C3 maintenance of behavioural change
Reasons for non-adherence: Methods used to improve adherence:
● stress – the perceived inability to cope as a
threat to behaviour change ● health education/promotion – relevant to
target group, improved access to information
● Rational non-adherence, including cost- ● Reduction of perceived threats – resistance,
benefit analysis, financial barriers, patient- fears, understanding of needs, safety and
practitioner relationship security
● Lifestyle changes – replacing unhealthy
● Learned helplessness – control over behaviours with healthy behaviours; reduction
behavior and outcomes in stress, improved self-esteem and self-
confidence, emotional resilience, insight into
● lack of support – significant others, health own behaviour, improved outlook on life
professionals. ● Support for behavioural change including
provision of incentives, persuasive health
reminders (texts, self- tracking, progress
monitoring) and social prescribing.
, Stress (non-adherence)
● Stress can arise from poverty (Non-adherence is worse in lower socioeconomic groups)
● Stress is closely associated with chaotic lifestyles. Being disorganised can be stressful and stress can make people
disorganised (In these circumstances people forget to take medication or find it hard to follow medical advice)
● Stressed clients are usually anxious, so their attention becomes narrower. When speaking to professionals, they
latch onto key words and ignore the rest (For example, once a client hears the word ‘cancer’, they may not pay
attention to the more positive information that follows which would reduce their anxiety e.g. treatment)
● Stress can also interfere with memory. Even if clients understand medical advice, adherence is impossible if they
cannot remember it (Between 40% and 80% of medical advice is immediately forgotten and only about half of what
is remembered is correct)
, Evaluation
Research support One weakness is the long-term effects of stress
on non-adherence are unclear.
One strength is research evidence to support the
role of stress in non-adherence. For example, For example, studies tend to look at the short-term
Hamidreza Roohafza et al. (2016) studied almost effects, so it is unclear how non-adherence
10,000 clients with diabetes and/or hypertension changes over time with stress levels. We would
(high blood pressure). They found that the clients expect adherence to increase as stress reduces
experiencing the highest levels of stress were non- (which would point to a practical application). But
adherent to medication and/or exercise advice. we do not know this for sure.
This supports the view that stress can substantially This means the role of stress is unclear and it is
increase the risk of non-adherence even in life- hard to develop practical interventions to increase
threatening disorders. Short-term versus long-term adherence.
effects
Reasons for non-adherence: Methods used to improve adherence:
● stress – the perceived inability to cope as a
threat to behaviour change ● health education/promotion – relevant to
target group, improved access to information
● Rational non-adherence, including cost- ● Reduction of perceived threats – resistance,
benefit analysis, financial barriers, patient- fears, understanding of needs, safety and
practitioner relationship security
● Lifestyle changes – replacing unhealthy
● Learned helplessness – control over behaviours with healthy behaviours; reduction
behavior and outcomes in stress, improved self-esteem and self-
confidence, emotional resilience, insight into
● lack of support – significant others, health own behaviour, improved outlook on life
professionals. ● Support for behavioural change including
provision of incentives, persuasive health
reminders (texts, self- tracking, progress
monitoring) and social prescribing.
, Stress (non-adherence)
● Stress can arise from poverty (Non-adherence is worse in lower socioeconomic groups)
● Stress is closely associated with chaotic lifestyles. Being disorganised can be stressful and stress can make people
disorganised (In these circumstances people forget to take medication or find it hard to follow medical advice)
● Stressed clients are usually anxious, so their attention becomes narrower. When speaking to professionals, they
latch onto key words and ignore the rest (For example, once a client hears the word ‘cancer’, they may not pay
attention to the more positive information that follows which would reduce their anxiety e.g. treatment)
● Stress can also interfere with memory. Even if clients understand medical advice, adherence is impossible if they
cannot remember it (Between 40% and 80% of medical advice is immediately forgotten and only about half of what
is remembered is correct)
, Evaluation
Research support One weakness is the long-term effects of stress
on non-adherence are unclear.
One strength is research evidence to support the
role of stress in non-adherence. For example, For example, studies tend to look at the short-term
Hamidreza Roohafza et al. (2016) studied almost effects, so it is unclear how non-adherence
10,000 clients with diabetes and/or hypertension changes over time with stress levels. We would
(high blood pressure). They found that the clients expect adherence to increase as stress reduces
experiencing the highest levels of stress were non- (which would point to a practical application). But
adherent to medication and/or exercise advice. we do not know this for sure.
This supports the view that stress can substantially This means the role of stress is unclear and it is
increase the risk of non-adherence even in life- hard to develop practical interventions to increase
threatening disorders. Short-term versus long-term adherence.
effects
