• Patient Teaching into Practice
    • Patient Education
      • The nurse’s role in patient education
      • Patient / family education standards
      • The growing need for patient teaching
      • Interdisciplinary collaboration, patient education
      • Patient Education – What does the future hold?
    • Theoretical Basis of Patient Education
      • The Theoretical Basis of Patient Education – Introduction
      • The Health Belief Model
      • Patient Education: Self-efficacy
      • Related theories of Patient Education
      • Characteristics of adult learners
      • Behavioral, cognitive, humanist approaches
      • Patient Education: Learning readiness
    • The Process of Patient Education
      • Process of Patient Education: Introduction
      • Assessing learning needs
      • Developing learning objectives
      • Planning and implementing teaching
      • Evaluating teaching and learning
      • Developing an effective teaching style
      • Using adult learning principles
    • The Family and Patient Education
      • Family structure and style
      • Impact of illness on the family
      • Doing a family assessment
      • Strategies for teaching family members
      • Expanding needs of family caregivers
      • Developing a partnership with the family
    • Providing Age-Appropriate Patient Education
      • Providing Age-Appropriate Patient Education: Introduction
      • Teaching parents of infants
      • Teaching toddlers
      • Teaching pre-school children
      • Teaching school age children
      • Teaching adolescents
      • Teaching young adults
      • Teaching adults in midlife
      • Teaching older adults
    • Impact of Culture on Patient Education
      • Impact of Culture on Patient Education: Introduction
      • How culture influences health beliefs
      • Doing a cultural assessment
      • Cultural negotiation
      • Using interpreters in health care
      • Non-English speaking patients
      • A model of care for cultural competence
    • Adherence in Patient Education
      • Adherence in Patient Education: Introduction
      • Impact on treatment recommendations
      • Causes of non-adherence
      • The patient as a passive recipient of care
      • Effect of interpersonal skills on adherence
      • Interventions that can increase adherence
    • Helping Patients Who Have Low Literacy Skills
      • Helping Patients Who Have Low Literacy Skills: Introduction
      • Designing low literacy materials
    • Resources for Patient Education
      • Resources for Patient Education: Introduction
      • Selected Patient Education Resources

EuroMed Info

Gesundheit und Vorsorge im Überblick

The patient as a passive recipient of care

The concept of compliance requires a dependent lay person and a dominant professional; one giving expert advice, suggestions, or orders, and the other carrying them out. Adherence to medical treatment is a concept based on professional beliefs about the appropriate roles of patients and health care professionals. The dominant professional view has been that the role of the professional is to diagnose, prescribe,and treat, and the role of the patient is to comply with what the health care professional believes is best. This view is an excellent example of the ethical principle of beneficence-attempting to do good. However, seen from this point of view, patient non-adherence is a behavior that challenges important beliefs, expectations, and norms. The non-adherent patient is viewed as interfering with, and in some instances, sabotaging the normal process and practice of health care. In some extreme instances in which patients continuously make choices that produce poor health care outcomes, their behavior is seen as deviant and irrational. In the case of people who are mentally ill, non-adherence is also seen as a symptom of illness, the nature of which makes patients incompetent to make informed, rational decisions about the need to adhere to treatment recommendations.

Experts studying adherence point out that in the traditional patient-professional model the relationship is not an equal one. The physician is superior to the patient, and the patient is seen as a passive recipient of health care. This model has led to an inherent tendency to blame the patient and to view non-adherence as irrational and deviant.Such experts believe that the roles of patients and professionals need to be re-examined and that health care professionals need to see patients as individuals who construct and give meaning to their illness and who actively evaluate treatments prescribed and advice given. In addition, much of the research in this area has focused on health care professionals‘ communication to the patient rather than communication between the two. Often health care professionals ask whether or not patients have adhered to treatment instructions, without asking why the patient found it difficult to comply or what the patient may have done instead. By using communication strategies that allow patients more equal participation in treatment decisions, nurses can help promote increased adherence.

The terms compliance and/or adherence imply that we dictate to the patient what is to be done or changed and that the patient should obey us. We are often uncomfortable with the patient’s right to choose not to follow our advice or to change his or her mind. We should strive to enlist the patient’s partnership and view patient education as a process of influencing behavior in ways acceptable to the patient. Effective patient education requires an understanding of factors that influence the patient in decision making: values, beliefs, attitudes, current life stresses, religion, previous experiences with the health care system, and life goals. Patient education providers may begin with giving information and demonstrating skills, but if the patient is not included in deciding how learning will be applied and the goals of patient education are not mutually agreed on between the teacher and the learner, behavioral changes usually will not occur.

The patient’s cooperation with the medical regimen involves choices every day. For example, the choice to follow a diabetic diet means making constant and sometimes inconvenient choices every day. We expect patients to do this every day for the rest of their lives even though we cannot guarantee that they will be free of serious diabetic complications. It is our role to offer guidance and support. We must be willing to respect patients‘ right to choose although we may not agree with their choice.

Effect of interpersonal skills on adherence

Zufällige Artikel

„Herr Kaiser“ bekommt neue Zähne von Zahnklinik Ungarn geschenkt

Herr Kaiser: Neue Zähne bei ungarischer Zahnklinik für „Mr. Versicherung“

Beinahe 2 Jahrzehnte lang stand "Herr Kaiser" in Werbespots im deutschen Fernsehen für die Versicherungswelt, … [Weiterlesen...]

Nachbehandlung Bruststraffung

Was muss man nach der Bruststraffung für die Nachbehandlung beachten?

Die Operation der Bruststraffung dauert je nach Operationsmethode etwa 1 bis 2,5 Stunden. Danach ist die … [Weiterlesen...]

Augenoperation mit LASIK

Das so genannte LASIK Verfahren gehört zu den Augen OP – Varianten, bei denen durch den Einsatz eines Lasers … [Weiterlesen...]

Videos

TV-Sendungen

ZDF: Mediathek Medizin & Gesundheit

ARD: Mediathek Gesundheit & Ernährung

Euromed Info – Bereiche

  • Gesundheit
  • Gesundheitsschutz
  • Schönheit
  • Zähne

Patient Teaching

  • Patient Education
  • Theoretical Basis of Patient Education
  • The Process of Patient Education
  • The Family and Patient Education
  • Providing Age-Appropriate Patient Education
  • Impact of Culture on Patient Education
  • Adherence in Patient Education
  • Helping Patients Who Have Low Literacy Skills
  • Resources for Patient Education

Featured article

The concept of compliance requires a dependent lay person and a dominant professional; one giving expert advice, suggestions, or orders, and the other carrying them out. Adherence to medical treatment … Read more ...

Recommendable link

Journal of Public Health: The Need of Patient Education