Are Expert Patients an Untapped Resource for ART Provision in Sub-Saharan Africa英文文献资料.docVIP

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Are Expert Patients an Untapped Resource for ART Provision in Sub-Saharan Africa英文文献资料.doc

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Are Expert Patients an Untapped Resource for ART Provision in Sub-Saharan Africa英文文献资料

HindawiPublishingCorporation AIDSResearchandTreatment Volume2012,ArticleID749718,8pages doi:10.1155/2012/749718 ReviewArticle AreExpertPatientsanUntappedResourceforARTProvisionin Sub-SaharanAfrica? TomDecroo, WimVanDamme, GuyKegels, DanielRemartinez, andFreyaRasschaert 1 2 2 3 2 1 2 3 M′edecinsSansFronti`eres,AvenueEduardoMondlane38,Tete,Mozambique DepartmentofPublicHealth,InstituteofTropicalMedicine,Antwerp,Nationalestraat155,2000Antwerpen,Belgium M′edecinsSansFronti`eres,Maputo,Mozambique CorrespondenceshouldbeaddressedtoTomDecroo,tomdecroo2@ Received29November2011;Revised23January2012;Accepted24January2012 AcademicEditor:AnnDuerr Copyright?2012TomDecrooetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Sincetheintroductionofantiretroviraltreatment,HIV/AIDScanbeframedasachroniclifelongcondition,requiringlifelongad- herencetomedication.Reinforcementofself-managementthroughinformation,acquisitionofproblemsolvingskills,motivation, andpeersupportisexpectedtoallowPLWHAtobecomeinvolvedasexpertpatientsinthecaremanagementandtodecreasethe dependencyonscarceskilledmedicalsta?.WedevelopedaconceptualframeworktoanalysehowPLWHAcanbecomeexpertpa- tientsandperformedaliteraturereviewoninvolvementofPLWHAasexpertpatientsinARTprovisioninSub-SaharanAfrica.This paperrevealedtwopublishedexamples:oneontrainedPLWHAinKenyaandanotheronself-formedpeergroupsinMozambique. Bothprograms?ttheconceptoftheexpertpatientanddescribehowcommunity-embeddedARTprogramscanbee?ectiveand improvetheaccessibilityanda?ordabilityofART.Usingtheirday-to-dayexperienceoflivingwithHIV,expertpatientsareableto providebetter?ttingsolutionstopracticalandpsychosocialbarrierstoadherence.Thereisaneedforcarefuldesignofmodelsin whichexpertpatientsareinvolvedinessentialcarefunctions,capacitated,andempoweredtomanage