|| Westaway MS & Wolmarans L
||Cognitive and affective reactions of black urban South
African towards tuberculosis.
||TUBERCLE & LUNG DIS 1994, 75, 447-453.
It was hypothesised that cognitive and affective
reactions towards TB were based on perceived prevalence, perceived
seriousness and perceived social stigma. The objectives of the study
were to ascertain the underlying dimensions that were used when
people reacted cognitively and emotionally to TB, and to determine
possible restricting social influence factors on voluntary presentation
and case holding. Therefore, a questionnaire was designed to obtain
information on background details, perceptions of TB (transmission,
prevention, diagnosis and treatment), and a 19-item cognitive affective
scale. 19 trained interviewers administered the questionnaire. Interviews
were conducted with 487 black adults (67 TB patients on ambulatory
therapy and 420 non-TB community members), from two urban townships
in the Transvaal, South Africa.
The results indicated that the majority of respondents
were aware of the infectious nature of TB, that it could be cured
and the length of treatment. The most problematic issues were isolation
for TB sufferers and the harm TB sufferers did to others. Cognitive/affective
reactions were similar for TB patients and community members. Ten
items out of the 19-item cognitive affective scale had communality
estimates equal to or greater than 0.30. Three factors were extracted.
The first factor seemed to combine personal threat (high personal
and family risk) with social rejection by the immediate family and
community for TB sufferers. Factor 2 had strong overtones of social
stigma, with its emphasis on dirt, poverty and poor nutrition. Factor
3 rejected alcohol and tobacco consumption as causal agents of TB.
The conclusions were that the predominant cognitive/affective
reactions towards TB were personal threat, social rejection and
social stigma, providing partial support for the hypothesis. The
powerful force of social rejection and social stigma cannot be underestimated.
These inhibiting factors require urgent attention to improve voluntary
presentation and compliance behaviour.
|KEYWORDS: COGNITION; SOCIAL BEHAVIOUR; SOCIAL AWARENESS;