Patients with tuberculosis of lungs with anosognosia:
coping-behavior and protective mechanisms of personality

Uzlov N.D., Gabdrakhmanova N.N. (Berezniki, Perm Region)

	Uzlov Nikolay Dmitrievich –  is a candidate of medical sciences, lecturer of natural and humanity sciences department in Bereznyaki Department of State University of Perm. E-mail: knots51@mail.ru
	Gabdrakhmanova Nadezda Nikolaevna –  is a psychologist of "Regional against Tuberculosis Dispenser в„– 2", Bereznyaki, Perm Region. E-mail: klimchuk59@yandex.ru

Abstract. 106 patients with uncomplicated forms of tuberculosis of lungs were surveyed. Considerable prevalence (44,3 %) of patients with anosognosic type of the relation to an illness was established. The comparative analysis of Р РЋР С“oping-strategy, hardiness and mechanisms of psychological protection was executed between groups of patients with anosognosic type (47 people) and patients with other types of the relation to an illness (59 people). It was shown that the anosognosia at tuberculosis of lungs is resistance; it difficult gives in to correction. In its formation take part both social (criminal experience, alcoholism, antisocial installation) and psychological factors. The patients with anosognosic type of the relation to an illness use non-constructive coping-strategy ("disclaiming" and "escape-avoidance"); and "seeking social support" as auxiliary adaptive resource. Anosognosia is characterized by higher levels of hardiness and its components: commitment, control, and challenge. Patients with other types have lower level of commitment and integrated indicator of hardiness more often. The hardiness of patients with anosognosia that was developed by negative life experience, allows keeping a steady life attitude without world outlook change, despite illness existence. Protective mechanisms of denial and reactive formation are in a base Р С•f anosognosia. In the base of anosognosia protective psychological mechanisms of denial and jet formation, unlike other types of the relation to an illness where regression prevails lie. Recommendations about work with anosognosic patients are offered (accounting of features of the personality, detection of risk factors, correct argumentation, and positive reinforcement, diagnostic of types of the relation to an illness).

Key words: pulmonary tuberculosis, anosognosia, the type of the relation to the illness, coping behavior, coping-strategy, hardiness, protective psychological mechanisms.