title: Psychosocial trauma of diagnosis: a qualitative study on rural TB patients' experiences in Nalgonda district, Andhra Pradesh.
abstract: BACKGROUND
  The current tuberculosis (TB) control strategy in India largely ignores psychosocial needs of the patients. The present study was prompted by the recognition that, if TB treatment is to be culturally sensitive and effective, the psychosocial problems and issues need to be recognized and addressed.
  
  
  OBJECTIVE
  The main aim of this study was to explore psychosocial problems and issues among rural patients being diagnosed with TB.
  
  
  METHODS
  110 respondents who had known about their TB diagnosis less than two months prior to conducting the interviews were recruited purposively from two selected rural TB units at Yadagirigutta and Chintapally in Nalgonda district in Andhra Pradesh (A.P.). Semi-structured interview schedule was used for the collection of primary data. A qualitative content analysis method was employed to analyze and interpret the data. Data analysis was carried out following multi-step procedure that consisted of data reduction, coding and identification of dominant themes.
  
  
  RESULTS
  The diagnosis of TB was generally seen as a shocking and demoralizing experience, and raised a host of social and psychological problems among the patients. Six prominent themes emerged from the in-depth interviews with the respondents: i) worry, ii) disbelief, iii) embarrassment, iv) fear of death, v) fate, and vi) relief.
  
  
  CONCLUSIONS
  Effective care for TB requires a much broader approach beyond focusing on anti-tuberculosis drugs and diagnostic techniques. For medical care to be most effective and acceptable to patients, general practitioners should treat both illness and disease in their patients at the same time. Knowledge of the nature of psychosocial problems is crucial for the design of new approaches and methods to improve the quality of life of TB patients.
authors.affiliation: Tata Institute of Social Sciences, Hyderabad (Andhra Pradesh), India. venkatrajubojja@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: Venkatraju
authors.forename: Sheela
authors.initials: S
authors.lastname: Prasad
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012424:Rural Population; D012938:Social Perception; D012944:Social Support; D014342:Truth Disclosure; D014376:Tuberculosis / Q000175:diagnosis / Q000523:psychology*