Compliance, concordance and adherence: what are we talking about?

Khair, Kate

doi:10.1111/hae.12499

Cited by 24 publications

(27 citation statements)

References 20 publications

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“…This was emphasised during data collection by participants' actual use of the term 'non-adherent' , which infers a privileging of HCPs over experiential knowledge. In contrast, concordance implies that an exchange about a condition's management has taken account of how to integrate self-care into a patient's unique life circumstances and activities [15]. In this sense, concordance is seen as patient-centred [16], whilst adherence may mean agreeing with a HCP's Table 4 Key leaning points from our analysis (see also Fig.…”

Section: Discussionmentioning

confidence: 99%

Appraising the situation: a framework for understanding compassionate care

Tierney

Seers

Reeve

et al. 2017

J of Compassionate Health Care

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Background: Compassion in healthcare represents an ideal way of interacting with patients. It entails an active response to suffering, distress or discomfort that can be associated with people seeking health related support or treatment. However, reports from within healthcare highlight that compassionate care (CC) is not always achieved. It may be especially problematic when trying to work with a patient who seems unwilling or unable to engage with advice provided by a healthcare professional (HCP). Methods: We conducted a grounded theory study to understand the meaning of CC for HCPs working with patients with type 2 diabetes. Data were collected between May-October 2015 using focus groups and individual interviews; 36 HCPs took part in total. For the current paper, we used constant comparison to analyse data from transcripts where participants talked about working with a 'non-adherent' patient. Results: Analysis highlighted how appraisal of their encounter with a non-adherent patient could affect whether CC was seen as possible by participants. Therefore, we used a transactional model of emotions as a framework for understanding HCPs' narratives. This involved a consideration of their primary appraisal of such encounters, which participants said often resulted in a sense of threat, failure and rejection. Their secondary appraisals, which centred on coping resources, included problem-focused approaches (e.g. supporting the patient to plan how to move forwards in managing their health) and emotion-focused approaches (e.g. recognising change was hard, appreciating it may not be the right time for the patient to change). These appraisals could be modified by: a) gaining experience as a HCP; b) altering what was seen as professional success; c) their connection with the patient; d) how much autonomy they had in their job. Conclusions: Our findings provide new insights and emphasise that CC in response to non-adherent patients is not determined solely by a HCP's innate nature, but can be affected by an individual's appraisal of this interaction and the resources he/she has available to cope. This has implications for the environment within which staff work.

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Section: Discussionmentioning

confidence: 99%

Appraising the situation: a framework for understanding compassionate care

Tierney

Seers

Reeve

et al. 2017

J of Compassionate Health Care

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“…The importance of perceived control in a stressful situation in the doctor-patient relationship Patients are more likely to agree to suggested treatment if they feel in control of the situation in the patient-doctor relationship [28].…”

Section: And Prof Sęk Contains the Following Statement: Thus It Maymentioning

confidence: 99%

The patient-doctor relationship – a psychological perspective

Śliwińska¹,

Makara-Studzińska²,

Śliwiński³

2015

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This review of available literature aims to present models of co-operation between the patient and the doctor, the consequences of employing these models, and the ways of building relationships. In order to ensure a comprehensive view of this issue and trace the dynamics of changes in this area, we decided to review the relevant literature published since the 1950s. The databases we queried contained academic opinion papers, reports of empirical studies, and publications in psychology of health. Used databases: Academic Search Complete, eBook Academic Collection, Health Source: Nursing/Academic Edition, MEDLINE, PsycARTICLES, and PsycINFO. The analysis focused on the association between the models of patient-doctor relationship and adherence to treatment (adherence or compliance; adherence to treatment). The paper contains descriptions of how models have changed, followed by a detailed characterisation of the paternalistic and partnership-based approaches, also with regard to possible effects on the patient's willingness to adhere to medical instructions. StreszczenieCelem niniejszego przeglądu dostępnej literatury jest przedstawienie modeli współpracy między pacjentem i lekarzem, konsekwencji ich stosowania i sposobów budowania relacji. W celu jak najszerszego spojrzenia na zagadnienie i uwidocznienia dynamiki zmian tego obszaru zdecydowano się na przegląd literatury od lat 50. ubiegłego wieku. Bazy, jakie przeszukiwano, zawierały zarówno poglądowe artykuły naukowe, badania empiryczne, jak i publikacje z zakresu psychologii zdrowia. Były to: Academic Search Complite, eBook Academic Collection, Health Source Nurcing/Academin Edition, MEDLINE, PsycARTICLES, PsycINFO. Podczas analizy skupiono się na związku modelu relacji lekarza i pacjenta z realizacją zaleceń lekarskich (adherence or compliance; adherence to treatment). W niniejszej pracy można znaleźć opis kształtowania się modeli relacji lekarza i pacjenta w ciągu ostatnich 60 lat. Następnie szczegółowo scharakteryzowane są podejścia paternalistyczne i partnerskie z uwzględnieniem możliwego wpływu na chęć realizowania zaleceń lekarskich przez pacjenta. Psychology in a health contextThe biomedical model is now being extended to include behavioural, social, and psychological paradigms [1]. In this way, health can be construed holistically, and the individual can be viewed as an element of multiple systems that form a hierarchy among themselves and remain in a state of dynamic balance owing to the flow of information [2].Contemporary conceptualisations of the health sciences are not limited to a patient's somatic sphere. The biological realm is increasingly being expanded to include the mental realm. Overall, the health sciences, through the influence of psychology, have been enriched by evidence-based theoretical concepts and the possibility of practical application of psychological knowledge, as in the development of models of health [3]. With regard to health issues, this change is reflected in studies of pro-health behaviours and their structure, and ...

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“…[1][2][3][4][5][6][7][8] Patient compliance is a major factor in long term disease management. 9 This is particularly true for adolescents who are beginning to transition from childhood to adulthood, during a period in life when they are learning to handle more responsibility. Among these patients with HMB due to an underlying BD, many do well in the short term, when they are acutely aware how taking certain medications and following instructions will better control or resolve their bleeding symptoms.…”

Section: Introductionmentioning

confidence: 99%