Studies suggest that the stigma towards patients with pulmonary tuberculosis is still currently a reality. The stigma related to this disease interferes with the patients’ self-esteem, their quality of life, family and social relationships and, also, with their medical treatment. In Portugal, this stigma matter towards patients with pulmonary tuberculosis has not been deeply investigated, despite some studies occasionally suggesting its relevance. This investigation analyses the stigma related to pulmonary tuberculosis patients, in Pulmonary Diagnostic Centres of the northern regions of Portugal and is carried out in two stages. The first stage comprehends a preliminary study, of qualitative nature, on nurses from Pulmonary Diagnostic Centres of continental Portugal. This preliminary study aims to identify whether stigma is present in nurses’ speeches. The results from this study and the theoretical background available show that the stigma towards tuberculosis in Portugal is a reality, which intensifies the importance of exploring this matter. The second stage presents the study of the stigma of tuberculosis from the perspective of the patients and of the nurses of Primary Healthcare. For this purpose, three studies were carried out: “Study I” comprises three methodological studies to evaluate the metrical characteristics of Tuberculosis Related Stigma Scale and of Social Support Satisfaction Scale, and to build and validate the content of the survey “A minha Opinião” (My opinion); “Study II”, of quantitative paradigm, aims to evaluate the stigma and the satisfaction towards the social support, from the perspective of pulmonary tuberculosis patients enduring current medical treatments in Pulmonary Diagnostic Centres or in the follow-up stages; and “Study III”, of qualitative paradigm, explores the matter of stigma in tuberculosis, from the Primary Healthcare nurses’ perspectives, in order to identify stigma manifestations to the person suffering from pulmonary tuberculosis throughout their clinical experience. The results of these studies have confirmed the presence of a high stigma towards patients with pulmonary tuberculosis. Similar results were obtained when analysing nurses’ speeches. The stigma is also present, and nurses appear as victims and, simultaneously, as stigma boosters. The National Healthcare System and their orientations are, cumulatively, a source for stigma towards the patients. Lastly, through data triangulation, we were able to understand and consolidate the answer to the research question that triggered this investigation. We have also described the broadness of the stigma in our sample panel, and we have also verified that not only the stigma remains a reality in society, but it also causes economic impact and physical, moral, and social suffering, therefore motivating discouragement, or even depression, and favouring social and family isolation of the diseased. We have concluded this investigation by showing an explicative model of the stigma felt by the pulmonary tuberculosis patient, where it is possible to see its origin and consequences to the diseased and family members, and healthcare professionals. Globally, these results suggest the need to reflect on the healthcare policies for this disease and its treatment and, simultaneously, the need to empower healthcare professionals in this matter. Considering that, for public health reasons and for a Greater Good, the benefit of permanent monitoring persists, with emphasis on the medication intake directly observed by health professionals, there are currently tools and resources that may aid the nurse and the patient to fulfil desired goals regarding the treatment journey and efficiency. These tools may add value to the binomial diseased patient-healthcare system, protecting both the patient and the nurse; and to the healthcare system, by helping achieve the desired targets. This should constitute the main focus of clinical practice and research, since this is a particularly relevant aspect to the pulmonary tuberculosis patient’s care, in Portugal.
| Date of Award | 2 Jul 2025 |
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| Original language | Portuguese |
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| Awarding Institution | - Universidade Católica Portuguesa
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| Supervisor | Beatriz Araújo (Supervisor) |
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