Psychosocial characteristics of tuberculosis patients in Russia and treatment compliance factors

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Abstract

The authors of the article analyse approaches to treatment for tuberculosis (TB), which have become widespread throughout the world. Scientists from different countries have made attempts to study the influence of psychological, social, cultural, ethnic, and geographical factors on the spread of tuberculosis and the effectiveness of its treatment. But so far little is known about personal or sociocultural factors that lead to a violation of treatment compliance, which significantly actualises the problems stated in this article. The relevance of the study is also determined by the fact that all measures currently used for treating tuberculosis do not lead to its complete eradication and elimination of the epidemic in the world as well as in the Russian Federation. The purpose of this work was to study the psychosocial characteristics of TB patients in Russia and their interrelationships, which will provide an opportunity to predict the patients’ behaviour in a disease situation and their treatment compliance. The study involved 1600 respondents aged 19-60 years: 800 women and 800 men, residents of Samara (Russia), of which 800 persons were TB patients and the other 800 were conditionally healthy. The following psychodiagnostic techniques were used: The World Health Organisation Quality of Life (WHOQOL) Questionnaire (core module), The Level of Social Frustratedness Questionnaire, The Neurotic Disorders Questionnaire (Russian modification of H.D. Hansgen’s BVNK-300), M. Bond’s Defense Style Questionnaire (DSQ) in Russian adaptation by E. Tunik, The Ways of Coping Questionnaire (WSQ) by S. Folkman and R. Lazarus in a modified and adapted Russian version, The Type of Attitude Towards the Disease (TATD) Questionnaire, and The Level of Compliance Questionnaire. It was found that the TB patients had a significantly decreased quality of life, especially in the spheres of social relations, psychological state and spirituality. Characteristic features of the TB patients in Russia were disorders of the digestive and cardiovascular systems, sleep and motor disorders, affective instability, mental exhaustion, excitability, impaired working ability, fears, and social-psychological maladaptation. The respondents tended to use more maladaptive psychological defence mechanisms. As the leading coping ways for the TB patients, search for social support and acceptance of responsibility were identified. The prevailing types of attitudes toward the disease were characterised by an intrapsychic orientation, causing impaired social adaptation of these patients. The authors constructed regression models of compliance to determine strategies for TB patients psychological support. The results of the study as well as the constructed models can be used for training professional personnel in the field of medicine, clinical psychology, social work and social pedagogy in order to optimise the provision of medical, social, psychological and pedagogical assistance to TB patients in Russia and in other countries of the world: studies show that the factors identified and analysed in this paper are similar in TB patients in different countries, regardless of their geographic location or the level of economic development and cultural features.

About the authors

Elena V. Zahkarova

Samara State Medical University of the Ministry of Health of the Russian Federation

Email: proscha1088@mail.ru
Ph.D., Associate Professor, is Head of the Department of General Psychology and Social Work 89 Chapaevskaya St, Samara, 443099, Russian Federation

Elena G. Filshtinskaya

Samara State Medical University of the Ministry of Health of the Russian Federation

Email: fil-alena@rambler.ru
senior lecturer of the Department of General Psychology and Social Work 89 Chapaevskaya St, Samara, 443099, Russian Federation

References

  1. Ababkov, V.A. (Ed.). (1995) Psikhodiagnosticheskaya metodika dlya opredeleniya nevroticheskikh i nevrozopodobnykh narusheniy: Posobiye dlya vrachey i psikhologov. Saint Peterburg: Saint Petersburg V.M. Bekhterev Psychoneurological Research Institute. (In Russ.)
  2. Belostotsky, A.V., Kasaeva, T.C., Kuzmina, N.V., & Nelidov, N.V. (2015). Problem of treatment adherence in tuberculosis patients. Tuberculosis and Lung Diseases, (4), 4-9. (In Russ.)
  3. Bond, M., & Wesley, S. (1996). Manual for the Defense Style Questionnaire (DSQ). Montreal: McGill University
  4. Buynevich, I.V., Bondarenko, V.N., & Shilova, O.V. (2016). Lichnostnyye osobennosti patsiyentov s tuberkulezom legkikh, nakhodyashchikhsya na palliativnom lechenii. Universitetskaya Nauka: Vzglyad v Budushcheye: Conference Prosideengs (pp. 209-212). Kursk: Kursk State Medical University. (In Russ.)
  5. Chang, S.H., & Cataldo, J.K. (2014). A systematic review of global cultural variations in knowledge, attitudes and health responses to tuberculosis stigma. International Journal of Tuberculosis and Lung Disease, 18(2), 168-173. doi: 10.5588/ijtld.13.0181.
  6. Chang-gyo Yoon, Dong Yoon Kang, Jaehun Jung, Soo Yon Oh, Jin Beom Lee, Mi-Hyun Kim, Younsuk Seo, Hee-Jin Kim. (2018). The Infectivity of Pulmonary Tuberculosis in Korean Army Units: Evidence from Outbreak Investigations. Tuberculosis and Respiratory Diseases, 82(4), 298. https://doi.org/10.4046/trd.2018.0077
  7. Cocozza, A.M., Linh, N.N., Nathavitharana, R.R., Ahmad, U., Jaramillo, E., Gargioni, G.E.M., & Fox, G.J. (2020). An assessment of current tuberculosis patient care and support policies in high-burden countries. The International Journal of Tuberculosis and Lung Disease, 24(1), 36-42. https://doi.org/10.5588/ijtld.19.0183
  8. Cramm, J., Finkenflügel, H., Møller, V., & Nieboer, A. (2010). TB treatment initiation and adherence in a South African community influenced more by perceptions than by knowledge of tuberculosis. BMC Public Health, 10(1), 72
  9. Culqui, D.R., Munayco, C.V.E., Grijalva, C.G, Cayla, J.A., Horna-Campos, O., Kenedy, A.Ch., & Suarez L.A.O. (2012). Factors Associated With the Non-Completion of Conventional Anti-Tuberculosis Treatment in Peru. Archivos de Bronconeumología, 48(5), 150-155
  10. Dobrovolskaya, O.E., & Khabarova, T.Yu. (2016). Socio-psychological characteristics of patients with tuberculosis. Central Scientific Herald, 1(3), 11-13. (In Russ.)
  11. Enane, L.A., Eby, J., Arscott-Mills, T., Argabright, S., Caiphus, C., Kgwaadira, B. et al. (2020). TB and TB-HIV care for adolescents and young adults. The International Journal of Tuberculosis and Lung Disease, 24(2), 240-249. https://doi.org/10.5588/ijtld.19.0416
  12. Erokhin, V.V., Alekseeva, L.P., Martynova, M.V., & Kornilova, Z.K. (2014). Sociopsychological rehabilitation in former prisoners with tuberculosis concurrent with HIV infection. Tuberculosis and Lung Diseases, (6), 25-34. https://doi.org/10.21292/2075-12302014-0-6-25-34 (In Russ.)
  13. Fagundez, G., Perez-Freixo, H., Eyene, J., Momo, J.C., Biyé, L., Esono, T., … Herrador, Z. (2016). Treatment Adherence of Tuberculosis Patients Attending Two Reference Units in Equatorial Guinea. PLOS ONE, 11(9), e0161995. https://doi.org/10.1371/journal.pone.0161995
  14. Gurova, Ya.V., Udalova, T.Yu., Mordyk, A.V., Bagisheva, N.V., Rudenko, S.A., & Fefelov, I.D. (2016). Personal characteristics of patients with fibro-cavernous pulmonary tuberculosis. Medical and Social Expertise and Rehabilitation, 19(3), 143-148. https://doi.org/10.18821/1560-9537-2016-19-3-143-148 (In Russ.)
  15. Haslinda, N., & Hanafiah, M. (2017). Systematic review of factors associated with medication adherence among pulmonary tuberculosis patients. International Journal of Public Health and Clinical Sciences, 4(6), 31-45.
  16. Jakab, Zs., Acosta, C.D., Kluge, H.H., & Dara, M. (2015). Consolidated Action Plan to Prevent and Combat Multidrugand Extensively Drug-resistant Tuberculosis in the WHO European Region 2011-2015: Cost-effectiveness analysis. Tuberculosis, 95(1), S212-S216. https://doi.org/10.1016/j.tube.2015.02.027
  17. Kadyrov, R.V., Asriyan, O.B. & Kovalchuk, S. A. (2014). Oprosnik “Uroven komplayentnosti”. Vladivostok: Maritime State University Publ. (In Russ.)
  18. Kandrychyn, S.V. (2018). Psychosomatics of tuberculosis: bibliometric approach. Tuberculosis and Lung Diseases, 96(4), 63-67. https://doi.org/10.21292/2075-1230-2018-96-463-67 (In Russ.)
  19. Kim, H.W., & Kim, J.S. (2020). One Step toward a Low Tuberculosis-Burden Country: Screening for Tuberculosis Infection among the Immigrants and Refugees. Tuberculosis and Respiratory Diseases, 83(1), 104. https://doi.org/10.4046/trd.2019.0079
  20. Kryukova, T.L., & Kuftyak, E.V. (2007). Oprosnik sposobov sovladaniya (adaptatsiya metoMahindran, R., & Ahmad, Z. (2020). Contributing risk factors towards the prevalence of multidrug-resistant tuberculosis in Malaysia: A systematic review. Tuberculosis, 122, 101925. https://doi.org/10.1016/j.tube.2020.101925
  21. Mordyk, A.V., Udalova, T.Yu., Bagisheva, N.V., Gurova, Ya.V., & Rudenko, S.A. (2016). Sovershenstvovaniye vedeniya patsiyentov s fibrozno-kavernoznym tuberkulozom legkikh na osnove rezul'tatov psikhologicheskogo issledovaniya. Palliativnaya Meditsina i Reabilitatsiya, (4), 40-45. (In Russ.)
  22. Mordyk, A.V., Udalova, T.Yu., Sitnikova, S.V., Puzyreva, L.V., & Ledeneva, T.N. (2016). Lichnost patsiyenta TB/HIV. Dalnevostochny Meditsinsky Zhurnal, (1), 50-53. (In Russ.)
  23. Nikiforov, G.S. (2006). Psikhologiya Zdorovya. Saint Peterburg: Piter Publ. (In Russ.) Pascale, P. (2015). Human and tuberculosis co-evolution: An integrative view. Tuberculosis, 95(1), S112-S116. https://doi.org/10.1016/j.tube.2015.02.016
  24. Peltzer, K., Naidoo, P., Matseke, G., Louw, J., Mchunu, G., & Tutshana, B. (2012). Prevalence of psychological distress and associated factors in tuberculosis patients in public primary care clinics in South Africa. BMC Psychiatry, 12, 89. https://doi.org/10.1186/1471244X-12-89
  25. Ruiz-Grosso, P., Cachay, R., de la Flor, A., Schwalb, A., & Ugarte-Gil, C. (2020). Association between tuberculosis and depression on negative outcomes of tuberculosis treatment: A systematic review and meta-analysis. Public Library of Science ONE, 15(1). https://doi.org/10.1371/journal.pone.0227472
  26. Saint Petersburg V.M. Bekhterev Psychoneurological Research Institute. (2009). Metodika dlya psikhologicheskoy diagnostiki sposobov sovladaniya so stressovymi i problemnymi dlya lichnosti situatsiyami: Posobiye dlya Vrachey i Meditsinskikh Psikhologov. Saint Peterburg. (In Russ.)
  27. Saint Petersburg V.M. Bekhterev Psychoneurological Research Institute. (2007). Metodiki psikhologicheskoy diagnostiki bolnykh s endogennymi rasstroystvami. Usovershenstvovannaya meditsinskaya tekhnologiya. Saint Peterburg. (In Russ.)
  28. Seuk, P.J. (2018). The Prevalence and Risk Factors of Latent Tuberculosis Infection among Health Care Workers Working in a Tertiary Hospital in South Korea. Tuberculosis and Respiratory Diseases, 81(4), 274. https://doi.org/.4046/trd.2018.0020
  29. Shaip, K., Arianit, J., Armond, D., Bahri, T., Nora, J.-K., Mimoza, P., Valbona, Z., & Burim, N. (2017). Tuberculosis Treatment Adherence of Patients in Kosovo. Tuberculosis Research and Treatment, 2017, 1-8. https://doi.org/10.1155/2017/4850324
  30. Sherstneva, T.V., Skornyakov, S.N., Podgayeva, V.A., Sherstnev, S.V., & Kosova, A.A. (2015). Puti formirovaniya priverzhennosti lecheniya bol'nykh tuberkulezom. Uralsky Med. Zhurnal, (8), 112-116. (In Russ.)
  31. Streltsov, V.V., Zolotova, N.V., Baranova, G.V., Akhtyamova, A.A., Kharitonova, N.Y., & Vasilyeva, I.A. (2014). Specific features of psychological care for patients with pulmonary tuberculosis during intensive chemotherapy (in the hospital setting). Tuberculosis and Lung Diseases, (2), 22-27. (In Russ.)
  32. Tola, H.H., Garmaroudi, G., Shojaeizadeh, D., Shojaeizadeh, D., Tol, A., Yekaninejad, M. S., Ejeta, L.T., Kebede, A., & Kassa, D. (2017). The Effect of Psychosocial Factors and Patients’ Perception of Tuberculosis Treatment Non-Adherence in Addis Ababa, Ethiopia. Ethiopian Journal of Health Sciences, 2(5), 447-458. https://doi.org/10.4314/ejhs.v27i5.2
  33. Tunik, E.E. (2010). Psikhologicheskiye Zashchity. Testovaya Metodika. Saint Peterburg: Rech Publ. (In Russ.)
  34. Van den Boogaard, J., Boeree, M.J., Kibiki, G.S., & Aarnoutse, R.E. (2011). The complexity of the adherence-response relationship in tuberculosis treatment: Why are we still in the dark and how can we get out? Tropical Medicine & International Health, 16(6), 693-698. https://doi.org/10.1111/j.1365-3156.2011.02755.x
  35. Vasserman, L.I., Berebin, M.A., & Iovlev, B.V. (2014). Psikhologicheskaya diagnostika urovnya sotsialnoy frustrirovannosti. In L.I. Vasserman & O.Yu. Shchelkova (Eds.), Psikhologicheskaya Diagnostika Rasstroystv Emotsionalnoy Sfery i Lichnosti (pp. 187-213). Saint Petersburg: Skifiya-print Publ. (In Russ.)
  36. Vasserman, L.I., Karpova, E.B., Iovlev, B.V., & Vuks, A.Ya. (2014). Psikhologicheskaya diagnostika tipov otnosheniya k bolezni. In L.I. Vasserman & O.Yu. Shchelkova (Eds.), Psikhologicheskaya Diagnostika Rasstroystv Emotsionalnoy Sfery i Lichnosti (pp. 214-237). Saint Petersburg: Skifiya-print Publ. (In Russ.)
  37. Wurie, F.B., Cooper, V., Horne, R., & Hayward, A.C. (2017). Determinants of non-adherence to treatment for tuberculosis in high-income and middle-income settings: A systematic review protocol. British Medical Journal Open, 8, e019287. https://doi.org/10.1136/bmjopen2017-019287
  38. Zolotova, N.V., Baranova, G.V., Streltsov, V.V., Kharitonova, N.Y., & Bagdasaryan, T.R. (2019). Specific psychological features of new pulmonary tuberculosis patients in the context of psychotherapeutic care during in-patient treatment. Tuberculosis and Lung Diseases, 97(1), 18-24. https://doi.org/10.21292/2075-1230-2019-97-1-18-24 (In Russ.)
  39. Zolotova, N.V., Baranova, G.V., Streltsov, V.V., Kharitonova, N.Y., Bagdasaryan, T.R., & Polyakova, A.S. (2018). Changes in the course of tuberculosis in the patients with different psychological status. Tuberculosis and Lung Diseases, 96(7), 33-38. https://doi.org/10.21292/20751230-2018-96-7-33-38 (In Russ.)

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