Khanal, Sudeepa, Elsey, Helen orcid.org/0000-0003-4724-0581, King, Rebecca et al. (3 more authors) (2017) Development of a Patient-Centred, Psychosocial Support Intervention for Multi-Drug-Resistant Tuberculosis (MDR-TB) Care in Nepal. PLoS ONE. e0167559. ISSN 1932-6203
Abstract
Multi-drug-resistant tuberculosis (MDR-TB) poses a major threat to public health worldwide, particularly in low-income countries. The current long (20 month) and arduous treatment regime uses powerful drugs with side-effects that include mental ill-health. It has a high loss-to-follow-up (25%) and higher case fatality and lower cure-rates than those with drug sensitive tuberculosis (TB). While some national TB programmes provide small financial allowances to patients, other aspects of psychosocial ill-health, including iatrogenic ones, are not routinely assessed or addressed. We aimed to develop an intervention to improve psycho-social well-being for MDR-TB patients in Nepal. To do this we conducted qualitative work with MDR-TB patients, health professionals and the National TB programme (NTP) in Nepal. We conducted semi-structured interviews (SSIs) with 15 patients (10 men and 5 women, aged 21 to 68), four family members and three frontline health workers. In addition, three focus groups were held with MDR-TB patients and three with their family members. We conducted a series of meetings and workshops with key stakeholders to design the intervention, working closely with the NTP to enable government ownership. Our findings highlight the negative impacts of MDR-TB treatment on mental health, with greater impacts felt among those with limited social and financial support, predominantly married women. Michie et al's (2011) framework for behaviour change proved helpful in identifying corresponding practice- and policy-level changes. The findings from this study emphasise the need for tailored psycho-social support. Recent work on simple psychological support packages for the general population can usefully be adapted for use with people with MDR-TB.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 Khanal et al. |
Keywords: | Adult,Aged,Antitubercular Agents/adverse effects,Female,Focus Groups,Humans,Male,Middle Aged,Nepal,Patient Education as Topic,Patient-Centered Care/methods,Psychosocial Support Systems,Surveys and Questionnaires,Tuberculosis, Multidrug-Resistant/drug therapy,Tuberculosis, Pulmonary/drug therapy,Young Adult |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Hull York Medical School (York) |
Depositing User: | Pure (York) |
Date Deposited: | 09 May 2019 13:50 |
Last Modified: | 16 Oct 2024 15:41 |
Published Version: | https://doi.org/10.1371/journal.pone.0167559 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1371/journal.pone.0167559 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:145883 |
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Filename: journal.pone.0167559.pdf
Description: Development of a Patient-Centred, Psychosocial Support Intervention for MultiDrug-Resistant Tuberculosis (MDR-TB) Care in Nepal
Licence: CC-BY 2.5