Extended self-efficacy theory to explain patients’ non-adherence to tuberculosis treatment in Mpumalanga healthcare facilities
- 1School of Computing, College of Science, Engineering and Technology, University of South Africa, Pretoria
Abstract
Background: Tuberculosis (TB) remains a major burden in the province of Mpumalanga, South Africa. Treatment adherence is a key factor in the outcome of therapy. Objectives: To develop a conceptual framework based on extended self-efficacy theory to explain patients’ non-adherence to TB treatment in healthcare facilities in the province of Mpumalanga. Method: The study employed a quantitative approach with a cross-sectional survey design. Data were collected through structured questionnaires distributed to 89 patients receiving TB treatment. Descriptive statistics, the Pearson correlation coefficient and multiple regression analysis were among the many analyses carried out in this study. Results: Self-efficacy has a significant influence on medication literacy (β = 0.136, t = 2.359, p 0.001), patient satisfaction (β = 0.105, t = 2.115, p 0.001) and pill burden (β = 0.166, t = 2.977, p 0.001) towards non-adherence to TB treatment and, thus supporting hypotheses H1, H2 and H3. There was a negative relationship between patient satisfaction and attitudes toward healthcare workers (β = 0.039, t = 0.684, and p 0.72). Therefore, H4 is not supported. Attitude towards TB treatment has a significant effect on patient satisfaction towards non-adherence to TB treatment (β = 0.143, t = 2.691, p 0.001); hence, H5 was accepted. Conclusion: Self-efficacy had a partial significant mediating effect on the relationship between medication literacy and medication adherence. This study emphasises self-efficacy and the importance of improving treatment attitudes, medication literacy and the efforts of healthcare professionals to prevent non-adherence to TB treatments. Contribution: The findings contribute to the body of knowledge and offer a platform for assessing the current strategies on fighting the disease through the developed research model aimed at determining the obstacles to non-adherence to TB treatments at healthcare facilities. The research model suggests various strategies that ultimately reduce the rate of treatment default, limits community transmission, and lower the global risk of multi-drug-resistant tuberculosis (MDR-TB).
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BibTeX
@article{motsi2026extended,
title = {{Extended self-efficacy theory to explain patients’ non-adherence to tuberculosis treatment in Mpumalanga healthcare facilities}},
author = {Harma Motsi and Bester Chimbo},
journal = {Curationis},
year = {2026},
month = oct,
doi = {10.4102/curationis.v49i1.2840},
url = {https://doi.org/10.4102/curationis.v49i1.2840},
note = {CC BY},
}
RIS
TY - JOUR
TI - Extended self-efficacy theory to explain patients’ non-adherence to tuberculosis treatment in Mpumalanga healthcare facilities
AU - Harma Motsi
AU - Bester Chimbo
PY - 2026
DA - 2026/10/01
JO - Curationis
DO - 10.4102/curationis.v49i1.2840
UR - https://doi.org/10.4102/curationis.v49i1.2840
AB - Background: Tuberculosis (TB) remains a major burden in the province of Mpumalanga, South Africa. Treatment adherence is a key factor in the outcome of therapy. Objectives: To develop a conceptual framework based on extended self-efficacy theory to explain patients’ non-adherence to TB treatment in healthcare facilities in the province of Mpumalanga. Method: The study employed a quantitative approach with a cross-sectional survey design. Data were collected through structured questionnaires distributed to 89 patients receiving TB treatment. Descriptive statistics, the Pearson correlation coefficient and multiple regression analysis were among the many analyses carried out in this study. Results: Self-efficacy has a significant influence on medication literacy (β = 0.136, t = 2.359, p 0.001), patient satisfaction (β = 0.105, t = 2.115, p 0.001) and pill burden (β = 0.166, t = 2.977, p 0.001) towards non-adherence to TB treatment and, thus supporting hypotheses H1, H2 and H3. There was a negative relationship between patient satisfaction and attitudes toward healthcare workers (β = 0.039, t = 0.684, and p 0.72). Therefore, H4 is not supported. Attitude towards TB treatment has a significant effect on patient satisfaction towards non-adherence to TB treatment (β = 0.143, t = 2.691, p 0.001); hence, H5 was accepted. Conclusion: Self-efficacy had a partial significant mediating effect on the relationship between medication literacy and medication adherence. This study emphasises self-efficacy and the importance of improving treatment attitudes, medication literacy and the efforts of healthcare professionals to prevent non-adherence to TB treatments. Contribution: The findings contribute to the body of knowledge and offer a platform for assessing the current strategies on fighting the disease through the developed research model aimed at determining the obstacles to non-adherence to TB treatments at healthcare facilities. The research model suggests various strategies that ultimately reduce the rate of treatment default, limits community transmission, and lower the global risk of multi-drug-resistant tuberculosis (MDR-TB).
SN - 0379-8577
SN - 2223-6279
ER -