The patient with multi-drug resistant – Pulmonary tuberculosis adherence to treatment: A qualitative study
Read
Not available
Timeswas read the article
Total PDF
Total HTML
Share statistics
array:23 [ "pii" => "S113086212200081X" "issn" => "11308621" "doi" => "10.1016/j.enfcli.2022.03.019" "estado" => "S300" "fechaPublicacion" => "2022-08-01" "aid" => "1994" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Clin. 2022;32 Supl 2:S58-S61" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S1130862122000821" "issn" => "11308621" "doi" => "10.1016/j.enfcli.2022.03.020" "estado" => "S300" "fechaPublicacion" => "2022-08-01" "aid" => "1995" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Clin. 2022;32 Supl 2:S62-S65" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "titulo" => "Stigma experienced by women living with HIV/AIDS in Aceh province: A phenomenological study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S62" "paginaFinal" => "S65" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Scheme 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "sc1.jpeg" "Alto" => 1087 "Ancho" => 2925 "Tamanyo" => 149443 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Respondent characteristics.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Trisna Sari, Syarifah Rauzatul Jannah, Asniar, Teuku Tahlil, Suryane Sulistiana Susanti" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Trisna" "apellidos" => "Sari" ] 1 => array:2 [ "nombre" => "Syarifah Rauzatul" "apellidos" => "Jannah" ] 2 => array:1 [ "apellidos" => "Asniar" ] 3 => array:2 [ "nombre" => "Teuku" "apellidos" => "Tahlil" ] 4 => array:2 [ "nombre" => "Suryane Sulistiana" "apellidos" => "Susanti" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862122000821?idApp=UINPBA00004N" "url" => "/11308621/00000032000000S2/v1_202208030734/S1130862122000821/v1_202208030734/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1130862122000808" "issn" => "11308621" "doi" => "10.1016/j.enfcli.2022.03.018" "estado" => "S300" "fechaPublicacion" => "2022-08-01" "aid" => "1993" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Enferm Clin. 2022;32 Supl 2:S54-S57" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "The preparedness of disaster among nurses in community health centers in rural areas during the COVID-19 pandemic in Malang City" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S54" "paginaFinal" => "S57" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Mukhamad Fathoni, Turniningtyas Ayu Rachmawati, Elvira Sari Dewi, Ari Prasetya Djati, Sumi Lestari, Ah Yusuf, Christrijogo Sumartono Waluyo" "autores" => array:7 [ 0 => array:2 [ "nombre" => "Mukhamad" "apellidos" => "Fathoni" ] 1 => array:2 [ "nombre" => "Turniningtyas Ayu" "apellidos" => "Rachmawati" ] 2 => array:2 [ "nombre" => "Elvira Sari" "apellidos" => "Dewi" ] 3 => array:2 [ "nombre" => "Ari Prasetya" "apellidos" => "Djati" ] 4 => array:2 [ "nombre" => "Sumi" "apellidos" => "Lestari" ] 5 => array:2 [ "nombre" => "Ah" "apellidos" => "Yusuf" ] 6 => array:2 [ "nombre" => "Christrijogo Sumartono" "apellidos" => "Waluyo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862122000808?idApp=UINPBA00004N" "url" => "/11308621/00000032000000S2/v1_202208030734/S1130862122000808/v1_202208030734/en/main.assets" ] "en" => array:18 [ "idiomaDefecto" => true "titulo" => "The patient with multi-drug resistant – Pulmonary tuberculosis adherence to treatment: A qualitative study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "S58" "paginaFinal" => "S61" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Yuli Sartika Sari, Hajjul Kamil, Marthoenis" "autores" => array:3 [ 0 => array:3 [ "nombre" => "Yuli Sartika" "apellidos" => "Sari" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 1 => array:4 [ "nombre" => "Hajjul" "apellidos" => "Kamil" "email" => array:1 [ 0 => "hajjul.kamil@unsyiah.ac.id" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "apellidos" => "Marthoenis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Faculty of Nursing, Universitas Syiah Kuala, Banda Aceh, Indonesia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Politeknik Kesehatan Aceh Utara, Aceh, Indonesia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Multi-drug resistance tuberculosis (MDR-TB) is one of the major global public health problems that prevent the achievement of tuberculosis (TB) control in low and middle-income countries in the.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">1</span></a> MDR TB causes not only high rates of morbidity and mortality but also increases psychosocial challenges in sufferers.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Based on data on May 17, 2018, the number of new TB cases in Indonesia was 420,994 in 2017.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">3</span></a> The increasing number of MDR-TB cases in Indonesia causes the government to bear increasingly high costs for managing and controlling MDR-TB cases.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a> Besides requiring expensive medical costs and a long time, patients with MDR TB experience higher mortality than those infected with drug-sensitive TB.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a> From the results of a qualitative study examined in Pakistan, it was found that the burden of treatment costs was one of the most prominent factors besides drug side effects and trust, which was a failure in TB treatment.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">6</span></a> Failure in treatment due to patient non-compliance in the treatment process can lead to tuberculosis germ resistance to TB drugs.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">People who experience recurrent disease or are resistant to various types of drugs need an extended treatment program.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a> The duration of standard treatment with Multidrug-Resistant Tuberculosis (MDR-TB) patients is 19–24 months.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Changes in medication adherence and behavioral practices in promoting self-care in pulmonary TB patients are urgently needed. Nearly two-thirds of the patients treated for TB are not aware of how TB is spread, so it is unlikely that the patient or family is aware of steps to prevent the spread of TB.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a> Therefore, getting an education about how TB is transmitted and adopting healthy behaviors can prevent the transmission of this disease to other people.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Change in attitude and behavior in medication adherence is fundamental in promoting self-care in pulmonary TB patients. In 1987, Pender developed the theory of the Health Promotion Model (HPM). According to Pender's view, health-promoting behavior can be operationalized in life on an individual lifestyle. Pender develops HPM as a framework for describing health behaviors that focus on personal progress towards favorable circumstances and health improvement.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The experience of MDR-TB in Indonesia has not been well explored. Therefore, this study aims to examine the experience of patients with MDR TB living in the area of the Lhokseumawe district of Indonesia.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">This qualitative study with a phenomenological approach involved All patients with MDR-TB (6 persons) living in the district of Lhokseumawe, Indonesia, were invited to the study. They were recruited through their local TB program holders. Researchers collected data on the participants until saturation was achieved. Researches consider the data saturation has reached when many themes recur and no new themes emerge. Data collection utilized an in-depth interview method and field notes. In the interview, researchers used an open-ended approach to explain their experiences during the treatment period entirely. The data collection process was carried out from August to October 2019.</p><p id="par0040" class="elsevierStylePara elsevierViewall">After obtaining approval for a research permit from the Nursing Research Ethics Committee of the Faculty of Nursing at Syiah Kuala University with research code number 112007160719, the researchers applied ethical principles to prevent ethical problems. Participants who agreed to participate in the study then signed an informed consent form and filled out the demographic information sheet. Interviews are conducted in the living room or the family room following requests from participants, and each one lasts about 40–60<span class="elsevierStyleHsp" style=""></span>min. Interview transcripts were analyzed using a data analysis process developed according to Collaizi.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a> The limitation in this research is that triangulation of sources, methods, and theories is not done.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">The detail of demographic information about the study participants is provided in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. After conducting in-depth interviews with the participants, the researchers identified five themes.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">The study results, namely the patient's perception of the disease experienced, perceived obstacles, factors that support adherence in treatment, hopes to achieve healing, and health promotion behavior in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Theme 1: patients’ perceptions about the disease experienced</span><p id="par0055" class="elsevierStylePara elsevierViewall">Participants feel that the treatment they are taking has a severe impact and a dangerous disease. Feelings of deep anxiety and fear are felt, alienated, shunned, disrespected, and considered a humiliating and unclean condition.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Following are excerpts from participant interviews:<span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">“.... <span class="elsevierStyleItalic">Because a doctor is explaining that the weight of the treatment...heavy... because it is confirmed as the doctor said it was cumbersome, not everyone can run it, serious times indeed... (P3)</span></p></span></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Theme 2: perceived obstacles</span><p id="par0065" class="elsevierStylePara elsevierViewall">Participants revealed that drug side effects and length of treatment time were obstacles in MDR TB treatment. In addition, the negative attitude of health workers during the treatment and treatment period has made them lazy to take medication.</p><p id="par0070" class="elsevierStylePara elsevierViewall">The following are excerpts from participant interviews:<span class="elsevierStyleDisplayedQuote" id="dsq0010"><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">“... <span class="elsevierStyleItalic">I am weak...vomiting...if people talk sometimes, I don’t hear enough...the sixth month of the foot aches in the bones in all parts of the body starting from the waist down and a few months later becoming dead taste like paralyzed” (P3)</span></p></span></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Themes 3: factors that support adherence in the treatment</span><p id="par0075" class="elsevierStylePara elsevierViewall">Participants revealed that when they were in a state of decline and fear, all they did was recite dhikr, hear Alquran, and believe in the power of God. In addition, support in the care he received during the treatment period such as a source of support and support from health workers themselves in the form of motivation. Participants also revealed that what was just as important was family support.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Following are excerpts from participant interviews:<span class="elsevierStyleDisplayedQuote" id="dsq0015"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">“<span class="elsevierStyleItalic">Yes...that's...this is the fear that sometimes arises...then...Istighfar..” (P2)</span></p></span></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Themes 4: hope to achieve healing</span><p id="par0085" class="elsevierStylePara elsevierViewall">Participants expressed hope that they could recover after undergoing treatment to return to good health and be close to their family and friends. They can carry out activities as before the illness.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Following are excerpts from participant interviews:<span class="elsevierStyleDisplayedQuote" id="dsq0020"><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">“<span class="elsevierStyleItalic">..... I hope that I can still gather with friends…....that's hope...can still read the Alquran.....can still be with hugs and kisses..” (P4)</span></p></span></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Themes 5: health promotion behavior</span><p id="par0095" class="elsevierStylePara elsevierViewall">Participants express positive attitudes in promoting themselves that arise from within themselves due to increased self-awareness about the disease they suffer.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Following are excerpts from participant interviews:<span class="elsevierStyleDisplayedQuote" id="dsq0025"><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">“<span class="elsevierStyleItalic">... so my mother uses it... I also use this (pointing to the mask), so the communication is still a mask..” (P3)</span></p></span><span class="elsevierStyleDisplayedQuote" id="dsq0030"><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">“<span class="elsevierStyleItalic">... sit down...wear...(show mask)...if that person doesn’t understand it... I keep the distance from him...” (P4)</span></p></span></p><p id="par0105" class="elsevierStylePara elsevierViewall">In this study, the attitudes identified during the MDR TB treatment period were anxiety because of fear of the disease they experienced leading to death, hopelessness, non-compliance in treatment, regret, and surrender to the condition of the illness they experienced. Feelings of pain, sadness, and despair because the illness suffered can cause death.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a> They feel other people's changes in the way they view and interact. Things that are felt like a disease experienced are shame, feeling “discriminated,” and disrespected. In this study, participants felt stigmatized health workers who often saw them as “insecure” and avoided interacting with participants. Stigmatization can be in the form of unfavorable treatment, conflicts that occur due to speaking, or painful attitudes of people; this conflict is overcome by the client patiently and surrendering to the powerful.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Drug effect is an essential obstacle felt by MDR Sufferers. The most dominant effects of the drugs are nausea and vomiting. Nausea and vomiting are symptoms that often occur during the treatment period.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a> Another obstacle that is felt from the effect of the drug is psychological problems. Mental health problems are one of the impacts experienced by TB sufferers, mental health disorders related to psychological, emotional, and spiritual well-being.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> Long treatment time, heavy drugs, and routine of taking large amounts of medication every day cause fatigue and boredom. The treatment in patients with MDR TB requires 19–24 months.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The negative treatment experienced by health workers during treatment is like an attitude in providing services that makes them lazy to seek treatment. Negative attitudes of health professionals and lack of social support contribute to patients who fail treatment.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a> Increased communication between health care providers and MDR-TB patients and increasing their knowledge and understanding of treatment programs will create a sense of individual self-empowerment and increase their confidence in treatment.</p><p id="par0120" class="elsevierStylePara elsevierViewall">One of the factors that support the adherence of MDR TB patients during the treatment period identified in this study is internal supporting factors such as spiritual coping and positive coping. Spiritual coping or religious coping is a way for individuals to use their beliefs in managing stress and problems in life.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">17</span></a> Another factor influencing adherence in treatment is support in care consisting of sources of support (health care facilities), forms of support for health workers in motivating treatment, and family support. Many factors influence long-term medication adherence. Health policymakers and practices can support long-treated MDR-TB patients by appreciating that MDR-TB conditions affect the psychosocial life of sufferers. Develop strategies to reduce perceived effects by providing opportunities to share their anxieties, suffering, and biopsychosocial change.</p><p id="par0125" class="elsevierStylePara elsevierViewall">In this study, there is a desire to recover after undergoing MDR TB treatment and hope that no family members will experience something like this. The experience of clients who have experienced relapses and feel the heaviness of undergoing treatment in the hope that they can be completely cured and not relapse.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a></p><p id="par0130" class="elsevierStylePara elsevierViewall">The study's findings reveal the relationship between adherence behavior in treatment in MDR TB patients with HPM Pender's theory. One of the strengths of HPM is a behavioral judgment regarding prior behavior. In this case, previous behaviors and acquired characteristics can influence beliefs, feelings, and perform health-promoting behaviors. The positive attitude of MDR TB sufferers in self-promoting behavior to prevent transmission to other family members and the surrounding environment. The emergence of this attitude is due to experiences related to the past associated with the disease they are experiencing and an increase in self-awareness about their illness. Identifying and reducing perceived barriers to health-promoting behavior will improve the quality of patient care and facilitate planning for educational services in changing behavior. Because behaviors with positive influences tend to be repeated and behaviors with negative consequences are usually less duplicated, the influence related in this study is a good predictor for the occurrence of healthy self-care behavior in patients.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a></p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusion</span><p id="par0135" class="elsevierStylePara elsevierViewall">During the MDR TB treatment, the patients suffered severely from the side effect of the drugs, the length of treatment, and negative treatment from some health workers, so they were lazy to seek treatment. However, the support of family and social environment, adequate service facilities, positive self-confidence, and spiritual coping from sufferers can increase treatment adherence.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Self-promoting behavior to prevent transmission to other family members and the surrounding environment can be done by wearing a mask and maintaining distance. The emergence of this attitude is caused by experiencing an increased self-awareness to prevent disease transmission.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Funding</span><p id="par0155" class="elsevierStylePara elsevierViewall">This research was carried out with independent funding by the researchers.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflict of interest</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1753086" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Result" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Discussion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1544153" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 4 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Theme 1: patients’ perceptions about the disease experienced" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Theme 2: perceived obstacles" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Themes 3: factors that support adherence in the treatment" ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Themes 4: hope to achieve healing" ] 4 => array:2 [ "identificador" => "sec0040" "titulo" => "Themes 5: health promotion behavior" ] ] ] 5 => array:2 [ "identificador" => "sec0045" "titulo" => "Conclusion" ] 6 => array:2 [ "identificador" => "sec0050" "titulo" => "Funding" ] 7 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflict of interest" ] 8 => array:2 [ "identificador" => "xack619481" "titulo" => "Acknowledgments" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-09-26" "fechaAceptado" => "2022-03-26" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1544153" "palabras" => array:3 [ 0 => "MDR TB" 1 => "Qualitative" 2 => "Experience" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patients with multi-drug resistance tuberculosis might experience differently during the treatment than those without tuberculosis. This study aims to explore the experience of multi-drug resistance tuberculosis patients during the treatment period.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Six patients undergoing multi-drug resistance tuberculosis treatment were recruited as participants. This qualitative-phenomenological study uses an in-depth interview method and is completed with field notes. Data were analyzed using steps according to Colaizzi.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Result</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The study identified five themes related to the patients’ experience and behavior for the therapy, including the patient perceptions about the illness, perceived obstacles, factors that support adherence in treatment, hopes to achieve healing, and health promotion behavior.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Discussion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Many factors influence long-term treatment adherence. It is recommended to support patients with MDR TB who have been in care for a long time; policymakers and health practices must respect that condition of MDR-TB affects the psychosocial life of sufferers. Develop strategies to reduce perceived effects by providing opportunities to share their anxieties, suffering, and biopsychosocial changes.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Result" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Discussion" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the 3rd Aceh International Nursing Conference (AINC). Full-text and the content of it is under responsibility of authors of the article.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Participant \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Marital Status \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Education \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Job \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Treatment Duration \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Senior High School \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Entrepreneur \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Two months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Senior High School \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Entrepreneur \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Two months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diploma in Midwifery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Midwife \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Married \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Senior High School \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Housewife \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nine months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Married \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Junior high school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Housewife \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Three months \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">P6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">63 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Married \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Junior high school \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Housewife \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ten months \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Demographic profile of the participants.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Superordinate themes \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Subthemes \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">f</span> \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Patients’ perceptions about the disease experienced. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Understanding of the illness experience.Negative attitude when sickStigma. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[5][6][4] \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perceived obstacles \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Drug side effectsLong treatment timeThe negative attitude of health workers. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[6][5][4] \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Factors that support adherence in the treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Internal supportSupport in care \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[5][6] \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hope to achieve healing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Desire and reason to recover \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[5] \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Health promotion behavior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">A positive attitude by maintaining distance and use of masks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">[5] \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Superordinate themes and subthemes of the lived experiences of the MDR-TB patients.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:17 [ 0 => array:3 [ "identificador" => "bib0090" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Social support a key factor for adherence to multidrug-resistant tuberculosis treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R.D. Deshmukh" 1 => "D.J. Dhande" 2 => "K.S. Sachdeva" 3 => "A.N. Sreenivas" 4 => "A.M.V. Kumar" 5 => "M. Parmar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijtb.2017.05.003" "Revista" => array:6 [ "tituloSerie" => "Indian J Tuberc" "fecha" => "2018" "volumen" => "65" "paginaInicial" => "41" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29332647" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0095" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The battle continues: an interpretative phenomenological analysis of the experiences of multidrug-resistant tuberculosis (MDR-TB) patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Buenafe" 1 => "T.B. Lota" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Psychol Stud (Mysore)" "fecha" => "2018" "volumen" => "63" "paginaInicial" => "9" "paginaFinal" => "18" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0100" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO apresiasi Indonesia on track Upaya Akhiri TBC pada 2030" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.I. Kemenkes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:1 [ "fecha" => "2018" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0105" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Knowledge toward drugs resistant tuberculosis in one of the highest burden drug resistant country" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.R. Ramadhani" 1 => "B.W. Lestari" 2 => "H. Suryadinata" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "AMJ" "fecha" => "2018" "volumen" => "5" "paginaInicial" => "127" "paginaFinal" => "132" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0110" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Social, economic, and psychological impacts of MDR-TB treatment in Tijuana, Mexico: A patient's perspective" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.D. Morris" 1 => "L. Quezada" 2 => "P. Bhat" 3 => "K. Moser" 4 => "J. Smith" 5 => "H. Perez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5588/ijtld.12.0480" "Revista" => array:6 [ "tituloSerie" => "Int J Tuberc Lung Dis" "fecha" => "2013" "volumen" => "17" "paginaInicial" => "954" "paginaFinal" => "960" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23743315" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0115" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Determinants of default from tuberculosis treatment among patients with drug-susceptible tuberculosis in Karachi, Pakistan: a mixed methods study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Chida" 1 => "Z. Ansari" 2 => "H. Hussain" 3 => "M. Jaswal" 4 => "S. Symes" 5 => "A.J. Khan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "PLoS One" "fecha" => "2015" "volumen" => "10" "paginaInicial" => "1" "paginaFinal" => "14" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0120" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Studi kualitatif perilaku pasien tuberkulosis multi drugs resistant di wilayah kerja puskesmas poasia kota kendari tahun 2017" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.S.P.K. Hapsari" 1 => "L. Dupai" 2 => "F. Prasetya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Ilmiah Mahasiswa Kesehatan Masyarakat" "fecha" => "2017 2018" "volumen" => "3" "paginaInicial" => "1" "paginaFinal" => "10" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0125" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A qualitative evaluation of hospital versus community-based management of patients on injectable treatments for tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Banda" 1 => "M. Phiri" 2 => "D.B. Cohen" 3 => "I. Namakhoma" 4 => "N. Desmond" 5 => "S.B. Squire" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12889-017-4524-0" "Revista" => array:6 [ "tituloSerie" => "BMC Public Health" "fecha" => "2018" "volumen" => "18" "paginaInicial" => "1" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28693529" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0130" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Faktor risiko kejadian multi drug resistant tuberculosis di RSUP Dr. Sardjito" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.N. Widiastuti" 1 => "Y.W. Subronto" 2 => "D. Promono" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Berita Kedokteran Masyarakat" "fecha" => "2018" "volumen" => "33" "paginaInicial" => "325" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0135" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Investigating the relationship between components of pender's health promotion model and self-care behaviors among patients with smear-positive pulmonary tuberculosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Zare" 1 => "Z. Asadi" 2 => "M.V. Shahroodi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Evid Based Care J" "fecha" => "2017" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0140" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Psychological research as the phenomenologist views it" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.F. Colaizzi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:3 [ "editores" => "R.S.Valle, M.A.King" "titulo" => "Existential-phenomenological alternatives for psychology" "serieFecha" => "1978" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0145" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Being diagnosed with multi-drug resistant tuberculosis: experiences of patients from Rural Kwazulu Natal, South Africa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Ukanwa" 1 => "S. Madiba" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Recent Sci Res" "fecha" => "2013" "volumen" => "4" "paginaInicial" => "1831" "paginaFinal" => "1834" ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0150" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pengalaman Klien Sedang Menjalani Pengobatan MDR-TB" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.Y. Dulahu" 1 => "S.W. Ladiku" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Jambura Nurs J" "fecha" => "2019" "volumen" => "1" "paginaInicial" => "29" "paginaFinal" => "43" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0155" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health-related quality of life and its association with medication adherence in active pulmonary tuberculosis – a systematic review of global literature with focus on South Africa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Schwenkglenks" 1 => "B. Bennett" 2 => "A. Abulfathi" 3 => "E. Sinanovic" 4 => "T. Kastien-Hilka" 5 => "B. Rosenkranz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12955-016-0426-6" "Revista" => array:4 [ "tituloSerie" => "Health Qual Life Outcomes" "fecha" => "2016" "volumen" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26892667" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0160" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Faktor Yang Berhubungan Dengan Perilaku Menular Pada Pasien MDR-TB Paru Di RSUD DR Soedarso Pontianak" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Kurniawati" 1 => "A. Ridha" 2 => "I. Saleh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1021/ci400128m" "Revista" => array:6 [ "tituloSerie" => "J Chem Inf Model" "fecha" => "2019" "volumen" => "53" "paginaInicial" => "1689" "paginaFinal" => "1699" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23800267" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0165" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lived experience of patients on tuberculosis treatment in Tshwane, Gauteng province" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O.O. Akeju" 1 => "S.C.D. Wright" 2 => "T.M. Maja" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Heal SA Gesondheid" "fecha" => "2017" "volumen" => "22" "paginaInicial" => "259" "paginaFinal" => "267" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0170" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Religiusitas Koping Religius, dan Kesejahteraan Subjektif" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.S. Utami" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Psikologi" "fecha" => "2012" "volumen" => "39" "paginaInicial" => "46" "paginaFinal" => "66" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack619481" "titulo" => "Acknowledgments" "texto" => "<p id="par0150" class="elsevierStylePara elsevierViewall">We would like to thanks the nurses who assisted us during the data collection of this study.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/11308621/00000032000000S2/v1_202208030734/S113086212200081X/v1_202208030734/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/11308621/00000032000000S2/v1_202208030734/S113086212200081X/v1_202208030734/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S113086212200081X?idApp=UINPBA00004N" ]
