Insights of TB-DOTS Nurses on the Barriers Adherence among TB-Patients in Cabanatuan City: A Qualitative Study

Abstract

The Philippines ranks fourth globally in TB incidence, making complete treatment adherence crucial to combat the disease (Flores, 2025). Non-adherence leads to more severe, drug-resistant, and costly infections, making the fight against TB even harder (Tirore et al., 2024). To explore factors influencing adherence, a qualitative descriptive study was conducted in Cabanatuan City, Nueva Ecija, Philippines. The study used a semi-structured interview among eight TB-DOTS nurses purposively sampled from healthcare facilities. Data were analyzed using thematic analysis (Braun and Clarke), which consists of six-phase approach. To ensure trustworthiness of the study, data were triangulated by cross-referencing all participants to identify consistent patterns. In addition, an audit trail was maintained, and peer debriefing was conducted to validate the interpretation of the themes with a senior researcher. In addition, participants provided informed consent prior to the interview. Findings revealed three overarching major themes. (1) Hidden Hurdles of TB Treatment. It refers to barriers to adherence to medication. (2) Beyond Pills: Empowering TB Patients highlighted the positive impact of a robust support system. (3) The Patient's Drive: Inner Strength & Flexible Care. It illuminates patient self-efficacy and adaptive support from healthcare providers. The study concludes that improving TB treatment adherence requires a comprehensive, human-centered strategy that directly addresses these "hidden hurdles" and leverages patients' intrinsic motivation through empowering, personalized, and flexible care. The study has a significant impact to the public health. A human-centered approach is uniquely effective in helping TB Patients. Future interventions, such as financial assistance and social support programs, aims to reduce the identified barriers, and ultimately aiming for a TB-free community.