W8 - Herrera et al (2017) Non-adherence (in HTN) Flashcards
Which theory and research method was used for this study on non-adherence in HTN pts? (Herrera)
a) social cognition theory + QL
b) dialogical self-theory + QL
c) phenomenology + mixed methods
b) dialogical self-theory + QL
Dialogical constructivist view, originating from
psychotherapy research on resistance to change!
What did Herrera et al. research?
a) Behaviour changes in HF patients
b) Implicit/explicit motivations for adherence/non-adherence to treatment in HTN patients
c) social isolation in First Nation communities
b) Implicit/explicit motivations for adherence/non-adherence to treatment in HTN patients
Chronic illness prevalence is rising, and many treatments focus on lifestyle behaviour changes. Research shows that pt adherence is low.
What percentage was found for adherence to medications?
a) 50%
b) 25% - 50%
c) 70%
d) 30% - 60%
d) 30% - 60% for medication adherence
** even lower numbers for adherence to diet and exercise
SATA:
Researchers have conceptualized that adherence is a COMPLEX PROCESS including pt, HCP, health system, illness + therapy factors such as…
a) pt self-efficacy
b) wellness vs illness in the foreground
c) problem awareness
d) information
A, C and D
a) pt self-efficacy
c) problem awareness
d) information
** information on illness, tx complexity + dosage and visibility of symptoms
Most research and intervention projects focus on empowering ___________, which neglects more IMPLICIT processes such as ________
a) non-adherence motives; adherence motives
b) more conscious pro-adherence motives and beliefs; anti-adherence motivations
b) more conscious pro-adherence motives and beliefs; anti-adherence motivations
** EXCEPTION is the motivational interviewing technique (MI)! MI addresses anti-adherence motives
Most adherence models see medical non-adherence as ________, caused by irrational biases and beliefs.
a) a behavioural problem
b) a problematic attitude
c) a psychological resistance
a) a behavioural problem
The constructivist dialogical theory defines non-adherence/resistance as…
a) an expression of conflict b/w internal motivations/voices
b) a manifestation of irrational/destructive personality traits
c) an assertion of autonomy based on personal beliefs
a) an expression of conflict b/w internal motivations/voices
** both pro- and anti-adherence voices express pt VALUES and emotional experiences that need to be acknowledged, not dismissed or rejected.
SATA:
Why would understanding non-adherence motivations be helpful for HCPs?
a) allows HCP to empathize with pt instead of confronting
b) it contributes to personalizing interventions
c) can lead to active collaboration
d) can lead to change
All of the above
Which model am I? (related to adherence)
“I was developed to understand why people did not adopt preventive behaviours.
4 key elements: the perceived threat of disease; perceived benefits of the health behaviour; perceived barriers to that behaviour; and a cue to action.”
**hint: most common!
Health Beliefs Model
** key elements: #1 - perceived threat of a disease (including perceived susceptibility and severity), #3 - perceived barriers to that behaviour (including time, monetary cost, stigma, side effects)
Which theory am I? (related to adherence)
“non-adherence is the result of the pts maladaptive coping mechanism”
Protection motivation theory
Which model am I? (related to adherence)
“I incorporate the pts continuous assessment of the effects of the coping behaviour of the disease.
Self-regulation model
Which model am I? (related to adherence)
“information and motivation are not enough to understand adherence. Must also consider pt’s behavioural skills!”
Information-motivation-behavioural skills model
Which theory/model am I? (related to adherence)
_____ emphasizes social norms while _____ includes the pt’s perceived behavioural control.
a) Theory of planned behaviour; theory of reasoned action
b) Protection motivation theory; self-regulation model
c) Health beliefs model; theory of reasoned action
d) Theory of reasoned action; theory of planned behaviour
d) Theory of reasoned action; theory of planned behaviour
Leventhal’s common-sense theory focuses on…
a) common practical sense of the patient
b) the rational evaluation of the pros and cons of the behaviour change
c) the subjective illness representation of each person to understand how they cope and adapt to it
c) the subjective illness representation of each person to understand how they cope and adapt to it
- NOT on the objective consequences
- NOT on the rational analysis of costs and benefits
- is influenced by personality and cultural context!
Nurses using the decisional balance theory (Janis and Mann) utilizes which technique for communicating with patients?
a) active listening
b) motivational interviewing
c) sympathetic presence
b) motivational interviewing
used for weighing pros and cons of adherence and non-adherence to help tilt pt toward adherence
