Tuberculosis (TB) is a contagious and deadly infectious disease caused by the Mycobacterium tuberculosis bacteria. Most of the TB germs attack the lungs, but can also attack other organs such as brain, bone, skin, lymph nodes, joints and intestines. Symptoms of TB is coughing for 2-3 weeks or longer, cough producing phlegm, chest pain, appetite and weight loss, and night sweating although not doing any activities.
World TB Report by the WHO in 2006 put Indonesia as the third largest TB patients in the world, but in 2009 this dropped to number 5 in the world after India, China, South Africa and Nigeria. The success of reducing the number of TB disease cannot be separated with the treatment and commitment of the TB patients in taking medication.
Based on the research of UNDIP psychologist, Dra. Hastaning Sakti, M. Kes. ASA (Call for Healthy Body and Soul) psychological program which is a combination of transpersonal psychotherapy with interactive counseling skills (KKI) proved effective in increasing adherence to medication and TB patients’ levels of gamma interferon.
"Obedience is very important in the treatment of tuberculosis because boredom on taking the drugs and the lack of service to people with TB can affect on the patient’s medical, immunological and psychological side," said Hastaning in an open examination to obtain her doctorate at the UGM Faculty of Psychology on Wednesday (20/4). Her promoter is Prof. Dr. Johana E. Prawitasari, co-promoter Prof. dr. Marsetyawan, M. Sc, Ph.D and Dr. Kwartarini Wahyu.
In front of the examiners team lead by Dean of the UGM Faculty Psychology, Prof. Dr. Faturohman, Hastaning said that ASA psychological program proved successful in reducing stress levels in patients with tuberculosis who had been reluctant to take medication. "The condition of TB illness that is uncomfortable in the body, and fear of health services and the number of drugs that must be taken are the stressor and if responded negatively it will alter hormonal balance," said the lady born on July 1, 1960 in Semarang.
Stress affects the immune and health response, thus when stress is well managed through the ASA program, stress levels will be decreased and the adherence to take medication will remain intact. Hastaning conveys treatment of TB disease can be optimized by increasing the patient’s commitment to health and self-efficacy. The increased commitment and self-efficacy as well as decreasing emotional conditions as the effect of psychological treatment programs can reduce the levels of cytokines IFN-y.
"There was a good influence on the function of the brain that activates T cells and produce IFN-y. The decreases in interferon gamma indicate inactive macrophages to form antibodies. There is no formation of antibodies because it has been significant decreases in emotional status to keep healthy in the long term in addition to the better quality of health," she said.
Hastaning proposed ASA program was able to improve adherence to medication in patients with TB. This psychological program has advantages as an act of preventive, promotive and curative with the basis of transpersonal psychotherapy and community health empowerment. “Finally, the ASA psychological program can be used to manage the stress that is often experienced by sufferers of TB associated with long-term treatment," she said.