Social Support and Depression Among Pulmonary Tuberculosis Patients in Anhui, China

Abstract

Xue-Hui Fang,1,2,* Qian Wu,3,* Sha-Sha Tao,4,* Zhi-Wei Xu,5 Yan-Feng Zou,4 Dong-Chun Ma,1,2 Hai-Feng Pan,4 Wen-Biao Hu6 1Anhui Provincial Chest Hospital (Anhui Institute of Tuberculosis Control), Hefei, Anhui, 230022, People’s Republic of China; 2Anhui Provincial Chest Hospital Affiliated to Anhui Medical University, Hefei, Anhui, 230022, People’s Republic of China; 3Department of Tuberculosis Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, People’s Republic of China; 5School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, 4006, Australia; 6School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia*These authors contributed equally to this workCorrespondence: Hai-Feng Pan, Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, People’s Republic of China, Tel [phone], Fax [phone], Email [email protected] Wen-Biao Hu, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia, Email [email protected]: Pulmonary tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis affecting multiple tissues and organs. It is one of the leading causes of death and is a social disease in China. Increasing studies have revealed that the state of mental health and the social support are associated with the morbidity, mortality and community transmission of pulmonary TB patients. However, the previous global TB control and research strategy focused almost solely on the biomedical aspects. Therefore, in this study, we evaluated the level of depression and explored potential factors, including social support domains and socio-demographic characteristics in pulmonary TB patients to research the mental health state and the association between social support and pulmonary TB, ultimately implementing a multilevel intervene.Methods: A cross-sectional study was carried out to describe the status of depression and social support, and explore related factors associated with depression among pulmonary TB patients in Anhui Province, China. Five counties (districts) in Anhui Province, China were selected by simple random sampling method. Patients diagnosed with pulmonary TB eligible to the study criteria were investigated. A structured questionnaire composed of information on socio-demographic characteristics, self-rating depression scale (SDS) and social support rating scale (SSRS) was used to collect the data.Results: In this study, a total of 250 questionnaires were issued, and the effective questionnaires 237 were actually returned. Of the 237 patients with pulmonary TB, 71.3% of them were male and the mean age was 46.16 years (SD = 13.09). Depression symptoms were observed in 125 (52.7%) participants. Objective support (β = − 0.192, P=0.002) and subjective support (β = − 0.158, P = 0.015) had significantly negative effects on depression, while the effect of support utilization was not statistically significant. In contrast, being female (β = 0.119, P = 0.036) and patients with positive sputum smear results (β = 0.140, P = 0.014) were positively related to depression. Patients with monthly income between 500 and 999 were less likely to suffer from depression (β = − 0.134, P = 0.024) than those who were poorer. Additionally, both education level and marital status were found to be correlated with social support and depression state (all P< 0.05).Discussion: In summary, the prevalence of depressive symptoms in pulmonary TB patients were high in Anhui Province, China. Low levels of social support can be an important predictor of depression symptoms. Therefore, screening for depression among pulmonary TB patients in the primary care setting is greatly warranted. Furthermore, psychological interventions should focus on providing available and adequate social support in order to improve mental health of them.Keywords: pulmonary tuberculosis, mental health, depression, social support, epidemiology

Keywords

• pulmonary tuberculosis
• mental health
• depression
• social support
• epidemiology