Background: Physical symptoms and mental disorders are prevalent among persons living with HIV (PLWH). Different symptoms among PLWHs are always associated with lower quality of life and poorer prognosis. In previous studies, we identified and validated an HIV/AIDS-related symptom-management guideline used by healthcare providers which was developed based on the current guidelines.
Objectives: This study was intended to integrate the evidence into clinical practice. We sought to examine the feasibility, appropriateness and effectiveness of an HIV/AIDS-related symptom-management protocol, which was developed based on the current best-available evidence.
Methods: The integrating process was divided into 4 stages: evaluating the status quo, building the evidence-based strategies, applying evidence-based decisions, and evaluating results. The HIV/AIDS-related symptom-management protocol developed using an evidence-based approach, involved a multidisciplinary team of physicians, nurses, physical therapists, healthcare workers and patients, and applied the Fudan Pathway for Evidence-based Nursing Practice Model with pre-intervention and post-intervention symptom assessments, symptomatic treatments, health education, and psychological counselling, etc.
Results: 1) System changes: a new, revised symptom-management best-practices protocol was integrated into the daily work. The evidence-based quality assessment standard, the new pre-admission assessment tool, several symptom-assessment tools and a health education manual for HIV/AIDS patients were developed. 2) A mixed-model growth analysis showed a significantly greater increase in HIV/AIDS-specific QOL(MOS-HIV) scores for the group receiving the symptom-management protocol(α=2.36, P=0.04).
Conclusions: The evidence-based HIV/AIDS-related symptom-management protocol with a multidisciplinary implementation approach can improve the quality of life of patients, and has a high potential benefit in relieving negative symptoms. The protocol can be applied at other HIV/AIDS units or clinics.