Isolation and stigma: the experience of patients with active tuberculosis

Tuberculosis treatment is an important component of community health programs. Understanding how different groups of patients experience tuberculosis can influence the completion of drug therapy. This study explored how a sample of patients with active tuberculosis experienced their illness. Guided by questions from Kleinman's (1980) explanatory model, 28 semistructured interviews were conducted in public health clinics. The analysis suggested that patients understood tuberculosis through the medical model and perceived themselves as disease vectors. After their diagnosis became known, almost all patients felt that their family and friends avoided or shunned them. Patients responded to these attitudes by isolating themselves and becoming secretive about their illness. An awareness of patients' experiences can help nurses to understand behaviors that may be labeled as noncompliant and design interventions that address these behaviors. Modifying community attitudes and behaviors poses a longer term challenge to the elimination of tuberculosis.