Clinico psycho social conference: A novel learning experience for postgraduate students of community medicine

Abstract

The School of Public Health (SPH), Postgraduate Institute of Medical Education and Research (PGIMER), has initiated a Clinico Psycho Social Conference (CPSC) for its postgraduate students. Focus is on the social aspects of the disease. Present case attempts to demonstrate the potential of CPSC as a training method. The index case was a female, who got married at 35 years of age to a graduate farmer from a joint Jat family of Punjab. She conceived within 2 months of marriage. A private practitioner referred her to government hospital. Her husband accompanied her to the hospital, where she was confirmed HIV positive. She was then referred to PGIMER. The patient was in a state of shock, initially, when she knew about her HIV status, as she said, “Eh bimari mainu kithon lag gai, kyun lag gai? ? ?” (from where and why did I get this disease?). Her husband supported her in this phase of crisis as she told, “Pati ne keha ki bade hospital vich dikha ke dekhiye” (My husband suggested that we should take a chance and consult a bigger hospital.). Her main concern seemed to be the survival of the fetus. She said, “Sayad bacha bach jave, kafi muridan ton mangaya hai” (May be our child survives; the conception was a result of lots of praying to the God). She was counseled in PGIMER on various issues such as immunization, breast feeding, etc. She regularly took Ziduvudine. She told, “Davai Khani hai, CD4 jaida hai ate AIDS hon vich time lagda hai” (The doctor told me that my CD4 count was high; it takes time for the development of AIDS, so I have to take the medicine). She did not tell her in-laws about her HIV status. Her mother, sister and brother accompanied her to the hospital. She gave birth to a 4-kg male baby through caesarian. About her plans, she told that “asi hun bachha karna hi nahin” (We do not want another child). Her husband was reported to be HIV negative.