Everyday, people work, play, eat, sleep, have fun, and just try to live a healthy, normal life. But in some cases or situations, all these things change and living becomes not so “normal” when a person is affected by a chronic illness. Chronic illness is defined as a long-term health problem caused by an irreversible disorder (Black, 2001). A chronic illness can alter an individual’s quality of life dramatically in all aspects of daily living. Quality of life is something that is intensely personal and particular, including the person’s ability to live independently, age, and ability to contribute to society (Potter, 2001).Some people are able to cope better than others depending on the severity and type of illness, coping strategies, and most important of all, the person’s network of support such as family and friends. Any change experienced in life can be stressful and traumatic.
But a downward change in a person’s quality of life can be very difficult, especially knowing that life will never be the same again and the illness is possibly life threatening. Having a chronic illness is very overwhelming and often takes over a person’s life, making the person feel powerless and a lot of times depressed.People affected by a chronic illness such as AIDS/HIV go through major changes, basically altering their quality of life. This paper will discuss how a chronic illness such as AIDS/HIV can affect an individual’s quality of life in areas such as their physical functioning, psychological well being, and social functioning. Fatigue is very common condition for people with HIV; it can be physical or psychological. When HIV multiplies, the infected body uses more energy trying to fight it, causing fatigue.But most people have more energy as soon as they start taking their prescribed anti-HIV medications. This is why it is very important as a nurse taking care of an HIV patient to emphasize the importance of compliance to treatment and medications.
People with HIV and fatigue tend to get sicker faster than people without fatigue. Also, anemia is a common cause of fatigue among HIV/AIDS patients. Anemia is caused by loss of red blood cell and damaged to the bone marrow caused by anti-HIV medications.It is possible that the patient may need blood transfusion as a treatment for anemia. But this may not be possible for a patient who is a Jehovah witness, because they do not allow giving or receiving blood. Another important subject a nurse must emphasize on HIV patients is proper nutrition, because people with HIV require more energy than healthy people. If the patient is not getting enough nutrients, their energy level will be low.
It is essential for HIV/AIDS to find out the cause of fatigue and treat it, because fatigue can have major effects on the person’s quality of life.A person that is fatigue, for example may have difficulties with activities of daily living such as preparing meals, household chores, self-care, etc. It is already exhausting enough for them trying to keep up with the variety of anti-HIV medications they have to take everyday. It’s the nurse’s role to assure the patients to have an acceptable quality of life. This can be achieved by assisting patients with setting realistic goals for themselves and teaching them appropriate interventions to help manage their energy level within limitations to improve their quality of life.
Fatigue can make the disease progress faster if left untreated, and could lead to other complications, since ongoing fatigue can weaken the immune system. Aside from disease stage and therapeutic interventions, important variables such as social support and control and coping strategies can potentially impact the quality of life of the HIV/AIDS patient. Social support may consist of family, friends, and healthcare workers or caregivers. These groups of people are very important part of the patient’s recovery, because they provide encouragement, empathy, assistance, and fulfillment of the patient’s needs.Research has shown that “satisfaction with support had a positive and significant association with quality of life and contributes to better overall health and illness adaptation.
“(Tsasis, 2000) On the other hand, patients with no effective social support or nonsupportiveness from family and friends may have poor health outcomes. Social support can help patients to cope with the harmful effects of stress that may be experienced from living with HIV/AIDS. Lack or loss of social support may result in increased risks for psychosocial and situational stressors.Research has shown that “when psychosocial stressors such as disturbances in mood, low self-esteem, illness-related stress and markedly reduced social interaction are not addressed in persons living with HIV/AIDS, symptoms such as hopelessness, withdrawal, and depression are more likely to occur.
“(Tsasis, 2001) It is very important for the nurse to include family, friends, and caregivers when giving information or when educating the patient. This will enhance the therapeutic effectiveness of the supportive relationships. With older adults, based on Erikson’s developmental stage of integrity vs. espair, they may find the chronic illness as a source of despair due to lack of social support.
It is very common for older adults to have less family and friends around to provide emotional support, encouragement, and they possess limited coping strategies and resources. Improving the quality of life of an older adult may be a little more challenging than it is with a younger adult. When it comes to the socioeconomic condition of people with HIV/AIDS, they are more likely to fall into the poverty level. Unemployment is the main cause of financial loss, in addition to the high costs of treatments and anti-HIV medications.
The lifetime cost for treating a person with AIDS is estimated at around $119,000 (Key, 1995). The cost of life-sustaining drugs alone can be staggering. Symptomatic patients can take as many as 13 to 15 medications each day to fight current infections. The monthly price tag for such a regimen can reach up to $14,000 (Key, 1995).
Financial losses linked to unemployment can also result in further lifestyle changes. With minimal amount of money available to spend, there are times when most patients could not afford daily essentials such as food, clothing, hygiene products, etc.This problem leads to other problems such as lower self-esteem and confidence in themselves, decreased ability to socialize, and less confidence in their ability to return to work. The nurse’s role in this case is to provide patient information on how they can get professional help and assist them to cope with the consequences by words of encouragement. Nurses and other healthcare workers are more likely to have more understanding and insight when it comes to the argument of over end of life care and physician assisted suicide.Most healthcare workers realize that quality of life bears no relation to bedpans and wheelchairs.
It is not about losing sexual functioning, inability to play sports, or the inability to perform self-care. It’s much more bigger than that; “quality of life is found in self worth, personal autonomy, the love of oneself and others. ” (Gallagher, 2001) The moral issue assisted dying presents can be stated in two ways, should the suffering patient have the right to end life when recovery is impossible or should the physician have the authority to end such a life if so requested.Whether assisted dying is approached the first way or the second way, it directly influences how a person sees the issue. As a nurse, it is sometimes difficult to see patients lose hope and to hear them wish for death after caring and getting emotionally attached to them.
But, it is very important as a nurse to avoid own beliefs and values interfere with the patient’s or the family’s wishes. There will always be issues and arguments in this particular subject, since every individual has their own personal opinions, beliefs, and perception on quality of life.Also, religion maybe a factor, for example, Catholics do not believe in assisted suicide. In conclusion, HIV/AIDS continues to be a great challenge to the world as it affects more and more people everyday.
The greatest challenge of this illness is how to improve the quality of life of people with living HIV/AIDS. New drugs and extensive research have transformed the disease and people are living longer. For this reason, it is important for healthcare workers and family members to be active participants in the care of a person living with HIV/AIDS to achieve optimal quality of life.