CONTEXT: Patient-centric care recognizes the psycho-social needs of Tuberculosis (TB) patients. Integrating psycho-social interventions to improve the resilience of persons with TB and their caregivers during the TB care cascade is a need.
AIMS : We share the field experiences and outcomes of implementing a participatory patient-centric psycho-social intervention for persons with TB in a selected tertiary TB care facility in Tamil Nadu.
SETTINGS AND DESIGN : We used co-creation methods to develop a psycho-social intervention module based on the self-efficacy constructs used in chronic disease management. Participants consisted of persons with TB admitted to the Government Hospital of Thoracic Medicine, Tambaram, and their family caregivers.
METHODS AND MATERIAL: Participatory and game-based intervention (designated as Wings of Support sessions) was conducted in group mode (n =10-12) (both patients and caregivers) for 45-60 minutes once weekly. Each session focused on TB stigma, medication adherence, nutritional issues, unhealthy behaviors like alcoholism, stress, anxiety, and other related issues. Each session employed specific concepts and techniques involving motivation, goal setting, psychoeducation, problem-solving, mindfulness, normalization, behavioral activation, and cognitive coping.
RESULTS : Between March 2023 to January 2024, 44 sessions were conducted by healthcare providers and social workers on different themes related to TB disease, medication, and its management. A total of 450 persons with TB and their caregivers attended. Group Sessions related to TB stigma, nutrition, medication adherence, and family caregiving were co-created and implemented in an iterative and tailored manner by the study team, making it more adaptable and flexible. The intervention was found more receptive, and was perceived as highly relevant and useful by the participants, and in terms of techniques employed in the sessions, game-based activities, artistic recreation, and mindfulness techniques had the most acceptance and participation.
CONCLUSIONS : Post-intervention feedback highlighted the usefulness of Wings of Support sessions in improving their treatment resilience and helped identify potential TB champions. The intervention led to demand generation among other TB persons, caregivers, and healthcare workers in the same facility. Group-based participatory psycho-social interventions hold the potential to address a range of psycho-social and treatment needs of the person with TB and their caregivers in an efficient and program-friendly manner. The intervention is being proposed for evaluation in NTEP program settings using an experimental study design to test its efficacy