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Health Psychology

Health Psychology. Chapter 4: Adhering to Medical Advice. Terms. compliance adherence cooperation _______________. I. Theories of Adherence. Behavioral Model Cognitive Learning Models __________________________ Theory of Reasoned Action Health Belief Model. Health Belief Model

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Health Psychology

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  1. Health Psychology Chapter 4: Adhering to Medical Advice

  2. Terms • compliance • adherence • cooperation • _______________

  3. I. Theories of Adherence • Behavioral Model • Cognitive Learning Models • __________________________ • Theory of Reasoned Action • Health Belief Model

  4. Health Belief Model Theory of Reasoned Action Theory of Planned Behavior ___________________ Precaution Adoption Process Model Transtheoretical Model Health Belief Model Theory of Reasoned Action Self-Efficacy Theory Behavioral Model Health vs. Adherence Models

  5. Medication Adherence Examples • Size of dose • Number of doses • ________ of doses • Duration of treatment

  6. II. Measuring Adherence • Dr report • Pt report • _______________ • Pharmacy records • Behavioral observation (e.g., pill counts) • Blood/urine tests

  7. Example: Lung disease drug (theophylline) • Estimates of % of pts prescribed drug: • Dr reports: 78% • _______________: 62% • Videotapes of pt visits: 69% • Pt reports: 59%

  8. III. Predicting Adherence • A. Illness characteristics • Illness severity • Medication side effects • _______________ • Tx complexity

  9. B. Personal characteristics • Age • Gender • Social support • Emotional support • _______________ • Personal beliefs • C. Cultural Norms

  10. Types of Problem Pts (Groves) • Dependent clinger • Firm enforced ________________________ • Entitled demanders • Reassure of rights, address fear, direct energy towards coping • Manipulative help rejecters • Self-destructive denier • Psychological help (source of destructiveness)

  11. D. Practitioner-Patient Interaction • Communication • _______________ • behavioral instructions, not jargon • info about disease • info about specific tx requirements • not beginning with _____ • pts forget/misunderstand ______%

  12. Jargon Translated _______ test result normal result (good news) Idiopathic unknown reason Contraindicated don’t do it Lesion sore or damage Analgesic painkiller Hematoma bruise (swollen from blood) Thrombosis blood clot Subclinical not yet detectable Trauma injury

  13. Practitioner characteristics • technical competence • warm, caring, friendly, concerned • not _______________ • Time between referral & tx • Time to wait to see practitioner

  14. IV. Understanding Adherence • A. Why nonadherence? • lifestyle changes are difficult • don’t hear advice • don’t understand advice • seems too difficult/time-consuming/expensive • quit meds once they have worked/ don’t work • trouble ___________________________ • optimistic bias (won’t have neg consequences)

  15. B. How to Improve Adherence? • Education • not that effective • Behavioral strategies • more effective • __________________ • simple prescriptions • prescription tailored to pt’s schedule • cues for meds

  16. follow-up calls for missed apts • involve spouse, support network • reward compliance

  17. C. Does Adherence Pay Off? • MAYBE • results are mixed • _______________ = caused by txe.g., abdominal surgery that punctures bowels (result: periotonitis) • Handwashing

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