Predictors of hiv symptomatic self-care strategies among plwha attending art clinic of jimma university specialized hospital, south west Ethiopia

Abstract

Background: People living with HIV/AIDS experience multiple symptoms which might be caused by the infection itself, opportunistic infections or by treatment regimens. For effective treatment of the symptoms, the clients’ self-care practices and determination of factors affecting these practices are vital. There is no study which documented the self care practices of PLHA and their predictors in the study area. Objective: The main objective of this study was to assess predictors of self-care strategies utilized by PLWHA to manage symptoms. Methods: Cross-sectional study was conducted in JUSH from May 10 to June 7, 2010. Simple random sampling technique was employed to select subjects included in the study. Data were collected by nurses working in different units of JUSH in collaboration with nurses involved in counseling and delivery of other services to PLWHA using modified version of the Revised Sign and Symptom Check-List for HIV (SSC-HIVrev) and Symptom management manual strategies for people living with HIV/AIDS. Bivariate and Multivariable logistic regression models were used to determine the predictors of using the eight types of symptom self-care strategies (i.e., medications, complementary treatments, self-comforting, daily thoughts/activities, changing diet, help-seeking, exercise, and spiritual care). Result: The top six most frequently reported symptoms by the respondents were: fatigue (15.8%), night sweat (10.8%), peripheral neuropathy (8.7%), depression (7.2%), fever (6.7%) and dizziness (6.7%). Of the total eight self-care strategies used in the management of the top five symptoms self-comfort and daily thoughts were the major self-care strategies used across the symptoms. Educational status, sex and bothersome due to night sweat, and monthly individual income and effect of peripheral neuropathy on daily life were significant predictors of use of self-comfort as self-care in the management of fatigue, night sweat and peripheral neuropathy respectively. Whereas, living condition and severity of depression were significant predictors of use of daily thought as a self-care in the management of depression and in using dietary changes as a self-care in the management of fever, educational status and severity of fever were significant predictors. Conclusion and recommendation: The result of this study revealed that self-comfortwas widely used as self-care strategy in the management of fatigue, night sweat and peripheral neuropathy with significant predictors of educational status; bothersome due to night sweat; monthly individual income and effect of peripheral neuropathy on daily life respectively. As PLWHA are suffering from a number of complex symptoms and their active involvement in their own routine care is vital and to do so, all sectors working on HIV care and support or related issues should work on determination of most prevalent symptoms and development of self-care strategies.