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Perceotion of Tuberculosis among early diagnosed patient

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					Indian Journal of Community Medicine Vol. 31, No. 3, July-September, 2006

Patient Perception of Illness and Initial Reaction To The Diagnosis of Tuberculosis
U Eram, I A Khan, Md Z Tamanna, Z Khan, N Khaliq, A J Abidi Introduction Tuberculosis like other chronic infection needs treatment for prolonged period. It also carries social stigma and results in adverse psychological reaction1. A wrong perception of illness can create social stigma and panic in the community. Lack of awareness or incorrect knowledge about disease, might lead to harboring of wrong belief and misconception about various aspects of disease, which may affect the timely reporting, and poor compliance. Present study was conducted to ascertain the initial reaction to the diagnosis of tuberculosis. Material And Methods The present study was conducted on patients attending tuberculosis clinic under Rural and Urban Health Training Centre of JN Medical College, Aligarh. The present study includes 100 patents attending health centre and were put on ATT. They were interviewed with Hindi version of the “short explanatory model interview2” to assess psychiatric morbidity and patients perception of their illness respectively. They were interviewed about, psychological effect and initial reaction on disclosure of diagnosis of tuberculosis. The diagnosis of psychiatric disorder was made according to international classification of disease 10 (1CD-10) primary criteria for psychiatric diagnosis. Results Out of 100 patients 56 were males and 44 were females. The initial reaction to the diagnosis was negative in majority of the respondents. Only 18% of them were hopeful of cure, 30% had anxiety or tension while 26% had loss of interest from life or depression. 6% of patient denied the diagnosis while 20% of them could explain how they felt (Table-I). The negative reaction like tension and depression were more common in less educated patients. Similarly this negative reaction was also more prevalent in low socio economic class compare to educated and higher socio-economic class.
Table I : First Reaction of Patients to Tuberculosis. Reaction Tension/Anxiety Hopeful of cure Loss of interest from life/ depression Denied the diagnosis Cannot explain Male (n=56) 18 10 13 04 09 Female (n=44) 12 08 13 02 11 Total/%age 30 18 26 06 20

Discussion Tuberculosis is a disease both of individual and society. The patient suffering from tuberculosis shows a higher degree of psychiatric morbidity3,5. The patient develops psychiatric reaction such as denial, hopelessness about life, tension/ anxiety and are neglected by family and society. In our study we found that initial reaction to the diagnosis was negative in the larger proportion of respondent that includes anxiety/ tension, loss of interest or depression etc. In other studies 59% had fear of death, worry, tension etc. and E. Manoharan4 had observed one fifth of the subject has psychiatric morbidity. 75% of tuberculosis patients in a study had psychiatric illness with mixed anxiety and depression as the commonest. It was found that literacy and good socioeconomic condition has positive effect. Patients belonging to higher educated class and higher socioeconomic class were more hopeful of cure. So there is need to create awareness in the community on various aspects of disease and misconception has to be solved. Health education is critical component to reinforce positive attitude and eliminate negative one. References
1. Dubey K K, Bhasin S K, MS Psychological reactions amongst patients, their family members and the community regarding hospitalized tuberculosis patients in Delhi. Psychiatry Today II: 30-33, 1998. Kleinman A. patients and healers in the context of culture a exploration of borderland between anthroipology, medicine psychiatry. University of California Press, Berkeley, 1980. Beena Thoms, D. Survanarayan and Sudha Ganapathy – Treatment compliance in relation to sources of referral and initial relation to the diagnosis of tuberculosis. Ind J Tub, 1999. 46: 179 – 182. E Manoharan, K R John, A Joseph and K S Jacob – Psychiatric morbidity, Patients perspectives of illness and factors associated with poor medication compliance among the tuberculosis in Vellore, South India. Ind J Tub, 2001 48: 77 – 80. M S Bhatia, S K Bhasin, K K Dubey and Narendra Singhi – Pschyiatric morbidity in Tuberculosis patients. Indian Medical Gazette, 2000, 134: 5-6, January.

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Deptt of Community Medicine, J.N. Medical College, AMU, Aligarh. Email : zikitam@rediffmail.com Received : 28.04.05
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Patient Perception Of Tuberculosis


				
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