committee of Toronto, 1994.
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Hospital, Canada Mount Sinai. A comprehensive guide for the care of persons with HIV Disease: Module 4. Toronto: Mount Sinai Hospital, 1995.
Find full textBook chapters on the topic "AIDS (Disease), Palliative treatment. Rwanda"
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Pahuja, Meera, and Peter Selwyn. "HIV/AIDS." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 949–63. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0089.
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AIDS has been transformed from a rapidly fatal, untreatable illness to a manageable chronic disease. Early in the AIDS epidemic, HIV care and palliative care were inseparable; over time, these two treatment paradigms diverged. Whereas palliative care for AIDS once focused primarily on end of life care and pain and symptom management related to the manifestations of AIDS-specific opportunistic infections and malignancies, it now addresses the needs of a growing number of HIV-infected patients living for years with the disease and an expanding range of comorbidities, as well as a process that has been described as ‘accelerated ageing’. Comorbid chronic diseases which commonly occur in HIV-infected patients may affect cardiovascular, pulmonary, renal, hepatic, metabolic, and neurocognitive function. Attention to the symptoms that result, and to quality of life issues and psychosocial problems in long-surviving patients, will be increasingly important to support engagement with care and effective adherence with antiretroviral therapy over time. End of life care also remains important, as patients may still die from AIDS, or even more commonly, from end-organ failure, non-AIDS defining malignancies, and/or other complications of ageing and chronic comorbid disease. All these converging factors have now resulted in a new need for the reintegration of HIV care and palliative care, both to help HIV-infected patients live better and longer, as well as to manage late-stage and end of life issues when they emerge.
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Cohen, Mary Ann, and Joseph Z. Lux. "Palliative and Spiritual Care of Persons with HIV and AIDS." In Handbook of AIDS Psychiatry. Oxford University Press, 2010. http://dx.doi.org/10.1093/oso/9780195372571.003.0016.
Full textAbstract:
Palliative care of persons with HIV and AIDS has changed over the course of the first three decades of the pandemic. The most radical shifts occurred in the second decade with the introduction of combination antiretroviral therapy and other advances in HIV care. In the United States and throughout the world, progress in prevention of HIV transmission has not kept pace with progress in treatment, thus the population of persons living with AIDS continues to grow. Furthermore, economic, psychiatric, social, and political barriers leave many persons without access to adequate HIV care. As a result, persons who lack access to care may need palliative care for late-stage AIDS while persons with access to AIDS treatments are more likely to need palliative care for multimorbid medical illnesses such as cardiovascular disease, cancer, pulmonary disease, and renal disease. Palliative care of persons with HIV and AIDS cannot be confined to the end of life. We present palliative care on a continuum as part of an effort to alleviate suffering and attend to pain, emotional distress, and existential anxiety during the course of the illness. We will provide guidelines for psychiatric and palliative care and pain management to help persons with AIDS cope better with their illnesses and live their lives to the fullest extent, and minimize pain and suffering for them and their loved ones. This chapter reviews basic concepts and definitions of palliative and spiritual care, as well as the distinct challenges facing clinicians involved in HIV palliative care. Finally, issues such as bereavement, cultural sensitivity, communication, and psychiatric contributions to common physical symptom control are reviewed. The terms palliative care and palliative medicine are often used interchangeably. Modern palliative care has evolved from the hospice movement into a more expansive network of clinical care delivery systems with components of home care and hospital-based services (Butler et al., 1996; Stjernsward and Papallona, 1998). Palliative care must meet the needs of the “whole person,” including the physical, psychological, social, and spiritual aspects of suffering (World Health Organization, 1990).
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Wyld, Lucy N., Clare Rayment, and Mike I. Bennett. "Definition and assessment of chronic pain in advanced disease." In Oxford Textbook of Palliative Medicine, edited by Nathan I. Cherny, Marie T. Fallon, Stein Kaasa, Russell K. Portenoy, and David C. Currow, 313–20. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780198821328.003.0034.
Full textAbstract:
This chapter discusses the various definitions applied to pain including chronic, nociceptive, neuropathic, and breakthrough. It gives a broad overview of the epidemiology of pain including its prevalence of greater than 50% in those patients with advanced disease and its under-treatment. The second part of the chapter explains how best to characterize the pain complaint. It acknowledges the importance of a thorough history, including pain characteristics such as severity and associated features. Several pain measurement scales, which can be used both in clinical practice and research, are presented. Clinical examination and imaging are also discussed as aids to diagnosis and management of pain. It concludes with how to assess pain in the context of a palliative plan of care, stressing the need to consider the many challenges that patients face with advancing disease and how the management of pain is affected by other symptoms patients may have.
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"HIV and palliative care." In Oxford Handbook of Palliative Care, edited by Max Watson, Rachel Campbell, Nandini Vallath, Stephen Ward, and Jo Wells, 561–78. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198745655.003.0019.
Full textAbstract:
Since the discovery of HIV in 1983, there have been dramatic advances in the management of people living with the virus due to the availability of effective antiretroviral medication (ARV). Prior to this, acquisition of the virus would lead to the development of AIDS and eventual death within ten years for the majority. By 1996, a regime of triple therapy antiretroviral medication was developed which could sustainably suppress HIV viral replication and viral load in the blood. People living with HIV now have near-normal life expectancies, and opportunistic infection rates have reduced in the UK. Despite these advances, people living with HIV experience a high level of symptoms. Symptoms can be direct effects of the HIV virus, side effects of HIV treatment, or consequences of advanced disease. In the UK, advanced disease is still seen with late presentation of infection and poor adherence to ARV medication. Advanced HIV disease is associated with an impaired immune system, leading to high risk of developing opportunistic infections and HIV-associated malignancies. Painful peripheral neuropathy occurs at all stages of HIV infection and is resistant to many neuropathic pain treatments.
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Mooney, Stefanie N., Purvi Patel, and Sorin Buga. "Bowel Management." In Oxford Textbook of Palliative Nursing, edited by Betty Rolling Ferrell and Judith A. Paice, 186–205. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190862374.003.0014.
Full textAbstract:
This chapter reviews palliative considerations for bowel management in a patient with advanced disease such as cancer, liver failure, AIDS, or general debility. In particular, it discusses the definition, prevalence, pathophysiology, assessment, and management of gastrointestinal symptoms common in the palliative population, including constipation and diarrhea. It also reviews malignant bowel obstruction and ascites and how these may impact quality of life for patients with life-limiting illness. The discussion of management includes both pharmacologic approaches and supportive care options. This information is designed to help guide nursing assessment and treatment of bowel management, as well as provide useful insight to any clinical provider encountering these conditions.