Building Bridges: Anti-Retroviral Therapy & Care 搭建桥梁: 抗逆转录病毒疗法与护理 - PowerPoint PPT Presentation

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Building Bridges: Anti-Retroviral Therapy & Care 搭建桥梁: 抗逆转录病毒疗法与护理

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  1. Building Bridges:Anti-Retroviral Therapy & Care搭建桥梁:抗逆转录病毒疗法与护理 Dr. Sheoran Asian & Pacific Islander Wellness Center San Francisco, CA, USA Sheoran 博士 美国加州旧金山 亚太裔健康中心

  2. Overview概述1. Agency Background 机构背景2. Holistic Model整体模型3. Care services护理服务4. Adaptation potential适应潜能

  3. Agency Overview机构概述 • Educates, supports, empowers, advocates 教育、支持、授能、倡导 • Asians and Pacific Islanders (A&PIs) living with/at-risk for HIV/AIDS 与艾滋病患者同居或有患病危险的亚太裔人士 (A&PI) • Founded in 1987; grassroots response in communities of color 创立于 1987 年;得到各色人种社区的积极响应 • Oldest nonprofit targeting A&PIs around sexual health, HIV/AIDS in North America 北美最早成立的非盈利性机构,致力于向亚太裔人士提供性健康及艾滋病服务 • 25 Languages 25 种语言服务

  4. Asian & Pacific Islander Wellness Center is a non-profit, non-governmental organization that focuses on HIV and sexual health for Asian & Pacific Islanders. 亚太裔健康中心是一家非盈利性的民间组织,旨在为亚太裔人士提供艾滋病防治及性健康服务。 • Health Education 健康教育 • HIV Care Services 艾滋病护理服务 • Community Development & External Affairs 社区发展与外部事务

  5. Values价值观 • Client and Family Centered 以患者及家庭为中心 • Compassion 同情心 • Justice 公正 • Leadership 领导地位 • Sex-positive 安全性行为 • Wellness & Holistic 身心健康 • Respect & Integrity 尊重与诚实

  6. Gay, bisexual, other men who have sex with men 同性恋、双性恋,以及其他与同性发生性关系的男性 People living with HIV/AIDS Youth: Incarcerated, runaway, lesbian, gay, bisexual, queer, questioning 与艾滋病青年同居的人士:入狱者、越狱者、男/女同性恋、双性恋、同性恋、问题人士 Non-English, non-native English speakers 不会讲英语的人士、母语非英语人士 Transgender persons 变性人士 Sex workers 性工作者 Women working in massage parlors 在按摩院工作的女性 Immigrants, refugees, asylees 移民、难民、政治避难者 Target Population目标人群

  7. Why We Exist 我们因何而存在 Health Care System Gap 健康护理制度缺陷 STIGMA 歧视 Under-Utilization of Services 服务利用不足

  8. “Holistic Wellness Model”“整体健康模型” AQUA POL Anti Stigma Social Marketing 消除歧视 社会营销 Policy 政策 Advocacy 倡导 Research 研究 Technical Assistance 技术协助 Outreach 外展 乙肝 Referrals 转介 HIV Testing HIV 检测 HIV Positive HIV 阳性 HIV Care and Treatment HIV 护理和治疗

  9. Public Service Announcements公益服务通告 ..\..\..\TalkAIDS\Chinese-PSA H264.mov

  10. Care Services:护理服务: • Treatment case management 治疗病例管理 • Mental health counseling and psychotherapy 心理健康咨询和精神疗法 • On-site primary medical, psychiatric care 现场基本医疗、精神病治疗 • Individual, group support 个人、团体支持 • Peer / client advocacy 同伴/患者倡导 • Treatment Advocacy 治疗倡导 • Treatment education and peer support group activities 治疗教育和同伴支持团体活动 • Complementary therapies 补充疗法 • “Prevention with Positives” program model “积极防治艾滋病”计划模型

  11. HIV Case Management HIV 病例管理

  12. Intake process接纳流程 • Systems theory approach for case management intake. 病例管理接纳的系统理论方法。 • Focuses on right ness of fit between client and environmental systems at different levels 在不同层面关注患者与环境系统的和谐关系 • Work with client to address major needs on each of these levels 与患者合力解决各个层面的主要需求

  13. Assess Client Needs评估患者需求

  14. Mental Health Assessment心理健康评估 • Recognize stigma related to mental health 确定与心理健康有关的耻辱感 • Client should be referred for full mental health assessment as part of intake process. Accurate picture of clients mental status is important to assessing needs and supporting overall health. 作为接纳流程的一部分,应向患者提出接受全面心理健康评估的要求。准确全面地了解患者的心理状况对于需求评估和整体健康支持而言至关重要。

  15. HAART Highly Active Anti-Retroviral Therapy疗效显著的抗逆转录病毒疗法 (HAART) • Client bloodwork is monitored every 3 to 6 months for CD4+ T cell count and Viral Load. When CD4 + T cell count is around 350, generally the time ART is considered. 每 3 到 6 个月检测一次患者血液中的 CD4+ T 细胞数和病毒载量。当 CD4+ T 细胞数约为 350 时,通常便认为该实施 ART 疗法了。 • Physician and case manager consult on clients history of adherence to other medications. 医生和病例管理人员会查阅患者长期服用其他药物的记录。 • Client’s capacity to remain adherent to stringent requirements of ART is assessed. 评估患者坚持遵守 ART 严格要求的能力。 • Adherence is supported as needed by case manager, nursing staff and physician. 需要时,病例管理人员、护理人员和医生会提供帮助,支持患者坚持治疗。 • Family utilized to assist in support of medication adherence when possible and appropriate. 可能且适当时,家人需协助提供支持来保持药物治疗的连续性。

  16. Managing Medication Side Effects药物副作用管理 • Clients and family education about possible side effects of medications 对患者及其家人进行可能出现的与药物副作用有关的教育 • Clients are encouraged to discuss all side effects with physician and/or case manager. 鼓励患者同医生和/或病例管理人员讨论副作用有关情况。 • Clients often feel more comfortable reporting side effects to case manager. 患者常常能够更轻松地将副作用报告给病例管理人员。 • Case manager’s comfort and familiarity with discussing all aspects of side effects with client will foster open communication and reduced embarrassment and hesitation to report side effects. This is critical to supporting adherence. 案例管理人员与患者讨论副作用的方方面面时所表现出来的和蔼亲切将有助于双方的坦诚沟通,并消除患者报告副作用时的尴尬和犹豫不决。这对于支持连续性治疗而言至关重要。 • Case Manager and client check in often in the beginning of therapy regarding those side effects which require immediate medical attention. 病例管理人员和患者常常在对那些需要立即采取医疗措施的副作用治疗开始时进行登记。

  17. Joy Luck Club喜福会 • Networking 联网 • Treatment Education 治疗教育 • Benefits 福利 • Housing 住房福利 • Legal 法定福利 • Immigration 移民 • Insurance 保险

  18. Bridging Principles搭建桥梁原则 • MSM cultural competence and sensitivity MSM 文化能力和敏感度 • Comprehensive case management 综合病例管理 • Mental Health 心理健康 • Assess readiness of client to begin ART 评估患者开始接受 ART 的准备情况 • Support and referral linkages 支持和转介关联 • PLHA Leadership (UN: GIPA) PLHA 领导 (UN: GIPA) • Achieve Scale 实现

  19. CSTEPCalifornia Statewide Treatment Education Program加州治疗教育计划 (CSTEP) People living with HIV/AIDS deserve the most accurate and up-to-date treatment information as provided by informed, competent, respectful and compassionate service providers and peers. 与艾滋病患者同居的人士应获得由具有相关知识、有能力、有礼貌,且富有同情心的服务提供者及同伴提供的最新最准确的治疗信息。 • Standardized treatment education throughout state 全州范围内的标准化治疗教育

  20. Potential adaptations in the China MSM context中国 MSM 环境下的潜在适应 • Use holistic model 使用整体模型 • Based on capacity choose elements of model 根据能力选择模型元素 • Referral network to get target population into testing 转介网络,使目标人群习惯检验 • Collaborations (Hep B, STD, TB) 其他疾病(乙肝、性病、结核病) • Referral network/linkages for care & support 护理与支持的转介网络/关联 • PLHA Leadership development PLHA 领导培养 • Other…. 其他…

  21. Available Resources可用资源 • Rapid situational analysis (Needs assessment) 快速情景分析(需求评估) • Skills building 技能培养 • CSTEP CSTEP • Case management 病例管理 • MSM cultural competence MSM 文化能力 • Systems 系统 • Monitoring & Evaluation 监测与评估 • Tools 工具 • Provider guidelines for MSM cultural competence MSM 文化能力提供者指南 • Evidence Based Interventions 基于症状的干预

  22. Contact Information联系信息 Dr Sheoran sheoran@apiwellness.org +1-45-292-3400 www.apiwellness.org