Systems of support for foreign-born TB patients and their family members

Setting Adverse social determinants of health for people who are foreign-born are key drivers of TB-related disparity, particularly in low-incidence countries. Patients diagnosed with infectious TB and their family members must confront psychosocial challenges which may deepen pre-existing health inequities. However, little is known about patient and family members' perspective on these experiences. Objective To explore the infectious TB experience of patients and family members who are foreign-born. Design This study formed one component of an ecologically framed, qualitative case study conducted in Calgary, AB, Canada. Data were collected using semi-structured interviews, chart review and field notes, and analysed thematically. Results Eight families were represented in the sample comprised of six patients and 13 family members. Many patients and family members experienced high levels of fear and stress for months following the patient's diagnosis. Isolation was pervasive and multifaceted for both patients and family members. Intra-family support was critical for managing during early stages when the situation was most challenging. Support from outside the family was not prominent and attempts to obtain support from government programmes for paid sick leave and health insurance were mostly unsuccessful. Conclusion Patients and family members who are foreign-born experience multidimensional isolation as a result of TB stigma, language barriers and poor access to government programmes. TB programmes cannot meet family needs alone and systems of support should be created through collaboration with government institutions, and organisations serving ethnocultural communities.