<![CDATA[Background: Tuberculosis in Indonesia is a social as much as a biological problem, but empowerment programmes target adherence rather than stigma, and no South Kalimantan study has ranked the psychosocial determinants a nurse-led programme could act on. Objective: To rank perceived tuberculosis stigma, perceived social support and self-esteem by their association with quality of life among adults receiving treatment for pulmonary tuberculosis, so that a nurse-led community empowerment programme can act on the determinant that carries the greatest weight. Methods: Cross-sectional community diagnosis of 102 adults with pulmonary tuberculosis at the Lung Center ward and DOTS polyclinic, Ulin Regional General Hospital, Banjarmasin. Perceived and internalised tuberculosis stigma (28-item Indonesian scale), quality of life (WHOQOL-BREF-derived), perceived social support (MSPSS) and self-esteem (Rosenberg scale) were measured. Multiple linear regression was used, and the standardised coefficients were contrasted using the covariance matrix recovered from the collinearity diagnostics and selected by the identity R² = β′Rβ. Results: Severe stigma affected 94.1%; the three stimuli explained 80.6% of the variance in quality of life (R² = 0.806): stigma β = −0.766 (95% CI −0.862 to −0.670; partial r = −0.848), self-esteem β = 0.229 (partial r = 0.423) and social support β = 0.201 (partial r = 0.401), all p < 0.001. Stigma outranked self-esteem by 0.537 and social support by 0.565 standardised units (both p < 0.001, in all 16 admissible reconstructions), while the two contextual stimuli did not differ (p = 0.716). Conclusion: Perceived stigma is the dominant modifiable correlate of quality of life in this catchment, and the ranking is tested rather than asserted. Nurse-led empowerment should place stigma reduction through kader, family psychoeducation and survivor peer educators ahead of individual counselling, monitoring the continuous score.]]>
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