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Psychosocial support for TB, DR-TB Patients

  • Describe psychosocial support for the patient
  • Identify type of support available to DR-TB patients
  • Describe how to avoid stigma and discrimination

What is Psychosocial Support?

  • Psychosocial support means the way we take care of one another. It is about building a relationship of respect and acceptance where the dignity of people is strengthened.
    • Psycho: meaning psychological or to do with the mind, thoughts, feelings and emotions.
    • Social: about relationships and connections with people and the society we live in.
    • Support: ways of caring for a person and assisting them in difficult circumstances.
  • Psychosocial support addresses the ongoing psychological and social problems of individual patients, their partners, families and caregivers.

Rationale for Providing Psychosocial Support

  • Chronic disease condition
  • In Hospital based treatment, staying away from home or family for a long time
  • Loss of job or business
  • Stigma and discrimination
  • Daily intake of medicines with side effects for prolonged period
  • Co-morbidities

Stigma and Discrimination: Implications for DR-TB Response

  • What is Stigma?
  • Stigma is a powerful and shame and disapproval social label that radically and negatively affects the way individuals  view themselves or the way others view the individual
  • To stigmatise is to label someone, to see them as inferior because of an attribute that they have
  • Stigma is rooted in both fear and ignorance.
  • What is Discrimination?
    • The practice of treating one person or group of people less fairly or less well than other people or group because of prejudice about race, ethnicity, age, religion, or gender.
    • Persons infected and affected by TB, DR-TB may face discrimination as a result of their health condition

Types of Stigma

  • Self Stigma
    • self-hatred, shame, blame people
    • feel they are being judged by others so they isolate themselves
    • Clients who practice “self-stigma” isolate themselves from their families and communities
  • External Stigma: The judgemental words used on TB, DR-TB patients and also the negative attitudes shown them by the society, community or immediate families
  • Felt Stigma

Perceptions or feelings towards client

Causes of Stigma

  • The main causes of stigma include:
    • Insufficient knowledge, disbeliefs and fears about
      1. How TB is transmitted
      2. Fears about death and disease
      3. Intolerance
      4. Cultural/religious beliefs
      5. Terminologies – Mind your language !

Types of Psychosocial Support

  • Food
  • Shelter
  • Clothes
  • Security
  • Relationships
  • Referrals

Ways of Offering Psychosocial Support

  • Show respect and care for the patient
  • Help them to deal with difficult feelings, and cope with ’bad’ experiences.
  • Assess what mental health and supportive services are available at both the governmental and non-governmental level in order to refer patients when the need arises
  • the needs of individual patients and affected family members can be provided from the group in the community level community level
  • Establish linkages with relevant organizations for psychosocial support and services for your clients/patients
  • Any case beyond your knowledge, refer to someone with more specialized qualifications, e.g. a registered counselor, a social worker or psychologist.
  • Try to see, hear, think and feel what the unique needs of a patient at particular time might be such as:
  • Showing respect to the patient
  • Listening to a patient tell his/her story
  • Noticing the strengths of a patient
  • Providing encouragement
  • Letting a patient be honest about their feelings without judgment
  • Telling a patient stories that help them understand their situation more
  • Helping a patient join a sports group, social group, support groups or any hobby group
  • Joining in cultural activities like singing, dancing, attending Mosque or church, etc.

Qualities of a good Provider of Psychosocial Support

  • Friendly and approachable
  • Non-judgmental
  • Works for the best interests of a patient, family or community
  • Warm disposition
  • Show respect for individuals, families and communities and their beliefs.
  • Aware of the limitations of our knowledge and training
  • Work in the best interests of an individual, family or community
  • Respect the autonomy of people we work with.
  • Accepts the patient the way she/he is
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