adherence "active, voluntary, and collaborative involvement of the patient in a mutually...
TRANSCRIPT
AdherenceAdherence
"active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of
behavior to produce a therapeutic result“
It is the term used to indicate the actual cooperation of a patient in carrying out
recommended directions and actions for the prevention or treatment of a diseas
"active, voluntary, and collaborative involvement of the patient in a mutually acceptable course of
behavior to produce a therapeutic result“
It is the term used to indicate the actual cooperation of a patient in carrying out
recommended directions and actions for the prevention or treatment of a diseas
ComplianceCompliance
"the extent to which a person's behavior
coincides with medical advice"
"the extent to which a person's behavior
coincides with medical advice"
NoncomplianceNoncompliance
Means that patients disobey the advice of their
health care providers
Means that patients disobey the advice of their
health care providers
Compliance is the one area that providers can't
control
It is estimated that 30% to 70% of the recommended regimens are not followed
To improve patient adherence, it is
important to understand why nonadherence
occurs!!!!???
To improve patient adherence, it is
important to understand why nonadherence
occurs!!!!???
The greatest success adherence is attained:
1- Believes that he or she is susceptible to the disease 2- Is Convinced that the disease can be prevented 3- Understands that prevention is preferable to disease . 4- Knows that he or she can modify the course of the disease
SELECTING METHODS OF INFLUENCING BEHAVIOR
ALTERATION
Many patients are willing to cooperate in employing health care procedures if they understand the reasons behind
the recommended treatment
The approach used to influence or to inform the patient should be guided by individual’s needs, motives, and
self-established value
Authoritarian or Nonauthoritarian Styles
The two ways for health professional to
relate to patients
Authoritarian
-Forceful -doing most of the talking and -Advice giving -with the patient expected to listen and to obey
-Forceful -doing most of the talking and -Advice giving -with the patient expected to listen and to obey
Advantages of the Authoritarian Style
1-Some patients welcome the authoritarian approach, because it frees them from the responsibility of decision making; in this scenario the responsibility for initiating, altering, or maintaining the desired behavior remains in the hands of the authoritarian not in the hands of the patient
2-Sometimes the authoritarian approach is absolutely necessary like in times of emergency when correct decisions must be made quickly to avoid life-threatening events
3-It is justified in dealing with individuals not capable of decision making; such as the young and the mentally retarded
Disadvantages of the Authoritarian Style
1-Authority often generates resentment and temporary grudging compliance, as long as the external pressure is being applied
2-Excessive fear arousal leads to unpredictable behavior and the blocking out of other important information
3-Also, direct frontal attacks on personal value systems are often counterproductive. The confronted person may avoid the professional in the future or may even retaliate
Nonauthoritarian approach
seeks to develop the potential of the patient's desire to satisfy
his or her needs
The health professional and the patient conjointly explore the
various preventive options and planning objectives
Nonauthoritarian approach
Learning and change best take place when a person is free to reject
change
This freedom of choice allows the patient to be his or her true self, thus increasing the possibility of
learning new behavior(Carl Roger’s Paradox self theory)
Failure to show sensitivity to the feelings of others destroys the foundation of mutual trust and cooperation
Failure to show sensitivity to the feelings of others destroys the foundation of mutual trust and cooperation
Accurate Empathy: Emotional Understanding
Accurate Empathy: Emotional Understanding
Human communication is essentially an exchange of feelings not information …. People seldom think. They
always feel(Mittelman)
Human communication is essentially an exchange of feelings not information …. People seldom think. They
always feel(Mittelman)
Accurate Empathy
Patients are allowed to have their own feelings and are appreciated for being
themselves, regardless of their behavior
Even though we have great difficulty in sharing our patients emotions, we should appreciate and be aware of
those feelings
Patients are allowed to have their own feelings and are appreciated for being
themselves, regardless of theirbehavior
Even though we have great difficulty in sharing our patients emotions, we should appreciate and be aware of
those feelings
Environment
One of our most important tasks as
professionals and as employers is to provide
a growth enhancing environment
If we create a repressive, inhibiting, or
punitive environment, those around us will fail
to self-actualize (eg, their natural growth
processes will become distorted or diminished)
Modeling or Vicarious Learning
One of the most important ways that people learn new behaviors and are motivated to maintain such behaviors is by observing
others
One of the most important ways that people learn new behaviors and are motivated to maintain such behaviors is by observing
others
Credibility gap
To us as health professionals this means that our patients are going to look at us as being important models, especially in the area of
health behavior
If we don’t act as we say this gap often results in distrust or
cynicism on the part of thoseexposed to such situations
To us as health professionals this means that our patients are going to look at us as being important models, especially in the area of
health behavior
If we don’t act as we say this gap often results in distrust or
cynicism on the part of those exposed to such situations
Behavioral Change Strategies
for the Patient
What strategies are available to eliminate the old behavior to
substitute the new?
1- Positive thinking 2- Behavioral self-control
1-Positive Thinking
States that:“you can, if you think you can"
It concentrates on developing a positive attitude about succeeding at any given-task and of developing a positive self
image
The fundamental quality that an individual must possess to engage in
such an approach is will power
States that:"you can, if you think you can“
It concentrates on developing a positive attitude about succeeding at any given task and of developing a positive self-
image
The fundamental quality that an individual must possess to engage in
such an approach is will power
2- Behavioral Self-Control
Behavior and attitudes are learned and then are maintained or altered by both environmental
influences (cues) and the resultant consequences of
that behavior
Michael Mahoney and Carl Thoresen))
For successful self-control:
(1) Self-Observation specification of the behavior to be changed,
(2) Environmental Planning identification of the behavior's previous environmental cues, and
(3) Behavioral Management implementation of a plan to alter the cues or consequences or both as needed
1-Self-Observation
Paying attention to the behavior of interest and, very importantly, recording the level of occurrences
of the behavior
Several benefits arise from careful monitoring of one's own behavior:
(1 )increased self- awareness ,
(2 )immediate quantitative feed back on what we are doing or not doing, and
(3 )information about the environmental cues and subsequent consequences
Research has demonstrated that
keeping careful records of behaviors alone can alter
their frequency
2 -Environmental Planning
involves changing the environment so as to change
the cues preceding a behavior
Often this requires the elimination or avoidance of situations that trigger the
undesired behavior
3- Behavioral Management
Deals with changing the consequences of a behavior rather than the triggering
event or situation
One approach commonly used is the “when-then" principle
Client Reinforcement
External Reinforcement
&Internal
Reinforcement
Positive Reinforcement(External)
Desired behavior must be rewarded to enhance the probability of its being
repeated
Internal Reinforcement
In terms of self-praise and feelings of accomplishment as
means of motivating the maintenance of our new behavior
In terms of self-praise andfeelings of accom plishment as
means of motivating themaintenance of our new behavior
Patients deserve to know the cause of their dental
diseases and how they can prevent them
This is a responsibility for the health educatorOnce armed with the
knowledge, however, the patient reserves the right to
remain sick
In the final analysis, prevention is a shared responsibility between the practitioner and the patient
In the final analysis, prevention is a shared responsibility between the practitioner and the patient