Self-Stigma as The Trigger of Depression Factor in Multidrug - Resistant Tuberculosis (MDR-TB) Patients at a Public Hospital in Gresik

Widya Lita Fitrianur, Wiwik Widiyawati, Ervi Suminar

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Introduction: Multidrug-Resistant Tuberculosis (MDR-TB) is a chronic infectious disease that can affect the patient's physical appearance so that it has an impact on the patient's psychosocial condition, including the emergence of anxiety and depression. Anxiety and depression in MDR-TB patients have an impact on the patient's rejection of the diagnosis and they choose to stop the treatment process. The incidence of anxiety and depression in MDR-TB patients is influenced by several factors, one of which is self-stigma. The purpose of this study was to determine the impact of the factor of self-stigma on the incidence of depression in MDR-TB patients.

Method: The study design used a cross-sectional approach with a sample of 71 MDR-TB patients undergoing treatment. The study used a questionnaire that was filled out directly by the patient during the treatment process. The sampling technique used purposive sampling by setting inclusion criteria. The bivariate statistical test used in the study was chi-square.

Results: The results of the self-stigma study obtained a p-value = 0.000 <0.05 with an OR value of 54.643, meaning that there was a significant relationship between self-stigma and depression in MDR-TB patients.

Conclusions: MDR-TB patients with high self-stigma have a higher chance of experiencing depression than patients with low self-stigma. Suggestions in this study are that it is hoped that the family, health workers, community, and government can help reduce the stigma against patients with MDR-TB. Promotive efforts by providing support and education to the community can help to eliminate the stigma so that the incidence of depression in MDR-TB patients can be minimized.


Self-stigma, Depression, Multidrug Resistant Tuberculosis (MDR-TB)

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Bhaware, G. M., Quazi, Z. S. & Muneshwar, M. S. 2014. Assessment Of Mental Status Of Mdr Patients In Wardha District Using Global Mental Health Assessment Tool-Primary Care Version. Journal Of Academia And Industrial Research (Jair), Vol. 3.

Campbell, D. G., Bonner, M. L., Bolkan, R. C., Lanto, B. A., Zivin, K., Waltz, J. T., Klap, R., Rubenstein, V. L. & Chaney, F. E. 2016. Stigma Predicts Treatment Preferences And Care Engagement Among Veterans Affairs Primary Care Patients With Depression. Pmc 50, 533-544.

Coreil, J., Mayard, G., Simpson, M. K., Lauzardo, M., Zhu, Y. & Weiss, M. 2010. Structural Forces And The Production Of Tb-Related Stigma Among Haitians In Two Context. Elsevier : Social Sciene & Medicine, 71, 1409-1417.

Corrigan, P. W. & Rao, D. 2012. On The Self-Stigma Of Mental Illness : Stage, Disclosure, And Strategies For Change. Can J Psychiatry, 57.

Costelloe, S., Kemppainen, J., Brion, J., Mackain, S., Reid, P., Frampton, A. & Rigsbee, E. 2015. Impact Of Anxiety And Depressive Symptoms On Perception Of Stigma In Persons Living With Hiv Disease In Rural Versus Urban North Carolina. Aids Care, 27, 1425-1428.

Cremers, A. L., Laat, M., Kapata, N., Gerrets, R., Grobusch, K. & Grobusch, M. 2015. Assesing The Consequences Of Stigma For Tuberculosis Patients In Urban Zambia. Plos One, 10.

Daftary, A. 2012. Hiv And Tuberculosis : The Constructuon And Management Of Double Stigma. Social Sciene & Medicine, 74, 1512-1519.

Faizah, U., Agiananda, F., Winarsih, S. N., Ginting, T. T., Isbaniah, F. & Elvira, D. S. 2016. Gangguan Psikiatri Pasien Tb-Mdr (Multi Drug Resistant) Dan Stres Psikososial Yang Memengaruhi Di Rsup Persahabatan. J Indon Med Assoc, Volum : 66, Nomor : 10.

Hasanah, U., Makhfudli, M., Nikmah, L., Efendi, F., Aurizki, Ge. 2019. Peer Group Support On The Treatment Adherence Of Pulmonary Tuberculosis Patients. Iop Conf. Series : Earth And Environmental Science 246 (2019 )

Holubova, M., Prasko, J., Matousek, S., Latalova, K., Marackova, M., Vrbova, K., Grambal, A., Slepecky, M. & Zatkova, M. 2016. Comparison Of Self-Stigma And Quality Of Life In Patients With Depressive Disorders And Schizophrenia Spectrum Disorders-A Cross-Sectional Study. Neuropsychiatric Disease And Treatment, 12, 3021-3030.

Jangid, V. K., Agrawal, K. N., Yadav, S. G., Pandey, S. & Mathur, B. B. 2016. Health-Seeking Behavior And Social Stigma For Tuberculosis In Tuberculosis Patients At A Tertiary-Care Center In North West India. International Journal Of Medical Science And Public Health, 5.

Javaid, A., Mehreen, S., Khan, A. M., Ashiq, N., Ihtesham, M., Khan, A., Ullah, I. & Basit, A. 2017. Depression And Its Associated Factors With Multidrug-Resistant Tuberculosis At Baseline. Journal Of Depression And Anxiety, 6.

Jong, K. D. 2011. Psychosocial And Mental Health Interventions In Areas Of Mass Violence. Second Edition Ed. Amsterdam: Rozenberg Publishing Services.

Lien, Y.-J., Chang, H.-A., Kao, Y.-C., Tzeng, N.-S., Lu, C.-W. & Loh, C.-H. 2018. Insight, Self-Stigma And Psychosocial Outcomes In Schizopherenia : A Structural Equation Modelling Approach. Epidemiology And Psychiatric Sciene, 27, 176-185.

Lubis, L., Sarumpaet, S. M. & Ismayadi 2016. Hubungan Stigma, Depresi Dan Kelelahan Dengan Kualitas Hidup Pasien Hiv/Aids Di Klinik Veteran Medan. Idea Nursing Journal, Vii.

Mulyono 2014. Faktor-Faktor Determinan Kejadian Multidrug Resistance Tuberculosis. Kesehatan Masyarakat.

Nahda, N. D., Kholis, F. N., Wardani, N. D. & Hardian 2017. Faktor-Faktor Yang Berpengaruh Terhadap Kejadian Depresi Pada Pasien Tuberkuloasis Di Rsup Dr. Kariadi Semarang. Jurnal Kedokteran Diponegoro, 6.

Nawas, A. 2010. Penatalaksanaan Tb Mdr Dan Strategi Dots Plus. Jurnal Tuberkulosis Indonesia, 7.

Oktamianti, P., Bachtiar, A., Sutoto, S., Trihandini, I., Prasetyo, S., Achadi, S., Efendi, F. 2021. Tuberculosis Control Within Indonesia's Hospital Accreditation. Journal Of Public Research ;10 : 1979

Peltzer, K., Naidoo, P., Matseke, G., Louw, J., Mchunu, G. & Tutshana, B. 2012. Prevalence Of Psychological Distress And Associated Factors In Tuberculosis Patients In Public Primary Care Clinics In South Africa. Bmc Psychiatry, 12.

Safitri, N. A. R., Huda, M. & Marhamah 2017. Gambaran Penderita Tuberculosis Multi Drug Resisten (Tb Mdr) Di Rsud Dr. H. Abdul Moeloek Provinsi Lampung Januari-Desember 2015. Jurnal Analisis Kesehatan, Volume 6, No. 2.

Seung, K. J., Franke, M. & Linton, W. S. 2016. Multidrug-Resistant Tuberculosis Treatment In North Korea : Is Scale-Up Possible? Plos Medicine.

Wardani, I. Y. & Dewi, F. A. 2018. Kualitas Hidup Pasien Skizofrenia Dipersepsikan Melalui Stigma Diri. Jurnal Keperawatan Indonesia, 21, 17-26.

Wohl, A. R., Galvan, H. F., Carlos, A. J., Myers, F. H., Garland, W., Witt, D. M., Cadden, J., Operskalski, E., Jordan, W. & George, S. 2012. A Comparison Of Msm Stigma, Hiv Sigma And Depression In Hiv-Positive Latino And African American Men Who Have Sex With Men (Msm). Springer Science, 17, 1454-1464.


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