Beyond the Diagnosis: Exploring the Psychosocial Impact of Drug-Resistant Tuberculosis on Patients in Norway

Abstract

Background: This study aims to explore the varied experiences of patients with resistant tuberculosis in Norway, particularly among immigrants. The study emphasizes challenges and implications of being diagnosed with resistant tuberculosis, including the impact of psychosocial health during the disease, treatment, isolation and recovery phases. Norway is a low endemic country of tuberculosis. Most patients are immigrants and some have recently arrived in the country. Patients undergoing treatment for drug-resistant tuberculosis endure prolonged and demanding treatment that could affects their psychosocial health. Methods: This qualitative research approach conducted 16 in-depth interviews with individuals diagnosed and completed treatment for resistant tuberculosis, aged 18 and above, mean age of 33.6. The majority of the participants were immigrants, and eight of them had resided in Norway for less than four years before diagnosis. Data analysis followed the six-phase reflexive thematic analysis framework outlined by Braun and Clarke Results: The narratives of the participants highlighted the complexities of navigating the TB diagnosis, treatment, side effects and life after treatment. Immigrants encountered additional challenges, including language barriers and adapting to new social environments. All participants reported experiencing physical health issues which additionally affected their mental health and social activity. Many participants had persistent problems at the time of the interviews. Several participants expressed social isolation, and those with confirmed contagious pulmonary tuberculosis experienced hospital isolation up to six months. Three main themes emerged from the analysis: Delayed diagnosis despite seeking health care; Hospital isolation and social isolation; The life after tuberculosis. “They just think that I am healthy”. Conclusion: This study highlights the enduring impact of DR-TB on patients, the significance of timely diagnosis, the challenges within healthcare services and the importance of psychosocial support. The participants universally faced serious implications of the disease, including stigma and isolation, alongside reflections on missed early intervention opportunities. The need for enhanced healthcare awareness, improved communication and post-treatment follow-up is underscored. Further research conducted in low endemic countries should evaluate the recommendations on psychosocial follow-up after introducing short-oral treatment.