FACTORS INFLUENCING NON-ADHERENCE TO ANTI RETROVIRAL THERAPY AMONG HIV/AIDS PATIENTS VISITING GUCHA SUB COUNTY HOSPITAL
| Institution | Kenya Medical Training College |
| Course | diploma in phamacti... |
| Year | 3rd Year |
| Semester | Unknown |
| Posted By | MAKORI KERECHA |
| File Type | |
| Pages | 41 Pages |
| File Size | 453.07 KB |
| Views | 1576 |
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Description
FACTORS INFLUENCING NON-ADHERENCE TO ANTI RETROVIRAL THERAPY AMONG HIV/AIDS PATIENTS VISITING GUCHA SUB COUNTY HOSPITAL
An antiretroviral therapy (ART) adherence of at least 95% has been proven necessary in order for treatment to be effective. Failure to meet this level results in poor immunological and virological outcomes. The objective of study was to determine factors influencing non-adherence to Antiretroviral therapy among HIV and AIDS patients visiting Gucha Sub County hospital. Cross sectional study was carried out at Gucha Sub County hospital in Kisii County Kenya in December 2015. Patients in comprehensive care clinic meeting the inclusion criteria were selected using systematic random sampling method. Both qualitative and quantitative methods of data collection were utilized, where structured questionnaire with open and closed type questions where an approximate of 69 participants was selected using fishers et-al method. Key informant interviews for health care providers were conducted. Data was analyzed using SPSS software version 22. Data is presented using charts, graphs and frequency tables. Level of adherence was sub-optimal (83%). Taking ARV drugs without eating any food made patients suffer from side effects thus making them avoid taking the medication. Poverty contributes to lack of food which had a 39.73% on affecting ARV’s followed by Stress having 34.25% lastly lack of proper education having 26.02% effect. Stigma was 32.20% showing highly affecting patients on accessibility of ART’s due to social circle around the HIV patients, negative perception, lack of family and community support is some obstacles to ART adherence. Long travel and distance to hospital for ART and poor weather is barrier to accessibility of ART during such rainy seasons having 20.55% hence a major hinder to optimal adherence. This study is set to be useful to other scholars doing studies in this area and for planning interventions and effective strategies for maximizing long-term adherence to ART for successful treatment of HIV and AIDS from the findings we concluded that lack of meals during medication led to avoidance of taking medicine and long distances of travel from health facilities made the patients lose morale to access the facilities.The study recommended development strategies to enhance food security in household with people living with HIV Aids, intensify health education complains against stigma and promote family and community support for people living HIV.
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Sinus Mechanisms
A normal heartbeat results from an electrical impulse that originates from the hearts primary pace maker-(SA node)
• The Normal sinus rhythm records the hearts electrical impulse that starts in the SAN spreading through the normal conduction pathway.
• The SAN dominates other areas that may pace the heart slower and abnormally.
All other rhythms will be compared to the Normal Sinus
Rhythm
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Ventricular Rhythms
The ventricles (purkinje fibres) may assume the function of pacing the heart, they pace at a slower rate 20-40b/min which cannot sustain the body's perfusion requirements. Rhythms originating from the ventricles are called ventricular arrhythmias because they originate in the ventricles.
Ventricular arrhythmias occur when:-
a) The SAN fails to initiate an impulse
b) The AVN does not pick to pace
c) There is an irritable foci in the ventricular muscle
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Sickle cell Crisis
Sickle cell disease (SCD)
• A group of hereditary disorders in which the normal adult hemoglobin (hemoglobin A) is partly or completely replaced by abnormal sickle hemoglobin (HgbS).
• The most common genetic hematologic condition in children
• Transmitted by autosomal recessive pattern of inheritance.
• Patient with this condition is homozygous for the sickle cell gene, i.e. both genes are abnormal.
• The basic defect responsible for the sickling of
erythrocytes is contained in the globin fraction of hemoglobin
• The mode of transmission is hereditary
• The gene that determines the production of HgbS is situated on an autosome.
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Treatment modalities for hematological disorders
These are therapies aimed at preventing, alleviating the underlying cause or treating the hematological disorder
• They include
1. Nutritional therapy: meal management to ensure rich sources of iron, vitamin K, vitamin B9.
2. Supplements: administration of folate, iron sulfate.
3. Treatment of underlying cause: antimalarial, deworming, ulcer treatment
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Valvular heart disease
Outline
1. Review the role of valves in cardiac cycle
2. Define valvular heart disease
3. Identify types of VHD
4. Explain the assessment and diagnostic tests
5. Describe the management of patient with VHD
46 Pages
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Assessment and diagnostic evaluation of patient with haematological disorder
History taking
1. Nutrition: feeding habits; typical meal – to determine deficiencies
2. use of prescription and over-the-counter medications: most hematological conditions can result from herbs, or certain medications.
3. Prior chemotherapy or radiotherapy
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Disseminated intravascular coagulation (DIC)
It is a condition of combine platelet and coagulation factor disorder.
• It is characterized by widespread coagulation and bleeding in the vascular compartment.
• DIC occurs secondary to inappropriate systemic activation of normal clotting mechanisms.
• It is associated with underlying disease manifested as uncontrolled activation of coagulation and fibrinolysis.
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Circulatory Shock
3 elements ensures adequate tissue perfusion
1. Functioning pump (myocardial contractility)
2. Rate of Myocardial contraction
3. Adequate volume of blood (preload)
4. Normal vascular tone, SVR (Afterload)
• In order for adequate tissue perfusion to occur, cardiac output must be sufficient to deliver nutrient- and oxygen rich blood to the tissues.
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Hematologic emergencies (Disorders of haemostasis)
Disorders of hemostasis – hypercoagulability
states
Disorders occurring due to imbalance between procoagulants and anticoagulants.
Pro-coagulant factors:
Platelets
clotting factors
Ca2 PLUS
molecules released by damaged tissues
Anticoagulant factors
Protein C
Plasmin
Antithrombin III
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Leukemia
A group of malignant diseases of the bone marrow and lymphatic system.
• Characterized by an unrestricted proliferation of immature white blood cells in the blood-forming tissues of the body.
• Classified as malignant because the leukemic cells demonstrate the neoplastic properties of solid cancers.
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