Introduction
About 33.4 million people in the world today live with the human immunodeficiency virus (HIV), and 2.7 million of these were infected in 2008 alone (Abdul-Quader & Collins, 2011). This reflects a figure about 20 percent higher than the number of people living with the virus in 2000 (Abdul-Quader & Collins, 2011). Newly acquired instances of the Acquired Immuno-deficiency Syndrome (AIDS) cases were reduced substantially following the introduction of antiretroviral therapy for Human Immunodeficiency Virus (HIV) patients. Current efforts in the United States are geared towards helping uninfected individuals reduce the risk of acquiring HIV and maintain risk-free behaviors. Even in the face of these efforts, HIV infections between the year 2003-06 was estimated to be just over 55,000 people every year (Hall, et al., 2008). This paper contemplates a concept map for the treatment of Keith Rogers – a patient who recently realized that they were infected with HIV alongside their partner.
Patient Assessment
The case for Keith involves a HIV diagnosis that has been present for at least six months. Keith is currently in a homosexual relationship with his partner and both are under the support of their parents. Keith’s parents have recently become aware of Keith’s status and have since asked him to find another place to live for fear of infecting his younger sisters when using similar amenities. Moreover, Keith’s father has insurance for him but Keith has no insurance card of his own. He faces the uncertainty of what his insurance will cover in light of his HIV diagnosis and has therefore kept the diagnosis a secret from his parents for a while. Keith also maintains minimal information regarding the disease for fear of being discovered.
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Value and Relevance
The most immediate need for Keith is the knowledge deficit with regards to his recent diagnosis. This is evidenced as Keith verbalizes the lack of knowledge about the transmission of the HIV virus, its treatment and safe sex. As a result, the intervention intends to involve providing a month’s supply of condoms for the patient to promote safe sexual activity between the patient and his partner. Moreover, the patient will be taught on different ways to prevent the spread of the HIV virus, thereby curbing new infections and promoting knowledge in the patient regarding disease management. By using a team of interdependent specialists, it is possible to ensure that the patient’s knowledge needs are integrated and addressed (Boyd & Lucas, 2014). The expected outcome is that the patient can verbalize the four ways to prevent HIV spread.
The second need for the patient is with regards to the fear of transmission to family and loved ones. Since the patient’s diagnosis, Keith has maintained an autonomic response so as to reduce the chances of infection to his close relatives and partner. Simultaneously, the patient has felt deeply uncomfortable and dreadful when interacting with family members and close friends for fear of infecting them with HIV. Research indicates that this diagnosis might require both patient- and family-centered care strategies (Wolff, 2012). As a result, the treatment team intends to minimize isolation, reduce the use of masks, excess clothing and initiate frequent touch and physical contact. With time, the patient is expected to display lessened amounts of anxiety and fear in favor of a more balanced emotional response.
Lastly, the patient suffers social isolation due to his perception that others see him as a threat or that he is in danger. This is further accentuated by the fact that Keith views himself as promoting socially unacceptable sexual behavior. Keith’s behavior is aggravated by the fact that he lacks supportive family, friends and acquaintances who would support him during this time. Various patient resources could be used for this case, including the use of support groups to provide social support for Keith. Moreover, identifying supportive individual for Keith could provide the required support for his treatment, thereby resolving the social isolation phenomenon present.
Outcomes
From the above diagnoses, various outcomes are expected. Concerning the patient’s knowledgeability on the HIV virus, the patient is expected to learn and verbalize four ways to prevent HIV spread before they are discharged. The nurse will equip the patient with information and provide 30-days’ worth of condoms to promote responsible sexual behavior for the patient. The patient will also be treated to resolve their social isolation problem. Care resources will be used for this purpose to identify supportive individuals and encourage the patient to join them, thereby filling the gap left by non-supportive family and friends. This could be within support groups or other forums. Lastly, the patient is expected to have normalized emotional responses, thereby eradicating excess fear and anxiety. By initiating touch more often and reducing isolation techniques for treatment, the patient will be at ease regarding their fear of infecting loved ones.
Communication
The nurse practitioner involved in Keith’s treatment will be the chief communicator during this process. It remains in the best interests of the patient to involve the parents due to the long-term care implications of the disease. In the occasion that Keith’s parents remain non-supportive, the nurse practitioner may advice Keith on suitable social inclusion resources. Moreover, the nurse is responsible for communicating clinical requirements for the patient and facilitate informed decision making from the patient.
Conclusion
For this particular patient, it is important to keep in mind important aspects to his treatment, including his limited knowledge on HIV spread, safe sex practices, social isolation and fear of infecting loved ones. The concept map is an important tool in improving care for patients. Although therapy developments in treating people living with HIV have been remarkable in the past, the disease remains to be incurable for the foreseeable future. This means that disease management remains the most viable option to take when a patient is taken ill to this disease. This is the case applied to Keith.
References
Abdul-Quader, A. S., & Collins, C. (2011). Identification of structural interventions for HIV/AIDS prevention: the concept mapping exercise. Public Health Reports, 126(6) , 777-788.
Aberdeen, S. (2015). Concept mapping: a tool for improving patient care. Nursing Standard (2014+), 29(48) , 49.
Boyd, C. M., & Lucas, G. M. (2014). Patient-centered care for people living with multimorbidity. Current Opinion in HIV and AIDS, 9(4) , 419.
Hall, H. I., Song, R., Rhodes, P., Prejean, J., An, Q., Lee, L. M., & Janssen, R. S. (2008). Estimation of HIV incidence in the United States. Jama, 300(5) , 520-529.
Wolff, J. L. (2012). Family matters in health care delivery. Jama, 308(15) , 1529-1530.
