The psychosocial impact of hearing loss on the quality of adults with multi drug-resistant tuberculosis.

Abstract

Aminoglycosides used in the treatment of Multi Drug-Resistant Tuberculosis (MDR-TB) is an ototoxic agent, known to result in hearing loss. Hearing loss has been reported to have far-reaching psychological, physical, and social consequences, while the diagnosis of MDR-TB has negative impacts such as stigma, and financial implications. The effects of an acquired hearing loss with an MDR-TB diagnosis may, therefore, have an increased adverse impact on the overall Quality of life of an individual; however, there is minimal research in the area. A Qualitative Phenomenological research study was conducted on 10 participants, with a confirmed diagnosis of MDR-TB, and hearing loss. The researcher used a semi-structured questionnaire to collect data during face-to-face, audio-recorded interviews. Thematic analysis of results revealed that hearing loss in patients diagnosed with MDR-TB has a significant adverse impact on the patients‟ Quality of life. All participants were unable to return their „normal‟ lives, i.e., life before the diagnosis of MDR-TB and hearing loss. Stigma, discrimination, psychological distress, adverse changes in family status and family relationships, financial constraints, and social challenges were some of the common issues reported by participants. Unemployment posed a significant challenge, resulting in participants having no economic stability due to MDR-TB, which was then worsened by the hearing loss; consequently, generating a great deal of stress. Participants reported feelings of worthlessness, a loss of identity, lack of motivation, feelings of embarrassment, and loss of independence. Cultural and ethnic factors also appeared to have influenced the participant‟s willingness to seek assistance for the psychosocial challenges they had been experiencing. Consequently, there is a significant irreversible social, psychological, and economic impact of hearing loss that has a direct impact on the Quality of life of MDR-TB patients and their families, which are likely to persist even after MDR-TB has been cured. There is a need for improved treatment methods that are less toxic to hearing together with psychosocial intervention strategies that equip patients diagnosed with MDR-TB and hearing loss to alleviate the adverse effects they experience. Without such interventions, the fight against the psychosocial impact of hearing loss in MDR-TB patients remains incomplete.