Assessment and Management of Death Anxiety and Self-Esteem among People Living with HIV/AIDS (A Case Study of APIN Clinic, Lagos University Teaching Hospital)

By Akindele, Oluwafemi; Ayodeji, Iwayemi | Ife Psychologia, September 1, 2016 | Go to article overview

Assessment and Management of Death Anxiety and Self-Esteem among People Living with HIV/AIDS (A Case Study of APIN Clinic, Lagos University Teaching Hospital)


Akindele, Oluwafemi, Ayodeji, Iwayemi, Ife Psychologia


Introduction

HIV/AIDS is a global pandemic, which is threatening to rid the world of its entire workforce. By far, HIV/AIDS is one of the most deadly diseases of modern man. Hitherto, the attempts at getting a uniformity effective cure or preventive vaccine have eluded the arsenals of modern medicine. As early as 1993, the World Health Organization had stated that about one in forty adults in subSaharan Africa was HIV seropositive, and the picture in East Africa was far gloomier with 1 in 3 adults being seropositive (WHO, 1993).

The disease HIV/AIDS is a major cause of hospitalizations, outpatient clinic attendance, excessive health care expenses, lost earnings and productive activity, and leads to major disablement and early death of its victims. Hitherto, most people that develop the full - blown disease die within one or two years of its development. Incidentally, the citizens of the industrially advanced countries who develop the disease can now have their lives somewhat prolonged with the use of a cocktail of drugs, whereas our own nationals cannot have access to the same medication because they are very costly. It is a grave disease with significant economic implications for a developing country like Nigeria. Having no cure, and no preventive vaccine, HIV/AIDS is currently a major cause of premature death and excessive mortality. The disease afflicts mostly people aged 15-50 years who are usually in their most productive years and the major breadwinners of their families. The affliction of these people leads to financial losses, employment problems, declining productivity, increased health expenses, financial hardship for dependent family members, prolonged disability and early death (Ainsworth & Over, 1994). The death of these parents and breadwinner leaves many orphans in its wake and this accentuates a vicious cycle of poverty within the coming generation. For a disease that is spreading very rapidly very in a complex society like ours where most citizens are ignorant and illiterate, the economic impacts of having a large segment of the work force afflicted by the HIV/AIDS disease portends economic doom In the near future.

The HIV/AIDS disease has a number of psychological concomitants. The psychological impacts of the HIV/AIDS disease are exerted from the pre-clinical period and all through the course the disease. These psychological effects of the disease cause untoward suffering, disability, and diminished quality of life for the victims. Incidentally, attention has always been focused on the medical and drug management of the disease, with little devotion of resources towards the exploration of psychological care interventions. Though, the psychological problems associated with HIV/AIDS are common, very little published material is available on it (Howlett, Luabey & Kayembe, 1994). The psychological distress that attends this disease is either endured quietly by the victims or is seen as signs of its progression.

Estimates of the extent of psychological problems in association with HIV/AIDS have varied widely, depending on the locality, population, and nature of the presenting syndromes. For instance, it has stated that adjustment and stress reactions are observed in as many as 90% of people recently diagnosed as having HIV seropositivity (Howlett, Luabey & Kayembe, 1994). Although this usually subsides in most people with the passage of time and acceptance of the implications of the diagnosis, in a few people, these may persist for long, and result in serious psychiatric disorders (Rundell & Brown, 1990). There may also be other psychological and behavioural problems which may arise in the course of the illness.

The extent of severe psychiatric and behavioural disorders arising in the context of HIV/AIDS is varied, but estimates of this range from 1-30% of the cases presenting to hospital (Howett, Luabey & Kayembe, 1994). Incidentally, not detecting and managing the psychological problems associated with HIV/AIDS leads to unnecessary suffering, loss of function and far-reaching social impacts. …

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