Model Development on elderly with HIV caring in HIV Clinic of community hospitals, Ubon Ratchathani Province

Abstract

The care of the elderly with HIV infection in hospital clinics emphasizes providing treatment services according to the national service guideline and hospital contexts appropriately. This action research aimed to develop an integrated and continuous care model for the elderly with HIV infection (EHIV) from the hospital to the community in the HIV clinic of the community hospital of Ubon Ratchathani Province. This study focused on presenting only two steps of model development and implementation. The study units were clinics in two community hospitals. The target groups for model development were 12 people, including nurses, pharmacists, and medical technicians; 15 people, including volunteers from the network of PHA (People Living with HIV) and representatives of EHIV and 43 EHIV who provided information on the problem situation analysis. The development process was divided into problem situation analysis, model development, and model implementation in PHA clinic of district hospital. The tools used included questionnaires, interview guides, group processes, and participation in brainstorming to develop the model. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using content analysis.

The results were found: the problem were 16.3% of elderly persons with HIV did not take their antiretroviral drugs on time, not being a member of the elderly club, 79.1%, and found the  lowest level of screening for the elderly's health in 9 aspects and home visits in the community, (mean= 0.46) In aspects of the service providing  in the hospital clinics, it was found that the infected persons lacked holistic care as they were a particularly vulnerable elderly group, and there was a lack of geriatric specialists to create the services plan in the clinics. This led to the development of an integrated service model for HIV-infected elderly from hospital clinics to communities. The resulting model is the HCQ Model (Holistic Care, Continuous Care, and Quality of Life), which consists of holistic care covering all dimensions of the elderly, continuous care from the hospital to the community, and giving importance to the quality of life of the elderly until the end of life with dignity. This service model is an important mission of the hospital in providing services. The goal is for the elderly to receive comprehensive services in all dimensions as a special vulnerable group. This has been announced as a service policy in the two target hospital clinics together.