Latent transition analysis of stigma and its association with treatment adherence in pulmonary tuberculosis patients during anti-tuberculosis therapy

Objective To explore the changes in latent categories of stigma among patients with pulmonary tuberculosis over time and their correlation with treatment adherence. Methods A total of 236 patients with pulmonary tuberculosis were selected as the research subjects using the convenience sampling method. The social impact scale and medication adherence report scale were used to measure the enrolled research subjects at 1 month (T1) and 3 months (T2) after standard treatment. Latent profile analysis, latent transition analysis, and logistic regression were employed for statistical analysis. Results The scores of treatment adherence of pulmonary tuberculosis patients at T1 were significantly different according to marital status (χ 2 2 = 11.089, P = 0.001), education background (χ 2 = 19.4027, P 2 = 6.631, P = 0.010). At T2, the scores of treatment adherence were significantly different according to age (χ 2 = 9.485, P = 0.002), marital status (χ 2 = 9.567, P = 0.002), education (χ 2 = 10.604, P = 0.005), and living style (χ 2 = 6.186, P = 0.013). At T1 and T2, there were two latent profile categories of stigma, namely the high stigma group (C1) and the low stigma group (C2). The results of latent transition analysis showed that 38.65% of patients with pulmonary tuberculosis were continuously in the C1 group (continuous high stigma group), 28.37% of patients with pulmonary tuberculosis were continuously in the C2 group (continuous low stigma group), 24.16% of patients with pulmonary tuberculosis changed from the C1 group to the C2 group (decreasing stigma group), and 8.82% of patients with pulmonary tuberculosis changed from the C2 group to the C1 group (increasing stigma group). In the multivariate Logistic regression analysis, compared with the continuous low stigma group, the risk of low treatment adherence of pulmonary tuberculosis patients in the continuous high stigma group (OR = 10.740), the decreasing stigma group (OR = 2.145), and the increasing stigma group (OR = 4.166) increased (all P Conclusions This study found that there were four dynamic trajectories of stigma in patients with pulmonary tuberculosis: continuous high stigma group (38.65%), continuous low stigma group (28.37%), decreasing stigma group (24.16%), and increasing stigma group (8.82%). Compared with the continuous low stigma group, the risk of low treatment adherence of patients in the other three groups was significantly increased.