Pencegahan Stigma Pasien TB Paru Dalam Upaya Meningkatkan Perilaku Pencarian Pelayanan Kesehatan Berbasis Health Action Process Approach (HA

Abstract

Stigma toward tuberculosis (TB) patients remains a major barrier to health-seeking behavior and may hinder early detection and effective treatment. This study aimed to analyze and confirm the relationship model between stigma among pulmonary TB patients and health-seeking behavior based on the Health Action Process Approach (HAPA) in Lumajang Regency. An analytic quantitative approach with a cross-sectional design was employed. The study involved 202 smear-positive TB patients from 25 primary health centers in Lumajang Regency, selected using proportional random sampling. The study variables included social stigma, self-stigma, task self-efficacy, intention, action planning, coping planning, and health-seeking behavior. Data were collected using validated and reliable questionnaires and analyzed using Structural Equation Modeling–Partial Least Squares (SEM-PLS) version 4. The results showed that respondents had a mean age of 42.2 years, were predominantly male (58.9%), of Madurese ethnicity (82.7%), and had elementary-level education (41.6%). Hypothesis testing indicated that self-stigma had a significant effect on task self-efficacy, intention, and coping planning. Social stigma significantly influenced intention and action planning but did not have a significant effect on task self-efficacy. Furthermore, task self-efficacy affected intention, intention influenced action planning, action planning affected coping planning, and coping planning had a strong effect on health-seeking behavior. Self-stigma emerged as the strongest psychosocial factor influencing the psychological processes of TB patients. Strengthening self-efficacy and developing effective coping strategies are essential to overcoming stigma-related barriers and improving optimal health-seeking behavior.