Effective pain management as part of palliative care for persons living with HIV/AIDS in a developing country: A qualitative study

The aim of this research was to explore and understand nurses' experiences of managing pain for persons living with human immune virus/ acquired immune deficiency syndrome receiving palliative care at home in Botswana. Background: Community palliative and hospice care in Africa and Botswana were developed for persons with end-stage acquired immune deficiency syndrome and other terminal illnesses being cared for at home. As antiretro viral therapies extend the lives of persons living with human immune virus/acquired immune deficiency syndromes, there is an increase in the chronic conditions associated with human immune virus/acquired immune deficiency syndrome. Despite a strong demand for care of persons living with human immune virus/acquired immune deficiency syndromes and other chronic illnesses, little is known about Botswanan community nurses' capacity to manage community-based end-of-life care for persons living with human immune virus/acquired immune deficiency syndromes. Design: A qualitative study approach guided by van Manen's interpretive analysis was undertaken. Methods: Data were collected using semi-structured interviews that were audio-recorded, transcribed and analysed using qualitative interpretive analysis. Thirteen nurses from 12 health districts in Botswana were recruited to the study using purposeful sampling. Results: Participants identified that pain management was a significant issue. A lack of nurses' ability to advocate effectively for patients because of a lack of relevant skills and knowledge and poor availability of appropriate analgesics was a limiting factor along with doctors' reluctance to prescribe opioids to effectively manage pain