COVID-19 TREATMENT GUIDELINEIN TANZANIA, MARCH 2021
Posted by ULY CLINIC
24 Machi 2021 19:43:06
The guidance is based on proper case management aspects intended for clinicians involved in the care of patients with suspected or confirmed COVID-19. It is not meant to replace clinical judgment or specialist consultation but rather to strengthen frontline clinical management and the public health response.
NOTE. THIS GUIDELINE IS THE POPERTY OF MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT, GENDER, ELDERLY AND CHILDREN
11. PSYCHOSOCIAL INTERVENTIONS
11. Psychosocial interventions to be done
• For Suspects/Patients with COVID-19 and Family members
• For Carers in the Covid-19 Response
a. For Suspects/Patients with COVID-19 and Family members
Suspected and confirmed cases of the COVID-19 may experience fear of severe disease consequences and the infection. Consequently, they may experience denial, anxiety, fear, stress, loneliness, depression, insomnia, and despair, which may lower treatment adherence. Some of these cases may even have increased risk of serious distress. Suspected isolated cases may suffer from anxiety due to uncertainty about their health status and develop obsessive- compulsive symptoms, such as repeated temperature check. However, isolation could cause family disintegration, societal rejection, financial loss, discrimination, and stigmatization.
What to be done?
a. Assessment and initial counselling session
This should be done immediate after admission and during investigation. Session will involve
• Assessing knowledge about COVID-19 pandemic
• Assessing anxiety, stress, depression and suicide risk due to COVID-19 pandemic
• Assessing social resources
• Building psychological resilience for dealing with clinical procedures, receiving results and addressing psychosocial issues due to COVID-19 pandemic.
b. Provide Psychological First Aid (attend immediacy issues identified) to individuals in distress so they feel calm and supported to cope better with their challenges.
c. Provide appropriate psychological intervention in dealing with anxiety, stress, depression, suicidal thought and other psychosocial conditions while continue to observed for any psychiatric changes (when occurs) and managed accordingly
d. Prevent and address stigma and discrimination
e. Ensure that client’s social network (family members and significant others) are oriented about COVID-19 and safety precautions before linking with the patient.
f. Encourage family members to regulate their emotions before contact with client and provide necessary support through the available safety procedures.
g. Make a discharge plan, for those patients who have accomplished their treatment. This will involve a collaboration with survivor’s patient’s family, neighbourhood and inform them about the health status of the patient.
h. Making follow-up to discharged patients in order to observe their conditions, in case there is any changes immediately action should be taken
i. Collaborating with professionals from other discipline in delivering comprehensive care
Mode of Intervention
These services can be delivered through “in-person” session such as being in the same physical space or “remote” through the use of telepsychology/tele psychiatry where different technologies may be used in various combinations and for different purposes. For example, videoconferencing and telephone may also be utilized for direct service while email and text is used for non-direct services (e.g. scheduling).
b. For Carers in the Covid-19 Response
Many people will feel stressed and exhausted while working in the COVID-19 response. This is natural given the difficult demands. Everyone reacts differently to stress. You may experience some of the following:
• Physical symptoms: headaches, difficulty sleeping and eating
• Behavioral symptoms: low motivation to work, increased use of alcohol or drugs, disengaging from religious/spiritual practices
• Emotional symptoms: fear, sadness, and anger.
What to be done?
If you feel the above symptom, practice the following techniques to manage stress on a daily basis. Choose those that work best for you personally. If you do not manage to do this one-day, be kind to yourself and try again the next day.
a. Stay up to date with accurate information about COVID-19 and follow safety measures to prevent infection. Take “breaks “from COVID-19 media when needed.
b. Eat well, get enough sleep and exercise physically every day.
c. Do an activity you enjoy or find meaningful every day (e.g. art, reading, prayers, talking to a friend).
d. Take five minutes out of your day to talk to a friend, family member or other trusted person about how you are feeling.
e. Talk to your manager, supervisor or colleagues about your well-being at work, particularly if you are worried about working in the COVID-19 response.
f. Establish daily routines and stick to them
g. Minimize your use of alcohol, drugs, caffeine or nicotine. These might seem to help in the short term, but they can lead to lower mood, anxiety, difficulty sleeping and even aggression as the effects wear off. If you are consuming too much of any of these substances, you can cut down by reducing the amount available in your house and finding other ways to manage stress, such as those mentioned here.
h. At the end of each day, make a short list (in your head or on paper) of ways you were able to help others or things you are grateful for, such as” I helped by being kind to someone who was upset” or “I’m grateful for support from my friend”.
i. Be realistic about what you can and cannot control. Visualizing circles of control may help with this.
j. Try an activity to relax – see what works for you. You may already have some activities you use now or have used in the past. You can also try: slow breathing, stretching, dancing, praying or doing yoga; progressive muscle relaxation such as walking, jogging, running
Note
If stress is consistently persisting or stopping, you from doing your daily activities (e.g. going to work) then seek professional support.
Updated,
25 Machi 2021 07:28:04
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