Assessing psychological rehabilitation of leprosy patients discharged home in Abia and Ebonyi States of Nigeria

Amaç: Toplumda taburcu edieln lepralı hastaların hangi oranda psikolojik olarak rehabilite edildiğinin değerlendirilmesi amaçlandı. Lepra hastalarının taburcu olduktan sonra yaşadığı rekürren psikolojik hasar nedeniyle gelişlen red ve stresin azaltılması. Metod: Çalışmaya Nijerya'nın iki lepra yerleşkesinin bulunduğu Abia ve Ebony eyaletlerinde hastanede tedavi edildikten sonra evlerine taburcu edilen 33 hasta dahil edildi. Bu yerleşkelerden tanburcu edilen hasta listelerinden hastaların adresleri kaydedildi. Bulgular: Her iki cinste sonuçlar açısından bir farklılık yoktu.cinsiyet yaş ve evlilik durumu psikolojik rehabilityasyonu etkiliyordu. yüksek ortalama depresyon skoru olan erkekler (7.7±1.8) daha düşük ortalama depresyon skoru olan kadınlar (7.2±2.0) ile mukayese edildiğinde psikolojik olarak daha az rehabilite oldukları görüldü (t=22.9 p=0.00000). Çalışılan hastalar arasında, 40-49 yaşilarında, en az ortalama depresyon skoru 6.2±3.1 olan hastalar diğerlerine göre daha iyi psikolojik rehabilitasyon almışlardı (t=22.9, p=0.00000). Evli hastalar en düşük ortalama depresyon skoruna sahipti (5.8±1.5) ve diğerlerine göre gaha iyi şekilde psikolojik olarak rehabilite idi. Yalnızlık, depresyon ve izolasyon özellikle sızıntılı ülsere yarası olan hastalarda başta gelen şikayetleri oluşturmaktaydı. Sonuç: Yalnızlık, red depresyon ve diğer semptomları minimalize etmek için taburcu olan hastaların daha iyi bakım ve desteklenmelerinin sağlanması cesaretlendirilmelidir.

Nijerya'nın Abia ve Ebony eyaletlerinde evine taburcu edilen lepra hastalarının psikolojik rehabilitasyonlarının değerlendirilmesi

Aim: Study aimed to examine the extent to which discharged leprosy patients were psychologically rehabilitated in communities. This study intends to reduce rejection, distress and others, which discharged leprosy patients experience in communities due to recurrent psychological damage. Method: Study used all the 33 leprosy patients who were discharged home after being treated from the two leprosy settlements in Abia and Ebonyi States of Nigeria. The list of the discharged leprosy patients studied with their addresses was collected from these settlements. Result: There was no difference in the results recorded in both states. Sex, age and marriage affected psychological rehabilitation. Males with higher mean depression score 7.7±1.8 were less psychologically rehabilitated than females with lower mean depression scores 7.2±2.0 (t=22.9 p=0.00000). Among the patients studied, those aged 40-49 years, with the least mean depression score 6.2±3.1 were more psychologically rehabilitated than others (t=22.9, p=0.00000). Married patients had the least mean depression score 5.8±1.5 and were better psychologically rehabilitated than others. Loneliness, depression and isolation were noted as the main complaints of the patients especially those with leaking ulcers. Conclusion: To minimize loneliness, rejection, depression and others, increased care and support for discharged patients should be encouraged.

PDF

___

1. Bechelli LM, Dominguez V, Patwarry KM. WHO Epidemiological Random sample surveys of leprosy in Northern Nigeria (Katsina) Cameroon and Tailand (Khon Kaenn). Int J Lepr 1966:34 (3):223-53.
2. Becker G, Arnold R. Stigma as a social and cultural construct. In: Ainlay SC, Becker G Coloman LM eds. The dilemma of difference – a multidisciplinary view of stigma. New York, Plenum 1986:39-57
3. World Health Organization. The Final Push Towards Elimination of Leprosy: Strategic Plan 2000–2005. Document WHO/CDS/CPE/CEE/2000. 1. Geneva: WHO, 2000.
4. Cull JC, Hardy RE. Understanding the Psychological Aspects of Disability in Understanding Disability for social and Rehabilitation Services. Illinois: Thomas Springfield 1973.
5. Davey TF. Psychological Rehabilitation in Leprosy Settlements. J Leprosy (India) 1976;44:66.
6. Elissen MC. beliefs of leprosy patients about their illness. A study in province of South Sulawesi Indonesia. Trop Geogr Med 1991:43:379–82.
7. Goffman E. Stigma: Notes on the management of spoiled identity. New Jersey: Prentice Hall Inc. 1963.
8. Guttmann L. The married Life of Paraplegics and Tetraplegics. Paraplegia 1964:2:182-8.
9. Harknett S. Community based Rehabilitation and Concerns of Disabled People. International Newsletter on Commun Rehabil 1999:32:1–11.
10. Kelley E, Kelley AG, Simpara CH, Sidibe O, Makinen M. The impact of self-assessment on provider performance in Mali. Int J Health Plann Manage 2003;18:41–8.
11. Karat S. Preventive Rehabilitation in Leprosy. Lepr Rev 1968:39:39-44.
12. Kim YM, Rimon J, Winnard K. Improving the quality of service delivery in Nigeria. Stud Fam Plann 1992;23:118– 27
13. Lever P. Prevention of Impairment in Leprosy: Results from a Collaborative Project in China International. J Lepr 1995;63(4):507-17.
14. Lever P, Bijlmakers L, Zwanikken P, Saunderson R. Health systems Research in Leprosy control. What Contributions can it make? Lepr Rev 1998;69(2):122-7
15. Macaden VP. An Introduction to Community Based Rehabilitation in Leprosy. Partners Magazine for Paramedical 1996;30:3–5.
16. Neves MC, Puccineli B. Evolution View on the social Aspects of the Leprosy Problems. Int J Lepr 1973;41(4):588
17. Oliveira M H. The Effects of Leprosy on Men and Women: A Gender Study. Gender Tropical Dis 1997;4:1–9.
18. Pimpawun B. ‘Khi Thut’ The Disease of Social Loathing: An Anthropological Study of the Stigma of Leprosy in Rural North East Thailand. Social and Economic Research Project Report 1994;16:1-45.
19. Pfuhl EH. The deviance process. Belmont, California, Wadswerth.First, T.A. A study of Community Attitudes and knowledge in Relation to Leprosy. Hansen International 1986:1;184-90
20. Rotherge A. The Name “Leprosy” was the Principal Cause of failure in Health Education. International Journal of Leprosy 1974;42(1):107–8.