Nursing care for terminally ill AIDS patients - A study of palliative care in Namibia

Abstract

Background: HIV is a retrovirus that attacks cells of the immune system. The final stage of the infection is referred to as AIDS where the immune system is severely weakened and small infections can be fatal. Namibia is heavily affected by the HIV crises in Sub-Saharan Africa and has now reached a prevalence rate of 15.3% among adults. An estimated 200 000 Namibians are living with the infection. The HIV pandemic has increased the need of adequate palliative care in the region. Still, the palliative care in Sub-Saharan Africa including Namibia is poorly developed. The main aim of palliative care should be to improve the quality of life and to meet the patient’s needs. Caring for terminal AIDS patients is a challenge and there is a wide spectrum of needs to attend. Aim: The aim of this study is to gain knowledge of how the patients with AIDS in an African country like Namibia, are cared for by the nurses in the palliative stage of their disease. Method: An ethnographic approach has been used to meet the aim of this study. Data has been collected from two medical wards at Katatura Hospital in Windhoek, Namibia during five weeks. Participatory observations took place in the daily nursing work and were supplemented by informal interviews with the nursing staff. Result: The main issues in providing the palliative care in this context formed five categories; Nursing care of dying patients with AIDS, Where to be cared for, Nurses’ attitudes towards the dying patient, Nurses’ thoughts about HIV/AIDS and Resources and limitations. The standard of the hospital and its palliative and medical care is very low. Resources are limited and the dying patients are often left alone and unnoticed. The medical wards are understaffed and this is a source of great frustration for the nurses. The hospital management’s supervision of the daily nursing performance is insufficient and there is little or no room for patient complaints. Patients die in the medical wards every day but according to many of the nurses, palliative care does not exist in Katatura Hospital.