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College of Science
De La Salle University-Dasmarias
Dasmarias, Cavite Philippines
Submitted by:
Ambion, Jamica
Baraquio, Jezza Mae
Barrinuevo, Clarisse
Bucao, Francesca
Callorina, Hiram
Dazo, Angelica
Dela Cruz, Ezekiel
Guingab, Karl
Jose, EJ
Roxas, Allia Alanis
Sarte, Glendale
Suzuki, Mitch
Submitted to:
Ms. Cuaresma
28 August 2015
INTRODUCTION
What gives a family the resilience to work through a crisis? Why it that some
families fall apart when is faced with adversities, while other thrives and become
stronger? What are the qualities of these resilient families? And how do these
families establish and maintain their strength?
HIV and AIDS pose one of the greatest challenges to families in history. It
touches at the very heart of families, drawing them close together or driving them
further apart.
To help the family remain resilient, often is the only safety net, playing a
critical role in determining how well individuals and communities cope with AIDS
and its consequences.
A strong and supportive family is one of the first lines of defense against
HIV/AIDS.
OBJECTIVE
To identify and discus the various Family Resiliency Factors which made this
family respond positively in the midst of this catastrophic disease.
The results of his HIV tests were as follows: positive for HIV-ELISA
screening test, positive for HIV agglutination test, and positive for Western
blot confirmatory test. His wife was negative.
Epidemiology
UNAIDS estimates show that there were 33.3 million people living with
HIV at the end of 2009. In Asia, an estimated 4.9 million people were living
with HIV in 2009. The Philippines has a total of 6,498 cases since the first
reported case in 1984. In March 2011, there were 172 new HIV antibody
sero-positive individuals (DOH-NEC December 2010).
In Cambodia, the adult HIV prevalence declined in 2009 and in
Thailand, the epidemic appears to be stable. In the Philippines, the HIV
prevalence is still increasing (UNAIDS Global Report 2010).
There were a total 1,585 HIV positive OFWs, comprising 13% of cases
reported for the year.
Patient VD is a 49 year old male HIV positive person which began eight
months while he was assessing the donor screening before his consultation in
Saudi because he was also asymptomatic at that time. Results from his tests
showed as follows: (+) HIV- ELISA screening test, (+) HIV agglutination test,
and (+) Western blot confirmatory test. VDs latest CD4+ count was 456 with
no Hepatitis B virus and has active TB disease; hence treatment with
Antiretroviral Therapy was not indicated. He shows no signs and symptoms
pointing to an opportunistic infection, hence prophylaxis (specified action
prevention for the disease) was not yet indicated. His hypertension was
controlled with Amlodipine. The lipid profile, kidney function test and 12-LECG
were all within normal.
After learning he has HIV, his mind was starting to picture things back
at Saudi and from his past. He was thinking that the possibility of getting this
disease aside from sexual and parenteral modes of transmission was from the
bites of big Saudi Arabian bed bugs in his bed which in diagnosis of Dr. Silva
according to a research says that there is no HIV virus replication observed in
the bed bug cells and that the risk of insect transmission of HIV appears to be
extremely low or non-existent at all. They also isolated the sharing of utensils
so that the disease cannot be transmitted although this was not true.
Another, this disease brought VDs family emotional burden like fear and
uncertainties. Questions like: Makakapagtrabaho pa kaya ako dok?, May
gamut pa ito dok?, and Ano ang mangyayari sa akin? were raised by VD in
the meeting. Answers to this questions were as follows: After the family
understood the information about AIDS is, VD will avail the needed
treatments and drugs, he will also continue to work at a construction site,
working for a subcontractor on aluminum fabrication with the help of his wife,
he will also continue to be involved in church as preacher and worker, and he
will start to practice sexual abstinence to protect his wife from getting this
disease.
a.2. PAST MEDICAL HISTORY
VD grew up in Surigao. He is the eldest child among the seven siblings, his
father died of an unknown cause when he was 18 years old. After the death
of his father, he went to Manila to try to find a job. He wanted a job to help
his mother who was diagnosed with diabetes and hypertension, and his
siblings. He started to work as an assistant in a shop eventually learning the
skills and then working alone. At age 29, VD married his girlfriend who was
the shop's secretary. She was also the eldest among 4 children and her
mother died when she was young so she had to take care of her siblings.
They lived with her father and two sisters in her father's house.
VD is heterosexual. He had three sexual contacts. The first one was
with his girlfriend in the province when he was 18 years old. His second was
with a married woman whose promiscuity was not established. The third was
his wife. He denied having sexual intercourse with men.
B. CASE DISCUSSION
b.1. CASE OVERVIEW
VD is (+) HIV-ELISA screening test, HIV agglutination test, and Western
blot confirmatory Test. His CD4+ cell count was 45. CD4+ is a blood test
to determine how well the immune system is working in people who have
been diagnosed with human immunodeficiency virus (HIV). CD4+ cells are
a type of white blood cell. CD4+ cells are also called T-lymphocytes, Tcells, or T-helper cells.
Biomedical Management:
There is no HBV (Hepatitis B Virus) infection and active TB disease;
hence treatment with ART (Antiretroviral Therapy) was not indicated.
There are also no signs and symptoms pointing out to an opportunistic
infection, hence prophylaxis was not yet indicated. His hypertension he
tests results all positive for HIV-ELISA screening test, HIV agglutination test
and Western blot confirmatory test while his wifes was negative.
Upon hearing the bad news, VD was in a state of shock, disbelief denial,
fear and anxiety. He was worried about health deterioration and a shortened
life span. Despite this, VD managed to maintain a positive outlook in life
thanks to the support from his family and together they were able to face the
problems they were given.
b.5. COMPLICATIONS
No complications happened to VD but he needs to:
Monitor CD4+ every 6 months and viral load testing once a year and
assess the need for prophylaxis
But the possible complications that a person with HIV could acquire are as
follows:
Infections common to HIV/AIDS
Tuberculosis (TB). In resource-poor nations, TB is the most common
opportunistic infection associated with HIV and a leading cause of
death among people with AIDS.
Other complications
Wasting syndrome. Aggressive treatment regimens have reduced
the number of cases of wasting syndrome, but it still affects many
people with AIDS. It's defined as a loss of at least 10 percent of body
weight, often accompanied by diarrhea, chronic weakness and fever.
Kidney
disease. HIV-associated nephropathy (HIVAN) is an
inflammation of the tiny filters in your kidneys that remove excess fluid
and wastes from your bloodstream and pass them to your urine.
Because of a genetic predisposition, the risk of developing HIVAN is
much higher in blacks.
APGAR is a family therapy rating system in which the name APGAR contains
the first letters of five words: adaptability, partnership, growth, affection and
resolve. That represent 5-question assessment tool used for rapid assessment of
family and dysfunction. Each family member indicates a degree of satisfaction in
each of the five categories on a scale of 0 to 2 to measure an individuals level of
satisfaction about family relationships.
The genogram of VD and his wife shows that at an early age both had lost a
parent and as the eldest they became responsible for the role left. This life
experience is a positive resiliency factor which could help them cope against HIV.
But this doesnt stop them about worrying about how they will sustain for their twin
son whom just graduated high school. To address the worry, the present concern
was no different from their past experience of helping their younger siblings in their
schooling. There has been no major disagreement in the family, they communicate
via open communication between couple and their twins felt neither anger now
shame but wanted to keep it to themselves. There was no note of fear for their
fathers health or anxiety of potential separation. There is no shame or social
isolation as well from friends and classmates. And by looking at the APGAR, we see
a highly functional family.
Family ecomap is the snapshot of the patients social networks indication
their relative potential for providing support in the current clinical situation. It is a
support network and connection. The following support networks and connections
are:
facing the situation. There were certain issues that were addressed effectively
resulting to the maintenance of the familys harmonious relationship. The physician
was able to identify some important factors that helped VD and his family overcome
the situation. The family maintained a positive outlook in life. Exercising faith and
hope in times of trouble is a must. The family exercised spiritual strength. They
remained involved in their local churches. Having a strong faith truly helps in
keeping the family united. The family was always together and continued on
fulfilling their roles. Having someone to turn to in this type of crisis has a big impact
on the patient and the family as well. Their open communication also helped in
sustaining the family relationship. The family physician is important in determining
factors important in the patient and family. The physician helped the family in
setting up rules, addressing complains and monitoring the family. The wellness plan
made for the family was the continuous screening and checkups for VD, to further
identify the progression of the disease as well as clarifying inter and intrapersonal
problems. His wife is also monitored. Her blood pressure was monitored, her
intrapersonal and interpersonal problems along with conflicts that may arise when
she starts being a caregiver. For their twin sons, their school performance was
monitored; their health condition too was monitored. All were given immunization
and psychosocial attention.
CONCLUSION
The family is really important in facing harsh issues concerning ones health.
In our case, we can see the positivity of the family. Having an understanding family
is a blessing and should be treated with care. Understanding, loving, and supporting
each and every member through good and bad are major factors that can help the
family be resilient. Acceptance is the key. A resilient and functional family can face
challenges and situations, no matter how ill it may be. In conclusion we would like to
quote a passage from Jane However. Call it a clan, call it a tribe, call it a family.
Whatever you call it, whoever you are, you need one.