RUDN Journal of Psychology and PedagogicsRUDN Journal of Psychology and PedagogicsВестник Российского университета дружбы народов. Серия: Психология и педагогика2313-16832313-1705Peoples’ Friendship University of Russia named after Patrice Lumumba (RUDN University)2411110.22363/2313-1683-2020-17-2-330-347CLINICAL PSYCHOLOGY IN CULTURAL DIMENSIONКЛИНИЧЕСКАЯ ПСИХОЛОГИЯ В КРОСС-КУЛЬТУРНОМ ИЗМЕРЕНИИResearch ArticlePsychosocial characteristics of tuberculosis patients in Russia and treatment compliance factorsПсихосоциальные характеристики больных туберкулезом в России и факторы формирования приверженности лечениюZahkarovaElena V.ЗахароваЕлена ВладимировнаPh.D., Associate Professor, is Head of the Department of General Psychology and Social Workкандидат медицинских наук, доцент, заведующая кафедрой общей психологии и социальной работыproscha1088@mail.ruFilshtinskayaElena G.ФильштинскаяЕлена Геннадьевнаsenior lecturer of the Department of General Psychology and Social Workстарший преподаватель кафедры общей психологии и социальной работыfil-alena@rambler.ruSamara State Medical University of the Ministry of Health of the Russian FederationСамарский государственный медицинский университет Министерства здравоохранения Российской Федерации15122020172PERSONALITY AND CHALLENGES OF MODERN SOCIETYЛИЧНОСТЬ И ВЫЗОВЫ СОВРЕМЕННОГО ОБЩЕСТВА33034727062020Copyright ©; 2020, Zahkarova E.V., Filshtinskaya E.G.Copyright ©; 2020, Захарова Е.В., Фильштинская Е.Г.2020Zahkarova E.V., Filshtinskaya E.G.Захарова Е.В., Фильштинская Е.Г.http://creativecommons.org/licenses/by/4.0https://journals.rudn.ru/psychology-pedagogics/article/view/24111The authors of the article analyse approaches to treatment for tuberculosis (TB), which have become widespread throughout the world. Scientists from different countries have made attempts to study the influence of psychological, social, cultural, ethnic, and geographical factors on the spread of tuberculosis and the effectiveness of its treatment. But so far little is known about personal or sociocultural factors that lead to a violation of treatment compliance, which significantly actualises the problems stated in this article. The relevance of the study is also determined by the fact that all measures currently used for treating tuberculosis do not lead to its complete eradication and elimination of the epidemic in the world as well as in the Russian Federation. The purpose of this work was to study the psychosocial characteristics of TB patients in Russia and their interrelationships, which will provide an opportunity to predict the patients’ behaviour in a disease situation and their treatment compliance. The study involved 1600 respondents aged 19-60 years: 800 women and 800 men, residents of Samara (Russia), of which 800 persons were TB patients and the other 800 were conditionally healthy. The following psychodiagnostic techniques were used: The World Health Organisation Quality of Life (WHOQOL) Questionnaire (core module), The Level of Social Frustratedness Questionnaire, The Neurotic Disorders Questionnaire (Russian modification of H.D. Hansgen’s BVNK-300), M. Bond’s Defense Style Questionnaire (DSQ) in Russian adaptation by E. Tunik, The Ways of Coping Questionnaire (WSQ) by S. Folkman and R. Lazarus in a modified and adapted Russian version, The Type of Attitude Towards the Disease (TATD) Questionnaire, and The Level of Compliance Questionnaire. It was found that the TB patients had a significantly decreased quality of life, especially in the spheres of social relations, psychological state and spirituality. Characteristic features of the TB patients in Russia were disorders of the digestive and cardiovascular systems, sleep and motor disorders, affective instability, mental exhaustion, excitability, impaired working ability, fears, and social-psychological maladaptation. The respondents tended to use more maladaptive psychological defence mechanisms. As the leading coping ways for the TB patients, search for social support and acceptance of responsibility were identified. The prevailing types of attitudes toward the disease were characterised by an intrapsychic orientation, causing impaired social adaptation of these patients. The authors constructed regression models of compliance to determine strategies for TB patients psychological support. The results of the study as well as the constructed models can be used for training professional personnel in the field of medicine, clinical psychology, social work and social pedagogy in order to optimise the provision of medical, social, psychological and pedagogical assistance to TB patients in Russia and in other countries of the world: studies show that the factors identified and analysed in this paper are similar in TB patients in different countries, regardless of their geographic location or the level of economic development and cultural features.В статье проводится анализ подходов к лечению туберкулеза, получивших распространение в разных странах мира. Учеными разных стран предпринимались попытки исследования влияния психологических, социальных, культуральных, этнических, географических факторов на распространение туберкулеза и эффективность его лечения. Но пока мало известно о личностных, социально-культурных факторах, которые приводят к нарушению приверженности лечению, что существенно актуализирует проблематику, заявленную в данной статье. Актуальность исследования также обусловлена тем, что все применяемые в настоящее время меры по борьбе с туберкулезом не приводят к его полному искоренению и устранению эпидемии в мире, в том числе в РФ. Целью настоящего исследования явилось изучение психосоциальных характеристик больных туберкулезом в России и их взаимосвязи, что обеспечит возможность прогнозировать поведение пациента в ситуации болезни и его приверженность лечению (комплаентность). В исследовании приняли участие 1600 респондентов в возрасте 19-60 лет: 800 женщин и 800 мужчин, жители г. Самара (Россия), из которых 800 человек больны туберкулезом, 800 - условно здоровы. Использованы следующие психодиагностические методики: опросник качества жизни WHOQOL (ядерный модуль) Всемирной организации здравоохранения, «Уровень социальной фрустрированности», «Опросник невротических расстройств» (ОНР), опросник структуры психологических защит (тест СПЗ), опросник «Стратегии совладающего поведения», методика для психологической диагностики типов отношения к болезни (ТОБОЛ), опросник «Уровень комплаентности». Выявлено, что у больных туберкулезом выражено снижение качества жизни, особенно в сферах социальных отношений, психологического состояния и духовности. Для больных туберкулезом в Российской Федерации характерны расстройства пищеварительной и сердечно-сосудистой систем, нарушения сна и моторики, аффективная неустойчивость, истощаемость, возбудимость, нарушение работоспособности, страхи, социально-психологическая дезадаптация. Респонденты используют в большей степени неадаптивные, слабо эффективные способы психологической защиты. В качестве ведущих стратегий совладающего поведения у больных туберкулезом выявляются «Поиск социальной поддержки» и «Принятие ответственности». Преобладают типы реагирования на болезнь, характеризующиеся интрапсихической направленностью, обусловливающей нарушения социальной адаптации больных. На основании полученных результатов исследования построены регрессионные модели комплаентности, позволяющие прогнозировать поведение пациентов в ситуации болезни и определять стратегии психологического сопровождения больных туберкулезом. Результаты исследования, а также разработанные авторами модели могут быть использованы для подготовки профессиональных кадров в области медицины, клинической психологии, социальной работы и социальной педагогики с целью оптимизации оказания медико-социальной и психолого-педагогической помощи больным туберкулезом как в России, так и в других странах мира: как показывают исследования, факторы, выявленные и проанализированные в данной статье, сходны у больных туберкулезом в разных странах вне зависимости от географического положения, уровня экономического развития и культурных особенностей.tuberculosis patientsquality of lifesocial frustrationpsychological defenceways of copingtype of attitude towards the diseasecomplianceбольные туберкулезомкачество жизнисоциальная фрустрированностьпсихологические защитыстратегии совладающего поведениятип отношения к болезникомплаентность[Ababkov, V.A. (Ed.). 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