An Overview of Factors That Support Self-Efficacy Among Outpatient Pulmonary Tb Patients at The Dr. H. Soewondo Kendal Regional General Hospital
Keywords:
Self-efficacy, Pulmonary tuberculosis, Performance accomplishment, Verbal persuasion, Outpatient careAbstract
Pulmonary tuberculosis requires prolonged treatment, making self-efficacy an important psychological resource for maintaining treatment engagement. This study aimed to describe factors supporting self-efficacy among outpatient pulmonary TB patients at Dr. H. Soewondo Kendal Regional General Hospital. A descriptive quantitative design was applied to 88 respondents selected through purposive sampling. Data were collected using a questionnaire covering performance accomplishment, vicarious experience, verbal persuasion, and physiological information, then analyzed univariately. Respondents had a mean age of 39.86 years, and most were male (59.1%), junior high school graduates (38.6%), and private-sector workers (31.8%). Performance accomplishment was categorized as successful in 77 respondents (87.5%). High vicarious experience was reported by 38 respondents (43.2%), positive verbal persuasion by 70 respondents (79.5%), and high physiological information by 34 respondents (38.6%). These findings indicate that personal success experiences and positive interpersonal encouragement were the strongest supportive factors, while observational and physiological-emotional factors showed greater variation. Strengthening patient-centered education, family support, peer modeling, and psychosocial assistance may help sustain self-efficacy during pulmonary TB treatment. These strategies may support consistent engagement with outpatient care throughout the long-term therapeutic process.
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Addo, J., Pearce, D., Metcalf, M., Lundquist, C., Thomas, G., Barros-Aguirre, D., Koh, G. C. K. W., & Strange, M. (2022). Living with tuberculosis: A qualitative study of patients’ experiences with disease and treatment. BMC Public Health, 22, 1717. https://doi.org/10.1186/s12889-022-14115-7
Adisa, R., & Durojaye, D. M. (2025). Treatment adherence, social support and coping mechanisms among patients with drug-sensitive tuberculosis: A cross-sectional study in two directly-observed therapy centres in southwest Nigeria. BMJ Open, 15(10), e099559. https://doi.org/10.1136/bmjopen-2025-099559
Alfa, Z. S. (2023). Hubungan pengetahuan, sikap dan tindakan penderita tuberkulosis paru terhadap kepatuhan minum obat di Puskesmas Warungpring Kota Pemalang [Undergraduate thesis, Universitas Islam Sultan Agung].
Alinaitwe, B., Shariff, N. J., & Boddupalli, B. M. (2025). Treatment adherence and its association with family support among pulmonary tuberculosis patients in Jinja, Eastern Uganda. Scientific Reports, 15, 11150. https://doi.org/10.1038/s41598-025-96260-8
Ardiana, H., Amin, M., & Hidayati, L. (2021). Model intervensi pada pasien tuberkulosis untuk meningkatkan kepatuhan: A systematic review. NURSCOPE: Jurnal Penelitian dan Pemikiran Ilmiah Keperawatan, 7(2), 153–162. https://doi.org/10.30659/nurscope.7.2.153-162
Areas Lisboa Netto, T., Diniz, B. D., Odutola, P., Dantas, C. R., de Freitas, M. C. F. L. C., Hefford, P. M., & Bes, T. M. (2024). Video-observed therapy (VOT) vs directly observed therapy (DOT) for tuberculosis treatment: A systematic review on adherence, cost of treatment observation, time spent observing treatment and patient satisfaction. PLOS Neglected Tropical Diseases, 18(10), e0012565. https://doi.org/10.1371/journal.pntd.0012565
Badria, L., & Fatmawati, F. (2023). Pengetahuan dengan tingkat kecemasan klien gagal ginjal kronik. Jurnal Ilmiah Kesehatan Sandi Husada, 12(1), 288–293. https://doi.org/10.35816/jiskh.v12i1.1143
Chatterjee, S., Stallworthy, G., Das, P., & Vassall, A. (2024). Estimation of potential social support requirement for tuberculosis patients in India. Health Policy and Planning, 39(8), 854–863. https://doi.org/10.1093/heapol/czae065
Chauhan, A., Parmar, M., Dash, G. C., Chauhan, S., Sahoo, K. C., Samantaray, K., Sharma, J., Mahapatra, P., & Pati, S. (2024). Health literacy and tuberculosis control: Systematic review and meta-analysis. Bulletin of the World Health Organization, 102(6), 421–431. https://doi.org/10.2471/BLT.23.290396
Endalamaw, A., Gilks, C. F., Ambaw, F., Chatfield, M. D., & Assefa, Y. (2022). Satisfaction of tuberculosis patients to healthcare services at the global level: A systematic review. Health & Social Care in the Community, 30(6), e3435–e3446. https://doi.org/10.1111/hsc.13953
Ernawati, I., Fandinata, S. S., & Permatasari, S. N. (2020). Kepatuhan konsumsi obat pasien hipertensi: Pengukuran dan cara meningkatkan kepatuhan. Graniti.
Fernandes, A., Laohaprapanon, S., Nam, T. T., Sequeira, E. M. D. C., & Le, C. N. (2024). Adherence to pulmonary tuberculosis medication and associated factors among adults: A cross-sectional study in the Metinaro and Becora Sub-Districts, Dili, Timor-Leste. International Journal of Environmental Research and Public Health, 21(12), 1662. https://doi.org/10.3390/ijerph21121662
Fuady, A., Arifin, B., Yunita, F., Rauf, S., Fitriangga, A., Sugiharto, A., Yani, F. F., Nasution, H. S., Putra, I. W. G. A. E., Mansyur, M., & Wingfield, T. (2023). Stigma towards people with tuberculosis: A cross-cultural adaptation and validation of a scale in Indonesia. BMC Psychology, 11, 112. https://doi.org/10.1186/s40359-023-01161-y
Fuady, A., Arifin, B., Yunita, F., Rauf, S., Fitriangga, A., Sugiharto, A., Yani, F. F., Nasution, H. S., Putra, I. W. G. A. E., Mansyur, M., & Wingfield, T. (2024). Stigma, depression, quality of life, and the need for psychosocial support among people with tuberculosis in Indonesia: A multi-site cross-sectional study. PLOS Global Public Health, 4(1), e0002489. https://doi.org/10.1371/journal.pgph.0002489
Iribarren, S. J., Milligan, H., Chirico, C., Goodwin, K., Schnall, R., Telles, H., Iannizzotto, A., Sanjurjo, M., Lutz, B. R., Pike, K., Rubinstein, F., Rhodehamel, M., Leon, D., Keyes, J., & Demiris, G. (2022). Patient-centered mobile tuberculosis treatment support tools (TB-TSTs) to improve treatment adherence: A pilot randomized controlled trial exploring feasibility, acceptability and refinement needs. The Lancet Regional Health – Americas, 13, 100291. https://doi.org/10.1016/j.lana.2022.100291
Kafie, C., Mohamed, M. S., Zary, M., Chilala, C. I., Bahukudumbi, S., Gore, G., Foster, N., Fielding, K. L., Subbaraman, R., & Schwartzman, K. (2024). Cost and cost-effectiveness of digital technologies for support of tuberculosis treatment adherence: A systematic review. BMJ Global Health, 9(10), e015654. https://doi.org/10.1136/bmjgh-2024-015654
Kementerian Kesehatan Republik Indonesia. (2022). Laporan program penanggulangan tuberkulosis tahun 2021. Kementerian Kesehatan Republik Indonesia.
Kementerian Kesehatan Republik Indonesia. (2022). Profil kesehatan Indonesia 2021. Kementerian Kesehatan Republik Indonesia.
Kurniyawan, E. H., Noviani, W., Dewi, E. I., Susumaningrum, L. A., & Widayati, N. (2022). Hubungan tingkat stres dengan efikasi diri pada pasien TBC paru. Nursing Sciences Journal, 6(2), 55–62. https://doi.org/10.30737/nsj.v6i2.3201
Larasati, A. D., Raimonda, A. I. V., Ningsih, C. S., & Miko, T. K. P. (2023). Hubungan self efficacy dengan tingkat depresi perawat onkologi selama pandemi COVID-19. Jurnal Keperawatan Jiwa, 11(2), 503–510. https://doi.org/10.26714/jkj.11.2.2023.503-510
Leddy, A. M., Jaganath, D., Triasih, R., Wobudeya, E., Bellotti de Oliveira, M. C., Sheremeta, Y., Becerra, M. C., & Chiang, S. S. (2022). Social determinants of adherence to treatment for tuberculosis infection and disease among children, adolescents, and young adults: A narrative review. Journal of the Pediatric Infectious Diseases Society, 11(Suppl. 3), S79–S84. https://doi.org/10.1093/jpids/piac058
Lestari, N. Y. (2022). Efek efikasi diri dan kualitas hidup pasien diabetes melitus tipe 2 di Puskesmas Mlonggo dan Puskesmas Bangsri 1 Kabupaten Jepara Jawa Tengah [Undergraduate thesis, Universitas Islam Sultan Agung].
Lippincott, C. K., Perry, A., Munk, E., Maltas, G., & Shah, M. (2022). Tuberculosis treatment adherence in the era of COVID-19. BMC Infectious Diseases, 22, 800. https://doi.org/10.1186/s12879-022-07787-4
Liu, X., Thompson, J., Dong, H., Sweeney, S., Li, X., Yuan, Y., Wang, X., He, W., Thomas, B., Xu, C., Hu, D., Vassall, A., Huan, S., Zhang, H., Jiang, S., Fielding, K., & Zhao, Y. (2023). Digital adherence technologies to improve tuberculosis treatment outcomes in China: A cluster-randomised superiority trial. The Lancet Global Health, 11(5), e693–e703. https://doi.org/10.1016/S2214-109X(23)00068-2
Lolong, D. B., Aryastami, N. K., Kusrini, I., Tobing, K. L., Tarigan, I., Isfandari, S., Senewe, F. P., Raflizar, Endah, N., Sitorus, N., Pangaribuan, L., Simarmata, O. S., & Ariati, Y. (2023). Nonadherence to anti-tuberculosis treatment, reasons and associated factors among pulmonary tuberculosis patients in the communities in Indonesia. PLOS ONE, 18(8), e0287628. https://doi.org/10.1371/journal.pone.0287628
Lutfian, L., Azizah, A., Wardika, I. J., Wildana, F., Maulana, S., & Wartakusumah, R. (2025). The role of family support in medication adherence and quality of life among tuberculosis patients: A scoping review. Japan Journal of Nursing Science, 22(1), e12629. https://doi.org/10.1111/jjns.12629
Maynard, C., Tariq, S., Sotgiu, G., Migliori, G. B., van den Boom, M., & Field, N. (2023). Psychosocial support interventions to improve treatment outcomes for people living with tuberculosis: A mixed methods systematic review and meta-analysis. EClinicalMedicine, 61, 102057. https://doi.org/10.1016/j.eclinm.2023.102057
Mertisa, M., Oktarina, Y., & Subandi, A. (2023). Hubungan efikasi diri terhadap kepatuhan minum obat pada pasien penyakit tuberkulosis di Puskesmas Putri Ayu Kota Jambi. Jurnal Ilmiah Dikdaya, 13(2), 468–478. https://doi.org/10.33087/dikdaya.v13i2.517
Musiimenta, A., Tumuhimbise, W., Atukunda, E., Mugaba, A., Linnemayr, S., & Haberer, J. (2024). Digital adherence technologies linked to mobile money incentives for medication adherence among people living with tuberculosis: Mixed methods feasibility and acceptability study. JMIR Human Factors, 11, e47996. https://doi.org/10.2196/47996
Nasution, M. S. (2021). Hubungan dukungan keluarga dengan kepatuhan minum obat tuberkulosis paru (TB paru) pada pasien rawat jalan di Puskesmas Batu Horpak Kecamatan Tano Tombangan Angkola tahun 2021 [Undergraduate thesis].
Notoatmodjo, S. (2015). Metodologi penelitian kesehatan. Rineka Cipta.
Notoatmodjo, S. (2018). Metodologi penelitian kesehatan. Rineka Cipta.
Noviana, L., Nasution, S. Z., & Wahyuni, A. S. (2023). Dukungan keluarga terhadap kepatuhan minum obat pada penderita tuberculosis dengan multidrug resistant (TB-MDR). Journal of Telenursing (JOTING), 5(2), 1650–1658. https://doi.org/10.31539/joting.v5i2.6530
Noviani, W. (2018). Hubungan tingkat stres dengan efikasi diri pada pasien TB paru di wilayah kerja Puskesmas Patrang Kabupaten Jember [Undergraduate thesis, Universitas Jember].
Nursalam. (2020). Metodologi penelitian ilmu keperawatan: Pendekatan praktis (5th ed.). Salemba Medika.
Panda, U. K., Ra, D., Sahoo, S. S., Kakkar, R., & Singh, J. (2024). Interplay between tuberculosis, mental illness, and treatment compliance: An integrative literature review. Indian Journal of Tuberculosis, 71(3), 353–357. https://doi.org/10.1016/j.ijtb.2023.10.004
Pradhan, A., Koirala, P., Bhandari, S. S., Dutta, S., García-Grau, P., Sampath, H., & Sharma, I. (2022). Internalized and perceived stigma and depression in pulmonary tuberculosis: Do they explain the relationship between drug sensitivity status and adherence? Frontiers in Psychiatry, 13, 869647. https://doi.org/10.3389/fpsyt.2022.869647
Quarcoopome, L., & Tornu, E. (2022). Health-related quality of life of persons living with tuberculosis: A cross-sectional study. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 28, 100324. https://doi.org/10.1016/j.jctube.2022.100324
Rianto, L., Agustina, I., Alfian, S. D., Iskandarsyah, A., Pradipta, I. S., & Abdulah, R. (2024). Development and validation of a structured questionnaire for assessing risk factors of medication non-adherence among pulmonary tuberculosis patients in Indonesia. Frontiers in Pharmacology, 14, 1257353. https://doi.org/10.3389/fphar.2023.1257353
Ridho, A., Alfian, S. D., van Boven, J. F. M., Levita, J., Yalcin, E. A., Le, L., Alffenaar, J.-W., Hak, E., Abdulah, R., & Pradipta, I. S. (2022). Digital health technologies to improve medication adherence and treatment outcomes in patients with tuberculosis: Systematic review of randomized controlled trials. Journal of Medical Internet Research, 24(2), e33062. https://doi.org/10.2196/33062
Shringarpure, K., Gurumurthy, M., Sagili, K. D., Taylor, M., Garner, P., Tonsing, J., Rao, R., & Sachdeva, K. S. (2023). Patient adherence to tuberculosis treatment in the Indian subcontinent: Systematic review and meta-synthesis of qualitative research. BMJ Open, 13(5), e063926. https://doi.org/10.1136/bmjopen-2022-063926
Tornu, E., & Quarcoopome, L. (2022). Correlates of quality of life among persons living with tuberculosis: A cross-sectional study. PLOS ONE, 17(11), e0277192. https://doi.org/10.1371/journal.pone.0277192
Wang, Y., Jian, S., Huang, Z., Chen, H., Hu, Y., & Fang, S. (2024). Medication-related burden and its association with medication adherence among elderly tuberculosis patients in Guizhou, China: A cross-sectional study. Frontiers in Pharmacology, 15, 1416005. https://doi.org/10.3389/fphar.2024.1416005
Yani, D. I., Juniarti, N., & Lukman, M. (2022). Factors related to complying with anti-TB medications among drug-resistant tuberculosis patients in Indonesia. Patient Preference and Adherence, 16, 3319–3327. https://doi.org/10.2147/PPA.S388989
Zaidi, I., Sarma, P. S., Khayyam, K. U., Ahmad, Q. T., Ramankutty, V., & Singh, G. (2024). Factors associated with treatment adherence among pulmonary tuberculosis patients in New Delhi. Indian Journal of Tuberculosis, 71(Suppl. 1), S52–S58. https://doi.org/10.1016/j.ijtb.2023.08.006
Zuo, X., Dong, Z., Zhang, P., Zhang, P., Zhu, X., Qiao, C., Yang, Y., & Lou, P. (2022). Cognitive-behavioral therapy on psychological stress and quality of life in subjects with pulmonary tuberculosis: A community-based cluster randomized controlled trial. BMC Public Health, 22, 2160. https://doi.org/10.1186/s12889-022-14631-6
