RESUMO
Intoduction: Psychological strength plays an important role in reducing stress due to leprosy because leprosy can cause physical, psychological, and social problems. For that reason, this study aims to investigate the relationship between coping sources, coping strategies, and psychological well-being through leprosy stress. Methods: This research instrument uses a stress perception scale, coping sources, coping strategies, and psychological well-being scale to collect data from 125 participants consisting of women (33.60%) and men 66.40%. The test analysis in this study uses SmartPLS through structural equation modeling to prove the correlation. Results: The results of the SEM test indicate that there is a negative relationship between coping resources and leprosy stress, with a coefficient value of (-0.380), p-value of (0.000) <0.05, and a positive relationship is obtained with psychological well-being with the coefficient value of (0.427), p-value of (0.000) <0.05. Meanwhile, the SEM test shows a negative relationship between coping strategies and stress of leprosy, with the coefficient of (-0.566), p-value of (0.000) <0.05, and a positive relationship is obtained with psychological well-being (0.355), p-value of (0.000) < 0.05. Furthermore, on psychological well-being, stress shows a negative relationship, with the coefficient of (-0.212), p-value of (0.002). Discussion: Exploration of important coping sources is done to weaken the power of leprosy as a stressor and the use of effective coping strategies is needed to solve physical, psychological, and social problems for "People Affected by Leprosy", and simultaneously these two attributes are used to achieve prosperity. psychological. better.
RESUMO
BACKGROUND: While prednisolone is commonly used to treat recent nerve function impairment (NFI) in leprosy patients, the optimal treatment duration has not yet been established. In this "Treatment of Early Neuropathy in Leprosy" (TENLEP) trial, we evaluated whether a 32-week prednisolone course is more effective than a 20-week course in restoring and improving nerve function. METHODS: In this multi-centre, triple-blind, randomized controlled trial, leprosy patients who had recently developed clinical NFI (<6 months) were allocated to a prednisolone treatment regimen of either 20 weeks or 32 weeks. Prednisolone was started at either 45 or 60 mg/day, depending on the patient's body weight, and was then tapered. Throughout follow up, NFI was assessed by voluntary muscle testing and monofilament testing. The primary outcome was the proportion of patients with improved or restored nerve function at week 78. As secondary outcomes, we analysed improvements between baseline and week 78 on the Reaction Severity Scale, the SALSA Scale and the Participation Scale. Serious Adverse Events and the need for additional prednisolone treatment were monitored and reported. RESULTS: We included 868 patients in the study, 429 in the 20-week arm and 439 in the 32-week arm. At 78 weeks, the proportion of patients with improved or restored nerve function did not differ significantly between the groups: 78.1% in the 20-week arm and 77.5% in the 32-week arm (p = 0.821). Nor were there any differences in secondary outcomes, except for a significant higher proportion of Serious Adverse Events in the longer treatment arm. CONCLUSION: In our study, a 20-week course of prednisolone was as effective as a 32-week course in improving and restoring recent clinical NFI in leprosy patients. Twenty weeks is therefore the preferred initial treatment duration for leprosy neuropathy, after which likely only a minority of patients require further individualized treatment.