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Adhering to Medical Advice

Adhering to Medical Advice. Assist. Prof. Merve Topcu PSY 411 Health Psychology Department of Psy chology Çankaya University 2016-2017, Fall. Theories for adherence / compliance. Behavioral theory Self-efficacy theory Theories of Reasoned Action & Planned Behavior

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Adhering to Medical Advice

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  1. Adhering to Medical Advice Assist. Prof. MerveTopcu PSY 411 Health Psychology Department of PsychologyÇankaya University 2016-2017, Fall

  2. Theories for adherence / compliance • Behavioral theory • Self-efficacy theory • Theories of Reasoned Action & Planned Behavior • The transtheoretical model

  3. 1. Behavioral theory • Based on Operant Conditioning • Reinforcement • Positive • Negative • Punishment • Rewards • Extrinsic • Intrinsic

  4. 2. Self-efficacy theory • Bandura’s social-cognitive theory • Reciprocal determinism • Person (thinking) + Behavior + Environment • Self-efficacy (Person) • Perceived control over yourself and your environment • Situation specific, not global + outcome expectation Smoking cessastion & diabetic diet

  5. 2. Self-efficacy • Beliefs predict accomplishment • Acquired, increased, or decreased by: • 1. Performance • 2. Vicarious experience • Seeing others of similar skills perform • 3. Encouragement • 4. Physiological arousal • Anxiety, or high expectation

  6. 3. Theories of Reasoned Action & Planned Behavior

  7. 3. Theories of Reasoned Action & Planned Behavior The theory of planned behavior Jjjj

  8. 4. The TranstheoreticalModel of change • Stages of change model • 1. Precontemplation stage • Has not thought about changing • 2. Contemplation stage • Only thought about changing • 3. Preparation • Thoughts & preparation for change • 4. Action stage • Actually making the change • 5. Maintenance stage • Resists temptation to go back

  9. What is adherence? • Compliance • Patient’s behaviour that conform to phisicians orders • Adherence • A person’s ability & willingness to follow recommended health practices

  10. How to measure adherence? 1. Ask Practitioner 2. Ask patient 3. Ask others 4. Monitor medication 5. Biochemical evidence 6. Combination of these

  11. Factors predicting adherence • Severity of disease • Pain level • Seriousness of disease / disorder • Treatment characteristics • Side effects • Complexity of treatment • Personal characteristics • Age • Gender • Personality • Obsessive & compulsive features • Hostility • Level of anxiety • Effects of stresful life events • Self-efficacy • Avoidance coping • Responsibility • Environmental factors • Cultural norms • Social support • R/ship btw health care provider & patient

  12. Reasons for nonadherence • Requirement • Vagueness of physician advice • Unhealthy lifestyles • Optimistic bias • Finding hard to attach a treatment or phisician

  13. Improving adherence • Educational • Emotional regulation • Health education • Behavioral methods • Aims to change patient behaviors • Reducing economic barriers • Rewarding • Notifying of upcoming appointments • Simplifying medical schedules • Home visits • Prompts • Tailoring regimen • Graduated regimen • Verbal commitment and /or contingency contract • Encouraging self-reinforcement • Service fee

  14. To be continued...

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