The Relationships Between Stress, Patient-Healthcare Provider Interactions, Family Support, and Perceived Transportation Costs on Adherence to Pulmonary Tuberculosis Treatment
DOI:
https://doi.org/10.26911/jepublichealth.2026.11.04.03Abstract
Background: Treatment adherence is essential for successful pulmonary tuberculosis therapy and is influenced by psychological, interpersonal, and socioeconomic factors. This study aimed to analyze the association between stress, patient–healthcare provider relationship, family support, and perceived transportation costs with treatment adherence among patients with pulmonary tuberculosis receiving treatment at Primary Health Centers in Surakarta City.
Subjects and Method: An analytical observational study with a cross-sectional design was conducted among 132 patients with drug-susceptible pulmonary tuberculosis in the continuation phase of treatment at 17 Primary Health Centers in Surakarta City. Participants were selected using purposive sampling based on predefined inclusion and exclusion criteria. The independent variables were stress, patient–healthcare provider relationship, family support, and perceived transportation costs, while the dependent variable was treatment adherence. Data were collected using standardized questionnaires and analyzed using the Generalized Ordered Logit Model.
Results: Moderate stress (aOR=0.23; 95% CI=0.07 to 0.75; p=0.015), severe stress (aOR=0.18; 95% CI=0.06 to 0.55; p=0.003), and very severe stress (aOR=0.02; 95% CI = 0.03 to 0.12; p < 0.001), a “fair” patient–healthcare provider relationship (aOR = 40.84; 95% CI = 4.95 to 337.06; p = 0.001), a “good” patient–healthcare provider relationship (aOR = 31.35; 95% CI = 4.70 to 208.97; p < 0.001), and a moderate perception of transportation costs (aOR = 0.31; 95% CI = 0.11 to 0.82; p = 0.018) were significantly associated with adherence to pulmonary tuberculosis treatment. Mild stress, “fair” family support, “good” family support, and “severe” perceived transportation costs were not significantly associated with adherence to pulmonary tuberculosis treatment (p>0.05).
Conclusion: Treatment adherence among patients with pulmonary tuberculosis is associated with psychological, interpersonal, and economic factors. Strengthening patient–healthcare provider communication, integrating stress assessment and management into tuberculosis care, and reducing transportation barriers may improve treatment adherence and treatment outcomes.
Keywords:
tuberculosis, pulmonary, medication adherence, psychological stress, social support, health personnelHow to Cite
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