Bulpitt and Fletcher (1988)

Aims To review research on non-adherence in patients who were given medication to regulate hypertension. Procedures Review article of range of research, which identified problems with taking medication for high blood pressure. Tried to identify: The physical side effects The psychological effects Problems at work Effects of physical well-being. Findings Anti-hypertensive drugs have many side …

Types of Non-adherence and reasons why patients do not adhere

Medical Adherence: the extent to which patients take medications as prescribed by                                                  health care providers. Up to 40% of the population fail to adhere to medical advice. 125,000 people die every …

Adherence to Medical Advice

Types of non-adherence and reasons why patients don’t adhere - Types and extent of non-adherence. Rational non-adherence (e.g. Bulpitt, 1988);customising treatment (e.g. Johnson and Bytheway, 2000). Measuring adherence/non-adherence - Subjective: self reports (e.g. Riekart and Droter, 1999). Objective: pill counting (e.g. Chun and Naya, 2000); biochemical tests (e.g. Roth, 1987); repeat prescriptions (e.g. Sherman, 2000). Improving adherence …

Misusing Health Services

Delay in seeking information  SAFER ET AL (1979) devised a model on why patients delay treatment: Appraisal delay - the time taken for a person to interpret a physical symptom as a                                    potential indicator of illness. This is …

Safer et al (1979)

Aims To find out why patients delay treatment. Procedures The study was carried out in 4 clinics in a large inner city of the USA - 93 patients in total Interviewers approached patients, who were there to report a new symptom or complaint = 45 minutes of questions  They were asked: When they first noticed the …

Savage and Armstrong (1990)

Aims:  To compare the patient-centred style with the doctor-centred style led by a general practitioner on patients; satisfaction. Procedures: Random sample of 359 patients, from the ages of 16 to 75 – asked to give their consent to have the consultation recorded. The satisfaction was measured by two questionnaires asking about the quality of the …

Byrne and Long (1979)

Aims: To see the effect of different doctor/patient styles. Procedures:  2,500 recorded tapes of medical consultations in several countries including England, Ireland, Australia and Holland were listened. Findings:  Most tapes were doctor-centred, where the doctor asked closed questions that required brief replies, the focus was on the first symptoms and problems and the doctor would …

Patient and Practitioner diagnosis and style

Practitioner Style  BYRNE AND LONG (1979) found out the features of the doctor-centred style and the patient-centred style and concluded that meaningful dialogue led to more compliance by patients. Features of doctor-centred style: Impersonal atmosphere Intent on establishing the link between the symptoms and organic disorder. Patient was passive during consultaion. No open discussion on …

The Patient-Practitioner Relationship

Practitioner and patient interpersonal skills - Non-verbal communications (e.g. McKinstry and Wang); verbal communications (e.g.McKinlay, 1975; Ley, 1988). Patient and practitioner diagnosis and style - Practitioner style: doctor and patient-centred (Byrne and Long, 1976; Savage and Armstrong,1990). Practitioner diagnosis: type I and type II errors. Disclosure of information (e.g. Robinson and West, 1992). Misusing health services - …

Patient-Practitioner Interpersonal skills

Interpersonal skills - skills that are used between people who are attempting to communicate with each other. Non-verbal communication - the message is conveyed through a person's body. Verbal communication - it is related to speech. Non-verbal communication Paralanguage - speed, tone, volume, fluency of speech. Facial expressions - how emotions are conveyed. Gestures - …