Description of a Comparative Study on Self Esteem and Psychological Distress among Patients with Tuberculosis and Fracture in Selected Hospitals in Enugu, Nigeria

Background: Diagnosis of tuberculosis and lower limb fracture and treatment can affect a patient‘s’-
psychological well being. Psychological problems can affect the overall well being of the patient and
make palliation of physical symptoms more difficult. Psychological symptoms reflect on individuals
self esteem and level of psychological distress.
Objectives: Aim of this study is to ascertain and compare the emotional health and self esteem in
patients with tuberculosis and fracture admitted to chest units in University of Nigeria Teaching
Hospital, Enugu State University Teaching Hospital, and the National Orthopaedic Hospital Enugu,
Nigeria.
Methods: Study population consisted of 126 patients with pulmonary tuberculosis receiving treatment at
Direct Observed Treatment Short course (DOTS) clinics and 126 patients with lower limb fracture at
emergency and out – patients clinic. Socio-demographic interview schedule was used to assess the sociodemographic
characteristics of the respondents. Symptom Checklist-90 was used to assess the extent of
psychological symptoms in both respondents and Index of Self Esteem was used to assess self esteem.
Results: A significantly higher prevalence of psychiatric disorders was found in the tuberculosis group
(25.4%) than in the orthopaedic group (7.6%). Psychiatric disorders encountered included depression,
anxiety, and paranoid ideation and interpersonal sensitivity (SCL-90). Low self esteem was more prevalent
among patients with tuberculosis compare to fracture. In this study, the level of psychological distress was
higher in patients with tuberculosis compared with patients with fracture (p<0.001). The diagnosis of
tuberculosis may lead to a host of anxiety and worries among patients. For a stigma-ridden disease like
tuberculosis, the intensity of emotional reactions may be much high. We also found that tuberculosis
patients being of a younger age was significantly associated with poorer emotional health and that low self
esteem was more prevalent among participants with tuberculosis compared to those with fracture
(P<0.0001).