Self-Assessment Questions (SAQs) for Study Session 30
Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.
SAQ 30.1 (tests Learning Outcomes 30.1 and 30.2)
Which of the following statements regarding palliative care for PLHIV is false? In each case, explain what is incorrect.
A Palliative care is only given to patients who are near to death.
B Palliative care is provided only to PLHIV because HIV/AIDS is not curable.
C Palliative care is an essential part of care for patients with cancers.
D Patients with chronic illnesses like diabetes or stroke may need palliative care.
E Palliative care includes prevention and relief of suffering, pain and other physical problems, as well as attention to psychosocial and spiritual issues.
Answer
C, D and E are true.
A is false. Palliative care is not terminal care (care given to dying patients only); it is the care provided to patients with a chronic illness, from the time the disease is diagnosed until the end of life. It regards dying as a normal process, and affirms life. This is well described in statement E, which is true.
B is false. Palliative care is also needed for patients with other non-curable chronic diseases like cancer, diabetes and strokes, as described in the true statements C and D.
SAQ 30.2 (tests Learning Outcome 30.3)
Is the following statement true or false? Explain your reasoning.
‘Relieving pain is not a routine part of palliative care, since it is not treating the chronic disease that caused the pain.’
Answer
The statement is false. Even though the disease causing the pain is not curable, we have to manage pain properly. The reason for doing this is because pain makes patients suffer a lot, which in turn affects their quality of life. Treating pain is relieving patients from this suffering, and hence giving them a better quality of life. Pain management should be an integral part of managing non-curable chronic illnesses.
Read Case Study 30.1, and then answer the questions that follow it.
Case Study 30.1 Ato Aytenfisu’s story
Ato Aytenfisu is a 45-year-old man living with HIV who started antiretroviral medication two weeks ago. During your home visit you find that he is feeling ill. He has had a mild headache and watery diarrhoea two to three times per day for the past four days. He looks very unhappy. He has no vomiting, fever, neck stiffness or other symptoms.
SAQ 30.3 (tests Learning Outcomes 30.3, 30.4 and 30.5)
- a.What should you do first for Ato Aytenfisu?
- b.What should you do regarding the headache?
- c.What should you give him for the diarrhoea? What advice should you give him about managing the diarrhoea?
- d.How can you help him relieve his unhappiness?
Answer
- a.First, you reassure Ato Aytenfisu that his symptoms could be adverse side-effects from the ARV drugs he is taking, and that he will be alright after some days. But make sure he knows that if the headache and diarrhoea get worse, or if blood is seen in stools, he should visit the nearby health centre as soon as possible.
- b.For the headache you should give him paracetamol, as it is a mild symptom.
- c.Regarding the diarrhoea, you should give him oral rehydration solution (ORS) and advise him to drink it frequently in small amounts. If there is no ORS, you can advise him to take home-made fluids such as rice soup, weak tea or just plain water, but avoid taking sweet drinks, milk, strong tea or alcohol. Tell him to continue eating as usual. If the diarrhoea worsens, he should go to the nearby health centre for better management.
- d.With respect to the unhappiness, you could advise him to accept the illness as much as he can, and that it is possible to live a healthy life and be productive if he takes the antiretroviral drugs correctly. If available, you need to introduce him to a nearby PLHIV association, or a community-based organisation which provides support to PLHIV. You also need to arrange a follow-up visit.
SAQ 30.4 (tests Learning Outcome 30.6)
Which of the following is not part of the preventative home-based care you will give to bedridden patients with AIDS? Explain why it is not included.
A Frequent repositioning of a bedridden patient and skin care to prevent bed sores
B Providing oral care
C Providing hygienic care of the body
D Exercising the joints to prevent muscle stiffness and contraction
E Treating infection of the lungs.
Answer
E (treating infection of the lungs) is not part of preventative home-based care for bedridden patients. First, it is a treatment, not palliative care. Secondly, if the patient develops a lung infection, he/she has to be referred to a nearby health facility for specialist treatment as soon as possible. All the other statements (A to D) are part of preventative home-based care for bedridden patients.
SAQ 30.5 (tests Learning Outcome 30.7)
Is the following statement true or false? Explain your reasoning.
‘Since terminally ill patients will die soon, it is a waste of a health worker’s time to provide them with end-of-life care.’
Answer
This statement is absolutely false, because end-of-life care is very important for patients with a terminal illness. Indeed, it helps us to recognise that life and death are normal events. It helps the dying patient and loved ones to adjust to the many losses they face, and tries to ensure that a dignified death occurs with minimal distress.
Summary of Study Session 30