Objective:To determine the influence of community health nurses' social support on non-adherence with the maintenance phase of directly observed therapy (DOTS) among patients with tuberculosis (TB).Design: Prospective-cohort. Sample:One hundred purposively selected patients with TB starting with DOTS maintenance phase. Measurements:Participants answered the robotfoto and Berlin Social Support Scale (BSSS) to assess demographics and social support provided by nurses. Non-adherence was measured using the attendance record and documented in an abstraction form.Cox proportion-hazards regression determined the influence of social support provided by nurses to non-adherence. Results:With a median adherence of 3 weeks, 15% of the sample was non-adherent. The hazard of non-adherence was lower with high perceived emotional support (HR = 0.25, p = .046), perceived instrumental support (HR = 0.20, p = .044), perceived support seeking (HR = 0.27, p = .045), and received emotional support (HR = 0.45, p = .045).High received emotional support increased non-adherence (HR = 2.65, p = .039). Conclusion: Social support from nurses influenced DOTS non-adherence among patients with TB, a critical issue in the development of drug-resistance. Perceived emotional, instrumental, support seeking and received emotional support decreased the hazard of non-adherence, while received emotional support increased non-adherence. This study highlights the need to promote positive perception of instrumental support needs. Appropriate interventions should be provided to promote supportseeking skills. K E Y W O R D S community health nurses, DOTS program, perceived social support, Philippines, received social support 2 | ME THODS | Research design, subjects, and settingThis study employed a prospective-cohort design and recruited participants who were at least 18 years old, category I (newly diagnosed, smear-positive) pulmonary TB patients, about to start the maintenance phase of the DOTS program.A total of 100 purposively selected participants were included which yielded a power of 99.97% at a significance of 5% (two-tailed).This study was conducted in selected health centers from the cities of Manila, Quezon, and Marikina, Philippines. These health centers are accredited DOTS Satellite Treatment Centers of the Philippine Department of Health and provide a variety services for patients with TB. | Data measuresParticipants completed a two-part survey composed of the robotfoto and the BSSS. The robotfoto, a Dutch term denoting one's
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