Investigating the Correlation Between Stigma and Perceived Social Support with Self-Care Behaviors Among Tuberculosis Patients in Golestan Province

Abstract

Background and purpose: In 2023, the incidence of tuberculosis (TB) in Golestan Province was reported to be 26.1 cases per 100,000 people, which is three times higher than the national average in Iran. The contagious nature of tuberculosis has economic repercussions and indirect effects on the quality of life of affected individuals. The stigma associated with tuberculosis often leads to social isolation, which can hinder TB control efforts. On the other hand, social support from family, friends, healthcare workers, and community leaders improves quality of life, promotes self-care behaviors, and enhances patient adherence to medication regimens. This study aimed to determine the correlation between stigma, social support, and self-care behaviors in patients with tuberculosis. Materials and methods: This cross-sectional (descriptive-analytical) study was conducted in 2023, surveying 325 tuberculosis patients undergoing treatment in Golestan Province. Data were collected using a demographic information questionnaire, a 12-question stigma questionnaire (patients' perceptions of tuberculosis), the Sherborn and Stewart Perceived Social Support Questionnaire, and the self-care behaviors questionnaire for tuberculosis patients by Herandi et al. The data were analyzed using SPSS version 24 software. To investigate the relationship between perceived stigma and social support with the dimensions of self-care behaviors in tuberculosis patients, Spearman and chi-square tests were used. Logistic regression was employed to predict factors affecting self-care in the studied patients. Results: The average age of the participants was 51.97±17.33 years, with an age range of 19 to 84 years. The overall scores for the stigma questionnaire, perceived social support questionnaire, and self-care behaviors questionnaire were 29.03 ± 5.30, 71.14 ± 14.53, and 84.78 ± 10.17, respectively. Based on the univariate logistic regression model, the variables of race, number of family members, addiction, and age were analyzed for their effects on self-care behaviors. Additionally, the effects of marital status and age on stigma were examined. Significant effects of family size, income, and marital status on social support were observed. Spearman correlation tests showed an inverse and significant correlation between stigma and social support (r= -0.19, P= 0.001), stigma and self-care (r= -0.21, P<0.001), and a direct and significant correlation between social support and self-care (r= 0.55, P<0.001). Conclusion: As stigma increases, levels of social support and self-care behaviors decrease. Stigma has a significant impact on tuberculosis treatment, while higher levels of social support enhance self-care and accelerate the recovery process. To control tuberculosis effectively, comprehensive support from community leaders, the Ministry of Health, welfare organizations, relief committees, municipalities, and other organizations, as well as from patients' families and surrounding communities, is essential. Additionally, health and medical intervention programs aimed at increasing self-care behaviors, raising awareness among patients, and reducing stigma and misconceptions among families, friends, healthcare workers, and society at large are recommended.

Keywords

• stigma
• perceived social support
• self-care behaviors
• tuberculosis
• emotional support