Pulmonary tuberculosis (PTB) remains a major global public health challenge and imposes substantial physical, psychological and social burdens. Beyond conventional clinical outcomes, quality of life (QoL) and health-related quality of life (HRQoL) increasingly are recognised as important patient-centered outcomes that reflect multidimensional well-being. Existing primary studies on determinants of QoL in PTB are fragmented and heterogeneous with respect to populations studied, disease characteristics and measurement instruments. No comprehensive systematic review and meta-analysis has yet synthesised these determinants. This protocol describes a review designed to identify, integrate and quantitatively summarise factors associated with QoL among adult patients with PTB to inform nursing interventions and patient management strategies.
The primary objective is to systematically identify and synthesise evidence on factors associated with QoL or HRQoL in adults with PTB. The protocol aims to integrate findings across observational studies and, where feasible, to provide pooled effect estimates through meta-analysis to support targeted clinical and nursing practice.
This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement to promote transparent and rigorous reporting. The review will include a comprehensive literature search, independent dual screening and data extraction, methodological quality assessment, and either quantitative meta-analysis or narrative synthesis depending on study comparability.
Included study designs: Observational studies that examine associations between potential influencing factors and QoL or HRQoL.
Population: Adult patients with pulmonary tuberculosis. The protocol specifies adults but does not report further age thresholds or restrictions in the source.
Outcomes: Measures of QoL or HRQoL as reported by eligible studies. The protocol does not limit inclusion to specific QoL instruments but requires reported associations between factors and QoL/HRQoL.
Comparators and exposures: Any potential influencing factors examined by the primary studies. The protocol does not list specific factors here; it intends to capture those assessed in the literature.
A systematic search will be conducted across eight electronic databases from inception through 30 November 2025. The databases are five English-language sources: PubMed, Web of Science, The Cochrane Library, Embase and Scopus; and three Chinese-language sources: China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database and Wanfang Database. The protocol describes this as a comprehensive literature search but does not present the exact search strings in the source summary.
Two reviewers will independently screen titles and abstracts and then full texts to determine eligibility. Data extraction will also be performed independently by two reviewers. Any disagreements at screening, extraction or other review stages will be resolved through discussion or consultation with a third reviewer. The protocol emphasises independent dual processes to reduce bias and error.
Methodological quality of included observational studies will be assessed by two independent reviewers. The source text states that methodological quality assessment will take place but does not specify which risk-of-bias tool(s) will be used; those details were not reported in the source summary.
The protocol specifies that meta-analysis will be performed only when studies are sufficiently comparable in terms of population, influencing factors, QoL or HRQoL measurement and reported effect estimates. When heterogeneity or incompatibility prevents pooling, findings will be summarised narratively. Where quantitative synthesis is appropriate, Review Manager software will be used to perform the meta-analysis. The protocol indicates that subgroup and sensitivity analyses will be conducted where data permit.
Subgroup and sensitivity analyses are planned if data allow, to explore heterogeneity and the robustness of pooled estimates. Specific subgroup categories or sensitivity approaches are not detailed in the source summary; those elements were not reported in the provided text.
Because this study synthesises and performs secondary analysis of previously published data, formal ethical approval is not required. The authors plan to disseminate results via publication in a peer-reviewed journal and presentation at relevant academic conferences. The protocol is registered with PROSPERO under registration number CRD420251196862.