Compliance/adherence and self-management

Question 1

Two definitions for patient education:

1. It is a ____ to enhance the result of ______
2. Planned ______ process aimed at ____ change in such a way that the cure or care is ______

Answer 1

therapeutical tool 
treatment (or change)
communication
behavioral
enhanced

Question 2

_____, ______, and _____ make up patient education

Answer 2

Knowledge (on disorder and treatment)
skills (for dealing with complaints)
attitude (self-efficacy and health beliefs)

Question 3

What are the 4 levels of patient education?

Answer 3

1. Information (facts about the problem, procedures, general health, etc.)
2. Instruction (Concrete information aimed at activities)
3. Teaching (Educating)
4. Guiding/ coaching (Non-direct, emotional support)

Question 4

Patient education occurs in ___% of physiotherapeutic consults
patient non-compliance/adherence is generally seen in ___ out of ___ patients

Answer 4

97%
high (40-60%)
2 out of 5

Question 5

_____ refers to an active, collaborative role of the patient
_____ implies a more obedient/passive or reluctant patient

Answer 5

Adherence

Compliance

Question 6

Most medical practitioners believe in 2 major reasons for non-compliance which are…..?
However what are more complicated reasons for non-compliance?

Answer 6

1. Lack of skills/knowledge
2. Lack of motivation
3. Medical regimens and illness characteristics
4. The person’s cognitive and emotional state which may require social support
5. Interaction between patient and practitioner

Question 7

Consequences of non compliance:

1. the treatment ______ is not reached
2. no cure, no _____
3. Wasted time and _____
4. Demoralization of _____ and _____

Answer 7

goal
prevention
money
patient 
practitioner

Question 8

how does short-term and long-term adherence differ in the following matters:
1. requirement of supervision?
2 . The goal?
3. Visibility of the effects?
4. Cues?
5. Reward?

Answer 8

short-term (action):
requires supervision
the goal is cure
effects are visible
complaints are cues
recovery is reward

Long- term (maintenance):
is independent 
goal is prevention of recurrence 
no cues
reward is unclear

Question 9

Short term adherence is increased by…..

Answer 9

Goalsetting in SMART

tailoring the regimen to the needs of the patient

providing prompts and reminder (cues)

contracting

positive feedback

Question 10

What is contracting?

Answer 10

facilitating the patient to create a contract with themselves in order to achieve the goal/s. Can be done via motivational interviewing.

Asking questions like:
What are you going to do?
Where?
When?
How well?

Question 11

How do you use positive feedback to increase adherence?

Answer 11

make their progress visible, let them know how they are progressing

Choosing activities that the patient likes as part of the treatment - Intrinsic motivation

Direct positive feedback from the physiotherapist by giving attention, appreciation, and respect - non-verbal

Question 12

Long term adherence or maintenance is increased by….

Answer 12

Positive feedback through self reward, or diary/log

preventing relapse

generalize the behavior that was learned in clinic

Enhance self-management

follow- up

Advice about support groups

Question 13

Self-management is methods used in helping people gain ____ over conditions in their ______ which encourage undesirable ________.

More specific to physiotherapy :

Self-management is
______ that people have to perform to be able to live with a _____ disease

Answer 13

control
environment
behavior

TASKS
chronic

Question 14

What are the 3 types of tasks in self-management?

Answer 14

1. Medical = actions that concern treatment, rehab, prevention
2. Participation= Maintaining social role
3. Emotional= Cope with emotions coming with/reaction on disease

Question 15

What is the difference between self-management and self-regulation?

Answer 15

self-management is used in the context of chronic disease

self-regulation is a more broader term (can be used for both chronic and acute)

Question 16

What are inhibiting factors of self-management?

Answer 16

Physical condition of the patient (pain or lack of cognitive abilities)

Dysfunctional beliefs

Lack of feedback, helplessness

lack of knowledge concerning support possibilities

Question 17

When providing self management support enhancing the patient’s _______ is important by not setting unachievable _______

Answer 17

self-efficacy

goals

Question 18

managing your own process of behavioral change (long -term) is ________.
What are the 3 phases?

Answer 18

Self-regulation

1. Motivational= goals, what is the objective
2. Volitional= Planning and executing strategies to reach goals
3. Maintenance = dealing with frustrations and relapse

Question 19

Which 5 factors are important in self-regulation?

Answer 19

1. Setting the right goals (personal behavioral goals)
2. Plan of approach/action planning
3. Develop strategies
4. Pro-active coping /coping planning
5. Dealing with frustration

Question 20

Negative emotions can be a source for ______ thinking (dealing with frustrations)
and they are necessary to take _____

Answer 20

creative

initiative

Question 21

Simulation through _____ is a method for developing ______ to achieve set goals

Answer 21

visualization

strategies

Question 22

when planning the approach implementation of _____ is key for enhancing self-regulation.
How do you do it?

Answer 22

Implementation of intentions

By specifying where and when there is an opportunity to take action . Linking intention to action
“If….then….”

Question 23

What is meant by pro-active coping?

Answer 23

planning how one will cope with possible stressful circumstances or lapses. Can be done via an activity card