ArticlePatient preference and adherence2026
The Association Between Tuberculosis-Related Stigma and Sleep Quality Among Hospitalized Tuberculosis Patients: The Indirect Role of Anxiety.
Article in Patient preference and adherence, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: To investigate the relationship between perceived stigma and sleep quality among hospitalized tuberculosis patients, and to examine the indirect role of anxiety in this relationship. Methods: A cross-sectional study design was employed. A convenience sample of 2179 tuberculosis patients was selected and assessed using the TB-Related Stigma Scale (TSS), the Self-Rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI). The indirect effect of anxiety was examined using the PROCESS macro (Model 4; Hayes, 2018) with 5000 bootstrap resamples to generate 95% bias-corrected confidence intervals for indirect effects. Results: Perceived stigma was positively associated with PSQI scores ( Conclusion: Perceived stigma was indirectly associated with sleep quality through anxiety. These findings suggest that perceived stigma and anxiety may be potential contributing factors related to sleep quality in this population. Given the cross-sectional design, they should be interpreted as hypotheses-generating rather than evidence of causal intervention effects; future intervention studies may consider combined approaches-such as cognitive behavioral therapy together with social support and anxiety-management interventions-to examine whether targeting perceived stigma and anxiety improves sleep outcomes.
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