Sahasrabudhe Tushar, Nilgiri K Mithun
Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, IND.
Cureus. 2024 Sep 19;16(9):e69694. doi: 10.7759/cureus.69694. eCollection 2024 Sep.
Background This study chronicles the socioeconomic and emotional challenges experienced by patients suffering from drug-resistant tuberculosis (DR-TB) in India, the country with the highest tuberculosis (TB) burden globally. Current government measures under the National TB Elimination Programme (NTEP) that include widely available molecular diagnostic methods, well-defined DR-TB regimens, free drug distribution, treatment adherence strategies, etc. need to expand to cover socioeconomic and emotional aspects of the disease. Objective The objective of this study was to assess the effects of DR-TB and its treatment on the quality of life of patients in the psychological, social, environmental, and physical domains using validated scales. Method Conducted at a tertiary care center in Pune, this quantitative study utilized the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire to objectively assess the quality of life of 64 DR-TB patients. The questionnaire was self-administered but assisted by the investigator to understand the meaning of the questions, and it covered four domains: psychological, social, environmental, and physical. Results The results indicated significant psychological distress, with the psychological domain scoring the lowest mean (33.41), followed by social (35.52), environmental (41.27), and physical domains (41.88). These findings underscore the profound impact of DR-TB on the mental health, social interactions, and overall well-being of these patients. Furthermore, substantial employment challenges, financial constraints, and fears of disease transmission were prevalent among patients, highlighting socioeconomic disparities. Conclusion The study emphasizes the necessity of holistic interventions that include psychological support, socioeconomic empowerment, and public health campaigns to improve the quality of life and treatment adherence for DR-TB patients. Future research should explore integrated care models that address both the clinical and psychosocial needs of patients. The insights from this study suggest a need for policy enhancements and resource allocation to better support this vulnerable population, ultimately aiming for more comprehensive and sustainable DR-TB management, thus focusing not only on the outcome but also on morbidity.
背景 本研究记录了印度耐药结核病(DR-TB)患者所经历的社会经济和情感挑战,印度是全球结核病负担最重的国家。当前国家结核病消除计划(NTEP)中的政府措施,包括广泛可用的分子诊断方法、明确的耐多药结核病治疗方案、免费药物分发、治疗依从性策略等,需要扩展至涵盖该疾病的社会经济和情感方面。目的 本研究的目的是使用经过验证的量表,评估耐多药结核病及其治疗对患者在心理、社会、环境和身体领域生活质量的影响。方法 这项定量研究在浦那的一家三级护理中心进行,利用世界卫生组织生活质量量表(WHOQOL-BREF)问卷客观评估64例耐多药结核病患者的生活质量。问卷由患者自行填写,但由研究者协助理解问题含义,问卷涵盖四个领域:心理、社会、环境和身体。结果 结果表明存在明显的心理困扰,心理领域得分最低,平均分为33.41,其次是社会领域(35.52)、环境领域(41.27)和身体领域(41.88)。这些发现强调了耐多药结核病对这些患者心理健康、社会互动和整体幸福感的深远影响。此外,患者中普遍存在大量就业挑战、经济限制以及对疾病传播的恐惧,突出了社会经济差距。结论 该研究强调了采取综合干预措施的必要性,包括心理支持、社会经济赋权和公共卫生运动,以提高耐多药结核病患者的生活质量和治疗依从性。未来的研究应探索综合护理模式,以满足患者的临床和心理社会需求。本研究的见解表明需要加强政策和资源分配,以更好地支持这一弱势群体,最终目标是实现更全面和可持续的耐多药结核病管理,不仅关注治疗结果,还关注发病率。