Researchers at Case Western Reserve University's Frances Payne Bolton School of Nursing will assess how effective palliative care home health visits are in treating people with HIV and other chronic illnesses in a new four-year, $1.7-million study funded by the National Institute of Nursing Research.
With new medications, HIV is no longer a death sentence, said Jacquelyn Slomka, assistant professor of nursing and lead researcher. So patients with HIV are living longer, and, like other older people, developing chronic health conditions. Palliative care services can be especially helpful in meeting the everyday needs of patients with chronic conditions.
The study, in response to a call for proposals from the National Institutes of Health to explore palliative care for persons living with HIV, will examine outcomes for quality of life, symptom management, coping and advance care planning.
Two groups-each with 90 participants diagnosed with HIV at least two years before and having at least one chronic illness-will be studied for three years to track the benefits of having professionals provide supportive services through home visits and phone calls.
Each patient will be visited regularly by an advanced practice nurse (APRN) and a social worker to provide on-going assessment of needs in the home environment, to assure adequate symptom management, to help them follow what their doctors prescribe and to marshal community resources.
"If effective, the program can potentially become a model for HIV care in conjunction with their clinical care," said Slomka.
The number and severity of their chronic illnesses and whether others are around to help them will determine how often a nurse and social worker visit a patient. Each participant will be surveyed at the beginning and four more times throughout the study to measure the effectiveness of the program in obtaining the desired outcomes. The fourth year of the study will be used to analyze the findings.
The nursing school investigators are collaborating with the Hospice of the Western Reserve's Navigator Program, which will provide palliative care services by the APRN and social worker. Palliative care is an interdisciplinary approach to care that improves the quality of life of patients and their families who may be facing the problems associated with life-threatening illness. Palliative care assists patients through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.
"We want to improve the quality of life for persons living with HIV, and by doing so, hopefully improve outcomes for the patient," Slomka said.
Other collaborators from the nursing school include: Barbara Daly, the Gertrude Perkins Olivia Professor of Oncology Nursing; Maryjo Prince-Paul, assistant professor of nursing with expertise in palliative care; and Allison Webel, assistant professor of nursing with expertise in HIV.
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