How can you improve patient compliance? Clinical outcome data supports the three theories below as predictive models for behavior. The self-efficacy, health beliefs, and stages of change models can all be helpful in determining a patient’s readiness to change.
Open communication helps uncover hidden motivations and beliefs that can sabotage your efforts at treatment.
Self-efficacy is the belief that one can succeed in adopting a new behavior, which in turn is a predictor of whether he or she is likely to maintain it. A patient, for instance, may not feel that she can lose weight. For this patient, your communication would be aimed at raising her self-efficacy so she feels she can succeed—such as by asking what’s worked in losing weight in the past. With more self-efficacy, a patient is more likely to try, and be able to sustain, a new health behavior over time.
The health belief model focuses on a “perceived threat” that a patient thinks will happen if he or she continues an unhealthy behavior. Does your patient believe that a sedentary lifestyle can make his diabetes worse? If not, your communication with this patient would focus on explaining how exercise can lower his blood sugar levels, so he comes to believe that his daily lifestyle choices really do impact his health.
Good communication is based on knowing where your patient is on the spectrum toward starting a new health behavior, so you can tailor your dialog accordingly:
Precontemplation. At this stage, a patient has no intention of making a change, such as taking medicine to control hypertension.
Contemplation. A patient intends to take the action or make the behavior change in the next six months.
Preparation. A patient intends to make the change in the next 30 days and has already taken some steps toward change.
Action. A patient has just started the change, or has been making it for less than six months.
Maintenance. A patient has stayed with a change for six months or longer.
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