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E-Module

An HIV and Rehab Resource

  • Français
  • About
    • 1 – What is this resource about and who is it for?
    • 2 – Why was this resource created?
    • 3 – How can this resource be used?
    • 4 – Can this resource be used for teaching?
    • 5 – How was this resource developed?
    • 6 – Who contributed to developing this adapted resource?
    • 7 – Who funded the development of this resource?
    • 8 – Disclaimer
  • Section 1
    • 1.1 How is “rehabilitation” defined in this resource?
    • 1.2 How can rehabilitation help people living with HIV?
    • 1.3 How can the World Health Organization’s “ICF” help us think about rehabilitation for people living with HIV?
    • 1.4 How can the Episodic Disability Model help us think about rehabilitation for people living with HIV?
    • 1.5 Who provides rehabilitation for people living with HIV?
    • 1.6 Do rehabilitation providers need special skills or training to care for people living with HIV? If so, what?
    • 1.7 What roles do rehabilitation providers have related to HIV?
    • 1.8 When is rehabilitation clinical intervention useful along the HIV care continuum?
  • Section 2
    • 2.1 What do rehabilitation professionals need to know about the stages of HIV infection?
    • 2.2 What do rehabilitation providers need to know about CD4 count and viral load?
    • 2.3 What is the impact of HIV on body systems and why does this matter for rehabilitation providers?
    • 2.4 Who might rehabilitation providers treat?
    • 2.5 What do rehabilitation providers need to know about antiretroviral therapies?
  • Section 3
    • 3.1 What are the rehabilitation interventions that address impairments common among people living with HIV?
    • 3.2 What are the rehabilitation interventions that can address the activity limitations and participation restrictions common among people living with HIV?
    • 3.3 More information on the rehabilitation interventions available for people living with HIV
    • 3.4 – What do rehabilitation providers need to know about their patients’ beliefs and use of traditional healers, spiritual leaders and alternative therapies outside the formal medical system?
  • Section 4
    • 4.1: Intersectionality Theory in the Context of Rehabilitation
    • 4.2: Children and Youth
    • 4.3: HIV and Aging
    • 4.4: Substance Use
    • 4.5: Trauma
    • 4.6: Racialized Populations
    • 4.7: Indigenous Populations
    • 4.8: HIV, Sex and Gender
    • 4.9: HIV and COVID-19
    • 4.10: Is HIV itself a disability?
  • Section 5
    • 5.1 What are outcome measures?
    • 5.2 Why is it important to use outcome measures during rehabilitation with people living with HIV?
    • 5.3 How do rehabilitation providers know if an outcome measure will be useful in practice?
    • 5.4 What are floor and ceiling effects in outcome measurement?
    • 5.5 What is the difference between generic and HIV-specific outcome measures?
    • 5.6 How should you decide which outcome measures to use?
    • 5.7 How do you access a copy of an outcome measure?
    • 5.8 What are rehabilitation-related outcome measures that can be useful for people living with HIV?
  • Case Studies
    • Case #1 – Acute Care, Cardiorespiratory and Neurological
    • Case #2 – Musculoskeletal – Knee Pain
    • Case #3 – Aging, Cognition, Community, Stroke
    • Case #4 – Complex Case – Musculoskeletal, Episodic, Cardiorespiratory
    • Case #5 – Diabetes, Neuropathy, Substance Use
    • Case #6 – Transition from Paediatric to Adult Care
    • Supplemental Case Studies without Leading Questions
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Case Studies

Case studies have been provided to demonstrate the role for rehabilitation interventions in the support of people living with HIV.

Table of Acronyms
Acronym Description
ADL Activities of Daily Living
ART Antiretroviral Treatment
BAD Bipolar Affective Disorder
BMD Bone Mineral Density
CAD Coronary Artery Disease
CBHO Community-based HIV Organization
COPD Chronic Obstructive Pulmonary Disease
CP Cerebral Palsy
CVA Cerebrovascular Accident
CXR Chest X-Ray
DAT Diet as Tolerated
EDEN Episodic Disabilities Employment Network
ER Emergency Room
HAND HIV-Associated Neurocognitive Disorder
HA-MND HIV-Associated Mild Neurocognitive Disorder
HIV + HIV Positive
FITT Frequency, Intensity, Time, Type
IADL Instrumental Activities of Daily Living
ICF International Classification of Functioning
ICU Intensive Care Unit
IPPA Inspection, Palpation, Percussion, Auscultation
MI Myocardial Infarction
MoCA Montreal Cognitive Assessment
MSM Man who has Sex with Men
OT Occupational Therapist or Therapy
POA Power of Attorney
PCP Pneumocystis pneumonia
PRN As required
PT Physical Therapist or Therapy
ROM Range of Motion
SDM Substitute Decision Maker
SLP Speech-Language Pathologist or Therapy
SMART principle Specific, Measurable, Achievable, Relevant and Time-Bound
VAS Visual Analogue Scale
WBAT Weight Bearing as Tolerated
WSM Woman who has Sex with Men

Organization of the cases using the SOAP format:

The SOAP note (an acronym for subjective, objective, assessment, and plan) is a method of documentation employed by healthcare providers to write out notes in a patient’s chart, along with other common formats, such as the admission note.

Subjective Component: Is the patient’s chief complaint. This is a very brief statement of the patient (quoted) as to the purpose of the office visit or hospitalization.

Objective Component: Includes information that the healthcare provider observes or measures from the patient’s current presentation.

Assessment: A medical diagnosis for the purpose of the medical visit on the given date of the note written is a quick summary of the patient with main symptoms/diagnosis including a differential diagnosis and a list of other possible diagnoses.

Plan: The plan is what the healthcare provider will do to treat the patient’s concerns – such as ordering further labs, referrals given, procedures performed and education provided. The plan will also include goals of therapy and patient-specific disease-state monitoring parameters.

Wikipedia.com SOAP note.

A note on stereotyping:

We have given our cases a variety of gender, cultural and social identities for illustration purposes only. The reader should not use these examples to profile how HIV might present itself in one’s own region or community. Consult your local HIV prevalence reports or local Community-based HIV Organization to get a more specific overview.

Reference:
Realize. E-Module for Evidence Informed HIV Rehabilitation. Final update: 2020. 

Case #1 – Acute Care, Cardiorespiratory and Neurological

Case #1 – Sonia Part 1: Presenting Problem / Background Sonia is a 35-year-old Indigenous woman who presents to the emergency room (ER) at a downtown urban hospital with fever…

Case #2 – Musculoskeletal – Knee Pain

Case #2 – Geoff Presenting Problem / Background Geoff is a 42-year-old Asian individual who is gender fluid and uses the pronouns they/them.  Geoff works for a large hotel chain…

Case #3 – Aging, Cognition, Community, Stroke

Case #3 – Louis Part 1: Presenting Problem / Background Louis is a 63-year-old Caucasian male living with HIV who presents with failure to thrive in the community. He has…

Case #4 – Complex Case – Musculoskeletal, Episodic, Cardiorespiratory

Case #4 – Stella Part 1: Presenting Problem / Background Stella is a 58-year-old female living with HIV. Stella and her daughter immigrated to Canada from an HIV endemic country…

Case #5 – Diabetes, Neuropathy, Substance Use

Case #5 – John Presenting Problem / Background John, a 46-year-old Caucasian male who is living with HIV, is admitted to the acute care hospital after a community health nurse…

Case #6 – Transition from Paediatric to Adult Care

Case #6 – Natasha Presenting Problem / Background Natasha is a 17-year-old Caucasian female living with cerebral palsy (CP) and HIV who presents to her paediatric rehabilitation facility to commence…

Supplemental Case Studies without Leading Questions

Need more practice? Julie Phillips, HIV Advanced Practice Nurse at Sunnybrook Health Sciences Centre, Toronto, Canada, developed these supplemental cases.  Please help us! If you are interested to participate in…

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