Original Research Paper

Assessment Of Quality Of Life, Self-esteem And Psychiatric Morbidity In Patients Of Pulmonary And Extra-pulmonary Tuberculosis

Abstract :

INTRODUCTION: Tuberculosis being a highly infectious disease due to aerosol transmission is associated social stigma, marginalization and discrimination which lead to psychiatric burden, low self-esteem and poor quality of life. Psychiatric illnesses such as anxiety or depression can occur as co-morbidities in TB patients and may negatively influence quality of life and therapeutic results. However, the magnitudes of distress and psychological interventions and their effect on treatment outcomes are often undervalued and have not been adequately evaluated. Hence, besides routine clinical, microbiological and radiological assessment, a oader evaluation of the patient's overall health profile is necessary.MATERIAL & METHODS:A hospital based, single observer, cross-sectional study, after clearance from institutional ethical board conducted over a period of 3 months involving 100 patients of Tuberculosis attending the Pulmonary Medicine OPD . Demographic profile i.e. age, gender, occupation, education, socio-economic status (according to kuppuswamy scale), housing , any past/family history TB, Clinical type of Tuberculosis (PTB/EPTB) and drug resistance(MDR/non-MDR TB) were noted in case record sheet. The QoL, self worth and psychiatric morbidity were assessed using WHOQoL-BREF index, Rosenberg Self-Esteem Scale and Brief Psychiatric Rating Scale at the start of treatment, at 2 month follow-up and at the end of DOTS treatment.RESULT: 68% patients had extremely severe to very severe negative impact on quality of life whereas 32% subjects had moderate to mild impairment of quality of life. 43% subjects had low self esteem and 5% had marked psychiatric burden, 40% had moderate, 35% had mild and 20% had very mild psychiatric illness due to tuberculosis.Clinico-demographic factors that significantly affected the psycho-social burden were positive family history of tuberculosis and drug resistant TB.Conclusion: Treatment should not only target clinical and microbiological cure but instead a holistic approach with counseling and patient support should adopted for better outcome.

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