Evidence map›Paper›PMID 41715249›Full record

ArticleBMC psychology2026

Patients', caregivers' and healthcare workers' perspectives on integrating anxiety care in tuberculosis services in Pakistan: a qualitative interview study.

Fatima Khalid Qazi, Cath Jackson, Zala, Aliya Rehman, Ihtesham Ul Haq, Saima Aleem, Muhammad Asim, Haroon Latif Khan, Saima Afaq

Abstract read
In one paragraph

Article in BMC psychology, 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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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Fatima Khalid QaziInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan.
Cath JacksonValid Research Ltd, Wetherby, UK.
ZalaInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan.
Aliya RehmanInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan.
Ihtesham Ul HaqInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan.
Saima AleemInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan.
Muhammad AsimInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan.
Haroon Latif KhanInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan.
Saima AfaqInstitute of Public Health & Social Sciences (IPH&SS), Khyber Medical University (KMU), Peshawar, Pakistan. saima.afaq@york.ac.uk.

Funding

GCRF and Newton Consolidation Accounts (GNCAs) Ref No. MR/T037806/1
6 · The paper itself

Abstract

backgroundUp to 80% of active tuberculosis (TB) patients experience anxiety, threatening their treatment outcomes. The National TB Control Programme in Pakistan currently only provides mental health services for patients with multi-drug resistant TB, leaving those with drug sensitive TB (DSTB) unsupported. This study explored (1) experiences of anxiety and self-managed coping strategies used by patients with DSTB and their caregivers (2), current practice for the management of anxiety in DSTB patients, and (3) challenges and opportunities for implementation of an integrated care package for the management of anxiety in DSTB patients.

methodsFace-to-face interviews were conducted with nine healthcare workers, one service manager, 12 patients with DSTB and nine caregivers working in or attending four basic management units offering DSTB services in one province in Pakistan. The capability-opportunity-motivation-behaviour model was used to explore challenges and opportunities for implementation of the integrated care package. The data were analysed using framework analysis, then triangulated across participant groups.

resultsAll participant groups acknowledged that DSTB patients experience poor mental health including anxiety. Indeed, they needed prompting to focus on anxiety. No patients or caregivers had discussed anxiety in their TB consultations, instead patients used their own coping strategies and relied on caregiver support. Healthcare workers and the service manager reported a lack of guidelines and training. They used intuition and their own counselling strategies. All participant groups supported the idea of an integrated care package (high motivation), to improve patient well-being and aid recovery. Healthcare workers were highly motivated to deliver it themselves. In terms of capability and physical opportunity, healthcare workers recognised their lack of knowledge and skills, seeing training, resources, and protocols as essential. High patient workload and limited time in TB consultations were key barriers. Face-to-face appointments lasting less than 30 min on days when patients were already attending the facility were recommended.

conclusionsThis study provides important insights on feasibility and acceptability to inform the future implementation of an integrated package for anxiety management into routine DSTB services.

Indexed as

AnxietyAttitude of Health PersonnelCaregiversDelivery of Health Care, IntegratedHealth PersonnelTuberculosisTuberculosis, Multidrug-ResistantAdaptation, PsychologicalAdultCoping SkillsFemaleHumansMaleMental Health ServicesMiddle AgedPakistanIntegrated careLow-middle-income countries (LMIC)Non-communicable diseasesPsychosocial support.TB

Identifiers

PMID41715249
PMCPMC13023155

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.