An integrated treatment approach including an obligatory component of psychological support to patients with tuberculosis in the anti-tuberculosis medical organizations of the Samara region

Abstract

Aim to implement a comprehensive approach to treatment of patients with tuberculosis in anti-tuberculosis medical organizations. Material and methods. Fifty-two patients and fourteen employees took part in the study. For psychodiagnostics, we used the "TOBOL" questionnaire, the diagnostics of professional "burnout" by K. Maslach, S. Jackson, the Wheel of Life concept by Paul J. Meyer. The data was analyzed using Mann Whitney U-test, Wilcoxon signed rank test. Results. The older patients had a tendency for excessive vigilance and aggressiveness in their attitude to the disease. The harmonious and anosognostic types of attitude to the disease were prevalent in patients with permanent employment. The medical workers demonstrated a high level of emotional burnout. The training aimed at prevention of burnout was the part of the study. After the training, the registered values of emotional exhaustion were reduced by 7 points, the depersonalization score shifted from high to average, the reduction of personal achievements score raised by 5 points. Conclusion. The age and social status can influence the type of attitude towards tuberculosis. Patients under 40 years of age with permanent employment have a more favorable prognosis of adherence to treatment and persistent clinical cure of tuberculosis. The introduction of an integrated approach to the provision of medical care with the mandatory presence of psychological support is relevant and necessary. This study substantiates the expediency of creating a psychological assistance office in a medical organization.