Psychosocial Well-Being of People Living with HIV/AIDS in Chitwan District, Nepal: a Mixed Method Study.

BACKGROUND: Along with many physical issues associated with the HIV/AIDS there are socio-psychological ill-effects including depression, anxiety and stress. The antiretroviral therapy has been successful in prolonging the life but not much information is available on the psychosocial issues and social support from Nepal. METHODS: Sequential explanatory mixed method study design was followed. All the patients undergoing antiretroviral therapy in Bharatpur Hospital above 18 years of age and giving consent to participate were conveniently selected. Validated Nepalese version of Becks Depression Inventory and Becks Anxiety Inventory tool while translated and validated Multidimensional Scale of Perceived Social Support scale was used Purposive In-depth Interview was conducted with open ended questionnaire to obtain qualitative data. Chi-square and logistic regression were used for quantitative analysis while manual content analysis was used to analyze the qualitative data. RESULTS: The totals of 288 participants were included in the study About 43% had some level of depression, 98% had very low level of anxiety and almost half of the people had high support. In binary logistic regression model, the significant variables were sex, marital status and occupation. Females had 2.622 times more odds of depression than males, the risk of having depression in occupation group- agriculture and household was 3.661 and 2.508 time more as compared to jobholder respectively. Similarly, single individuals had 2.815 higher odds of depression than couples. Emotional disturbances and fear of vulnerability, stigmatization, dealing with difficulties were the major problems in these groups with good familial and organization support. CONCLUSIONS: Clinicians, health and AIDS professionals should routinely screen for depression among other interventions to promote psychological health in HIV/AIDS-positive individuals.

Caregiver Burden among Caregivers of Patient Undergoing Hemodialysis in Tertiary Care Center : A Descriptive Cross-sectional Study.

INTRODUCTION: Chronic kidney disease affects almost all aspects of life of the patients and caregivers. Dialysis is a common treatment modality for chronic renal failure. The caregivers of patients undergoing hemodialysis bear the emotional and psychological stress of having a chronically ill patient. The physical and psychological distress, limitations in personal and social activities, loss of freedom, financial limitations directly or indirectly affect the level of burden among caregivers. This study aims to study the level of burden among caregivers of patient undergoing hemodialysis. METHODS: A descriptive cross-sectional study among 123 caregivers giving care to hemodialysis patients for at least 3 months at Teaching Hospitals, Chitwan was carried out using simple random sampling technique. Level of burden was evaluated using the burden questionnaire (Zarit Burden Interview). RESULTS: The study revealed that 60 (48.78%) had mild to moderate, 53 (43.08%) had moderate to severe. The median scores for burden among the caregivers was (39.30±11.68) with 44.65%. CONCLUSIONS: Coping Strategies, social support, support interventions has greater impact on caregivers in achieving their roles in caring the patients and increases the capability to cope effectively with the patient's condition.

Quality of Life among People Living with Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome in a Anti-Retroviral Therapy Clinic.

BACKGROUND: The increasing burden of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and its association with the stigma, disability, less productive life, diminished immune has overall affected the quality of well being. There are also many factors that directly or indirectly affect the quality of Life of People living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome. Thus, this study aims to assess Quality of Life among people living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome. METHODS: A cross-sectional analytical study among 100 individuals of age 18 years and above and diagnosed from 6 month and above attending the ART clinic of Bharatpur Hospital was carried out between using simple random sampling technique. Quality of life was evaluated using World Health Organization Quality of life questionnaire (WHO QOL-BREF instrument). RESULTS: This study reveals that the Quality of Life median scores were highest for the environmental domain (25±2.6) and lowest for the social domain (11±1.4). The overall Quality of Life median scores in the other two domains were physical domain (23±2.4), and psychological domain (19±3.1). The Quality of Life scores of all four domains were strongly co-related with the total measure of the quality of life. The strongest correlation was seen in psychological domain .Sex, Education, Marital status, Cause of HIV, Co-morbidities of illness, and Family support was statistically associated with overall Quality of Life. CONCLUSIONS: Higher education, Good family support and no co-morbidties to the illness has a greater impact in improving the quality of Life.