study concept for analysing compliance improvement with ... fileproject structure. susanne dannehl....
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Project Structure
Susanne DannehlTechnische Universität Berlin Zentrum
www.prometei.de
www.zmms.tu-berlin.de
Study Concept for Analysing
Compliance Improvement with Technical AidsDipl.-Psych. Susanne Dannehl, Dr.-Ing. David Hochmann, Prof. Dr.-Ing. Marc Kraft
MethodsAlthough there are some theories in health psychology research to improve compliantbehaviour, these methods have not yet been applied in orthotic treatments. The resultsin other health-related behaviours (like smoking cessation) indicate effective strategiesto support patients in becoming compliant. Transferring these approaches to theconstant usage of technical aids like knee or foot orthoses is the objective of this study.The first concern was to identify relevant factors, which affect the compliance. To dateresearch of technical aids has given less attention to this topic. Although in a surveywith 40 experts (orthopaedists, orthopaedic technicians) a significant awareness of theproblems was identified for practitioners. They provided considerable information aboutimportant difficulties in the usage of orthotic devices and possibilities for improvements.
Other important factors for analysing and improving adherence with technical aids werederived from theoretical statements of the „Health Action Process Approach“(HAPA), developed 1992 by Schwarzer, Professor of Health Psychology in Berlin. In histheory, he summarized the appropriate variables, which contain attributes of patients.With a support of such attributes, like self-efficacy, compliance with several healthrelated behaviours (e.g. usage of dental floss) could be improved significantly.A third group of factors, which may influence compliance, can be described as processvariables. The quality of advice and comprehensibility of information can be relevantfactors to improve the compliance and usage of technical aids in orthotic treatments.
ConclusionCurrently, a first conclusion can be drawn, that there is tremendous potential to begained by further investigating the compliance of patients in the treatment withtechnical aids. A result of this study will be informative brochures for supporting patientsin coping with relevant problems while using an orthosis. These interventions will bebased on the aforementioned HAPA-theory. This additional treatment has to be efficient,without demanding special effort from health care provider or incurring extra costs.
Start exploring usage
issues with an expert survey
Study design parameter for compliance measuring assembly of electronic monitoring development of interventions
Study implementation recruitment of patient groups
with knee or foot orthoses in different settings
Sampling of recommendations for prospective improvement of
adherence in treatment with technical aids
04/2009 04/2010 04/2011 04/2012
IntroductionCompliance, which we define as theadherence e.g. to therapeutical advice, is aprecondition for medical treatments. Inusage of technical aids the compliance rateis low. A study by Hiemstra et al. (2009)demonstrated that after two weeks only 11out of 44 patients wore knee immobilizersin at least 76 % of treatment time.Birmingham et al. (2008) found out thatthe compliance rate within a year wasconstantly around 63-65 % with functionalknee braces as well as with neoprenesleeves. Under these conditions treatmentoutcomes can not be analysed validly,because for any measureable effect usageis necessary. This poster presents aconcept of how to investigate and how tofoster constistent usage of orthoses forlower limb.
To be compliantor not to be compliant, that is the Question…!
Subject matter in Shakespeare´s words
Chart of HAPA-Model
ReferencesHiemstra, L.A., Heard, S.M., Sasyniuk, T.M., Buchko, G.L., Reed, J.G., Monteleone, B.J. (2009). Knee immobilization for pain control after a hamstring tendon anterior cruciateligament reconstruction: a randomized clinical trial. American Journal of Sports Medicine; 2009 (37), 56-64
Birmingham, T.B., Bryant, D..M., Giffin, R.J., Litchfield, R.B., Kramer, J.F., Donner, A., Fowler, P.J. (2008). A Randomized Controlled Trial Comparing the Effectiveness of FunctionalKnee Brace and Neoprene Sleeve Use After Anterior Cruciate Ligament Reconstruction. American Journal of Sports Medicine; 2008 (36), 648 -53