The relationship between patients’ perception of nurse caring behaviors and tuberculosis stigma among patients with drug-resistant tuberculosis in Swaziland

Abstract

Background: Tuberculosis is major cause of death worldwide and Swaziland is one of the countries with highest rates. The fear of drug resistant tuberculosis among nurses may lead to poor nurse caring behaviors which patient perceive as stigma. Objectives: To examine (1) the relationship between patients’ perceptions of nurse caring and tuberculosis stigma; (2) the predictors of tuberculosis related stigma among patients with drug resistant TB in Swaziland. Methods: In this descriptive cross-sectional study, 84 patients who had drug resistant tuberculosis completed a demographic data sheet, Lee-Hsieh (2004) Caring behavior measurement and Van Rie at el (2008) Tuberculosis related stigma scale. Results: Poor perception of nurse caring behaviors frequency (x̅ = 2.52 ± 0.41), and a high level of TB related stigma (x̅ = 30.20 ± 9.31) was reported by patients. Gender and monthly income variables had a significant mean difference in nurse caring behaviors (p < .05). There were no demographic factors associated with TB related stigma. There was a correlation between the perception of nurse caring behaviors and TB stigma (r = −0.709, p < 0.01). Nurse caring behaviors can predict TB related stigma (p < 0.01) with explained variance of 52.8% and with “Sincerity, Empathy & Respect” sub scale being the strongest predictor (β = −0.599). Conclusion: Nurse caring behaviors can predict how patients perceive stigma. Therefore, emphases on caring behaviors education on nurses is needed to reduce TB stigma among patients with drug resistant TB which will lead to patients adhering to treatment. Keywords: Nurse caring behaviors, Stigma, Drug resistant tuberculosis