UBC Undergraduate Research

Childhood trauma and medication adherence in HIV + women : project update Gilgan, Andrea; Wengle, Becky; Leathem, Katie 2014

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CHILDHOOD TRAUMA AND MEDICATION ADHERENCE IN HIV+ WOMEN:  PROJECT UPDATE By Andrea Gilgan, Becky Wengle &  Katie Leathem  THE BACKGROUND ??? Childhood trauma has lifelong, lasting effect ??? Often occurs in a family context of secrecy: protection of perpetrator, blaming/disbelief of the victim ??? Examples: sexual abuse, physical abuse, severe emotional neglect ??? Often these occur simultaneously ??? Well-documented links exist between childhood trauma and risk for HIV THE POPULATION ??? St. Paul?s Hospital, 10C ? medical unit primarily devoted to the care of individuals with HIV and AIDS ??? Patients are medically, socially and culturally complex: ??? Multiple comorbidities, opportunistic infections, malnutrition, dental problems ??? Marginalized and isolated (fear of disclosing HIV+ status, sexual orientation, etc) ??? Many refugees and First Nations folks ??? Care is complicated by poverty, homelessness, psychiatric illness, discrimination, abuse, incarceration, intergenerational trauma resulting from residential school system THE PROJECT ??? A quantitative study designed to: ??? Discover the rates of childhood trauma among women admitted to 10C ??? Determine links between childhood trauma and HIV medication adherence in women admitted to 10C ??? Determine links between demographic information and childhood trauma and HIV medication adherence ??? All women admitted to 10C who are HIV+, 19+ years old and who can speak and read English were eligible ??? Some were excluded due to highly acute medical status, high level of sedation at time of recruitment, or language barrier PROJECT TOOLS ??? Informed consent form ??? Provides information about confidentiality, project goals, tasks, risk and benefits ??? Binghamton Childhood Abuse Screen ??? Series of true/false statements designed to provide screening-level assessment of experiences of childhood abuse or trauma ??? Demographic information form ??? Age, gender, cultural background, housing status, drug/alcohol use, involvement in sex work, HIV-related medical history ??? Anxiety scale ??? Administered in person following completion of above forms; designed to assess participant?s anxiety level and refer to further support if necessary THE WORK ??? Student research assistants received emails from 10C clinical educator when a woman was admitted to the unit ??? Student RAs attended to recruit the patient into the study ??? Gave her a letter of intent that described the study ??? Requested informed consent ??? Administered project measures either verbally in interview format or by leaving them with the patient to fill in herself (depending on literacy level, patient?s alertness and patient preference) ??? Collected data ??? Checked in with patient regarding anxiety level following interview (some questions can be very intrusive and anxiety-provoking) ??? Referred to further care if necessary ??? Provided honorarium PROJECT GOALS ??? Recruitment began in fall 2013 ??? Goal is to recruit 50 participants; currently have recruited approximately 18 ??? With information provided by the study, we will be able to: ??? Better support women who are patients on 10C who have experienced childhood trauma ??? Educate and inform care providers about how best to support women with HIV who have experienced childhood trauma both in hospital and in community ??? Support women in adhering to their medications better ??? Providing better medical outcomes! FUTURE DIRECTIONS ??? Project recruitment will be handed off to a nursing preceptorship student on 10C ??? Following completion of this study, future projects could include: ??? Examining links between childhood trauma and HIV medication adherence in women in the community ??? Determining ways to better support HIV medication adherence in women who have experienced trauma ??? Looking at HIV, trauma and medication adherence in men ACKNOWLEDGEMENTS ??? Principal Investigator: Julie Kille, MSN, RN ??? Co-Investigators: Patricia Lauridsen-Hoegh, LLB, BSN, RN; Jane McCall, MSN, RN; Dave Unger, MD ??? Research Assistants: Andrea Gilgan, Becky Wengle, Katie Leathem  


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