The necessity of psychological interventions to improve compliance with Tuberculosis treatment and reduce psychological distress

Abstract

Context: One of the major obstacles in treating TB is the patient's nonadherence to the treatment regimen resulting in prolonged disease transmission and development of resistance to anti-TB drugs. An individual's mental health affects his/her adaptation to the disease. Mental health issues and TB both are inextricably connected and research into this area will provide an opportunity to develop a more holistic model of TB treatment and prevention.

Aims: The aim of this study is to investigate the prevalence of mental health issues in patients with TB and its influence on individual perception of well-being with an emphasis on psychopathology as a major obstacle to treatment adherence. Research into this area will provide an opportunity to develop a more holistic model of TB treatment and prevention.

Settings and design: Primary data were collected with the help of ASHA workers, and primary survey-based study was designed.

Methods and material: A total of 249 diagnosed Tuberculosis cases were included in the study. A digitalized version of the PGIHQN-1 questionnaire was made and used to separate the psychiatric population from the normal group. Asha workers were trained to use the digital version on tablets.

Statistical analysis used: Using Microsoft Excel, Graphic Tables, and corelation were done using SPSS Statistics.

Results: Mental health issues were found in diagnosed TB cases, which required further evaluations. Along with mental health issues, limited resources, gender, limited education, lack of proper knowledge about the disease, having responsibilities (Marital status), locality were found to be the important factors that complicate TB outcomes, hence should be taken into consideration while imparting psychological interventions.

Conclusion: Mental health issues complicate TB outcome and hence need to be properly addressed, and thorough psychoeducation, psychological first aid (listen, protect, connect, model& teach), and timely intervention in the form of proper diagnosis and specific treatment and rehabilitation are needed.

Keywords: Anxiety and mood disorders; comorbidity; depression; medicine resistant tuberculosis; tuberculosis.

Figure 1

(a) Psychological + Physical health distribution of TB patients. (b): Psychological + Physical health distribution: classification into poor, very poor, extremely poor, good, very good, extremely good, average

Figure 2

(a): Classification of physical health status. (b): Classification of physical health status into poor, very poor, extremely poor, good, very good, extremely good (EG), average (A)

Figure 3

(a): Classification of psychological health status. (b): Classification of psychological health status into poor, very poor, extremely poor, good, very good, extremely good, average

Figure 4

Physical health wise percentage distribution of overall distressed and stable TB patients

Figure 5

Gender wise percentage distribution of overall distressed and stable TB patients

Figure 6

Locality wise percentage distribution of overall distressed and stable TB patients

Figure 7

Employment status wise percentage distribution of week and good

Figure 8

Education-wise percentage distribution of weak and good

Figure 9

Marital status wise percentage distribution of week and goods

Figure 10

Age-wise percentage distribution