Psychosocial characteristics of tuberculosis patients in Russia and treatment compliance factors

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.