University of Missouri - Saint Louis

The Graduate School

Announcement

An oral examination in defense of the dissertation for the degree

Doctor of Philosophy

Michael Kenneth Klebert
MS, Nursing, 1987 University of Texas, Galveston
BS, Nursing, 1981 Southern Illinois University Edwardsville
BA, Philosophy, 1979 Southern Illinois Carbondale

Stop-It: An Intervention for Chronic Diarrhea in People with HIV

Abstract

Chronic noninfectious diarrhea (CND) is a common symptom of HIV infection affecting 50-60% of people with HIV and AIDS (PWHIV/A) at some point during their illness, negatively affecting health related quality of life (HRQOL) and interacting with other symptoms of HIV infection. Untreated, CND is debilitating and demoralizing. People with HIV and/or AIDS with CND use more medical resources, have more outpatient visits, use more medications, and miss more work than people with HIV and/or AIDS without CND. CND can cause worry about a spiral toward death often termed, “the beginning of the end”. The Swiss Cohort Study established that CND is a negative predictor of survival. Quantifying diarrhea is difficult and rarely done outside the confines of the hospital. Clinicians rely solely on patient descriptions of diarrhea. Diarrhea is variously described along a continuum from loose poorly formed stools to totally watery. These descriptions are sometimes but not always associated with a discussion of frequency and duration. Few instruments exist to assist clinicians in quantifying diarrhea. This research establishes the validity of the SCR-1 and DQ-1 in identifying and quantifying diarrhea. The SCR-1 has high accuracy in predicting several different definitions of diarrhea frequency. The instruments may prove to be a valuable resource in assessing diarrhea in clinical trials.

Defense of Dissertation Committee