The tale of seeking treatment: A qualitative study of pulmonary tuberculosis patients

Aim: The aims of the study were unravelling patients’ health-seeking behaviour pathways to seek medication in healthcare facilities and key factors that determined patients’ immediacy in seeking medical treatment. Method: By involving 5 pulmonary TB patients who were undertaking treatment at Pegirian Primary Health Centre, Surabaya, Indonesia, the research was carried out using an explorative qualitative research design, and the chosen data collection technique was semi-structured interview. Results: The research findings demonstrated that all participants showed five rather similar health-seeking behaviour sequences, such as: (a) defining symptoms; (b) asking laypeople opinions on symptoms; (c) undertaking non-medical treatment to reduce the symptoms; (d) taking laypeople’s suggestions to visit healthcare facilities into consideration; (e) deciding to undergo treatment process. Several barriers that caused treatment delay were inaccurate symptom definition and poor health-related risk perception. Meanwhile, reinforcing factors were relatives’ appeal to seek treatment, the existence of comorbid/previous diseases, access to healthcare facilities, and increasing perceived severity of the symptoms. Conclusion: Research findings showed that participants performed similar health-seeking pathways. Hindering factors that caused treatment delay were mostly related to cultural-based illness definition and knowledge. Research findings would be potentially beneficial to local primary healthcare for designing interventions that encourage patients to seek professional help and reduce treatment delay. peerReviewed publishedVersion

研究目的：本研究旨在阐明患者前往医疗机构就诊取药的健康寻求行为（health-seeking behaviour）路径，以及影响患者即时就医的关键因素。
研究方法：本研究采用探索性质性研究设计，选取印度尼西亚泗水市佩吉里安初级卫生保健中心（Pegirian Primary Health Centre）正在接受治疗的5名肺结核（pulmonary TB）患者作为研究对象，数据收集采用半结构化访谈（semi-structured interview）法。
研究结果：研究结果显示，所有受试者均呈现出五条高度相似的健康寻求行为序列，具体包括：(a) 症状自我界定；(b) 向非专业人士咨询症状相关意见；(c) 采用非医疗手段缓解症状；(d) 考量非专业人士提出的就诊建议；(e) 决定启动治疗流程。导致治疗延误的若干阻碍因素包括症状界定不准确以及健康相关风险感知薄弱。与此同时，促进就医的强化因素包括家属敦促就医、合并症/既往病史、医疗机构可及性提升以及症状感知严重程度加重。
研究结论：本研究结果表明，受试者的健康寻求路径具有较高相似性。导致治疗延误的阻碍因素多与基于文化的疾病认知及健康知识水平相关。本研究结果可为当地初级卫生保健机构设计相关干预方案提供参考，以鼓励患者及时寻求专业医疗帮助并减少治疗延误情况。本研究为经同行评审的正式发表版本。