Psychological Features of Illness and Recovery Patterns in HIV Disease PHASE, Canadian Psychological Association and Health Canada Module Developed by Paul C. Veilleux, Ph.D. UHRESS - Centre Hospitalier de l’Université de Montréal Montreal, Quebec.
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Psychological Features of Illness and Recovery Patterns in HIV DiseasePHASE, Canadian Psychological Association and Health CanadaModule Developed by Paul C. Veilleux, Ph.D. UHRESS - Centre Hospitalier de l’Université de MontréalMontreal, Quebec
Headache, feeling ill, asthenia, insomnia, unusually vivid dreams, restlessness, severe agitation, mania, auditory hallucinations, confusion
Headache, asthenia, feeling ill, confusion, depression, seizures, excitability, anxiety, mania, early awakening, insomniaNeuropsychological and Neuropsychiatric Effects of Medications Used in HIV Disease
Headache, confusion, impaired concentration, somnolence, asthenia, depression, seizures, peripheral neuropathy
Nervousness, anxiety, confusion, seizures, insomnia, peripheral neuropathy, pain
Insomnia, maniaNeuropsychological and Neuropsychiatric Effects of Medications Used in HIV Disease
Visual hallucinations, depersonalization, tearfulness, confusion, hyperesthesia, thought insertion, insomnia
Delirium, peripheral neuropathy, diplopia
Paresthesias, seizures, headache, irritability, hallucinations, confusionNeuropsychological and Neuropsychiatric Effects of Medications Used in HIV Disease
Amphotericin B (cryptococcosis)
Confusion, paranoia, hallucinations, mania, coma
Depression, loss of appetite, insomnia, apathy
Psychosis, somnolence, depression, confusion, tremor, vertigo, paresis, seizures, dysathriaNeuropsychological and Neuropsychiatric Effects of Medications Used in HIV Disease
Depression, weakness, headache, myalgias, confusion
Confusion, anxiety, lability, hallucinations
etc.Neuropsychological and Neuropsychiatric Effects of Medications Used in HIV Disease
Body image, dignity
Income, Job, status
Love and intimacy
Sense of self and one’s role in the world
Anticipation, Control over the future
Sense of invulnerabil-ity and immortalityLosses and Transformations Facing Persons Living with HIV/Aids
Informing others about the diagnosis
Fear of loss of body functions and/or of physical disability
Fear of loss of mental functions and autonomy
Changes in body image and self-imageMajor Stressors Facing Persons Living with HIV/Aids
Loss of one’s home
Apprehension of social isolation as death approachesMajor Stressors Facing Persons Living with HIV/Aids
Organizing support services
Educating and organizing family, friends, and partners about one's changing needsManaging Chronic Health Problems
Weighing medical treatment needs against quality of life issues
Dealing with anticipatory grief in self and others
Determining what is worth the effort and what is notManaging Chronic Health Problems
Desire to have a child
Return to work
Return to school
For how long ???
Make an enlightened decision.Returning to Work: Psychological and Social Consequences
Continually give clients permission and encouragement to grieve.
Clients feel safest to grieve when they know their grief can be expressed and contained.Grief Issues in Therapy
1. What are the feelings and emotions of the patient or client?
2. What are your feelings and emotions regarding this person and situation?
3. What are the needs of the patient or client?
4. What solutions or strategies would you suggest?Case Study: Questions
What are your emotional reactions to this schedule?
How likely would you be to follow your schedule as instructed?Exercise: Daily Medication ScheduleQuestions for Small Group Discussion
were visually impaired ?
were depressed ?
were homeless ?
didn’t want anyone to know you were HIV+ ?
were cognitively impaired ?
What could help you to better follow your medication schedule ?Exercise: Daily Medication ScheduleQuestions for Small Group Discussion
3TC: one pill (150 mg) twice a day, can be taken with food
Crixivan: two pills (2X400mg) every 8 hours around the clock, with water, skim milk, juice, coffee, or tea; one hour before or two hours after a meal; drink a minimum of 1.5 litres (preferably water) throughout the day, store at room temperature, keep dryExercise: Daily Medication Schedule: Example 1
Saquinavir: five pills (5X200mg) twice a day, with a meal
ddI: two pills (2x100mg) twice a day, 30 minutes before or 2 hours after meals
d4T: one pill (40mg) twice a day; can be taken with foodExercise: Daily Medication Schedule: Example 2
Ritonavir: 5ml; 400mg twice a day; tastes awful
ddI: two pills (2x100mg) twice a day; must be taken one hour before or after the indinavir and the ritonavir
Hydoxyurie: one pill (500mg) twice a day; can be taken with food
Septra: one pill (5mg) once a day, without food if possibleExercise: Daily Medication Schedule: Example 3
Managing chronic health problems
Time issues and life issues
Preparing to diePsychosocial Issues Around AIDS and Late HIV-Disease
Assist the client in formulating questions for his or her physician.
Offer emotional support and suggest ways of establishing a sense of control whenever possible.The Psychologist’s Role in Medical Treatment
Continually review the new commitments you make in light of how many HIV-infected clients you are seeing at various stages of the disease.Maintaining Boundaries and Avoiding Burnout
Know the resources in your community and how to use them.Maintaining Boundaries and Avoiding Burnout