In a review of the literature from 1948 to 2001, 122 studies were found that correlated structural or functional social support with patient adherence to medical regimens. Meta-analyses establish significant average r-effect sizes between adherence and practical, emotional, and unidimensional social support; family cohesiveness and conflict; marital status; and living arrangement of adults. Substantive and methodological variables moderate these effects. Practical support bears the highest correlation with adherence. Adherence is 1.74 times higher in patients from cohesive families and 1.53 times lower in patients from families in conflict. Marital status and living with another person (for adults) increase adherence modestly. A research agenda is recommended to further examine mediators of the relationship between social support and health.

/pdf/social-support-and-patient-adherence-to-medical-treatment-a-4pbumyhsad.pdf

Social support and patient adherence to medical treatment: a meta-analysis.

Over the past two decades, hundreds of articles, editorials, and commentaries have been published describing the considerable disruptive effects on quality of care of individuals noncompliance with health and medical advice While much research has been directed at determining factors responsible for poor compliance, past studies have tended to focus upon easily measured characteristics of the patients, regimen, or illness which, unfortunately, are usually neither predictive nor alterable This paper systematically reviews the literature on patient acceptance of recommended health behaviors, attempting to find social-psychological and related variables which have proven to be consistent predictors of compliance The review suggests that certain health beliefs (especailly personal estimates of vulnerability to, and seriousness of, the disease, and faith in the efficacy of care), health-related motivations, perceptions of psychological and other costs of the recommended action, various aspects of the doctor-patient relationship, and social influence are the most productive dimensions for present intervention and further exploration Building upon an earlier formulation, an hypothesized model is presented which combines these elements for explaining and predicting compliance behavior Further research should, with standardized questionnaires and analysis techniques, employ prospective, experimental designs for a variety of population groups, settings, and regimens, to evaluate the ability of practical attempts to modify the model variables and thus enhance compliance

https://www.jstor.org/stable/pdfplus/3763271.pdf

Sociobehavioral determinants of compliance with health and medical care recommendations.

• We interviewed 315 consecutive elderly patients admitted to an acute care hospital to determine the percentage of elderly hospital admissions due to noncompliance with medication regimens or adverse drug reactions, their causes, consequences, and predictors. Eighty-nine of the elderly admissions (28.2%) were drug related, 36 due to noncompliance (11.4%), and 53 due to adverse drug reactions (16.8%). One hundred three patients had a history of noncompliance (32.7%). Factors statistically associated with a higher risk of hospitalization due to noncompliance were poor recall of medication regimen, seeing numerous physicians, female, medium income category, use of numerous medications, and having the opinion that medications are expensive. Factors associated with an increased risk of an admission due to an adverse drug reaction were use of numerous different medications, higher medication costs, receiving Medicaid, and not receiving any home services. In conclusion, many elderly admissions are drug related; noncompliance accounting for a substantial fraction of these. Elders at high risk of being noncompliant are identifiable using a variety of criteria. Economic factors were important in predicting admissions due to noncompliance as well as adverse drug reactions. (Arch Intern Med.1990;150:841-845)

https://jamanetwork.com/journals/INTEMED/articlepdf/613148/archinte_150_4_019.pdf

The Role of Medication Noncompliance and Adverse Drug Reactions in Hospitalizations of the Elderly

The Nature of Prejudice

• Simulations are of particular advantage in research studies where large samples are necessary to achieve statistical power and the information must be collected under uniform conditions in order to aid interpretation.

• In the study reported below, simulation was achieved through the use of medical photography accompanied by case studies of the same patients. All information was collected on the same day. The purpose of the study was to determine the validity of the three pressure ulcer risk assessment scales most commonly used in clinical nursing practice in the UK.

• Each clinical nurse assessed the same four patients using three risk assessment scales and a visual analogue scale designed to capture their own clinical judgement. External validity was assessed by a panel of tissue viability experts who provided independent ratings.

• Data were obtained from 236 clinical nurses, yielding 941 risk assessments.

• Experience with this approach to data collection suggests that it requires careful planning. This should include measures to ensure that the simulated information is valid and that all data collectors have been adequately trained and are able to motivate the nurses participating in the study. Providing consideration is given to these issues, the use of simulation can help to collect data that would be difficult to obtain by more conventional means. It is also important to recognize that clinical decisions are de-contextualized in simulations because they are reduced to verbal and visual summaries. The decision to use simulations should thus be taken only if this is acknowledged.

Examining the validity of pressure ulcer risk assessment scales: developing and using illustrated patient simulations to collect the data

s from the Literature on Popular and Unpopular Patients ' I. When a Student Dislikes a Patient: Highley, B. L. & Norris, C. M., 1957. Am. J. Nurs., No. 9, 1163-6.* Su=arizes five major dislikes related to working with patients as described by American student nurses: 1. Patients who feel bad and complain after everything has been done for them. 2. Patients who are not clean. 3. Patients who won't do what the nurse asks them to; won't cooperate; won't obey rules. 4. Patients who can help themselves but insist on the nurse doing everything. Patients who cling to the nurse or \"hang on to her coat tails\". 2. Who are \"good\" and \"bad\" Patients?: Ritvo, M. M., 1963. The Modern Hospital, 100, No. 6, 79-81. Some descriptive terms used by American student and graduate nurses to describe the \"good\" patient, obtained from 500 written questionnaires and over 1,000 informal interviews:

The Unpopular Patient

The Idea of Health: Implications for the Nursing Professional

Restraint-free care: from dream to reality.

Safe self-medication for elderly outpatients.

Learning is a two-way street: reciprocity and rewards

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