Nursing care for terminally ill AIDS patients - A study of palliative care in Namibia
Abstract: Background: HIV is a retrovirus that attacks cells of the immune system. The finalstage of the infection is referred to as AIDS where the immune system is severelyweakened and small infections can be fatal. Namibia is heavily affected by the HIVcrises in Sub-Saharan Africa and has now reached a prevalence rate of 15.3% amongadults. An estimated 200 000 Namibians are living with the infection. The HIVpandemic has increased the need of adequate palliative care in the region. Still, thepalliative care in Sub-Saharan Africa including Namibia is poorly developed. Themain aim of palliative care should be to improve the quality of life and to meet thepatient’s needs. Caring for terminal AIDS patients is a challenge and there is a widespectrum of needs to attend.Aim: The aim of this study is to gain knowledge of how the patients with AIDS in anAfrican country like Namibia, are cared for by the nurses in the palliative stage oftheir disease.Method: An ethnographic approach has been used to meet the aim of this study.Data has been collected from two medical wards at Katatura Hospital in Windhoek,Namibia during five weeks. Participatory observations took place in the daily nursingwork and were supplemented by informal interviews with the nursing staff.Result: The main issues in providing the palliative care in this context formed fivecategories; Nursing care of dying patients with AIDS, Where to be cared for, Nurses’attitudes towards the dying patient, Nurses’ thoughts about HIV/AIDS and Resourcesand limitations. The standard of the hospital and its palliative and medical care isvery low. Resources are limited and the dying patients are often left alone andunnoticed. The medical wards are understaffed and this is a source of greatfrustration for the nurses. The hospital management’s supervision of the dailynursing performance is insufficient and there is little or no room for patientcomplaints. Patients die in the medical wards every day but according to many of thenurses, palliative care does not exist in Katatura Hospital.
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