Depressive Symptoms Mediate the Associations of Stigma with Medication Adherence and Quality of Life in Tuberculosis Patients in China

Qiu, Lei; Tong, Yeqing; Lu, Zuxun; Gong, Yanhong; Yin, Xiaoxv

doi:10.4269/ajtmh.18-0324

Cited by 20 publications

(27 citation statements)

References 37 publications

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“…As far as we know, there have been no studies on TB stigma conducted in Northeast China. We also observed that studies in other parts of China explored factors associated with stigma in terms of only sociodemographic characteristics [ 28 ], drug compliance and quality of life [ 30 ], TB knowledge and family functioning [ 29 ]; there is a lack of research on associated treatment status and anxiety. Moreover, the factors associated with TB-related stigma may vary depending on social and cultural backgrounds and region [ 16 ].…”

Section: Introductionmentioning

confidence: 95%

Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study

et al. 2021

BMC Public Health

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Background The stigma of tuberculosis (TB) poses a significant challenge to TB control because it leads to delayed diagnosis and non-adherence. However, few studies on TB-related stigma have been completed in China. The aim of the current study was to explore the status of TB-related stigma and its associated predictive factors among TB patients in Dalian, Northeast China. Methods An institution-based, cross-sectional survey was conducted among outpatients at Dalian Tuberculosis Hospital in Liaoning Province, Northeast China. Data were collected by using a questionnaire that measured TB-related stigma, treatment status, anxiety, social support, doctor-patient communication and so on. A multiple linear regression model was used to determine the predictors of TB-related stigma. Results A total of 601 eligible participants were recruited. The mean score for TB-related stigma was 9.07, and the median score was 10. The average scores for anxiety, social support and doctor-patient communication were 4.03, 25.41 and 17.17, respectively. Multiple linear regression analysis revealed that patients who were female (β = 1.19, 95% CI: 0.38–2.01, P < 0.05), had self-assessed moderate or severe disease (β = 1.08, 95% CI: 0.12–2.03 and β = 1.36, 95% CI: 0.03–2.70, respectively, P < 0.05), and had anxiety (β = 0.38, 95% CI: 0.30–0.46, P < 0.001) were more likely to have a greater level of TB-related stigma than their counterparts. However, a significantly lower level of TB-related stigma was observed in patients with good social support (β = − 0.25, 95% CI: − 0.33--0.17, P < 0.001) and doctor-patient communication (β = − 0.14, 95% CI: − 0.29--0.00, P < 0.05). Conclusions This study showed that stigma among TB patients was high. Targeted attention should be paid to female patients and patients with moderate or severe disease in TB stigma-related interventions. Moreover, the important role of social support and doctor-patient communication in reducing TB-related stigma should also be emphasized.

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Section: Introductionmentioning

confidence: 95%

Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study

et al. 2021

BMC Public Health

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“…[ 13 ] in Tamil Nadu, and by Qiu L et al . [ 14 ] in China. Likewise, family type, marital status, categories of TB treatment, and phases of treatment were similar to previous studies.…”

Section: Discussionmentioning

confidence: 99%

“…Likewise, family type, marital status, categories of TB treatment, and phases of treatment were similar to previous studies. [ 9 13 14 15 16 ]…”

Section: Discussionmentioning

confidence: 99%

Social stigma among tuberculosis patients attending DOTS centers in Delhi

Kamble

Singh

Jethani

et al. 2020

J Family Med Prim Care

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Background: Every year >9 million people suffer from tuberculosis (TB) and India accounts for >25% of global TB burden. Tuberculosis patients experience both psychological and social suffering. Amongst the problems met by tuberculosis patients, social stigma has been increasingly recognized. This study was done to assess social stigma and associated factors among the tuberculosis patients attending Directly Observed Treatment Short-course (DOTS) centers in South East Delhi. Material and Methods: It was a cross-sectional study carried out among tuberculosis patients availing treatment from DOTS centers of South East Delhi. Out of 48 DOTS centers in South East Delhi, 6 centers were selected on the basis of population proportion to size. A total of 270 TB patients were interviewed using a semi-structured, pretested questionnaire consisting of stigma-based questions. Fisher exact and Chi-square test applied. Results: The mean age of patients was 31.5 years (SD ± 11.5) with age ranging from 18 to 77 years. Males were higher (57.4%) compared to females (42.6%). 123 (45.5%) perceived stigma with family/friends and 92/158 (58.2%) perceived stigma at workplace. Young patients (<30 years), males faced more stigma at workplace and lower socioeconomic class faced higher stigma with family and friends ( P < 0.05). Conclusion: There is still higher stigmatization faced by patients with TB at family/friends and at workplace. Motivation by friends/family and support at workplace has been crucial in achieving successful treatment outcomes.

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“…Approxiametely half of patients with tuberculosis have been reported to experience perceived stigma [1,2]. Perceived stigma may negatively affect adherence to treatment and quality of life [2,3]. Poor social support and depression seem to increase the negative effects of perceived stigma [1,4].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies suggest that perceived stigma negatively affect adherence to treatment and quality of life [2,3]. Patients with poor social support and those with depression seem to be more vulnerable to the negative effects of perceived stigma [1,4].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Depressive Symptoms and Perceived Stigma in Patients With Tuberculosis

Kelesoglu¹,

Güveli²

2020

Preprint

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Objective: The aim of this study is to determine the levels of perceived stigma and social support and presence of depressive and anxiety symptoms in patients with tuberculosis and to investigate the association of perceived stigma and depression with demographic and disease related factors.Methods: This study included patients older than 18 years of age with tuberculosis. The hospital anxiety depression scale (HADS), stigma of tuberculosis scale (STS), and multidimensional scale of perceived social support (MSPSS) were applied to the participants. Univariate and multivariate analyses were performed to define correlates of depression and perceived stigma.Results: A total of 204 patients were included. The risk of anxiety and depression were 25% and 36.8%, respectively. Multivariate binary logistic regression analyses suggested that higher HADS-anxiety scores and lower MSPSS scores were associated with a depressive HADS score and that a lower BMI, higher HADS-anxiety score, and higher HADS-depression score were associated with high levels of perceived stigma.Conclusions: The rates of depression, stigmatization, and anxiety were high in these patients. Anxiety symptoms were positively and social support was inversely associated with depressive symptoms. A lower BMI and higher depression and anxiety scores were independently associated with high levels of perceived stigma.

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Depressive Symptoms Mediate the Associations of Stigma with Medication Adherence and Quality of Life in Tuberculosis Patients in China

Cited by 20 publications

References 37 publications

Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study

Tuberculosis-related stigma and its determinants in Dalian, Northeast China: a cross-sectional study

Social stigma among tuberculosis patients attending DOTS centers in Delhi

Factors Associated With Depressive Symptoms and Perceived Stigma in Patients With Tuberculosis

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