RetourBasic psychological support tries to help people deal with emotional distress and help them recover from stress responses (53). In addition to following the principles of effective communication in Section 5.2, these guidelines should be followed:
- Distressed people may not always give a clear account of their situation or may take longer to explain themselves. They should be listened to patiently, without interrupting or rushing them. Asking for clarification usually helps. Sometimes, they might find it difficult to open up their feelings; being there and reassuring them is important. If they describe their feelings or difficult experiences, responding with empathy and sensitivity can help. Some examples of responses are:
That sounds like a very challenging experience.
I understand how painful this has been for you.
I can see why you are so worried (or frightened). - Sources of stress should be identified. After actively listening and allowing the person to speak without interruption, following questions may be needed:
What is your biggest worry these days?
How do you deal with this worry?
What are some of the things that give you comfort, strength and energy? - Their basic needs should be assessed. If they need more information or additional services, simply establishing contact with their family and providing other social support is important.
- Education should be provided about the normal stress reactions of people diagnosed with TB or experiencing difficulties with treatment or services.
- If the stress reaction is long or severe, specific stress management techniques should be offered (54).
- The health-care provider should look for potential signs of sexual or physical abuse (including domestic violence) in women, children and older people (e.g. unexplained bruises or injuries, excessive fear, overly withdrawn behaviour, reluctance to discuss matters when a family member is present, malnourishment in a family with access to sufficient food). When signs of abuse or neglect are present, the patient should be interviewed in a private space and asked if anything hurtful is going on. If abuse or neglect is strongly suspected or confirmed, help should be requested from colleagues with experience of dealing with this. If the patient gives consent, he/ she should be referred to relevant community resources for protection (e.g. trusted legal services and protection networks).