HIV case manager preparedness for practice in Ryan White CARE Act funded settings

The Effect of Routine Management Combined with Case Management Model on Social Support, Self-Efficacy, Self-Management Ability, and Psychological Flexibility of AIDS Patients

Objective

To explore the influence of conventional management combined with case management on social support and self-efficacy of AIDS patients.

Methods

The clinical case data of 120 AIDS patients who were treated and nursed in our hospital from June 2019 to June 2021 were selected as the research objects and were divided into the control group and the observation group according to the digital table method, with 60 cases each. The control group implements routine management, and the observation group implements case-based nursing management on this basis and compares the effects of self-efficacy, self-management ability, nursing ability, social support, and psychological flexibility of the two groups of patients.

Results

Before the intervention, the quality of life scores of the two groups was not statistically significant (P > 0.05). After the intervention, the physical function score, pain management score, and symptom response score of the observation group were significantly higher than those of the control group, and statistics showed that the difference was statistically significant (P < 0.05). Before the intervention, the self-management ability of the two groups of patients was not statistically significant (P > 0.05). After the intervention, the observation group's symptom management, emotional cognition management, social support and assistance, daily life management, disease knowledge management, and treatment compliance management were significantly higher than those of the control group. Statistics show that this difference is statistically significant (P < 0.05). Before the intervention, there was no significant difference in the nursing ability and psychological flexibility between the two groups of patients (P > 0.05). After the intervention, the observation group's health knowledge level, self-care skills, self-care responsibility, self-concept, and mental flexibility (resilience, strength, optimism) indicators were higher than the control group, while the depression mood disorder score was significantly lower than the control group; statistics showed that this difference was statistically significant (P < 0.05).

Conclusion

Routine management combined with case-based nursing management can effectively improve the self-management ability and psychological flexibility of AIDS patients, improve patient care ability and self-efficacy, and provide certain reference value for effective management of AIDS patients.

Assessing the Approach to HIV Case Management

Case management is a standard practice for assisting people living with HIV in the United States. While HIV case management has resulted in positive outcomes for clients and their families, clients still face challenges. As part of an evaluation of Utah's Ryan White Part B Program, the Utah Department of Health and researchers from the University of Utah assessed the use of a tiered approach for case management in eight other states to determine the feasibility and potential effectiveness of this approach. Through review of publicly available materials and interviews with health department employees, we examined each state's 1) definitions of tiers, 2) acuity scales, 3) services provided within the tiers, 4) qualifications of case managers, and 5) how evaluations were conducted. This article summarizes how these various features might be combined to create a model that states could use for tiered case management. We developed a three-tiered model using a numeric summary for nine items to assess acuity, with levels defined as maintenance outreach support services, brief-contact management, and medical/non-medical management. Since none of the states reviewed had an existing formal evaluation tool, we propose areas to be covered in an annual formal evaluation.