Christopher Shaw, a nurse working at Massachusetts General Hospital’s infectious disease clinic, is leading a discussion in GHDonline’s nursing community, (www.ghdonline.org/nursing)on exchanging global nursing lessons to improve patient adherence.
Shaw has posted two short case descriptions of immigrant patients struggling to adhere to their HIV treatment. Then, he asked:
What particular cultural considerations should nurses be thinking of when providing teaching to these patients?
What system-level modifications might be necessary to better care for these patients?
What tools or trainings have worked well elsewhere?
Do you think getting family or close friends involved would be beneficial but privacy laws prevent it. Have others found ways around this?
What lessons do we need to learn and incorporate into practice before initiating treatment with such challenging patients?
In response, expert panelist and veteran nurse Pat Daoust wrote, “One of the advantages I had while working in other countries was learning first-hand from my in- country nursing colleagues just what many of the cultural, religious and lifestyle challenges existed for our patients which would impact their ability to successfully or unsuccessfully adhere to ARVs. As we work more and more with the immigrant population here in the U.S. I think it really becomes our responsibility to investigate and learn from our patients about those barriers.”
Dehne Mengiste, the nursing director at I-TECH Ethiopia, trains cadres of adherence case managers and adherence supporters that work directly with patients to improve adherence. Mengiste offered suggestions to manage Shaw’s complex patients and then recommended connecting these patients to groups. “Joining the Association of People Living with HIV/ADIS,” she wrote, “brings a difference in the life of such cases, especially with those who speak same language and share some aspect of culture and religion.”
Go over to the nursing community to jump into the discussion!