Abstract
The World Health Organization cites the Philippines as one of the countries worldwide that continues to have a high burden of multidrug-resistant tuberculosis (MDR-TB), with high rates of infected Filipinos. This study investigated the lived experiences of individuals with MDR-TB. Using a qualitative method, the study documented the experiences and meaning-making of eight Filipino adults aged 26–50 who were between the third and ninth month of directly observed treatment. Data from semi-structured interviews were analyzed using interpretative phenomenological analysis that yielded five superordinate themes: (1) the recurrence of tuberculosis (TB) symptoms and the trauma of being diagnosed with MDR-TB; (2) experiences of confronting the reality of being infected with MDR-TB; (3) barriers to long-term treatment adherence; (4) significance of social support; and (5) coping with MDR-TB. These themes describe the subjective experiences of patients battling an infectious disease who were undergoing long-term outpatient treatment. The significance and implications of the findings toward a more comprehensive program of interventions for MDR-TB patients are discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Acha, J., Sweetland, A., Guerra, D., Chalco, K., Castillo, H., & Palacios, E. (2007). Psychosocial support groups for patients with multidrug-resistant tuberculosis: Five years of experience. Global Public Health, 2(4), 404–417. https://doi.org/10.1080/17441690701191610.
Aggarwal, A. N. (2010). Health-related quality of life: A neglected aspect of pulmonary tuberculosis. Lung India, 27(1), 1–3.
Aydin, I. O., & Ulasahin, A. (2001). Depression, anxiety comorbidity, and disability in tuberculosis and chronic obstructive pulmonary disease patients: Applicability of GHQ-12. General Hospital Psychiatry, 23(2), 77–83. https://doi.org/10.1016/S0163-8343(01)00116-5.
Baral, S., Aryal, Y., Bhatrrai, R., King, R., & Newell, J. N. (2014). The importance of providing counselling and financial support to patients receiving treatment for multi-drug resistant TB: Mixed method qualitative and pilot intervention studies. BMC Public Health, 14. https://doi.org/10.1186/1471-2458-14-46.
Baral, S. C., Karki, D. K., & Newell, J. N. (2007). Causes of stigma and discrimination associated with tuberculosis in Nepal: A qualitative study. BMC Public Health, 7, 211–220. https://doi.org/10.1186/1471-2458-7-211.
Bauer, M., Leavens, A., & Schwartzman, K. (2012). A systematic review and meta-analysis of the impact of tuberculosis on health-related quality of life. Quality of Life Research, 22(8), 2213–2235. https://doi.org/10.1007/s11136-012-0329-x.
Bhatia, M. S., Bhasin, S. K., & Dubey, K. K. (2000). Psychosocial dysfunction in tuberculosis patients. Indian Journal of Medical Sciences, 54, 171–173.
Chalco, K., Wu, D. Y., Mestanza, L., Muñoz, M., Llaro, K., Guerra, D., et al. (2006). Nurses as providers of emotional support to patients with MDR-TB. International Nursing Review, 53(4), 253–260.
Chang, B., Wu, A. W., Hansel, N. N., & Diette, G. B. (2004). Quality of life in tuberculosis: A review of the English language literature. Quality of Life Research, 13(10), 1633–1642.
De Torres, S. (2002). Understanding persons of Philippine origin: A primer for rehabilitation service providers. Buffalo, NY: Center for International Rehabilitation Research Information and Exchange (CIRRIE).
Department of Health. (2013). Leading causes of mortality. http://www.doh.gov.ph/Statistics/Leading-Causes-of-Mortality. Retrieved June 01, 2013.
Department of Health. (2014). Research monograph of the updated 2010–2016 Philippine plan of action to control tuberculosis. http://www.doh.gov.ph/sites/default/files/publications/researchmonograph.pdf. Retrieved June 01, 2013.
Dias, A., Falcão de Oliveira, D., Turato, E., & Moralez de Figueiredo, R. (2013). Life experiences of patients who have completed tuberculosis treatment: A qualitative investigation in southeast Brazil. BMC Public Health, 13, 595–603. https://doi.org/10.1186/1471-2458-13-595.
Dodor, E. A. (2012). The feelings and experiences of patients with tuberculosis in the Sekondi-Takoradi metropolitan district: Implications for TB control efforts. Ghana Medical Journal, 46(4), 211–218.
Framework of the PhilSTEP and Targets. (n.d.). Retrieved from http://www.ntp.doh.gov.ph/downloads/ntp_data/ntp_vmg_and_org_and_tb_burden.pdf. Retrieved 6 Nov 2017.
Gler, M., Macalintal, L., Raymond, L., Guilatco, R., Quelapio, M. I., & Tupasi, T. (2011). Multidrug-resistant tuberculosis among previously treated patients in the Philippines. International Journal of Tuberculosis and Lung Disease, 15(5), 652–656.
Grimaldo, E., Tupasi, T., Rivera, A., Quelapio, M., Cardaño, R., Derilo, J., et al. (2001). Increased resistance to ciprofloxacin and ofloxacin in multidrug-resistant Mycobacterium tuberculosis isolates from patients seen at a tertiary hospital in the Philippines. The International Journal of Tuberculosis and Lung Disease, 5(6), 546–550.
Hu, A., Loo, E., Winch, P. J., & Surkan, P. J. (2012). Filipino women’s tuberculosis care seeking experience in an urban poor setting: A socio-ecological perspective. Health Care for Women International, 33(1), 29–44. https://doi.org/10.1080/07399332.2011.630495.
Landeck, J., & Peck, E. (2011). MDR-TB quality improvement survey of patients and health providers: Tajikistan pilots. USAID Quality Health Care Project (QHCP) in the Central Asian Republics. http://www.qhcp.net/wpcontent/uploads/2011/04/Quality-Health-Care-Project-MDR-TB-Quality-ImprovementSurvey-of-Patients-and-Health-Providers-June-2011.pdf.
Marra, C. A., Marra, F., Cox, V. C., Palepu, A., & Fitzgerald, J. M. (2004). Factors influencing quality of life in patients with active tuberculosis. Health and Quality of Life Outcomes, 2, 58. https://doi.org/10.1186/1477-7525-2-58.
Mendoza, M., Gonzaga, A., Roa, C., Velmonte, M., Jorge, M., Montoya, J., et al. (1997). Nature of drug resistance and predictors of multidrug-resistant tuberculosis among patients seen at the Philippine General Hospital, Manila, Philippines. The International Journal of Tuberculosis and Lung Disease, 1(1), 59–63.
Morris, M. D., Quezada, L., Bhat, P., Moser, K., Smith, J., Perez, H., et al. (2013). Social, economic, and psychological impacts of MDR-TB treatment in Tijuana, Mexico: A patient’s perspective. International Journal of Tuberculosis and Lung Disease, 17(7), 954–960.
Munro, S. A., Lewin, S. A., Smith, H. J., Engel, M. E., Fretheim, A., & Volmink, J. (2007). Patient adherence to tuberculosis treatment: A systematic review of qualitative research. PLoS Medicine, 4(7), 1230–1245.
Naidoo, P., Dick, J., & Cooper, D. (2009). Exploring tuberculosis patients’ adherence to treatment regimens and prevention programs at a public health site. Qualitative Health Research, 19(1), 55–70.
Ong, W. T. (2012). Mind your body: Tuberculosis in the Philippines: 10 things you should know. The Philippine Star. http://www.philstar.com/health-and-family/763897/tuberculosis-philippines-10-things-you-should-know. Retrieved June 2, 2013.
Ormerod, L. P. (2005). Multidrug-resistant tuberculosis (MDR-TB): Epidemiology, prevention and treatment. British Medical Bulletin, 73 and 74, 17–24. https://doi.org/10.1093/bmb/ldh047.
Pachi, A., Bratis, D., Moussas, G., & Tselebis, A. (2013). Psychiatric morbidity and other factors affecting treatment adherence in pulmonary tuberculosis patients. Tuberculosis Research and Treatment, 1, 1–37. https://doi.org/10.1155/2013/489865.
Reid, K., Flowers, P., & Larkin, M. (2005). Interpretative phenomenological analysis: An overview and methodological review. The Psychologist, 18(1), 20–23.
Root, M. P. P. (2005). Filipino families. In M. Mc Goldrick, J. Giordano, & N. Garcia-Preto (Eds.), Ethnicity and family therapy (3rd ed., pp. 319–331). New York, NY: The Guilford Press.
Rundi, C. (2010). Understanding tuberculosis: perspectives and experiences of the people of Sabah, East Malaysia. Journal of Health Population and Nutrition, 28(2), 114–123.
Smith, J., & Osborn, M. (2008). Interpretative phenomenological analysis. In J. A. Smith (Ed.), Qualitative psychology: A practical guide to research methods (2nd ed., pp. 53–80). London: Sage.
Sukumani, J. T., Lebese, R. T., Khoza, L. B., & Risenga, P. R. (2012). Experiences of family members caring for tuberculosis patients at home at Vhembe district of the Limpopo Province. Curationis, 35(1).
Takumi, R. (2017). DOH seeks to eliminate TB by 2022. GMA News Online. Retrieved from http://www.gmanetwork.com/news/story/604586/lifestyle/doh-seeks-to-eliminate-tb-by-2022. Retrieved 12 Nov 2017.
Tomas, B. A., Pell, C., Cavanillas, A. B., Solvas, J. G., Pool, R., & Roura, M. (2013). Tuberculosis in migrant populations: A systematic review of the qualitative literature. PLoS ONE, 8(12), e82440. https://doi.org/10.1371/journal.pone.0082440.
Ukanwa, D., & Madiba, S. (2013). Being diagnosed with multi-drug resistant tuberculosis: Experiences of patients from rural Kwazulu Natal, South Africa. International Journal of Recent Scientific Research, 4(11), 1831–1834.
Vega, P., Sweetland, A., Acha, J., Castillo, H., Guerra, D., Smith Fawzi, M. C., et al. (2004). Psychiatric issues in the management of patients with multidrug-resistant tuberculosis. International Journal of Tuberculosis Lung Disease, 8(6), 749–759.
World Health Organization. (2010). Multidrug and extensively drug resistant TB (M/XDR-TB): 2010 report on surveillance and response. WHO/HTM/TB/2010.3. Geneva: WHO. http://apps.who.int/iris/bitstream/10665/44286/1/9789241599191_eng.pdf.
World Health Organization. (2011a). Tuberculosis: /MDR-TB & XDR-TB 2011 progress report. http://www.who.int/tb/challenges/mdr/factsheet_mdr_progress_march2011.pdf. Retrieved June 01, 2013.
World Health Organization. (2011b). 2011/ 2012 tuberculosis global facts. http://www.who.int/tb/publications/2011/factsheet_tb_2011.pdf. Retrieved June 01, 2013.
World Health Organization. (2012). WHO global tuberculosis report 2012. http://www.who.int/tb/publications/global_report/gtbr12_main.pdf. Retrieved June 01, 2013.
World Health Organization. (2013a). Multidrug-resistant tuberculosis (MDR-TB) 2013 update. http://www.who.int/tb/challenges/mdr/MDR_TB_FactSheet.pdf. Retrieved June 01, 2013.
World Health Organization. (2013b). Tuberculosis. http://www.who.int/features/tuberculosis/en/. Retrieved June 01, 2013.
Yamada, S., Caballero, J., Matsunaga, D. S., Agustin, G., & Magana, M. (1999). Attitudes regarding tuberculosis in immigrants from the Philippines to the United States. Family Medicine, 31(7), 477–482.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Brigaste, M.B.T., Teh, L.A. The Battle Continues: An Interpretative Phenomenological Analysis of the Experiences of Multidrug-Resistant Tuberculosis (MDR-TB) Patients. Psychol Stud 63, 9–18 (2018). https://doi.org/10.1007/s12646-017-0436-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12646-017-0436-4