**4.3 Quality of life of patients depending on the disease form**

Indicators of quality of life in groups of patients depending on the form of a disease are presented in **Table 3**.

The indicator of quality of life considerably differed at various methods of detection of tuberculosis of respiratory organs. On the scale of physical functioning, the highest rates are recorded in the first subgroup—revealed during inspection with the Diaskintest—65.4 ± 3.7— and it were patients who have been examined because of identification in family of the adult patient with active tuberculosis. These children and adolescents kept the physical functioning; only in a small part of children, some decrease in physical activity owing to existence of burdening due to the main disease pathology was noted. In subgroup of the patients revealed actively—at recourse for a medical care, indicators of quality of life in aspect of physical functioning the lowest indicators—55.1 ± 3.1 were that has been connected by existence of extensive process in a pulmonary parenchyma. These children and adolescents often observed bed rest and have been limited to activity within medical office. The subgroup of patients revealed by indicators of a physical state by digital fluorography was equal to average assessment on the scale of a physical state among all examined patients—60.9 ± 2.2 points (on average 60.5 ± 3.4 points). It demonstrates that the method of digital fluorography has revealed patients both with limited, and with pathology, widespread in a lung, which is reflected in different degree on their physical functioning. Indicators of emotional functioning of the patients revealed by the Diaskintest and digital fluorography have close and rather high rates—68.1 ± 2.8 and 65.1 ± 3.9 points. In these subgroups of patients, the existence of depression of mood owing to being diagnosed with a chronic disease was noted, many expressed concern about preservation of vigorous activity in the future. Indicators of social functioning of the patients revealed by the Diaskintest and digital fluorography also have rather high rates—71.4 ± 4.7 and 70.5 ± 3.2 points. At the same time at representatives of the third subgroup—the patients revealed at recourse for a medical care, to a thicket at adolescents with common and destructive forms of tuberculosis, authentically low results—54.9 ± 3.3 points are observed. In the patients of the third subgroup, the main reasons for decline in quality of life in the social sphere are they had restrictions in communicating with peers because of understanding of the infectious nature of the disease and their possible transmissibility for people around. Life at school for children and adolescents revealed by a test method with the Diaskintest and digital fluorography is broken to a lesser extent (64.8 ± 2.5 and 60.7 ± 1.5 points), than at identification at recourse for a medical care—54.7 ± 2.9 points. An average value on the scale of school functioning among all three subgroups surveyed was 60.1 ± 3.6 points.


**31**

**Table 4.**

*Assessing Quality of Life in Children and Adolescents Diagnosed with Pulmonary Tuberculosis*

The received results speak about existence of problems in school, which are often connected with poor progress in such disciplines as mathematics, physics, and chemistry demanding bigger concentration and assiduity. The scale of psychosocial functioning as a result of scales of emotional and social activity has revealed big differences for the children and adolescents revealed at test with the Diaskintest—70.1 ± 4.4 points and at recourse for a medical care—50.7 ± 2.8 points that once again is confirmed by results on each of these scales. The average level of quality of life (a total scale) was the lowest at identification at recourse for a medical care—52.5 ± 3.1 points, the highest—children when carrying out have tests with the Diaskintest and carrying out digital fluorography in groups of the increased risk (68.0 ± 3.7 and 65.1 ± 3.1 points). The general point among all contingent surveyed

**4.4 Quality of life of patients depending on associated diseases**

Indicators of quality of life in groups of patients depending on the form of

Initial level of quality of life separately in forms of a disease has revealed insignificant distinctions on a total scale—63.7 ± 2.8 points—in the group of patients with primary forms of tuberculosis of respiratory organs and 59.9 ± 2.7 points for children and adolescents with secondary forms of a disease. However, subjective indicators of physical functioning for patients with primary forms were much higher, than in the second subgroup (67.5 ± 2.1 and 58.2 ± 3.4). It proves that the inflammatory process in respiratory organs is more extensive, it is more difficult for the patient to cope with physical activities in the form of a run or a long walk, and they noted weakness and difficulty in performance of daily household chores more often. Also for children and adolescents with secondary forms of tuberculosis, decrease in number and volume of physical exercises is noted. Indicators of emotional functioning are approximately equal in the first and second subgroup of patients—63.2 ± 3.7 and 64.8 ± 3.7 that reflect negative influences of a disease on an emotional condition of the patient regardless of the form of tuberculosis of respiratory organs. Children of both subgroups are emotionally unbalanced that is expressed in capriciousness, unwillingness for a long hospital stay, and refusal of medical and diagnostic manipulations. Social functioning in the group of children and adolescents with primary forms of tuberculosis is reliable above similar indicators in the second subgroup—64.7 ± 2.8 and 51.9 ± 2.4. This results from the fact that the general condition of patients of the first subgroup clinically does not change considerably; these forms of tuberculosis proceed most often with symptoms that do not influence communication with peers in a group, whereas secondary forms of tuberculosis in children and, especially, in adolescents proceed as clinically expressed that causes the necessity of temporary restriction of the

**Aspects of quality of life Primary forms n = 50 (M ± σ) Secondary forms n = 40 (M ± σ)**

Physical functioning 67.5 ± 2.1 58.2 ± 3.4 Emotional functioning 63.2 ± 3.7 64.8 ± 3.7 Social functioning 64.7 ± 2.8 51.9 ± 2.4 School functioning 51.7 ± 2.9 53.8 ± 1.8 Psychosocial functioning 64.2 ± 2.6 56.3 ± 2.1 Total scale 63.7 ± 2.8 59.9 ± 2.7

*Indicators of quality of life of patients depending on the form of disease (in points).*

*DOI: http://dx.doi.org/10.5772/intechopen.82672*

was on average 61.9 ± 3.3 points.

disease are presented in **Table 4**.

**Table 3.**

*Indicators of quality of life of patients depending on the method of identification (in points).*

*Assessing Quality of Life in Children and Adolescents Diagnosed with Pulmonary Tuberculosis DOI: http://dx.doi.org/10.5772/intechopen.82672*

The received results speak about existence of problems in school, which are often connected with poor progress in such disciplines as mathematics, physics, and chemistry demanding bigger concentration and assiduity. The scale of psychosocial functioning as a result of scales of emotional and social activity has revealed big differences for the children and adolescents revealed at test with the Diaskintest—70.1 ± 4.4 points and at recourse for a medical care—50.7 ± 2.8 points that once again is confirmed by results on each of these scales. The average level of quality of life (a total scale) was the lowest at identification at recourse for a medical care—52.5 ± 3.1 points, the highest—children when carrying out have tests with the Diaskintest and carrying out digital fluorography in groups of the increased risk (68.0 ± 3.7 and 65.1 ± 3.1 points). The general point among all contingent surveyed was on average 61.9 ± 3.3 points.

### **4.4 Quality of life of patients depending on associated diseases**

Indicators of quality of life in groups of patients depending on the form of disease are presented in **Table 4**.

Initial level of quality of life separately in forms of a disease has revealed insignificant distinctions on a total scale—63.7 ± 2.8 points—in the group of patients with primary forms of tuberculosis of respiratory organs and 59.9 ± 2.7 points for children and adolescents with secondary forms of a disease. However, subjective indicators of physical functioning for patients with primary forms were much higher, than in the second subgroup (67.5 ± 2.1 and 58.2 ± 3.4). It proves that the inflammatory process in respiratory organs is more extensive, it is more difficult for the patient to cope with physical activities in the form of a run or a long walk, and they noted weakness and difficulty in performance of daily household chores more often. Also for children and adolescents with secondary forms of tuberculosis, decrease in number and volume of physical exercises is noted. Indicators of emotional functioning are approximately equal in the first and second subgroup of patients—63.2 ± 3.7 and 64.8 ± 3.7 that reflect negative influences of a disease on an emotional condition of the patient regardless of the form of tuberculosis of respiratory organs. Children of both subgroups are emotionally unbalanced that is expressed in capriciousness, unwillingness for a long hospital stay, and refusal of medical and diagnostic manipulations. Social functioning in the group of children and adolescents with primary forms of tuberculosis is reliable above similar indicators in the second subgroup—64.7 ± 2.8 and 51.9 ± 2.4. This results from the fact that the general condition of patients of the first subgroup clinically does not change considerably; these forms of tuberculosis proceed most often with symptoms that do not influence communication with peers in a group, whereas secondary forms of tuberculosis in children and, especially, in adolescents proceed as clinically expressed that causes the necessity of temporary restriction of the


**Table 4.**

*Indicators of quality of life of patients depending on the form of disease (in points).*

*Psychology of Health - Biopsychosocial Approach*

disease are presented in **Table 3**.

**4.3 Quality of life of patients depending on the disease form**

**Aspects of quality of life Diaskintest Digital** 

**fluorography**

Physical functioning 65.4 ± 3.7 60.9 ± 2.2 55.1 ± 3.1 60.5 ± 3.4 Emotional functioning 68.1 ± 2.8 65.1 ± 3.9 47.2 ± 3.1 60.1 ± 3.7 Social functioning 71.4 ± 4.7 70.5 ± 3.2 54.9 ± 3.3 65.6 ± 3.1 School functioning 64.8 ± 2.5 60.7 ± 1.5 54.7 ± 2.9 60.1 ± 3.6 Psychosocial functioning 70.1 ± 4.4 68.4 ± 2.6 50.7 ± 2.8 63.1 ± 2.8 Total scale 68 ± 3.7 65.1 ± 3.1 52.5 ± 3.1 61.9 ± 3.3

*Indicators of quality of life of patients depending on the method of identification (in points).*

**Recourse for a medical care**

**All**

Indicators of quality of life in groups of patients depending on the form of a

The indicator of quality of life considerably differed at various methods of detection of tuberculosis of respiratory organs. On the scale of physical functioning, the highest rates are recorded in the first subgroup—revealed during inspection with the Diaskintest—65.4 ± 3.7— and it were patients who have been examined because of identification in family of the adult patient with active tuberculosis. These children and adolescents kept the physical functioning; only in a small part of children, some decrease in physical activity owing to existence of burdening due to the main disease pathology was noted. In subgroup of the patients revealed actively—at recourse for a medical care, indicators of quality of life in aspect of physical functioning the lowest indicators—55.1 ± 3.1 were that has been connected by existence of extensive process in a pulmonary parenchyma. These children and adolescents often observed bed rest and have been limited to activity within medical office. The subgroup of patients revealed by indicators of a physical state by digital fluorography was equal to average assessment on the scale of a physical state among all examined patients—60.9 ± 2.2 points (on average 60.5 ± 3.4 points). It demonstrates that the method of digital fluorography has revealed patients both with limited, and with pathology, widespread in a lung, which is reflected in different degree on their physical functioning. Indicators of emotional functioning of the patients revealed by the Diaskintest and digital fluorography have close and rather high rates—68.1 ± 2.8 and 65.1 ± 3.9 points. In these subgroups of patients, the existence of depression of mood owing to being diagnosed with a chronic disease was noted, many expressed concern about preservation of vigorous activity in the future. Indicators of social functioning of the patients revealed by the Diaskintest and digital fluorography also have rather high rates—71.4 ± 4.7 and 70.5 ± 3.2 points. At the same time at representatives of the third subgroup—the patients revealed at recourse for a medical care, to a thicket at adolescents with common and destructive forms of tuberculosis, authentically low results—54.9 ± 3.3 points are observed. In the patients of the third subgroup, the main reasons for decline in quality of life in the social sphere are they had restrictions in communicating with peers because of understanding of the infectious nature of the disease and their possible transmissibility for people around. Life at school for children and adolescents revealed by a test method with the Diaskintest and digital fluorography is broken to a lesser extent (64.8 ± 2.5 and 60.7 ± 1.5 points), than at identification at recourse for a medical care—54.7 ± 2.9 points. An average value on the scale of school functioning among all three subgroups surveyed was 60.1 ± 3.6 points.

**30**

**Table 3.**

social activity by patients. So, adolescents of the second subgroup, patients with disseminate forms of tuberculosis, are forced to observe a high bed rest that, along with emotional depression, leads to narrowing of communication by other patients within the chamber or with the persons who are looking after them. On the scale of school functioning of reliable differences, it is almost not established—51.7 ± 2.9 and 53.8 ± 1.8 points. Patients, both in the first and second subgroups, equally often experience difficulties when performing tasks at school and skip classes because of feeling sick or needing medical manipulations. The scale of psychosocial functioning as total scale of emotional and social functioning has revealed authentically high rates of quality of life in the first subgroup of patients, than in the second—64.2 ± 2.6 and 56.3 ± 2.1. It is explained by the existence of numerous and ineffective courses of treatment of the anamnesis and by alarm and fear of uncertainty of the future. Children and adolescents of the second subgroup have big degree of consciousness and knowledge of the chronic pathology and realize the need for a continuous intake of medicines in the hospital conditions. It leads to lower indicators of quality of their life in comparison with patients of the first subgroup.
