Assessment of Palliative Care Needs of HIV-Positive Clients in Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State

Abstract

This descriptive study assessed the palliative care needs of HIV-positive clients in Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State. Identification of these needs, will help the health care-givers to plan on approach(es) that can be implemented to improve the quality of lives of the clients. Population of study was 4119 confirmed adult HIV-positive clients that were registered and access health services at NAUTH as of the time of the study. A sample of 387 clients was purposively drawn for the study. Palliative Need Assessment Scale was used to elicit data on the clients’ demographic information and prevalence of palliative care needs while clinical information (CD4 cell count and line of ART) were elicited from the clients’ case file. The findings revealed that none of the items that reveal presence of problems/need that require palliative care in the physical, psychological, spiritual and socio-cultural domains had significant mean scores of ≥ 2.5. Clients were still grateful to God and were able to make acceptable decision about their health care because they received adequate information about their health status from their health caregivers. MANOVA analysis showed that female clients reported more psychological problems at significant level of p. 0.02. Low CD4 cell count (below 200cells/mm3) was inversely proportional to more physical, psychological and socio-cultural needs. MANCOVA analysis also showed that, female gender interaction with low CD4 (below 200cells/mm3), first line of ART and less than 6 months duration of management was inversely proportional to more problems in the physical and psychological domains at various significant levels as thus: CD4 cell count: physical (0.04), psychological (0.02); line of ART: physical (0.02), psychological (0.01); duration of accessing care: physical (0.02) while psychological (0.00). This result suggests that close attention should be paid to females, clients with low CD4 cell count, clients on first line of ART and less than 6 months duration of management. Palliative care services should be made available and accessible to all clients.