"If you will counsel properly with love, they will listen": A qualitative analysis of leprosy affected patients' educational needs and caregiver perceptions in Nepal

Individual, socioeconomic and healthcare access factors influencing the delays in leprosy presentation, diagnosis and treatment: a qualitative study

BACKGROUND

This study investigated the factors influencing the presentation, diagnosis and treatment of leprosy in primary healthcare.

METHODS

Qualitative research was conducted on patients undergoing treatment in a priority hyperendemic region for leprosy control in northeastern Brazil. Interviews were conducted between September and December 2020 at primary healthcare centers. Data were analysed based on the basic interpretive qualitative structure according to Andersen and Newman's model of healthcare utilisation.

RESULTS

Knowledge of leprosy symptoms influenced patients' search for a diagnosis. Unfavorable socioeconomic conditions experienced by patients made diagnosis and treatment difficult. Incorrect evaluations by health professionals caused difficulties and delays in obtaining a diagnosis of leprosy. Perceptions about the disease, such as non-acceptance of the disease and the adverse effects of the medications, affected treatment seeking and treatment continuity.

CONCLUSIONS

Patients with leprosy faced delays and healthcare access barriers related to knowledge of the disease, socioeconomic conditions and the structure of healthcare services, which must be considered when creating care plans, surveillance and control actions against leprosy. Appropriate interventions are necessary to reduce delays and better control the disease.

Experiences of living with leprosy: A systematic review and qualitative evidence synthesis

OBJECTIVE

The objective of the review was to identify, appraise, and synthesise qualitative studies on the lived experience of individuals diagnosed with leprosy, the impact of the disease, and how they coped with the disease burden.

INTRODUCTION

Leprosy is a chronic disease with long-term biopsychosocial impact and is a leading cause of preventable disabilities. It traps the individuals with leprosy in a vicious circle of disease, stigma, and poverty. The efforts to reduce stigma and discrimination and improve their quality of life have not kept pace with the success of the multidrug treatment.

INCLUSION CRITERIA

This review considered published literature on the lived experience of individuals diagnosed with leprosy. There were no limitations on gender, background, or country. All qualitative or mixed-methods studies were accepted.

METHODS

The review followed the JBI meta-aggregation approach for qualitative systematic reviews. A structured literature search was undertaken using multiple electronic databases: PubMed, Embase, Web of Science, and CINAHL.

RESULTS

The search identified 723 publications, and there were 446 articles after deduplication. Forty-nine studies met the inclusion criteria. The final 173 findings were synthesised into ten categories and aggregated into four synthesised findings: biophysical impact, social impact, economic impact, and mental and emotional impact. These synthesised findings were consistent across the included studies from a patient's perspective. The way people coped with leprosy depended on their interpretation of the disease and its treatment. It affected their help-seeking behaviour and their adherence to treatment and self-care. The review has identified a multi-domain effect on the affected individuals, which goes beyond the biological and physical effects, looking at the social issues, specific difficulties, emotions, and economic hardships.

CONCLUSIONS

The researchers, health professionals, and policymakers could use the synthesised findings to address the concerns and needs of the leprosy-affected individuals and offer appropriate support to manage their lives.

SYSTEMATIC REVIEW REGISTRATION NUMBER

PROSPERO Registration number: CRD42021243223.

The Stress of Leprosy as a Mediator of the Relationship Between Coping Resources, Coping Strategies, and Psychological Well-Being in Persons Affected by Leprosy. The Structural Equation Models Through a Correlation Study

Intoduction

Psychological strength plays an important role in reducing stress due to leprosy because leprosy can cause physical, psychological, and social problems. For that reason, this study aims to investigate the relationship between coping sources, coping strategies, and psychological well-being through leprosy stress.

Methods

This research instrument uses a stress perception scale, coping sources, coping strategies, and psychological well-being scale to collect data from 125 participants consisting of women (33.60%) and men 66.40%. The test analysis in this study uses SmartPLS through structural equation modeling to prove the correlation.

Results

The results of the SEM test indicate that there is a negative relationship between coping resources and leprosy stress, with a coefficient value of (−0.380), p-value of (0.000) <0.05, and a positive relationship is obtained with psychological well-being with the coefficient value of (0.427), p-value of (0.000) <0.05. Meanwhile, the SEM test shows a negative relationship between coping strategies and stress of leprosy, with the coefficient of (−0.566), p-value of (0.000) <0.05, and a positive relationship is obtained with psychological well-being (0.355), p-value of (0.000) < 0.05. Furthermore, on psychological well-being, stress shows a negative relationship, with the coefficient of (−0.212), p-value of (0.002).

Discussion

Exploration of important coping sources is done to weaken the power of leprosy as a stressor and the use of effective coping strategies is needed to solve physical, psychological, and social problems for “People Affected by Leprosy”, and simultaneously these two attributes are used to achieve prosperity. psychological. better.

The life experience of leprosy families in maintaining interaction patterns in the family to support healing in leprosy patients in Indonesian society. A phenomenological qualitative study

Background

Family involvement in overcoming the severity of leprosy is very important in the life of leprosy sufferers in communities who experience the clinical and, psychological, social and behavioral consequences of the disease. However, this need, psychosocial, is felt to be not optimal. This study is to identify how the experiences of family members as caregivers provide assistance to individuals with leprosy in improving healing and maintaining patterns of interaction in the family.

Methods

The design uses qualitative research with in-depth, face-to-face interviews with family members in a semi-structured manner with the hope of obtaining complete data. Using purposive sampling with Participatory Interpretative Phenomenology analysis, there are 12 families with 15 family members consisting of 4 men and 11 women.

Results

This study produced a family theme that tried to follow what would happen to individuals with leprosy, with four sub-categories: 1) Using various coping alternatives to recognize the disease, 2) Family members in the shadow of leprosy, 3) Trying to empathize with other family members. sick, 4) Caring for the emotional response of the family and seeking support.

Conclusions

This analysis shows that deficiency in cognitive aspects can be closed by maintaining a lifestyle in the family through efforts to understand, support, establish communication, increase maximum involvement in restoring self-confidence, especially in individuals with leprosy with psychosocial problems in the family. The results of this study can be used as psychosocial support in maintaining communication between family members to support treatment programs and accelerate the recovery of leprosy.

Although families have high empathy for the physical, psychological, and social problems faced by individuals with leprosy, they are rarely involved in the personal affairs of individuals with leprosy, and there are indications that they left them to cure their disease. Meanwhile, overcoming problems in their own way without involving other family members, becomes the main choice for people with leprosy to avoid conflicts between family members, because they realize that leprosy is a disgrace in their family. However, the interaction between family members is an Indonesian culture that continues to be preserved. And for whatever reason, the culture of interaction between family members cannot be abandoned, even though there are obstacles that must be faced because this is a tool to strengthen kinship. The writer found that the family tried to help in healing leprosy suffered by their family members, even though they were in the shadow of leprosy. Through various coping strategies implemented, families try to help the healing process of their illness, with the hope that they will rise from adversity and have high motivation to recover. And restoring the confidence of people with leprosy is important to support a definitive treatment program.

COVID-19 in LMICs: The Need to Place Stigma Front and Centre to Its Response

COVID-19 has caused unprecedented health, economic and societal impacts across the world, including many low- and middle-income countries (LMICs). The pandemic and its fallout have laid bare deep-seated social and economic inequalities with marginalised groups being at greater risk of infection and being disproportionately affected by containment measures and their socioeconomic consequences. Stigma is a central element to such inequalities but remains largely overlooked in the debate on the response to COVID-19, including in LMICs. Yet we know from experiences with other infectious diseases such as HIV/AIDS and Ebola that disease-related stigma is detrimental to halting and controlling pandemics and achieving equitable development. Emerging evidence suggests that stigma associated with COVID-19 is already taking hold. This paper assesses potential driving factors of COVID-19-related stigma, and how this intersects with existing stigma fault lines and explores mechanisms through which COVID-19-related stigma may be counteracted, with a focus on LMICs.