Health of the Nation - Assignment Example

Health of the Nation Introduction The Health of the Nation initiative was undertaken by the UK government in order to provide a comprehensive method for bringing about improvements in the health situation for the country. The initiative focused of five areas which include coronary heart disease, cancer, mental problems, accidents and HIV/AIDS as well as other sexually transmitted diseases (Adler, 1997). With several objectives and nearly thirty targets associated with the initiative it is certainly a significant project for the goverment. When it comes to HIV patients, one of the demands of the initiative are for health providers to be effective communicators and provide counselling to their patients in order to help them in ways other than providing medical assistance. However, since nurses or other practitioners may not be skilled counsellors or specialise in dealing with HIV patients, the communication skills of medical service providers have to be improved significantly (Chippindale and French, 2001). Why Counselling The World Health Organisation reports that more than 90% of people who have HIV/AIDS do not know about it and many are even afraid to take the test. This is particularly true for those individuals who have been actively engaged in activities which are risk factors for HIV since there is still a social stigma associated with being an AIDS patient. Even in developed nations like the UK and in many developing countries, discrimination, social isolation and loss of basic rights might be experienced by those who have contracted AIDS (BBC, 2006). Therefore counselling might be required before a test can be conducted and it must be shown to the patient why testing for HIV is beneficial for them and for their wellbeing. The procedures for the test must be explained to the patients and they should be told what treatments or options they have in case the test results are positive (Chippindale and French, 2001). While counselling before the test results arrive can be a short-lived matter, positive test results can demand a deeper connection to be formed between the patient and the medical service provider and can even cause the patient to seek professional mental health for the psychological management of the disease (BBC, 2006). Professional Help The need for professional help for handling the mental state of patients who have been tested positive for AIDS/HIV can not be over stated. Temoshok and Baum (1990) make it quite clear that there is a significant psychological aspect of handling this disease and due to the public focus and individual effect it has on a person equating the contraction of the disease with a death sentence, the grief patterns associated with the disease may be quite complicated. In effect, although the counselling required for patients suffering from Cancer or other terminal disease may be similar to the one given to those suffering from HIV/AIDS. In such situations, a medical practitioner may have to offer whatever support they can and since they come with a medical perspective this support can be quite beneficial for an HIV patient. However, communication skills and passing the right message to a person who has just been diagnosed with HIV or AIDS is vitally important. Other than health and longevity concerns a person who is about to take the test for HIV or a person who has been diagnosed with HIV/AIDS will certainly have concerns about confidentiality, their legal rights and even medical insurance problems. They may even perceive their risky activities as low risk, be in denial or even avoid counselling if it makes them uncomfortable. However, even as a social influence HIV testing is important because the longer a person remains undiagnosed, the greater the chances they have of unknowingly spreading the disease to others around them. Counselling may have to be imposed as a part of government regulations since as per the report given by Hewish (2005): “Uptake of voluntary counselling and testing is poor, even in those with high risk sexual practices. Many infected people never attend GUM clinics for voluntary counselling and testing even if referred. It also seems that pre-test counselling is not dramatically effective in reducing high risk sexual activity (Hewish, 2005, Pg. 1).” In the given situation, the role of the medical practitioner becomes doubly important as a person who gives medical advice as well as elementary counselling for those who may be afraid of talking to anyone about their disease. A practitioner who recommends counselling is not only helping the patient come to terms with their disease but also helping society at large since the patient can be made to understand what effect their disease can have on others. This is particularly true if the patient does not stop from engaging in risky behaviour. Therefore as a part of the testing procedures and during the communication process with the patient it must be explained to them why they are at risk from HIV/AIDS. If the patient can understand that their behaviour puts them at risk there is a greater chance that they might stop engaging in risky activities. Similarly, even if their tests come out to be negative, they should always be motivated to stop engaging in behaviour which puts them at risk for HIV/AIDS since it can act as the famous once of prevention. It must be clarified that a negative test report is neither a guarantee nor a certificate which permits a person to continually engage in risky behaviour (Chippindale and French, 2001). A lack of knowledge on the part of the patient can also be handled with counselling since HIV is not AIDS and even without treatment HIV can take several years to develop into AIDS during which the patient can have a relatively normalised life. With treatment, the onset of AIDS can also be delayed therefore the patient can have a decade or more rather than just a few years of life. Of course such a discussion implies a positive test result which can be emotionally devastating for the patient and the breaking of this news should be handled by professionals with extreme care. Whenever there is a positive diagnosis for AIDS, there are several moral, ethical and legal considerations which the patients as well as medical service providers have to be aware of. For example, the regular partner of the individual who has been tested positive for AIDS would have to be informed to prevent any harm being done to them and the nature of their work may also have implications based on their positive status. Other sexual partners or those who have engaged in risky activities with the person tested positive may also need to be tested or at least informed about their need for being tested. The person who is positively diagnosed with HIV/AIDS may go through several phases of emotional changes the first of which is shock over being diagnosed and the recognition of their own mortality. This shock is made even more significant since they may understand immediately or while they are waiting for their results that their life will change significantly if the results are positive. They may also be afraid of what effects medicine and treatment will have on them and it can be compounded with a social fear of isolation and rejection. If they do not have a social support network then their depression over the disease may be quite severe. If they have a partner or other friends who can help them they may fear isolation if news regarding their disease is shared with others. Since there is no cure for this disease, most patients understand that having hope is not really something they can accept which can lead to them being angry and frustrated. They may be angry about being infected, angry about restrictions placed on their lifestyle and the demanding medical regime which they have to follow. All these must be recognised and accepted as a part of the process by which patients have to come to terms with HIV/AIDS (Chippindale and French, 2001). For a person who is suffering from HIV/AIDS, care and counselling may be required as a part of their existence throughout their lives. Although some may be able to come to a level of acceptance about their disease and continue to live their life as best as they can, others may welcome death once they are in the final stages of their disease or are coming to a point where they are unable to handle the demands placed on their body. Rabkin et. al. (1994) presented their analysis of the situation when they said that: “Few people who are not profoundly depressed speak about being ready to die or welcoming it, except if they are in the advanced stage of a terminal illness. People with AIDS who have become debilitated after going through extensive treatments often speak of being ready to die since they no longer have a meaningful quality of life (Rabkin et. al., 1994, Pg. 147).” In such cases, end of life counselling is required for AIDS patients and this can be offered by Hospice workers or counsellors who specialise in this field. At the end stage, a patient may need to be asked regarding their wishes as to where they would like to spend their last moments, who would they like to be with them before the end and if they would like an authority figure from their faith to visit them. An AIDS patient may feel the need to apologise to their loved ones or to say something which they have not or even to do something which they can and such opportunities should be provided (Shernoff, 1996). Throughout the process by which care is provided to the patients who have been diagnosed as having HIV/AIDS, it must be noted that along with the patient’s mental and physical state, the health care service provider may also have to look out for his/her own well-being. While caring for terminal patients can be infinitely rewarding since the counsellor or medical officer knows that they have made the final days of a person more comfortable, it can also be an emotionally draining experience therefore counsellors themselves may need to understand their connections with the patients and follow the ethical guidelines which are applicable to such relationships. In conclusion, Counselling is almost as necessary for patients suffering from HIV/AIDS as is the medical aid provided to them since one takes cares of the body while the other takes care of the mind. Works Cited Adler, M. 1997, ‘Sexual health–a Health of the Nation failure’, British Medical Journal, vol. 314, no. 1. pp. 1743-1744. BBC. 2006, ‘Call for widespread HIV testing’, BBC.co.uk, [Online] Available at: http://news.bbc.co.uk/1/hi/health/4793413.stm Chippindale, S. and French, L. 2001, ‘HIV counselling and the psychosocial management of patients with HIV or AIDS’, British Medical Journal, vol. 322, no. 1. pp. 1533-1535. Hewish, D. 2005, ‘HIV counselling’, PatientPlus.co.uk, [Online] Available at: http://www.patient.co.uk/showdoc/40024567/ Shernoff, M. 1996, ‘Counseling End Stage Clients With AIDS’, The Body, [Online] Available at: http://www.thebody.com/shernoff/article11.html Temoshok, L. and Baum, A. 1990, Psychosocial Perspectives on AIDS: Etiology, Prevention, and Treatment. Lea Publishers Read More