Improvement of Tuberculosis (TB) Patient Treatment Adherence through Family-Centered Approach and Social Cognitive Theory in Probolinggo Regency

Abstract

Tuberculosis (TB) is still a public health problem. The existence of TB prevention programs involving the community has increased the discovery of TB suspects, but it has not been followed by treatment adherence of TB patients. The purpose of this study is to determine the improvement of treatment adherence of tuberculosis (TB) patients through a family-centered approach and social cognitive theory in Probolinggo Regency. This study is a quasi-experimental study using a pretest-posttest nonequivalent control group design. The population comprised all adherence TB patients in Probolinggo Regency (112 people); the sample comprised partially adherent TB patients, including family members, according to the inclusion criteria, using a cluster random sampling technique to select 80 respondents, divided into two groups: 40 in the intervention group and 40 in the control group. Patients in the intervention group received a family-based approach and social cognitive which focuses on interaction. The personal factors (knowledge, increased self-efficacy, medication-taking behavior) and the environment (family support) are important parts of care. The focus is not solely on the individual patient but on the relationship among behavior, environment, and mindset, applying theory through education twice a week for 60 minutes over 2 months. The control group received standard health services without additional intervention. Data were collected using a questionnaire, the Morisky Medication Adherence Scale (MMAS-8), which has undergone validity and reliability testing (Cronbach's alpha: 0.80), and a family-based nursing module. Data analysis with the help of SPSS nonparametric test, Wilcoxon W. Data processed on September 16, 2025. The results showed that, in the intervention group, the average non-adherence was 62.5%, and in the control group, 47.5%. Post-test showed that the average t adherent reached 77.5%, while the control group was non-adherent at 47.5%. The results of the independent-samples t-test show that in the intervention group, the mean rank is 56.3, and in the control group, it is 24.6, with a significant difference (P-value: 0.000 < α = 0.005). and results Mann-Whitney test significant (P-value: 0.000 < α = 0.005). There is a difference between the intervention and control groups. This means there is an increase in average adherence to family-based methods compared with standard health service methods. A family-centered approach, grounded in education and social cognitive theory, increases self-efficacy, and observational learning can improve adherence among patients with TB.