The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 2: Overview of Clinical IssuesIn addition to these studies, which were conducted mostly in late-stage patients admitted tohospice or hospital with symptomatic disease, a symptom prevalence study was conducted usinga large national probability sample of over 3000 patients with HIV infection in the United Statesreceiving 26 picas care in 1996. 39 For this sample, the prevalence of the most common ten symptoms forthe preceding six months was as follows:• Fever, sweats, or chills (51%)• Diarrhea (51%)• Nausea or anorexia (50%)• Numbness, tingling, or pain in hands/feet (49%)• Headache (39%)• Weight loss (37%)• Vaginal discharge, pain, or irritation (36%)• Sinus infection or pain (35%)• Visual problems (32%)• Cough or dyspnea (30%)Another study of AIDS outpatients receiving care in New York in the early 1990’s found a meanof 16.7 current symptoms (using the Memorial Symptom Assessment Scale), of which the mostcommon were worrying (86%), fatigue (85%), sadness (82%), and pain (76%). 40 With these populationsas well, the concordance of symptom types with those in the previously published studiesis noteworthy, as is the high prevalence of symptoms in relatively non-selected populations ofpatients with HIV.Table 2-1: Common Symptoms in HIV / AIDSPainConstitutional• Neuropathic• Fatigue / weakness• Nociceptive• Anorexia / weight loss– Somatic • Fever– Visceral • SweatsGastrointestinal• Nausea / vomiting• Diarrhea• ConstipationRespiratory• Dyspnea• Cough• Respiratory SecretionsNeurologic• Delirium / agitation• Dementia• DepressionDermatologic• Dry Skin• Pruritis• Decubiti / skin breakdown14U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau
A Clinical Guide to Supportive and Palliative Care for HIV/AIDS • Chapter 2: Overview of Clinical IssuesTable 2-2: Prevalence of Current Symptoms in Different PatientPopulations with HIV Infection26 picasPATIENT POPULATIONSMoss Foley Fantoni LaRue Kelleher(U.K.) (Canada) (Italy) (France) (U.K.)(n=100) (n=100) (n=1128) (n=314) (n=118)% (rank) % (rank) % (rank) % (rank) % (rank)IIWeight loss 85%(1)! 91%(1)§ —- 31%(6) 58%(1)Anorexia 44%(3) —- 34%(2) —- 38%(3)Pain 71%(2) 63%(3) 29%(4) 52%(1) 55%(2)Cough 30%(5) 34%(8) 32%(3) 27%(8) 19%(6)Dyspnea / resp. symptoms 17%(11) 48%(5) 19%(6) 22%(12) 15%(9)Fatigue — ** 77%(2) 55%(1) 50%(2) —Nausea / vomiting 24%(8) 35%(7) 22%(5) 28%(7) 17%(8)Cognitive dysfunction 32%(4) 43%(6) —- —- 19%(7)Depression 26%(7) 32%(9)* —- 26%(10) 10%(12)*Anxiety —- —- —- 40%(3) —-Diarrhea 23%(9) —- 11%(8) 24%(11) 14%(10)Mouth sores —- —- —- 33%(5) —-Fever / sweats —- —- —- 27%(9) —-Pruritis / dry skin 27%(6) 24%(11) 17%(7) 23%(12) —-Constipation 22%(10) 23%(12) —- —- 25%(4)Visual loss —- 25%(10) 12%(9) —- —-Headache 11%(12) —- —- —- 11%(11)Hemiparesis / ataxia —- —- —- —- 23%(5)Incontinence —- 55%(4) —- —- —-Insomnia —- —- —- 37%(4) —-! Includes fatigue * Includes anxiety§ Includes anorexia ** Indicates that the symptom was not included as aseparate category for this study populationSources: References 30, 31, 32, 33, 34.U.S. Department of Health and Human Services • Health Resources and Services Administration • HIV/AIDS Bureau 15
Page 4 and 5: DedicationA Clinical Guide to Suppo
Page 6 and 7: Lynn A Jansen, RN, PhDAssistant Res
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Chapter 14.26 picasCulture and Care
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Chapter 17.26 picasEthical IssuesLy
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DRUGS AND THERAPIES INDEXNOTES: Ent
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The Clinical Guide to Supportive and Palliative Care for HIV/AIDS

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