Analysis Of Psychological Adjustment Based On The Kumpher Resilience Framework In Tuberculosis Patients

Objective:to explore the level of the psychological distress and post-traumatic growth of tuberculosis patients, and the association among stigma, perceived stress, individual’s interpersonal resilience factors and psychological distress and post-traumatic growth, so that we can provide the scientific theoretical foundation for improving the mental health problem of tuberculosis patients from the perspective of positive psychology.Methods:According to the convenient sampling method,325 tuberculosis patients were recruited from Shandong chest hospital. General Information Questionnaire, Kessler Psychological Distress Scale (K10 scale), Post-traumatic Growth Inventory (PTGI), The Perceived Stress Scale (PSS-10), Positive and Negative Affect Scale (PANAS), Internality, Powerful Others, and Chance Scale (IPC), Self-Esteem Scale (SES) were used to explore the level of psychological distress and post-traumatic growth, perceived stress and individual’s interpersonal resilience factors. SPSS 19.0 software was used for statistical analysis including descriptive statistics, ANOVA, t test, Pearson correlation analysis and multiple hierarchical regression analysis. Amos 22.0 was used to execution Path Analysis predicting patients’psychological adjustment.Results:1. Demographic characteristics and clinical informationThe mean age of tuberculosis patients were (35.86±16.46), ranging from 18 to 88 years; 60.9% of the patients were male,61.2% were married; the average time since TB diagnose was (7.31±17.59) years, ranging from 0 to 228 months; 88.9% of patients did not have family history of tuberculosis,76.3% did not contact with other tuberculosis patients,81.8% were primary diagnose patients,92.6% had tuberculosis symptoms at this moment, and 33.5% were influenced by the drug side effects after taking medicine.2. The scores of K10 in tuberculosis patients and its differences in socio-demographic and clinical factorsThe average score of K10 was (18.39±6.08),62.8% of patients were considered affected by psychological distress. The results of the t-tests and ANOVAs showed that the K10 scores differed significantly in terms of job, therapeutic category, current tuberculosis symptoms and drug side effects (P<0.05).3. Analysis on influence factors of psychological distress in tuberculosis patientsThe multiple hierarchical linear regression analysis showed that stigma (β=0.207, P<0.001), perceived stress (β=0.321, P<0.001), self-esteem (β=-0.198, P<0.001) and negative affect (β=-0.346,P<O.001) had significantly predictive effect on psychological distress. Path analysis showed that perceived stress might have an effect on psychological distress through self-esteem, meanwhile perceived stress and stigma might impact on psychological distress through negative affect.4. The scores of PTG in tuberculosis patients and its differences in socio-demographic and clinical factorsThe average score of PTG was (61.10±20.13),48% of patients were considered to have post-traumatic growth. The results of the t-tests and ANOVAs showed that the PTG scores only differed significantly with respect to family history of tuberculosis (P<0.05).5. Analysis on influence factors of PTG in tuberculosis patientsThe multiple hierarchical linear regression analysis showed that perceived stress (β=0.202, P<0.001), self-esteem (β=0.252, P<0.001), powerful others (β=-0.163, P<0.05) and positive affect (β=0.557, P<0.001) had significantly predictive effect on PTG. Path analysis showed that self-esteem might have an impact on PTG through positive affect, meanwhile perceived stress might affect on PTG through self-esteem and positive affect.Conclusions:1. The tuberculosis patients generally suffer from psychological distress. Meanwhile, they may generate different level of PTG.2. Stigma, perceived stress, self-esteem and negative affect are the important influence factors of psychological distress. Perceived stress might have an impact on psychological distress through self-esteem, meanwhile perceived stress and stigma might have an effect on psychological distress through negative affect.3. Perceived stress, self-esteem, powerful others and positive affect are the important influence factors of PTG. Self-esteem might have an effect on PTG through positive affect, meanwhile perceived stress might affect on PTG through self-esteem and positive affect.