richard williams dr andrew nayagam maureen wotherspoon
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Addressing the long term psychosocial and medico-legal needs of HIV positive patients: The West Sussex structured interview (WeSSI). Richard Williams Dr Andrew Nayagam Maureen Wotherspoon. Background. Emotional support and induction Time constraints Patients’ recall Changing needs - PowerPoint PPT PresentationTRANSCRIPT
Addressing the long term psychosocial and medico-legal needs of HIV positive patients: The West Sussex structured interview (WeSSI)
Richard Williams
Dr Andrew Nayagam
Maureen Wotherspoon
Background
• Emotional support and induction
• Time constraints
• Patients’ recall
• Changing needs
• Chronic disease - changing advice
Background
• Up-to-date information
• Accountability for patient knowledge
• Responsibility to review and address patient need
• Long term HIV positive patients as well as those more recently diagnosed
Rationale
A framework is required to set standards in
the management of HIV positive patients by
addressing relevant medical, legal and psycho-
social issues
The West Sussex Structured Interview (WeSSI)
• Produced by multi-disciplinary team • Addressed a range of psychosocial and
medico-legal issues
• Focussed on patients diagnosed for more than 3 years
• Patient satisfaction questionnaire
Audit results: Demographics (N=20)
• 10 male, 10 female
• 11 White European, 9 Black African
• 13 heterosexual, 7 homosexual • 2 age 16-24, 8 age 25-39, 10 age 40+
• 2 diagnosed < 6/12, 1 diagnosed 6-12/12, 15 diagnosed > 3 years
Results (N=20)
• 19/20 required either an intervention or received new information
• 14/15 patients diagnosed >3 years received either an intervention or new information
Results: Interventions (N=14)
• Referral to Clinical Nurse Specialist (N=7)
• Referral to Doctor (N=3)
• Referral to Nurse Psychotherapist (N=3)
• Referral to Women’s Group (N=5)
• Provider Notification (N=2)
• Rearrangement of appointments due to concerns about confidentiality (N=1)
Results: New Information Received (N=20)
90%
10%
New Information Received (N=18) No New Information Received (N=2)
Results: New information received
• Post exposure prophylaxis for a sexual exposure (N=14)
• Prevention of mother to child transmission (N=11)
• Safe sex (N=4)
• Criminalisation of transmission (N=3)
Results: Interventions for Patients Diagnosed >3 years (N=15)
60%
40%
Intervention (N=9) No Intervention (N=6)
Results: Interventions for patients diagnosed >3 years (N=15)
• Referral to CNS (N=4)
• Referral to Doctor (N=3)
• Referral to Nurse Psychotherapist (N=1)
• Referral to Women’s Group (N=4)
• Rearrangement of appointments due to concerns about confidentiality (N=1)
Results: New Information Received for Patients Diagnosed >3 years (N=15)
87%
13%
New Information Received (N=13) No New Information Received (N=2)
Results: New information received for patients diagnosed >3 years
(N=15)• Post exposure prophylaxis (N=12)
• Prevention of mother to child transmission (N=7)
• Safe Sex (N=3)
• Criminalisation (N=2)
Results: An insight into our patients
• 8/9 Black African patients had not disclosed their result to friends
• 3/9 Black African patients had not disclosed
their results to friends, family or partners; 2 were referred to a women’s group
• 7/20 patients indicated they did not receive social support; 5 received an intervention
Results: Patient satisfaction questionnaire (N=16)
• 15/16 patients found the WeSSI ‘completely’ or ‘mostly’ acceptable
• All 16 patients who responded found the WeSSI comprehensive and relevant
Conclusion
• The WeSSI addressed unmet knowledge gaps by providing new information for 18/20 patients
• As a result of the WeSSI, 14/20 patients received an intervention
• 14/15 patients who had received their diagnosis >3 years prior to the WeSSI received either an intervention or new information
• Patients found the WeSSI relevant, comprehensive and acceptable
Recommendations
• Health advising services should consider adopting the WeSSI
• A modified WeSSI should be considered for follow up on an annual basis
Richard Williams
Lead Health Adviser Warren Browne UnitSouthlands HospitalShoreham-by-SeaWest SussexBN43 6TQ
01273 446041