Abstract Book Vol. 2 [International Conference on AIDS (14th: 2002: Barcelona, Spain)]

XIV International AIDS Conference

Abstracts WePeF6606-WePeF6609 239

Description: Work developed in a specialized health care center for children either infected or exposed to HIVin Sapopemba,a very poor and violent district in
S.o Paulo city,Brazil.They are assisted by pediatritians,psicologists,nutricionists
and nurses.
The method chosen by the professional crew to fight difficulties faced by the
pacients such as lack of aderence to treatment, receiving a positive HIV test
result,feeling abandoned by family and friends was that of telling stories.This
choise was based in Winnicot saying that tales are naturally used by the child
as a natural way of organizing,elaborating and taking over its psycological conflicts.The stories are chosen according to the wish of e pacients and told by pediatricians or psycologists usually in an interactive way.Other members of the crew
also take part in the activities.There are also activities created specifically for
teenagers,concerning themes like sexuality and drug abuse.The birthdays of pacients are always celebrated to recall the importance of fighting for life.Monthly a
different kind of nurture is chosen for discussion and its virtues explored.The crew
of professionals working directly with HIV pacients is offered emotional support to
help cope with stress and have a better understanding of the situation.
Lessons learned: These activities play a relevant role,along with medical treatment; Better aderence to treatment was noticed; Children deal better with personal difficulties
Recommendations: That the crew be careful in choosing adequated themes for
stories; Parents should be advised to repeat stories as many times as the child
desires; Imagine new ways of getting closer to the children
Presenting author: Elza Padreo, Rua Romdo Puigari, 111, Jardim da Sabde,
CEP: 04164-000, S.o Paulo, Brazil, Tel.: [phone], Fax: [phone], E-mail: [email protected]
WePeF6606 Support and care for people living with HIV/AIDS
in Malawi
L.A. Hatchett1, C.N. Kaponda2, C.N. Chihana2, E. Chilemba2, M. Nyando2,
A. Simwaka2, J. Levy1. 'University of Illinois at Chicago, university of illinois at
chicago, health research and policy centers, mc 275, 850 wjackson blvd suite
400, chicago i/ 60607, United States; 2University of Malawi Kamuzu College of
Nursing, Lilongwe, Malawi
Background: An estimated 1 million people currently live with HIV/AIDS in
Malawi, with over 75,000 new cases reported annually (National AIDS Control
Programme, 1999). Providing care and support for those without adequate medication and basic survival resources poses an enormous challenge. That little information is available about the needs of Malawians living with HIV/AIDS (PLWA)
further exacerbates the problem and forms the focus of this investigation.
Methods: In-depth interviews concerning support and care issues of PLWA
were conducted in the Chichewa language with 30 PLWA and 15 female caregivers recruited from urban and peri-urban communities in Lilongwe district. Interviews were transcribed, translated into English, coded, and analyzed using
QSR NUD*IST
Results: Having regular food, adequate nutrition, bedding, and effective medication to treat recurrent AIDS symptoms such as diarrhea, vomiting, and headaches
are PLWA most commonly reported unmet needs. Caregivers report frustration
from not knowing how to appropriately care for loved ones with little information
about HIV/AIDS and no basic medical supplies; soap, lotion, and bandages. Limited access to hospitals exists due to poor transportation and availability. Healthseeking patterns typically begin with accessing traditional healers and remedies,
then moves to seeking western medicine at local hospitals when symptoms continue or worsen. Women provide the major caregiving for family members with
little help from outsiders, a pattern that interferes with performing basic survival
activities such as planting crops, marketing goods, and child rearing. Extended
family members are unable to assist PLWA adequately because of dire poverty.
Conclusions: Establishing local community support groups for women caregivers and PLWA to learn safe care for patients and share information, resources
and responsibilities is a necessary start to bridging needs.
Presenting author: Lena Hatchett, university of illinois at chicago, health research and policy centers, mc 275, 850 w jackson blvd suite 400, chicago il
60607, United States, Tel.: [phone], E-mail: [email protected]
WePeF6607 Caring for the caregiver in a paediatric residential
care facility
J. Schoeman. Cotlands Baby Sanctuary, c/o Cotlands, P 0 Box 74042,
Turifontein, 2140 Johannesburg, South Africa
Description: Cotlands Baby Sanctuary, situated South of Johannesburg, was established 65 years ago as a home for unmarried mothers and babies. Over the
years the focus has changed, and six years ago Cotlands opened a 20-bed paediatric HIV/AIDS hospice - the first of its kind in South Africa.
Issues: Initially we only experienced a death every few months, but as the epidemic has grown and the hospice has become more fully utilized we now average

one to three deaths a week. This naturally places a tremendous emotional strain
on the staff, as they constantly have to deal with loss. Despite this, the turnover
rate of the hospice staff is negligible, so we have documented the care provided
to the staff. This is our Caring for the Caregiver model.
The model deals with:
1. Establishing what motivates us to do the jobs we do.
2. Symptoms of burnout

3. Stress reduces
4. Management issues
5. Staff Counselling
Lessons Learned: This model has been effectively utilized at Cotlands. This is
evident by the stability of staff and the consistently high level of job satisfaction
maintained, despite low salaries and long working hours.
Recommendations: Cotlands began training other institutions in caring for children with HIV/AIDS in 2001. One component of this course was the Caring for
the Caregiver module. Most participants identified this as one of the most valuable modules of the course. The participants' evaluations recommended that:
1. Managers be trained to implement this model in their organizations, and
2. A support group is established for on-line workers.
Funding has been received for this and will be implemented in 2002.
Presenting author: Jackie Schoeman, c/o Cotlands, P O Box 74042, Turffontein,
2140 Johannesburg, South Africa, Tel.: [phone], Fax: [phone]
2609/6688, E-mail: [email protected]
WePeF6608 Home care of persons with HIV/AIDS in Thailand: a
train-the-trainers program for nurses and family
caregivers of persons with AIDS
W.L. Maneesriwongul1, S. Panutat1, A.B. Williams2, P. Putwatan1,
S. Srirapongam 1. 1 Ramathibodi School of Nursing, Ramathibodi Hospital
Faculty of Medicine, Mahidol University, Ramathibodi School of Nursing, 270
Rama 6 Rd., Rathavee, Bangkok 10400, Thailand; 2Yale University School of
Nursing, New Haven, Connecticut, United States
Issues: As the AIDS epidemic has overwhelmed the hospital system in Thailand,
persons with AIDS (PWAs) receive more and more care at home by their main
caregivers such as parents and spouses. In response to the increasing demand
for home care of PWAs and the lack of opportunity for family caregiver training,
a three-phase training program was conducted for nurses and family caregivers.
This program is in collaboration between Ramathibodi School of Nursing and
Yale University School of Nursing, and sponsored by the World AIDS Foundation
to improve nurses'self-efficacy to offer family caregiver training and to develop a
package of training manuals for nurses and family caregivers.
Description: Two training workshops were conducted emphasizing the development of teaching and training skills along with specific information related to
care for PWAs in the home, based on the needs of family caregivers and nurses
caring for PWAs. There were 45 nurses from 23 hospitals around Thailand participated in this program. Participants received needed knowledge including training
skills, and conducted training sessions for family care givers at their home institutions. They received additional knowledge and shared lessons learned to each
other during the follow-up workshop. Program effectiveness was evaluated using
qualitative and quantitative techniques. Along with the training, a draft of training
manuals was reviewed and refined.
Results: The program found significant improvement of nurses' self-efficacy in
establishing teaching contents, selecting teaching methods, and teaching patients/family caregivers (p < 0.01). The final packages of the training manuals
which helpful for nurses in training of family caregivers to care for PWAs will be
distributed nationwide after the completion of this program. Additionally, applications of these materials were found useful in the care of other chronically-ill
patients who must be cared for at home.
Presenting author: Wantana Maneesriwongul, Ramathibodi School of Nursing,
270 Rama 6 Rd., Rajthavee, Bangkok 10400, Thailand, Tel.: [phone], Fax:
[phone], E-mail: [email protected]
WePeF6609 Home care of persons with HIVIAIDS in Thailand:
development of training curricula for nurses and
family caregivers of persons with AIDS
S. Panutat1, W.L. Maneesriwongul1, A.B. Williams2, P Putwatana,
S. Srirapongam1, S. Jaiyavat', L. Ounprasertpong1, S. Churaitatsanee',
S. Wongsathapornpat1, S. Santati', S. Chottivitayatarakorn'. 'Ramathibodi
School of Nursing, Ramathibodi Hospital Faculty of Medicine, Mahidol University
Ramathibodi School of Nursing, 270 Rama 6 Rd, Rajthavee, Bangkok, Thailand;
2Yale University School of Nursing, New Haven, Connecticut, United States
Issues: AIDS is a serious national public health problem and likely to be the leading cause of death in Thailand. As the AIDS epidemic has overwhelmed the hospital system, family caregivers have to provide more and more care for persons
with AIDS (PWAs) at home. In response to the increasing demand for home care
and the lack of opportunity for family caregiver training, a three-phase training program was conducted for nurses and family caregivers in Thailand in collaboration
between Ramathibodi School of Nursing and Yale University School of Nursing,
and sponsored by the World AIDS Foundation to develop a training curriculum
that can improve the knowledge and ability of nurses to offer family caregiver
training, and to develop curriculum providing family caregivers with information

and skills needed to meet care taking responsibilities.
Description: There were 18 family caregivers and 18 nurses caring for PWAs
participated in 4 focus group discussions. The discussions were around needed
knowledge and skills along with special information to care for PWAs in the home.
The development of training curricula was guided by findings of the focus group
discussions to ensure the responsiveness to Thai context.
Results: The suggested curricula for nurses and family caregivers include knowl