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ON-GOING COUNSELLING WITH
PLHIV = FIRST STEP OF
POSITIVE PREVENTION
KONTINUIRANO (“ON-GOING”)
SAVETOVANJE PLHIV KAO PRVI KORAK
POZITIVNE PREVENCIJE


    Mr sci med prim dr MILA PAUNIĆ
   Center for HIV and STIs Prevention
  Institute for Students Health, Belgrade
                   SERBIA
one of the          the most          the most
 most efficient      productive         effective
    Jedna od        najproduktivnijih   najefektivnijih
   najefikasnijih



                     VCCT
                                        cheaper than
more humane,        more friendly
                                        any other pr.
    humanija                            practice
more convenient prijateljskija          Jeftinija od drugih
   prikladinija                         prevent. praksi
Many
                   Professionals
                  Brojni profesionalci




                    VCCT
                                         “the most
“represents the best                     powerful”
  pr. activity”                          pr. activity
  “redstavlja najbolju                   “najmoćniju
prev.aktivnost”                           prev. akt.”
WHAT VCCT REALLY MEANS ?
VCCT is a conversation between a counselor and a client with aims to:

- encourage client’s dealing with personal concerns and stress
related to HIV/AIDS
- encourage clients to decrease or/and to avoid personal risk-related
beh.
- provide support to PLHIV


              ŠTA ZAPRAVO PREDSTAVLJA VCCT?

VCCT je razgovor između savetnika/ce i klijenta sa ciljem:

- ohrabrivanja klijenta da se izbori sa svojim brigama i stresom u vezi
HIV-a i AIDS-a
- ohrabrivanja klijenata da smanje ili /i izbegnu rizično ponašanje
- pružanje podrške PLHIV
Provide support to PLHIV



   explaining clearly to the
   patient/client:
   He/she is always
   welcome

   On-going care and support

   klijentu jasno objasniti :
                On/ona je uvek
   dobrodošao/la

Kontinuirana nega i podrška
Clearly offer to the        Jasno nuditi klijentu
Client the possibility      mogućnost ponovnog
to meet again               susreta



 Enough space and          Dovoljno prostora i dovoljno
 enough time to provide a   vremena za pružanje
 confidential setting for   poverljivog “setinga” za
 counselling                savetovanje
 Convenient time and       Prikladno vreme i laka
 easy access for people     dostupnost za osobe kojima
 seeking counselling        je potrebno savetovanje
SAVETOVANJE ZA
COUNSELLING FOR              DOBROVOLJNO HIV
VOLUNTARY HIV TESTING        TESTIRANJE
Counsellors need to have    Savetnici treba da umeju
listening skills and to be   da slušaju klijente i da im
able to explain things       stvari objašnjavaju na
clearly                      razumljiv način
Non-judgemental             Da ne osuđuju klijente
Counsellors must be able:   Savetnici treba da:
to respect the rights and    poštuju klijente,
dignity of clients,
                             održavaju i čuvaju
Able to keep information    poverljivost
confidential
                             da su emocionalno
emotionally stable          stabilni
Listen          Slušaju
and give         i daju
people time      klijentima
                 dovoljno
to voice their
concerns         vremena
                  da izraze
                 svoje brige


Understand
                 Razumeju
the person’s
                 šta se sa
situation
                 klijentom
                 dešava
ON GOING Counselling has             ON GOING Savetovanje
a holistic aim:                      ima sveobuhvatni cilj:
To help people to cope with their   Da pomogne ljudima da se izbore i
reactions to HIV infection           prihvate svoju HIV infekciju
To find realistic ways to solve     Da nađu realne načine da reče
problems                             probleme
To prevent re-infection             Da se prevenira re-infekcija
To protect others from infection    Da se zaštite drugi od infekcije




COUNSELLING (ON GOING                SAVETOVANJE (ON GOING
COUNSELLING ) IS NOT                 SAVETOVANJE) NIJE –
ABOUT TELLING PEOPLE                 GOVORITI LJUDIMA ŠTA
WHAT TO DO                           TREBA DA (U)RADE
During the counselling:     Tokom savetovanja naš zadatak
                            je:
Explain all the facts      Objasniti sve činjenice u vezi sa
about HIV and AIDS          HIV-om i AIDS-om jasno i
clearly and simply and      jednostavno i dati odgovarajuće
provide appropriate         informacije
information


Discuss sexuality and      Diskutovati otvoreno o
                            seksualnosti i seksu ne osuđujući
sex in a non-judgemental    klijenta, tako da se klijent ohrabri
and open way that           da govori
encourages people to talk
Detection of HIV for every patient surely has
profound emotional, spiritual, social, behavioural
and medical consequences to their own life




Saznanje prisustva HIV infekcije za svakog pacijenta zasigurno nosi duboke
emocionalne, duhovne, socijalne, bihejvioralne i medicinske posledice na
njegov život /porodični život
social relations, sexual relations, work,
education, studying, level of self-
confidence and self-respect, spiritual
needs, legal status, social and, generally -
human rights


socijalne odnose, seksualne odnose, posao, školovanje,
učenje, nivo samopouzdanja i samopoštovanja, duhovne
potrebe, pravni status, društvena i, uopšte gledano,
ljudska prava
During counselling
sessions there are
many questions that
counsellor should
answer



U toku savetovanja mogu
se otvoriti brojna pitanja
na koje savetnik/savetnica
treba da „odgovori“
The most common subjects are:

disturbance of a person LWHIV about
„possible further transmission“ of infection,
sadness and/or anger, secrecy,
discrimination in society and family …




Najčešće teme su:

uznemirenost osobe koja živi s HIV-om zbog
“mogućeg daljeg prenosa” infekcije, tuga i/ili bes,
tajnost, diskriminacija u društvu ili u porodici…
… emotional and sexual relationship breaks,
physical isolation, hospitalization, physical
consequences of illness, preparation for
symptomatic period, depression and apathy




… prekid emotivnih i seksualnih veza, fizička izolacija,
hospitalizacija, fizičke posledice bolesti, priprema za
simptomatski period, potištenost i bezvoljnost
   All these
    things
    require
    continuous
    support



   Sve
    nabrojano
    zahteva
    kontinuiranu
    podršku
It is important
to provide
understandable
and detailed
information
about HIV and
AIDS

Potrebno je
pružiti
razumljive i
detaljne
informacije o
HIV-u i AIDS-u
Professionals working
with PLHIV should
possess comprehensive
knowledge about
measures for
improvement of health,
sexuality and sexual
behaviour…

Profesionalci koji imaju
pacijente sa HIV-om, trebalo
bi da imaju obimno znanje o
merama za unapređenje
zdravlja, o seksualnosti i
seksualnom ponašanju…
… counsellours should be
able of giving
support in order to obtain
safer sex both to people
living with HIV and their
partners …

… savetnici bi trebalo da umeju
da pruže podršku kako bi
seksualni odnos bio sigurniji i
za one koji žive s HIV-om i za
njihove seksualne partnere
… our patients have rights to decide whether
or not to have sex - and that is why they need
explicit information and practical support!

… jer naši pacijenti imaju pravo i mogu da odluče da li
će ili neće stupiti u seksualne odnose - i zato su im
potrebne eksplicitne informacije i praktična podrška!
Counsellours should also be capable of giving
adequate information about patients’ rights
and give adequate support and care

Takođe, savetnici bi trebalo da umeju da pruže
adekvatnu informaciju o pravima pacijenta i da pruže
adekvatnu podršku i negu
Empathy that patient living with HIV
recognizes in their doctor or counsellor will
contribute to patient’s higher self-esteem and
self-respect, better therapeutic cooperation

Empatija koju pacijent koji živi sa HIV-om prepozna
kod svog lekara ili savetnika, doprineće da on sebe
više vrednuje i poštuje, bolje sarađuje u terapijskom
segmentu
he/she will perceive
situation more
realisticly and the
essence of preventive
message will reach the
patient more effectively
and will be better
accepted.


realnije sagleda situaciju, a
suština preventivne poruke
uspešnije će dopreti do
pacijenta i biće mnogo
snažnije prihvaćena.
Establish trust             Gradimo poverenje
Help a person to make       Pomažemo klijentima
realistic decisions and      da donesu realistične
start to change risky        odluke i počnu da
behaviour                    menjaju svoje ponašanje




Links to referral systems   Upućivanje -“Referal”:
/treatment/health
care/support networks        lečenje/nega/mreže
                             podrške
An important message both for counsellors and patients is that


People living with HIV may lead long and
fulfilled lives

Ljudi koji žive s HIV-om mogu da vode duge i
ispunjene živote
4 “Cs”
• Competence          2. Commitment
3. Communication 4. Compassion



             “S P K S”
•Stručnost         2. Posvećenost
3. Komunikacija       4. Saosećanje
   A patient of mine once told me a truth comprised in
    a Swahili proverb, which means that if we want to
    understand our patients completely, we must give
    them our whole heart and soul.

   at the same time try to avoid “burn out”


   Jednom mi je jedan pacijent rekao istinu sadržanu u
    “Svahili izreci” , koja znači – ako želite da u
    potpunosti razumete pacijente, morate im posvetiti
    (dati) celo svoje srce i dušu
   a u isto vreme probati da izbegnete da “pregorite”
If you want to see with my eyes,
     give me your heart
                 Swahili proverb
Ako želiš da me shvatiš,
     daj mi svoje srce
                  Swahili izreka
Thanks!

                   Hvala!




vctbelgradejan05

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mila paunic - ongoing counselling of plhiv

  • 1. ON-GOING COUNSELLING WITH PLHIV = FIRST STEP OF POSITIVE PREVENTION KONTINUIRANO (“ON-GOING”) SAVETOVANJE PLHIV KAO PRVI KORAK POZITIVNE PREVENCIJE Mr sci med prim dr MILA PAUNIĆ Center for HIV and STIs Prevention Institute for Students Health, Belgrade SERBIA
  • 2. one of the the most the most most efficient productive effective Jedna od najproduktivnijih najefektivnijih najefikasnijih VCCT cheaper than more humane, more friendly any other pr. humanija practice more convenient prijateljskija Jeftinija od drugih prikladinija prevent. praksi
  • 3. Many Professionals Brojni profesionalci VCCT “the most “represents the best powerful” pr. activity” pr. activity “redstavlja najbolju “najmoćniju prev.aktivnost” prev. akt.”
  • 4. WHAT VCCT REALLY MEANS ? VCCT is a conversation between a counselor and a client with aims to: - encourage client’s dealing with personal concerns and stress related to HIV/AIDS - encourage clients to decrease or/and to avoid personal risk-related beh. - provide support to PLHIV ŠTA ZAPRAVO PREDSTAVLJA VCCT? VCCT je razgovor između savetnika/ce i klijenta sa ciljem: - ohrabrivanja klijenta da se izbori sa svojim brigama i stresom u vezi HIV-a i AIDS-a - ohrabrivanja klijenata da smanje ili /i izbegnu rizično ponašanje - pružanje podrške PLHIV
  • 5. Provide support to PLHIV explaining clearly to the patient/client: He/she is always welcome On-going care and support klijentu jasno objasniti : On/ona je uvek dobrodošao/la Kontinuirana nega i podrška
  • 6. Clearly offer to the Jasno nuditi klijentu Client the possibility mogućnost ponovnog to meet again susreta Enough space and Dovoljno prostora i dovoljno enough time to provide a vremena za pružanje confidential setting for poverljivog “setinga” za counselling savetovanje Convenient time and Prikladno vreme i laka easy access for people dostupnost za osobe kojima seeking counselling je potrebno savetovanje
  • 7. SAVETOVANJE ZA COUNSELLING FOR DOBROVOLJNO HIV VOLUNTARY HIV TESTING TESTIRANJE Counsellors need to have Savetnici treba da umeju listening skills and to be da slušaju klijente i da im able to explain things stvari objašnjavaju na clearly razumljiv način Non-judgemental Da ne osuđuju klijente Counsellors must be able: Savetnici treba da: to respect the rights and poštuju klijente, dignity of clients, održavaju i čuvaju Able to keep information poverljivost confidential da su emocionalno emotionally stable stabilni
  • 8. Listen Slušaju and give i daju people time klijentima dovoljno to voice their concerns vremena da izraze svoje brige Understand Razumeju the person’s šta se sa situation klijentom dešava
  • 9. ON GOING Counselling has ON GOING Savetovanje a holistic aim: ima sveobuhvatni cilj: To help people to cope with their Da pomogne ljudima da se izbore i reactions to HIV infection prihvate svoju HIV infekciju To find realistic ways to solve Da nađu realne načine da reče problems probleme To prevent re-infection Da se prevenira re-infekcija To protect others from infection Da se zaštite drugi od infekcije COUNSELLING (ON GOING SAVETOVANJE (ON GOING COUNSELLING ) IS NOT SAVETOVANJE) NIJE – ABOUT TELLING PEOPLE GOVORITI LJUDIMA ŠTA WHAT TO DO TREBA DA (U)RADE
  • 10. During the counselling: Tokom savetovanja naš zadatak je: Explain all the facts Objasniti sve činjenice u vezi sa about HIV and AIDS HIV-om i AIDS-om jasno i clearly and simply and jednostavno i dati odgovarajuće provide appropriate informacije information Discuss sexuality and Diskutovati otvoreno o seksualnosti i seksu ne osuđujući sex in a non-judgemental klijenta, tako da se klijent ohrabri and open way that da govori encourages people to talk
  • 11. Detection of HIV for every patient surely has profound emotional, spiritual, social, behavioural and medical consequences to their own life Saznanje prisustva HIV infekcije za svakog pacijenta zasigurno nosi duboke emocionalne, duhovne, socijalne, bihejvioralne i medicinske posledice na njegov život /porodični život
  • 12. social relations, sexual relations, work, education, studying, level of self- confidence and self-respect, spiritual needs, legal status, social and, generally - human rights socijalne odnose, seksualne odnose, posao, školovanje, učenje, nivo samopouzdanja i samopoštovanja, duhovne potrebe, pravni status, društvena i, uopšte gledano, ljudska prava
  • 13. During counselling sessions there are many questions that counsellor should answer U toku savetovanja mogu se otvoriti brojna pitanja na koje savetnik/savetnica treba da „odgovori“
  • 14. The most common subjects are: disturbance of a person LWHIV about „possible further transmission“ of infection, sadness and/or anger, secrecy, discrimination in society and family … Najčešće teme su: uznemirenost osobe koja živi s HIV-om zbog “mogućeg daljeg prenosa” infekcije, tuga i/ili bes, tajnost, diskriminacija u društvu ili u porodici…
  • 15. … emotional and sexual relationship breaks, physical isolation, hospitalization, physical consequences of illness, preparation for symptomatic period, depression and apathy … prekid emotivnih i seksualnih veza, fizička izolacija, hospitalizacija, fizičke posledice bolesti, priprema za simptomatski period, potištenost i bezvoljnost
  • 16. All these things require continuous support  Sve nabrojano zahteva kontinuiranu podršku
  • 17. It is important to provide understandable and detailed information about HIV and AIDS Potrebno je pružiti razumljive i detaljne informacije o HIV-u i AIDS-u
  • 18. Professionals working with PLHIV should possess comprehensive knowledge about measures for improvement of health, sexuality and sexual behaviour… Profesionalci koji imaju pacijente sa HIV-om, trebalo bi da imaju obimno znanje o merama za unapređenje zdravlja, o seksualnosti i seksualnom ponašanju…
  • 19. … counsellours should be able of giving support in order to obtain safer sex both to people living with HIV and their partners … … savetnici bi trebalo da umeju da pruže podršku kako bi seksualni odnos bio sigurniji i za one koji žive s HIV-om i za njihove seksualne partnere
  • 20. … our patients have rights to decide whether or not to have sex - and that is why they need explicit information and practical support! … jer naši pacijenti imaju pravo i mogu da odluče da li će ili neće stupiti u seksualne odnose - i zato su im potrebne eksplicitne informacije i praktična podrška!
  • 21. Counsellours should also be capable of giving adequate information about patients’ rights and give adequate support and care Takođe, savetnici bi trebalo da umeju da pruže adekvatnu informaciju o pravima pacijenta i da pruže adekvatnu podršku i negu
  • 22. Empathy that patient living with HIV recognizes in their doctor or counsellor will contribute to patient’s higher self-esteem and self-respect, better therapeutic cooperation Empatija koju pacijent koji živi sa HIV-om prepozna kod svog lekara ili savetnika, doprineće da on sebe više vrednuje i poštuje, bolje sarađuje u terapijskom segmentu
  • 23. he/she will perceive situation more realisticly and the essence of preventive message will reach the patient more effectively and will be better accepted. realnije sagleda situaciju, a suština preventivne poruke uspešnije će dopreti do pacijenta i biće mnogo snažnije prihvaćena.
  • 24.
  • 25. Establish trust Gradimo poverenje Help a person to make Pomažemo klijentima realistic decisions and da donesu realistične start to change risky odluke i počnu da behaviour menjaju svoje ponašanje Links to referral systems Upućivanje -“Referal”: /treatment/health care/support networks lečenje/nega/mreže podrške
  • 26. An important message both for counsellors and patients is that People living with HIV may lead long and fulfilled lives Ljudi koji žive s HIV-om mogu da vode duge i ispunjene živote
  • 27. 4 “Cs” • Competence 2. Commitment 3. Communication 4. Compassion “S P K S” •Stručnost 2. Posvećenost 3. Komunikacija 4. Saosećanje
  • 28. A patient of mine once told me a truth comprised in a Swahili proverb, which means that if we want to understand our patients completely, we must give them our whole heart and soul.  at the same time try to avoid “burn out”  Jednom mi je jedan pacijent rekao istinu sadržanu u “Svahili izreci” , koja znači – ako želite da u potpunosti razumete pacijente, morate im posvetiti (dati) celo svoje srce i dušu  a u isto vreme probati da izbegnete da “pregorite”
  • 29. If you want to see with my eyes, give me your heart Swahili proverb Ako želiš da me shvatiš, daj mi svoje srce Swahili izreka
  • 30. Thanks! Hvala! vctbelgradejan05