Abstract:

Objective The mental health status and its influencing factors of multidrug-resistant pulmonary tuberculosis (MDR-PTB) patients were investigated and analyzed by questionnaire, so as to provide scientific basis for improving the mental health level of patients. Methods From January 2012 to June 2018, 316 MDR-PTB patients admitted to Sanya Central Hospital, Sanya People’s Hospital and Sanya Hospital of Traditional Chinese Medicine were investigated with Symptom Checklist-90 (SCL-90), including 9 factors of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoia and psychosis. Three hundred and sixteen questionnaires were sent out and 308 qualified questionnaires were finally collected, with a qualified rate of 97.5%. Logistic regression analysis were used to analyze the univariate and multivariate variables influencing mental health of MDR-PTB patients. Results Anxiety, depression, paranoia and fear were the most common negative psychology in MDR-PTB patients, accounting for 43.5% (134/308), 40.6% (125/308), 16.9% (52/308) and 9.7% (30/308), respectively. Among 308 MDR-PTB patients, 225 had negative psychology (poor mental health group), 83 had no negative psychology (good mental health group).The total average score of SCL-90 in poor mental health group(1.83±0.68)was higher than that in the good mental health group(1.20±0.26), the difference was statistically significant (t=5.317,P<0.05). Univariate analysis showed that in the group with poor mental health, 61.8% (139/225) were married, 34.2% (77/225) lived alone, 65.3% (147/225) had average or poor sleep quality, 63.6% (143/225) had income less than 30000/year, 61.3% (138/225) had tuberculosis cavities, 57.8% (130/225) had adverse reactions to anti-tuberculosis drugs, 64.0% (144/225) had no improvement in the treatment effect, which compared with (74.7% (62/83), 19.3% (16/83), 45.8% (38/83), 37.3% (31/83), 34.9% (29/83), 74.7% (62/83), 42.2% (35/83)) in the group with good mental health, and the differences were statistically significant (χ ²=4.465,P=0.035;χ ²=6.425,P=0.011;χ ²=9.661,P=0.002;χ ²=16.942,P<0.001;χ ²=17.017,P<0.001;χ ²=7.394,P=0.007;χ ²=11.872,P=0.001). Logistic regression analysis showed that sleep quality was average or poor (OR=2.813, 95%CI: 1.718-6.529,P=0.018), income was less than 30000/year (OR=2.390, 95%CI: 1.604-5.748,P<0.001), tuberculosis cavity (OR=1.975, 95%CI: 1.416-4.530,P=0.037), adverse reactions to antituberculosis drugs (OR=3.517, 95%CI: 2.135-8.762,P=0.024) and no improvement in treatment (OR=6.113, 95%CI: 4.835-16.204,P=0.006) were risk factors affecting mental health of MDR-PTB patients. Conclusion The mental health of MDR-PTB patients is poor, and the risk factors affecting their mental health are average or poor sleep quality, economic income less than 30000/year, tuberculosis cavity, adverse reactions of anti-tuberculosis drugs and no improvement in treatment. Psychological support and care for MDR-PTB patients should be strengthened.

Key words: Tuberculosis,pulmonary, Tuberculosis,multidrug-resistant, Health status indicators, Questionnaires, Outcome assessment (health care), Factor analysis,statistical