Marseille 2007
| Abstract #274 - A Pilot HIV/AIDS Palliative Care Program Meets Psychosocial Needs of Patients and their Families | ||||
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Session: 26.25: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Dr Elena Vvedenskaya - Regional AIDS Centre, Russian Federation |
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| Additional Authors: Dr Grigory Moshkovich, Ms Oxana Shilova, Dr Ludmila Varlova, Dr Larisa Bykova, | ||||
| Aim: The aim of the paper is to present a pilot HIV/AIDS palliative care program started in one of the largest areas in Russia and supported by the Global Fund and show that good palliative care meets not only medical but psychosocial needs of patients and their families and improves their quality of life. | ||||
| Method / Issue: People living with advanced HIV/AIDS, majority of whom today are IV drug users, bear an increased burden with regard to limited access to comprehensive, quality care addressing this wide range of medical and psychosocial needs and end-of-life care. By the end of January 2007, the registered number of people living with HIV/AIDS in the Nizhny Novgorod area has reached 4900. Skilled psychosocial care is vital for this community as a component of holistic palliative care as it feels the tremendous gap in total care for patients and can improve significantly their quality of life. | ||||
| Results / Comments: A pilot regional HIV/AIDS palliative care project started in the Nizhny Novgorod area in June 2005 and was supported by the Global Fund. A multidisciplinary palliative care model was set up in the frame of the GLOBUS project with the emphasis to psychosocial assistance and support to people living with HIV/AIDS and their families. Palliative care has been provided in the outpatient and day care departments of the HIV/AIDS Center, in a hospice HIV-unit, in a hospice unit in a city tuberculosis hospital, and in the community. The mobile palliative care team consists of a nurse, a doctor, a social work specialist, a psychologist. There were 100 patients in the program. A case management approach was used. Every patient along with severe medical problems had different psychosocial problems and all of them were met by the team. The following problems were recognized which needed human support and specialist assistance: high level of distress, difficult relationships with nearest people, isolation/feeling loneliness, depression and neuroses, absence or lack of food or money, absence of documents or/and a place to life in, loss of job and working place, different types of discrimination and stigma, hospital admission and medical aid refusals, lack of medicines, problems with children-gardens and schools, etc. | ||||
| Discussion: Our experience has showed an unmet need for palliative care both medical and psychosocial of patients with advanced HIV/AIDS disease. The programs success can be attributed to the services engagement of HIV/AIDS and tuberculosis primary care providers. All patients needed different types of psychosocial support and assistance provided both by specialist and peer consultants. Results suggest an important and ongoing need for psychosocial support as a component of palliative care services for patients with advanced HIV/AIDS in Russia. The projects experience has shown very good outcomes and is very important for further palliative care promotion and development in the area and in other regions across the country. Further studies will be provided to estimate patients actual symptoms and psychosocial needs particularly. | ||||
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