Indian Journal of Palliative Care
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 ORIGINAL ARTICLE
Year : 2008  |  Volume : 14  |  Issue : 1  |  Page : 1--6

The palliative care needs of patients with stage 3 and 4 HIV infection


Settlers Hospital, Grahamstown, E Cape, South Africa

Correspondence Address:
C Jameson
Settlers Hospital, Grahamstown, E Cape
South Africa
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1075.41919

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Objective : To investigate the palliative care needs of patients with stage 3 and 4 HIV infection in Settlers Hospital, Grahamstown. Design : Observational study done by patient interviews. Setting : A district hospital in a small town in South Africa. Participants : A total of 50 patients admitted to the medical ward of the hospital with stage 3 and 4 HIV infection who were well enough to be interviewed and who consented. Interventions : All the patients were interviewed by a team comprising an Honors student in psychology and a nurse or a medical doctor (CJ) and a nurse. Main outcome measures : The self-reported needs of these patients as identified by an interview. Results : A total of 55 patients admitted to the ward between February and May 2005 were identified as fulfilling the criteria of having stage 3 and 4 HIV infection. Of these patients, three were too ill and two refused consent to be interviewed. Ninety-four percent of the patients had unresolved medical problems and needed symptom relief. All the patients had some socioeconomic problems and 56% had no income. Poor housing (50%) and no access to electricity (28%), or running water (48%) were also major problems. As were lack of transport (96%) and worries about the future of children left behind (72%). Surprisingly psycho spiritual issues were not a major problem with 80% having spiritual and family support. Conclusions : Medical problems with poor symptom control were the commonest problems, followed by socioeconomic issues related to no income, poor living conditions and fears for the future of their children. Spiritual and psychological issues were surprisingly less of a problem possibly because the immediacy and severity of the demands of day-to-day survival. As a result of the needs identified among these patients, it became apparent that a palliative care ward catering to these needs was needed. The guiding principles in the development of this ward were the need for privacy, for a teamwork approach and for meticulous medical care, all of which underpin good palliative care.






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