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Background <p>Tuberculosis (TB) treatment adherence remained a major challenge in high-burden settings, and psychosocial factors such as TB-related stigma and patient motivation may be associated with whether patients completed therapy.</p> Objective <p>This study examined the relationships between TB-related stigma, patient motivation, and treatment adherence among patients with pulmonary TB in a high TB burden area of West Sumatra, Indonesia.</p> Methods <p>A cross-sectional survey was conducted from October to December 2025 among adults with drug-sensitive pulmonary TB receiving care in Padang Municipality and Padang Pariaman Regency. The sample comprised 268 participants, selected using a multistage stratified clustered sampling. TB-related stigma (9 items), motivation (4 items), and treatment adherence (4 items) were measured using 4-point Likert scales. The relationships among the variables were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM).</p> Results <p>The sample was predominantly male (80.2%), with a median age of 42 years and an interquartile range of 36–63, and 72.0% reported a monthly family income below IDR 3.2&#xa0;million. Motivation showed a positive association with treatment adherence (β = 0.533; t = 9.879; <i>p</i> &lt; 0.001). TB-related stigma showed a strong negative association with motivation (β = −0.817; t = 38.152; <i>p</i> &lt; 0.001) and a negative direct association with adherence (β = −0.443; t = 8.294; <i>p</i> &lt; 0.001).</p> Conclusion <p>TB-related stigma was associated with poorer treatment adherence both directly and through reduced patient motivation, suggesting the need for stigma-sensitive, motivation-strengthening strategies within routine TB services.</p>

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Tuberculosis-related stigma, patient motivation and treatment adherence among patients with pulmonary tuberculosis in a high tuberculosis burden area of West Sumatra Province Indonesia

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  • 发表日期：

    2026年5月6日

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  • Ricvan Dana Nindrea,
  • Milya Novera,
  • Armaita,
  • Long Chiau Ming,
  • Lemmuel Tayo,
  • Yodi Kasinda,
  • Puti Karima Aprila,
  • Nailah Putri Rivani

摘要

Background

Tuberculosis (TB) treatment adherence remained a major challenge in high-burden settings, and psychosocial factors such as TB-related stigma and patient motivation may be associated with whether patients completed therapy.

Objective

This study examined the relationships between TB-related stigma, patient motivation, and treatment adherence among patients with pulmonary TB in a high TB burden area of West Sumatra, Indonesia.

Methods

A cross-sectional survey was conducted from October to December 2025 among adults with drug-sensitive pulmonary TB receiving care in Padang Municipality and Padang Pariaman Regency. The sample comprised 268 participants, selected using a multistage stratified clustered sampling. TB-related stigma (9 items), motivation (4 items), and treatment adherence (4 items) were measured using 4-point Likert scales. The relationships among the variables were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM).

Results

The sample was predominantly male (80.2%), with a median age of 42 years and an interquartile range of 36–63, and 72.0% reported a monthly family income below IDR 3.2 million. Motivation showed a positive association with treatment adherence (β = 0.533; t = 9.879; p < 0.001). TB-related stigma showed a strong negative association with motivation (β = −0.817; t = 38.152; p < 0.001) and a negative direct association with adherence (β = −0.443; t = 8.294; p < 0.001).

Conclusion

TB-related stigma was associated with poorer treatment adherence both directly and through reduced patient motivation, suggesting the need for stigma-sensitive, motivation-strengthening strategies within routine TB services.