Prevalence, Burden, and Correlates of Physical and Psychological Symptoms Among HIV Palliative Care Patients in Sub-Saharan Africa: An International Multicenter Study

• Published in: Journal of pain and symptom management Vol. 44; no. 1; pp. 1 - 9
• Main Authors: Harding, Richard, BSc, MSc, DipSW, PhD, Selman, Lucy, BA, MPhil, PG Cert Pall Care, Agupio, Godfrey, RN, Dinat, Natalya, MD, FCOG, MPhil Pall Med, Downing, Julia, RN, PhD, Gwyther, Liz, MB, ChB, FCFP, Dip Pall Med, MSc, Mashao, Thandi, RN, Mmoledi, Keletso, CPN, MPH, BTech, Moll, Tony, MB, ChB, BSc, Sebuyira, Lydia Mpanga, BM, BCh, BA (Hons), MA, FRCP, Ikin, Barbara, RN, BA, Higginson, Irene J., BMedSci, BM BS, FFPHM, FRCP, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2012; Elsevier
• Subjects: Adult; Africa; Africa South of the Sahara - epidemiology; Aged; Anesthesia & Perioperative Care; Antiretroviral therapy; Biological and medical sciences; Burden; Cross-Sectional Studies; Female; Health Surveys; HIV; HIV Infections - epidemiology; Human viral diseases; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infectious diseases; Male; Medical sciences; Middle Aged; Pain - epidemiology; Pain Measurement; Pain Medicine; Palliative Care; Pharmacology. Drug treatments; Prevalence; Psychiatric Status Rating Scales; Psychological problems; Quality of Life; Stress, Psychological - epidemiology; SubSaharan Africa; symptoms; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Sub-Saharan Africa; Africa; Africa South of the Sahara; symptoms; HIV; palliative care; Africa; Human; Immunopathology; Prevalence; Multicenter study; Retroviridae; AIDS; Immune deficiency; Lentivirus; Epidemiology; Infection; Virus; Symptomatology; Viral disease; Palliative care; Psychopathology; Human immunodeficiency virus; International
• ISSN: 0885-3924; 1873-6513
• DOI: 10.1016/j.jpainsymman.2011.08.008

Abstract Context Despite HIV remaining life limiting and incurable, very little clinical research focus has been given to the prevalence and related burden of physical and psychological symptoms for those accessing palliative care. Despite evidence of problems persisting throughout the trajectory and alongside treatment, scant attention has been paid to these manageable problems. Objectives This study aimed to measure the seven-day period prevalence and correlates of physical and psychological symptoms, and their associated burden, in HIV-infected individuals attending palliative care centers in sub-Saharan Africa. Methods Consecutive patients in five care centers across two countries completed the Memorial Symptom Assessment Scale-Short Form, with additional demographic and disease-oriented variables. Results Two hundred twenty-four patients participated. The most common symptoms were pain in the physical dimension (82.6%) and worry in the psychological dimension (75.4%). Interestingly, 71.4% reported hunger. Women, and those with worse physical function, were more likely to experience burden. However, being on antiretroviral therapy (ART) was not associated with global, physical, or psychological symptom burden. Conclusion This study is the first to report physical and psychological symptom burden in HIV-infected populations receiving palliative care in sub-Saharan Africa. Despite increasing access to ART, these burdensome and manageable problems persist. The assessment of these problems is essential alongside assessment of ART virological outcomes.