Chronic illness and compliance

Abstract

For a person with a chronic illness, life is altered in some way. Whether simple or complex, changes are nevertheless permanent. A patient with a chronic disease assesses recommended treatments on how well they can be integrated into his life. Evidence suggests that an individual's perception of his situation will determine whether or not he will comply with a medical regimen. Health professionals neglect the patient's point of view if they believe that patients regard the health professional as an absolute authority, thereby contributing to noncompliance. The contingency contract provides a model of patient-provider transaction, which requires input from both parties. The health professional can work with the person to make the medical regimen compatible with the individual's lifestyle.

The influence of self-owned home blood pressure monitoring (HBPM) on primary care patients with hypertension: A qualitative study

“…All these positive influences lead to improved patient's self-efficacy. Self-efficacy is defined as a person's confidence to carry out behaviour necessary to reach a desired goal [19]. It is an important precondition for successful self-management and behaviour change in patients with chronic disease such as hypertension.…”

Diabetes: an adolescent's perspective

“…The growth of a sense of independence is a cntical dren and is more prevalent in Finland than in any other aspect of development during adolescence The presence country m the world It affects 0 3% of the Finnish ofjuvemle-onset diabetes can hinder such growth by limitpopulation of corresponding age The probability of devel-ing the degree of freedom allowed by adults and imposing opmg diabetes peaks at pnberty (Kaar & Maenpaa 1987, lifestyle constraints Regular injections of insulin, blood Reunanen 1992) As in many long-term medical con-glucose momtormg, adherence to a dietary regimen and ditions, treatment is based on self-care activities At the performance of regular exercise results in a lifestyle peronset of disease, children and their families are encour-ceived as diffenng from that of young people who do not aged to assume responsibility for self-care As children have diabetes Dunng the transition to adulthood, the approach adolescence, parents and health care pro-desire for social acceptance and the company of friends fessionals are faced with the difficult task of remainmg m tend to outweigh the demands of a self-care regimen a supportive role (l e mvolved with self-care and treat- (Cameron & Gregor 1987} Failure to maintain consistent ment) whilst encouraging adolescents to assume greater self-care is a major problem amongst young adults with diabetes cind is the most frequent cause of hospitalization (Hentinen & Kyngas 1992) H KyngQsand} Barlow…”

Constructions of chronic illness

“…Compliance rates in chronic illness are estimated at approximately 50% (Cameron and Gregor, 1987 ;Turk and Rudy, 1991). Non-compliance has been noted as having severe consequences, including exacerbation and progression of disability (Turk and Rudy, 1991).…”

“…Patients evaluate and adopt treatments using social rather than health criteria, such as financial costs associated with treatment, family expectations, the personal relationship they have with their physician (Cameron and Gregor, 1987) and a belief in the effectiveness of the treatment (Turk and Kerns, 1985). Thorne (1990) identified two explanations patients give for non-compliance with treatments.…”