The limits to patient compliance with directly observed therapy for tuberculosis: a socio‐medical study in Pakistan
- 1 July 2002
- journal article
- research article
- Published by Wiley in The International Journal of Health Planning and Management
- Vol. 17 (3), 249-267
- https://doi.org/10.1002/hpm.675
Abstract
Complying with the prescriptions of the directly observed therapy (DOT), one of the components of the Global Tuberculosis Programme of the WHO, is problematic for many patients. The factors leading to patient (non-) compliance with DOT are placed in a structural equation model. The study is based on a survey carried out in one general hospital in the Punjab province of Pakistan, amongst all sputum positive pulmonary TB patients (n = 621) who arrived at the TB unit from September 1997 to October 1998. The tested sequence of manifest variables and latent constructs shows that the social stratification perspective has to be extended by the stigmatization perspective. The advantages of universally applying DOT will increase even further when the latter perspective is involved in the analysis of non-compliance. There is a real danger that the patients reached by selective DOT will be stigmatized even more. Copyright © 2002 John Wiley & Sons, Ltd.Keywords
This publication has 25 references indexed in Scilit:
- Has directly observed treatment improved outcomes for patients with tuberculosis in southern Thailand?Tropical Medicine & International Health, 2002
- Management of Tuberculosis in the United StatesNew England Journal of Medicine, 2001
- Private practitioners in the slums of Karachi: what quality of care do they offer?Social Science & Medicine, 1998
- UNIVERSAL DIRECTLY OBSERVED THERAPY: A Treatment Strategy for TuberculosisClinics in Chest Medicine, 1997
- Social scientists and the new tuberculosisSocial Science & Medicine, 1997
- Perception and social consequences of tuberculosis: A focus group study of tuberculosis patients in Sialkot, PakistanSocial Science & Medicine, 1995
- Global Epidemiology of TuberculosisJAMA, 1995
- Structural equation modeling in practice: A review and recommended two-step approach.Psychological Bulletin, 1988
- Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size.Psychological Bulletin, 1988
- On the evaluation of structural equation modelsJournal of the Academy of Marketing Science, 1988