Table 5

Representative quotations on negative HCW attitudes and behaviours towards patients

HCW attitude or behaviourRepresentative quotation
Scolding patientsQ32. The doctor scolded me, ‘Why didn’t you come at the time the infection started?’ (Man with a prior treatment history).
Stigmatising behaviourQ33. They (staff in the hospital) treated me in an irreverent way. (Family member of a man without a prior treatment history)
Q34. (D)octors don’t have enough time to talk to patients. The staff nurse can counsel patients, but they treat the patients as untouchables. (Participant in a health visitor FGD).
Violation of confidentiality or disclosure of diagnosisQ35. (When the TB diagnosis has been disclosed), patients will ask us, ‘Why did you share my information with the (community) leader?… Who gave you the right to share information regarding my disease condition with others?… What will others think about me?’ (Participant in a health visitor FGD describing the type of language used by patients after disclosure of diagnosis).
CoercionQ36. Sometime we used to blackmail irregular patients by using permanent ID proof. For example, we got a driving license as proof of identification from an auto rickshaw driver (patient). Then we said to him, ‘If you take treatment irregularly, we will cancel your driving license.’ (Participant in a senior treatment supervisor FGD).
Demanding bribes for further careQ37. Ward staff in the hospital were asking for bribes for towing patients to the X-ray department. (Man with a prior treatment history).
Delays in patient registrationQ38. We generally assign TB Numbers within a week or within 2 weeks. If the patient is regular (on TB therapy), then we assign the TB Number the same day, but in the case of category II patients (ie, those with a prior treatment history), we take two or more days for giving the TB Number. (Participant in a senior treatment supervisor FGD).
Refusal of care to patientsQ39. They (nurses or supervising providers) do not want to care for the patient. For default cases (ie, prior treatment history)… the nurse will say, ‘Send him out. Don’t give him a strip of tablet.’ Or, ‘Why are you giving him tablets?’ (Participant in a health visitor FGD describing the type of language used by some HCWs towards some patients).
  • FGD, focus group discussion; HCW, healthcare worker; TB, tuberculosis.