Week 4- adherence Flashcards
compliance
doing exactly what treatment providers tell you to do
- the power is in the hands of the provider rather than patient
adherence
positive proactive behavior encompassing patient freedom of choice which results in lifestyle change
intentional partial adherence
adjusting dose/frequency
non-intentional partial adherence
non purposefully forgetting/missing/neglecting
balance of treatment adherence
pros and cons
upside: improved health outcomes leading to decreased readmission which causes less morbidity and mortality
downside: side effects of medications along with cost, as well as acceptance of highly stigmatized diagnosis
main cause of poor adherence
medications; specifically concerns about side effects
HCP characteristics
- relationship
- communication
- trust
- patient education
health system factors
- access
- cost
- quality of services
- coverage
non-modifiable characteristics of a patient
- demographics
- physical factors
factors affecting medication/treatment adherence
5
- condition
- medication factors
- healthcare system/HCP factors
- socioeconomic factors
- patient factors (major one)
condition factors
one of the components affecting treatment adherence
includes;
- disease control
- disease characteristics
- patient specific
medication factors
one of the components affecting treatment adherence
- regimen
- effects
- properties
healthcare system/HCP factors
one of the components affecting treatment adherence
- HCP characteristics
- health system factors
socioeconomic factors
one of the components affecting treatment adherence
- social/environmental factors
- lifestyle factors
- economic factors
patient factors
one of the components affecting treatment adherence
- cognitive and psychological
- behavioral
- non modifiable characteristics
- family/caregiver characteristics
indirect assesment of adherence
self-report from patients and their views/opinions
- is better option because it involves the person
direct assessment of adherence
lab tests, blood work, urine,
not ideal because it is considered tracking
nursing priorities for adherence
5
- coping
- self identity/esteem
- social support
- maximize optimal functioning
- maintain overall physical health
interventions to support treatment adherence
related to patient factors
- CBT
- motivational interviewing
- psycho-education
- personalized reminders
interventions to support treatment adherence
related to medication therapy
- improved dosing schedules
- expanding provider access
- involving people in decisions
- offering choice
- enhanced communication
community treatment orders adherence
benefits
- preventative in trying to break cycle of involuntary hospitilization
- maintains client in community
- more independence
community treatment orders adherence
challenges
- consent is required but may be viewed as coercive or threatning
- impact on patient rights as it anticipates risk
recovery enabling factors
5
- accessible support
- vocational training
- shared decision making
- respect
- spaces for belonging
3 factors that make healthcare recovery oriented
- focus is on person not illness
- client driven interventions
- strengths based approach
CHIME framework
personal recovery
Connectedness
Hope
Identity
Meaning
Empowerment
chronic disease management model
for recovery; 5
- self management is an outcome and process
- work necessiated by disease
- work of maintaining every day life
- work of dealing with altered view of future
- links back to health promotion
self management skills/tips
5
- stress management
- self motivation
- self confidence
- time management/organization
- healthy lifestyle/balanced diet
components essential to successful self management
- patient
- healthcare team
- system
patient component
essential part to successful self management
- individual factors
- context
- resources
health care team component
essential part to successful self management
- philosophy
- approach
- knowledge/skills
- resources
system component
essential part to successful self management
- philosophy
- resources
- structure/infrastructure
the patient in self management
- day to day factors
- provider contact
- knowing health history
- supporting in relation to caregiver burnout
health care provider in self management
- ongoing monitoring
- working in a team
- staying updated on whats new
- ensuring personal mental health
system in self management
- coordinated and integrated care
- accessibility
- skills development for intersectional areas
- resources
milieu therapy
type of talk therapy
- group method
- involves physical and social environment
- uses everyday activities
- routine
- teaches interpersonal skills
CBT (cognitive behavioral therapy)
type of talk therapy
- highly structured
- short term
- skill building and psychoeducation
- 6 to 10 sessions
- can involve mindfulness
cognitive model of anxiety
situation leads to automatic thoughts which leads to anxiety, leading back to the situation
- goes in loop
automatic thoughts
come from
automatic thoughts –> intermediate beliefs (rules and attitudes) –> core beliefs
automatic thoughts
- instant and unconscious interpretation of events that stem from intermediatre thoughts and core beliefs
- distorted which can lead to distorted moods
- feel real and factual
dysfunctional thought record
for reframing negative thoughts
tool that is used to help reduce and make thoughts questionable along with reframe them
DBT (dialectical behavioral therapy)
type of talk therapy
- used for borderline personality disorder
- system approach
- includes 1 on 1 and group skills
- highly structured and organized into 2 phases
1st phase of DBT
work is focused on building new regulation skills related to trauma
2nd phase of DBT
work on the managing amd recovering from trauma can begin
dialectics
behavioral program based on dialectical philosophy meant to counteract cognitive style of BPD
- how to hold 2 truths together
assumptions of DBT
- patient is doing the best they can but they can do better
- patient may not have caused the problems but they do have to solve them
- patient defines goal for their life worth living
purpose of group skills training
and nursing role
reinforce everyday life skills
- supporting person to move from guidance to independence with using the skills provided
