C3 (Maintenance Of Behavioural Change) Reasons For Non Adherence Flashcards
What is Non-Adherence?
Non-adherence occurs when patients do not follow medical advice, such as taking prescribed medication or attending follow-up appointments.
Reasons for Non-Adherence – Stress
Why Stress Causes Non-Adherence:
- Stress narrows attention, so patients miss details of medical advice (e.g., appointments, dosages).
- Disorganization from stress makes it hard to follow routines.
- Stress worsens with poverty or unhealthy lifestyles (e.g., no exercise).
- Stress impairs memory, making it hard to retain instructions.
Evaluation of stress for non adherence
✅ Strength
Research evidence supports stress as an explanation for non-adherence.
- Example: Rodulfat et al. (2016) found that clients with high stress were less likely to follow medical advice.
❌ Weakness
Uncertainty about long-term effects of stress on adherence.
Explanation: Studies focus on short-term effects, and it's unclear if non-adherence reduces when stress levels decrease
Rational Non-Adherence
Definition: Some clients deliberately choose not to follow medical advice based on logical decisions.
Key Factors in Rational Non-Adherence:
1️⃣ Side Effects:
Some medications have side effects like dizziness or memory problems.
2️⃣ Financial Barriers:
People without financial support may not afford medications.
3️⃣ Patient-Practitioner Relationship:
Patients are more likely to adhere if they trust their doctor.
Reasons Non adherence - Learned Helplessness
Definition: Feeling powerless after repeated exposure to stressful situations where one believes they have no control.
Link with Health: Patients may believe taking medication or following advice doesn’t help their health.
Results in not trying to change behavior (e.g., not taking medication or exercising).
Example thoughts
"It’s my fault I can’t do these exercises."
"Nothing I do can get better."
"I’ll never organize my medication."
Leads to passivity and loss of motivation
Downward Spiral of Learned Helplessness
Learned helplessness can lead to depression and non-adherence to medical advice.
⬇️
Depression increases non-adherence, trapping the person in a vicious cycle.
Example: Not taking medication → Feeling worse → More non-adherence
Evaluation - Applications of Learned Helplessness
✅ Strength Interventions can target learned helplessness.
- Cognitive therapy helps clients change their perception of control, showing links between actions (e.g., taking meds) and outcomes (e.g., health improvements).
- Helps break the downward spiral by reinforcing the positive effects of adherence.
❌ Weakness No clear correlation between learned helplessness and adherence.
- Other factors like depression and low self-esteem may cause non-adherence.
- Learned helplessness may have an indirect impact on health, not directly on medical advice adherence
Reasons for non adherence - Lack of Support
We are less likely to follow medical advice without support.
Loved ones:
Practical Support: Helping with tasks like attending appointments, accessing exercise resources.
Emotional Support: Providing encouragement, listening, and being a “shoulder to cry on.”
Lack of support can lead to better outcomes if medical advice depends more on professionals.
Health Professionals:
Practical Support: Providing information about adherence benefits.
Emotional Support: Filling the emotional gap expected by clients.
Perception of support from professionals matters; poor communication leads to feelings of neglect.
Evaluation - Evidence of Support’s Impact on Adherence
✅ Strength
Strong evidence links lack of support to non-adherence.
Example: Vulnerable groups like older people, homeless individuals, and those with mental health issues are at higher risk of non-adherence (Wheeler et al., 2014).
❌ Weakness
Support from professionals is only one factor influencing adherence.
Non-adherence remains widespread despite various interventions.
Effective interventions should address multiple factors.
