Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Click here to register

Sign In to gain access to subscriptions and/or personal tools.
Chronic Illness
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Whitaker, R.
Right arrow Articles by Goldstein, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Whitaker, R.
Right arrow Articles by Goldstein, E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?

The experience of long-term diagnosis with human immunodeficiency virus: a stimulus to clinical eupraxia and person-centred medicine

R. Whitaker

Clinical and Health Psychology Research Centre, School of Human and Life Sciences, Roehampton University, Whitelands College, Holybourne Avenue, London SW15 4JD, UK, email{at}eupraxia.eu, Biobehavioral Research Center, San Francisco State University, San Francisco, CA 94132-4025, USA

C. Vögele

Clinical and Health Psychology Research Centre, School of Human and Life Sciences, Roehampton University, Whitelands College, Holybourne Avenue, London SW15 4JD, UK

K. Mcsherry

Counselling Programme, School of Human and Life Sciences, Roehampton University, London SW15 4JD, UK

E. Goldstein

Department of Family and Community Medicine, University of California San Francisco, 995 Potrero Ave, Building 80, Ward 83, San Francisco, CA 94110 USA

The biopsychosocial challenges of living with human immunodeficiency virus (HIV) have changed over time and they dictate the need for relevant medical services. The meaning of an HIV diagnosis has moved from a terminal to a manageable condition with the development of antiretrovirals, bringing profound changes to the experience of living with HIV and the meaning and use of diagnostic labels. Six biological stage-related categories in the literature of psychological medicine of HIV are critiqued. Long-term HIV highlights the inadequacy of physician-centred, acute-care medicine in chronic illness and its exclusion of preventive, psychological and rehabilitative modalities. `Eupraxia' is presented as a conceptual framework for chronic care medicine, referring to best practice, wellbeing, best interests, and (public) welfare, through facilitated but collaborative approaches. A public-centred service model is proposed, using idiographic assessment and treatment by clinicians as patient delegates (proxies), monitoring joined-up care, providing group-based biopsychosocial treatment, facilitating autonomous and self-managing behaviour by the public, removing professional and practice hierarchies, and implementing real-time clinical and managerial accountability with public ownership and involvement. This model is superior in its health- and cost-effectiveness but can only work within a nationalized system that focuses equally on standardized outcomes and evidential and personalized health outcomes.

Key Words: Best practice • Patient-centred medicine • Chronic illness • Personalised treatment • Clinical design • Eupraxia

Chronic Illness, Vol. 2, No. 4, 311-320 (2006)
DOI: 10.1177/17423953060020040101
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?