Diabetes Management and Patient Adherence

Study Notes

Factors Affecting Patient Adherence

Adherence refers to the extent to which a person's behavior corresponds with agreed recommendations from a healthcare provider.
Factors affecting patient adherence include:
- Depression and medication cost
- Salient beliefs (e.g., attitudes, knowledge, and self-efficacy)
- Age, safety, tolerability, and polytherapy
- Information, perception, and duration of disease

Determinants of Health Behavior

Theories of health behavior include:
- Social Cognitive Theory (SCT): states that people learn within a social context, facilitated by concepts such as modeling and observational learning.
- Health Belief Model (HBM): developed to understand the failure of people to adopt disease prevention strategies or screening tests, and later used to study patients' responses to symptoms and compliance with medical treatments.
- Theory of Planned Behavior (TPB): states that behavioral achievement depends on both motivation (intention) and ability (behavioral control).
- Transtheoretical Model (TT): conceptualizes behavior change as a process involving a series of six distinct stages: precontemplation, contemplation, preparation, action, maintenance, and termination.

Modifying Patient Behavior

Influencing behavior can be achieved through:
- Health Action Process Approach (HAPA) model
- I-Change Model (integrated change model)
The I-Change Model differentiates between three phases: awareness, motivation, and action planning.
The model assumes that behavior change is a result of becoming aware of the necessity of behavior change, and subsequently, weighing the pros and cons of the desired behavior, perceptions of social influences, and self-efficacy.

Lifestyle Counseling

Goals of lifestyle counseling:
- Help patients gain insight into their own behavior, reasons, barriers, and solutions.
- Guide patients toward self-chosen lifestyle changes.
Steps in lifestyle counseling:
- Introduction: establish a work relationship
- Awareness: assess and improve awareness
- Motivation: assess and improve motivation
- Action: prepare for action and start making changes
- Relapse prevention: make plans for difficult situations
- Continuation: help clients keep going

Behavior Change

Key factors in behavior change:
- Intention: the cognitive representation of a person's readiness to perform a given behavior
- Motivation: determined by motivational factors and awareness factors
- Action planning: facilitates the translation of intention into actual action
Coping efforts: problem management and emotional management
Stress, coping, and health behavior: the primary appraisal is a person's judgment about the significance of an event as stressful, positive, controllable, challenging, benign, or irrelevant.

Description

This quiz assesses the factors that influence a diabetic patient's adherence to medication and lifestyle changes, including environmental, social, and internal factors. It also covers modifying patient behavior to manage Type 2 Diabetes.