Unmet palliative care needs among individuals living with HIV/AIDS: a cross-sectional study utilising SPICT-LIS, ESAS-R, and NAT: PD tools
Bibliographic record
Abstract
Individuals living with HIV/AIDS (PLWHA) face significant physical, psychological and social challenges, even with the progress made in antiretroviral therapy (ART). The integration of palliative care has been shown to enhance quality of life and reduce symptom burden; however, there is limited evidence from India on this topic. This cross-sectional study investigated the unmet palliative care needs of PLWHA attending a tertiary HIV clinic in Karnataka, India. Out of 118 eligible patients, 97 (82.2%) agreed to participate from January to June 2019. Data were gathered using the Supportive and Palliative Care Indicators Tool (SPICT-LIS), the Edmonton Symptom Assessment Scale - Revised (ESAS-R) and the Needs Assessment Tool for Progressive Disease (NAT: PD). Overall, 43.3% of participants met the SPICT-LIS criteria for palliative care needs, and 42.3% reported experiencing at least one severe symptom, with fatigue, pain and depression being the most common. Factors such as functional impairment (Karnofsky Performance Status < 80), recent hospitalization, and CD4 counts below 200 cells/μL were significant predictors of the need for palliative care. Despite these findings, 97.6% of eligible participants had never received palliative services. Barriers to care included stigma, lack of awareness and limited integration of services. These findings suggest the urgent need to incorporate palliative care into ART programs to improve the quality of life and address ongoing health disparities among PLWHA in India.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".