Illness Experience and Unmet Needs of Pulmonary Tuberculosis Patients: A Meta-Synthesis Guided by the Symptom Experience Model.

PURPOSE: Patients' illness experiences and needs are central to pulmonary tuberculosis management and have important implications for treatment engagement and health outcomes. This study addresses this gap by systematically synthesizing qualitative evidence to provide a comprehensive understanding of pulmonary tuberculosis patients' illness experiences and unmet needs, guided by the Symptom Experience Model.

METHODS: PubMed, Web of Science, Embase, PsycINFO, CINAHL, ProQuest, the Cochrane Library, CNKI, VIP, Wanfang, and SinoMed were searched from inception to December 2024 for qualitative or mixed-methods studies on the illness experience of pulmonary tuberculosis patients. Studies were screened and appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. Meta-integration techniques were used for synthesis. The Symptom Experience Model provided the interpretive framework for analysis. This review followed PRISMA 2020 guidelines for reporting systematic reviews. The PROSPERO registration was dated July 24, 2024 (Registration Number: CRD42024572729).

RESULTS: Twenty-one studies were included, comprising a total of 469 participants. A total of 36 themes were identified, grouped into nine descriptive categories and synthesized into two overarching findings. First, patients experience complex illness-related challenges, including physical symptoms, psychological distress, disrupted social roles, uncertainty about the future, and, in some cases, post-traumatic growth. Second, multiple unmet needs were identified, including inadequate health education, insufficient emotional support, stigma, barriers to healthcare access, and lack of socioeconomic support. While the Symptom Experience Model helped explain symptom perception and coping behaviors, it was less effective in addressing structural determinants such as poverty and systemic stigma.

CONCLUSION: Pulmonary tuberculosis causes profound suffering shaped by both individual responses and wider social contexts. Interventions should address emotional and cognitive processes, strengthen social support, and consider patients' lived realities. The Symptom Experience Model could be expanded to better reflect socioecological influences.