Heath Related Behaviour And Adherence

Question 1

What is health related behaviour?

Answer 1

Anything that may promote good health or lead to an illness

Question 2

Give some examples of health related behaviours

Answer 2

Smoking
Exercise
Practicing safe sex
Going to screening clinics
Taking drugs

Question 3

Name the 2 social cognition models

Answer 3

Health belief model

Theory of planned behaviour

Question 4

What are the limitations of conditioning theories?

Answer 4

Don’t account for: cognitive processes, knowledge, beliefs, memory, attitudes or expectations
Don’t account for social context

Question 5

Describe the cognitive dissonance theory

Answer 5

Discomfort felt when a person holds inconsistent beliefs and/or the actions or events occurring do not match their beliefs

Question 6

How can health campaigns use cognitive dissonance theory?

Answer 6

Give uncomfortable information to the public to create mental discomfort
This can prompt a change in behaviour

Question 7

What is the health belief model based on?

Answer 7

Threat - perceived susceptibility and severity

Behaviour - perceived benefits and barriers

Question 8

Describe the theory of planned behaviour

Answer 8

Beliefs/evaluation of outcomes leads to an attitude towards the behaviour
Subjective norm and perceived control
These 3 factors lead to intention to perform a behaviour

Question 9

What is the intention-behaviour gap?

Answer 9

The theory of planned behaviour is a good predictor of intentions but a poor predictor of behaviour
Intentions are not always translated into behaviour

Question 10

Describe the stages of change model (transtheoretical)

Answer 10

The way people think about health behaviours and the willingness to change is not static
5 stages that people may pass through: contemplation, preparation, action, maintenance, relapse
(There is also precontemplation - before you have even considered changing your behaviour)

Question 11

Define adherence

Answer 11

The extent to which patient behaviour coincides with medical advice

Question 12

When do we see the worst non-adherence?

Answer 12

When trying to target health behaviour or diet

Question 13

What are the problems with measuring adherence?

Answer 13

What counts as adherence?
Treatment usually continues over a period of time
Lack of consistency in measures
Hard to compare studies for different conditions with different treatments

Question 14

What are the direct measures of adherence?

Answer 14

Observation

Urine or blood test

Question 15

What are indirect measures of adherence?

Answer 15

Pill counts
Mechanical/electronic measures of dose
Patient self report/ second hand reports (carers etc)

Question 16

Name some of the many contributing factors to adherence

Answer 16

Illness
Treatment 
Patient 
Psychosocial 
Health care

Question 17

What things contribute to treatment factors?

Answer 17

Preparation (waiting etc)
Immediate character (complexity, duration, expense)
Administration
Consequences (side effects, stigma)

Question 18

Give examples of unintentional non-adherence

Answer 18

Memory
Dexterity for taking them
Problems accessing prescription

Question 19

What is concordance?

Answer 19

Nature of the interaction between clinician and patient
Negotiation of treatment regime with patient beliefs and priorities respected
Patient actively involved in making decisions

Question 20

Give examples for how clinicians can increase concordance

Answer 20

Define the problem clearly
Convey any equipoise 
Describe all options
Give consequences of no treatment 
Provide info how the patient likes it
Check pt understanding 
Elicit pt concerns and expectations 
Give pt time to consider