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Richard Williams Dr Andrew Nayagam Maureen Wotherspoon

Addressing the long term psychosocial and medico-legal needs of HIV positive patients: The West Sussex structured interview (WeSSI). Richard Williams Dr Andrew Nayagam Maureen Wotherspoon. Background. Emotional support and induction Time constraints Patients’ recall Changing needs

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Richard Williams Dr Andrew Nayagam Maureen Wotherspoon

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  1. Addressing the long term psychosocial and medico-legal needs of HIV positive patients: The West Sussex structured interview (WeSSI) Richard Williams Dr Andrew Nayagam Maureen Wotherspoon

  2. Background • Emotional support and induction • Time constraints • Patients’ recall • Changing needs • Chronic disease - changing advice

  3. Background • Up-to-date information • Accountability for patient knowledge • Responsibility to review and address patient need • Long term HIV positive patients as well as those more recently diagnosed

  4. Rationale A framework is required to set standards in the management of HIV positive patients by addressing relevant medical, legal and psycho- social issues

  5. The West Sussex Structured Interview (WeSSI) • Produced by multi-disciplinary team • Addressed a range of psychosocial and medico-legal issues • Focussed on patients diagnosed for more than 3 years • Patient satisfaction questionnaire

  6. Audit results: Demographics (N=20) • 10 male, 10 female • 11 White European, 9 Black African • 13 heterosexual, 7 homosexual • 2 age 16-24, 8 age 25-39, 10 age 40+ • 2 diagnosed < 6/12, 1 diagnosed 6-12/12, 15 diagnosed > 3 years

  7. Results (N=20) • 19/20 required either an intervention or received new information • 14/15 patients diagnosed >3 years received either an intervention or new information

  8. Results: Interventions (N=14) • Referral to Clinical Nurse Specialist (N=7) • Referral to Doctor (N=3) • Referral to Nurse Psychotherapist (N=3) • Referral to Women’s Group (N=5) • Provider Notification (N=2) • Rearrangement of appointments due to concerns about confidentiality (N=1)

  9. Results: New information received • Post exposure prophylaxis for a sexual exposure (N=14) • Prevention of mother to child transmission (N=11) • Safe sex (N=4) • Criminalisation of transmission (N=3)

  10. Results: Interventions for patients diagnosed >3 years (N=15) • Referral to CNS (N=4) • Referral to Doctor (N=3) • Referral to Nurse Psychotherapist (N=1) • Referral to Women’s Group (N=4) • Rearrangement of appointments due to concerns about confidentiality (N=1)

  11. Results: New information received for patients diagnosed >3 years (N=15) • Post exposure prophylaxis (N=12) • Prevention of mother to child transmission (N=7) • Safe Sex (N=3) • Criminalisation (N=2)

  12. Results: An insight into our patients • 8/9 Black African patients had not disclosed their result to friends • 3/9 Black African patients had not disclosed their results to friends, family or partners; 2 were referred to a women’s group • 7/20 patients indicated they did not receive social support; 5 received an intervention

  13. Results: Patient satisfaction questionnaire (N=16) • 15/16 patients found the WeSSI ‘completely’ or ‘mostly’ acceptable • All 16 patients who responded found the WeSSI comprehensive and relevant

  14. Conclusion • The WeSSI addressed unmet knowledge gaps by providing new information for 18/20 patients • As a result of the WeSSI, 14/20 patients received an intervention • 14/15 patients who had received their diagnosis >3 years prior to the WeSSI received either an intervention or new information • Patients found the WeSSI relevant, comprehensive and acceptable

  15. Recommendations • Health advising services should consider adopting the WeSSI • A modified WeSSI should be considered for follow up on an annual basis

  16. Richard WilliamsLead Health Adviser Warren Browne UnitSouthlands HospitalShoreham-by-SeaWest SussexBN43 6TQ01273 446041richard.williams@wsht.nhs.uk

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