Accepting the unacceptable: Medication adherence and different types of action patterns among patients with high blood pressure
Abstract Objective To gain deep insight into what it means for patients to live with drug-treated hypertension and to understand the implications for the doctors’ influence on patients’ adherence. Methods Group discussions with 43 drug-treated hypertensive patients. Documentary method was used for i...
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| Veröffentlicht in: | Patient education and counseling 2011-12, Vol.85 (3), p.468-474 |
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| creator | Marx, Gabriella Witte, Nicole Himmel, Wolfgang Kühnel, Steffen Simmenroth-Nayda, Anne Koschack, Janka |
| description | Abstract Objective To gain deep insight into what it means for patients to live with drug-treated hypertension and to understand the implications for the doctors’ influence on patients’ adherence. Methods Group discussions with 43 drug-treated hypertensive patients. Documentary method was used for interpretative analysis. Results Four basic phenomena were identified (fear, ignorance, reluctance to discuss matters with the doctor, impact of illness experiences), which resulted in different types of action patterns: (1) the assertive actor , (2) the unconscious avoider , and (3) the inconsistent actor . The types of action patterns do not refer to any implications for adherence. The patients’ action does not indicate their preferred model of doctor–patient interaction or their acceptance of taking medication. Conclusion Adherence must not be seen as meaningless behaviour, which can simply be learned, but rather as the result of subjective experiences on living with hypertension and the ability to accept the diagnosis and its treatment. Practice implications It is premature to initiate therapy straight after the diagnosis, before the patient is prepared to take the tablets. Supporting adherence means to stay in dialogue and to give the time, privacy and patience to enable patients to overcome their inhibitions of asking and to accept the therapy. |
| doi_str_mv | 10.1016/j.pec.2011.04.011 |
| format | Article |
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Methods Group discussions with 43 drug-treated hypertensive patients. Documentary method was used for interpretative analysis. Results Four basic phenomena were identified (fear, ignorance, reluctance to discuss matters with the doctor, impact of illness experiences), which resulted in different types of action patterns: (1) the assertive actor , (2) the unconscious avoider , and (3) the inconsistent actor . The types of action patterns do not refer to any implications for adherence. The patients’ action does not indicate their preferred model of doctor–patient interaction or their acceptance of taking medication. Conclusion Adherence must not be seen as meaningless behaviour, which can simply be learned, but rather as the result of subjective experiences on living with hypertension and the ability to accept the diagnosis and its treatment. Practice implications It is premature to initiate therapy straight after the diagnosis, before the patient is prepared to take the tablets. Supporting adherence means to stay in dialogue and to give the time, privacy and patience to enable patients to overcome their inhibitions of asking and to accept the therapy.</description><identifier>ISSN: 0738-3991</identifier><identifier>EISSN: 1873-5134</identifier><identifier>DOI: 10.1016/j.pec.2011.04.011</identifier><identifier>PMID: 21600724</identifier><language>eng</language><publisher>Oxford: Elsevier Ireland Ltd</publisher><subject>Adherence ; Adult ; Aged ; Antihypertensive Agents - therapeutic use ; Assertive ; Biological and medical sciences ; Doctor-Patient interactions ; Doctors ; Fear ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Hypertension ; Hypertension - drug therapy ; Hypertension - psychology ; Information Seeking Behavior ; Internal Medicine ; Male ; Medical sciences ; Medication Adherence ; Middle Aged ; Miscellaneous ; Nursing ; Patient perspectives ; Physician-Patient Relations ; Primary care ; Primary Health Care ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Qualitative Research ; Sickness Impact Profile ; Unconscious</subject><ispartof>Patient education and counseling, 2011-12, Vol.85 (3), p.468-474</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2011 Elsevier Ireland Ltd</rights><rights>Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-4f38f4df329a811e3d0d9050bf80cb7c24cbbd6833cae20785469874db3d7d553</citedby><cites>FETCH-LOGICAL-c503t-4f38f4df329a811e3d0d9050bf80cb7c24cbbd6833cae20785469874db3d7d553</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.pec.2011.04.011$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,30999,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27938011$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21600724$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Marx, Gabriella</creatorcontrib><creatorcontrib>Witte, Nicole</creatorcontrib><creatorcontrib>Himmel, Wolfgang</creatorcontrib><creatorcontrib>Kühnel, Steffen</creatorcontrib><creatorcontrib>Simmenroth-Nayda, Anne</creatorcontrib><creatorcontrib>Koschack, Janka</creatorcontrib><title>Accepting the unacceptable: Medication adherence and different types of action patterns among patients with high blood pressure</title><title>Patient education and counseling</title><addtitle>Patient Educ Couns</addtitle><description>Abstract Objective To gain deep insight into what it means for patients to live with drug-treated hypertension and to understand the implications for the doctors’ influence on patients’ adherence. Methods Group discussions with 43 drug-treated hypertensive patients. Documentary method was used for interpretative analysis. Results Four basic phenomena were identified (fear, ignorance, reluctance to discuss matters with the doctor, impact of illness experiences), which resulted in different types of action patterns: (1) the assertive actor , (2) the unconscious avoider , and (3) the inconsistent actor . The types of action patterns do not refer to any implications for adherence. The patients’ action does not indicate their preferred model of doctor–patient interaction or their acceptance of taking medication. Conclusion Adherence must not be seen as meaningless behaviour, which can simply be learned, but rather as the result of subjective experiences on living with hypertension and the ability to accept the diagnosis and its treatment. Practice implications It is premature to initiate therapy straight after the diagnosis, before the patient is prepared to take the tablets. Supporting adherence means to stay in dialogue and to give the time, privacy and patience to enable patients to overcome their inhibitions of asking and to accept the therapy.</description><subject>Adherence</subject><subject>Adult</subject><subject>Aged</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Assertive</subject><subject>Biological and medical sciences</subject><subject>Doctor-Patient interactions</subject><subject>Doctors</subject><subject>Fear</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - drug therapy</subject><subject>Hypertension - psychology</subject><subject>Information Seeking Behavior</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medication Adherence</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Nursing</subject><subject>Patient perspectives</subject><subject>Physician-Patient Relations</subject><subject>Primary care</subject><subject>Primary Health Care</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Qualitative Research</subject><subject>Sickness Impact Profile</subject><subject>Unconscious</subject><issn>0738-3991</issn><issn>1873-5134</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkk2L1TAUhosoznX0B7iRbMTZtJ7TpF8KwjD4BSMu1HVIk9Nprr1tJ0kd7sq_bjr3quBicHU48LwvIc9JkqcIGQKWL7fZTDrLATEDkcVxL9lgXfG0QC7uJxuoeJ3ypsGT5JH3WwAoS4EPk5McS4AqF5vk57nWNAc7XrHQE1tGdburdqBX7BMZq1Ww08iU6cnRqImp0TBju25dAwv7mTybOqb0LTerEMiNnqndFDvjaiPm2Y0NPevtVc_aYZoMmx15vzh6nDzo1ODpyXGeJt_evf168SG9_Pz-48X5ZaoL4CEVHa87YTqeN6pGJG7ANFBA29Wg20rnQretKWvOtaIcqroQZVNXwrTcVKYo-Gny4tA7u-l6IR_kznpNw6BGmhYvGxB5XpRQRvLsThKFaKoSQeB_oByijxrziOIB1W7y3lEnZ2d3yu0lglxlyq2MMuUqU4KQccTMs2P90u7I_En8theB50dAea2GzqlRW_-XqxpeH4peHziKP_zDkpNe21WmsY50kGaydz7jzT9pPdgxHsbwnfbkt9PixqhOovS5BPllvbr16BABsGlK_gsa1dHL</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Marx, Gabriella</creator><creator>Witte, Nicole</creator><creator>Himmel, Wolfgang</creator><creator>Kühnel, Steffen</creator><creator>Simmenroth-Nayda, Anne</creator><creator>Koschack, Janka</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>7X8</scope></search><sort><creationdate>20111201</creationdate><title>Accepting the unacceptable: Medication adherence and different types of action patterns among patients with high blood pressure</title><author>Marx, Gabriella ; Witte, Nicole ; Himmel, Wolfgang ; Kühnel, Steffen ; Simmenroth-Nayda, Anne ; Koschack, Janka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-4f38f4df329a811e3d0d9050bf80cb7c24cbbd6833cae20785469874db3d7d553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adherence</topic><topic>Adult</topic><topic>Aged</topic><topic>Antihypertensive Agents - therapeutic use</topic><topic>Assertive</topic><topic>Biological and medical sciences</topic><topic>Doctor-Patient interactions</topic><topic>Doctors</topic><topic>Fear</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - drug therapy</topic><topic>Hypertension - psychology</topic><topic>Information Seeking Behavior</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medication Adherence</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Nursing</topic><topic>Patient perspectives</topic><topic>Physician-Patient Relations</topic><topic>Primary care</topic><topic>Primary Health Care</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Qualitative Research</topic><topic>Sickness Impact Profile</topic><topic>Unconscious</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marx, Gabriella</creatorcontrib><creatorcontrib>Witte, Nicole</creatorcontrib><creatorcontrib>Himmel, Wolfgang</creatorcontrib><creatorcontrib>Kühnel, Steffen</creatorcontrib><creatorcontrib>Simmenroth-Nayda, Anne</creatorcontrib><creatorcontrib>Koschack, Janka</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>MEDLINE - Academic</collection><jtitle>Patient education and counseling</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marx, Gabriella</au><au>Witte, Nicole</au><au>Himmel, Wolfgang</au><au>Kühnel, Steffen</au><au>Simmenroth-Nayda, Anne</au><au>Koschack, Janka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accepting the unacceptable: Medication adherence and different types of action patterns among patients with high blood pressure</atitle><jtitle>Patient education and counseling</jtitle><addtitle>Patient Educ Couns</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>85</volume><issue>3</issue><spage>468</spage><epage>474</epage><pages>468-474</pages><issn>0738-3991</issn><eissn>1873-5134</eissn><abstract>Abstract Objective To gain deep insight into what it means for patients to live with drug-treated hypertension and to understand the implications for the doctors’ influence on patients’ adherence. Methods Group discussions with 43 drug-treated hypertensive patients. Documentary method was used for interpretative analysis. Results Four basic phenomena were identified (fear, ignorance, reluctance to discuss matters with the doctor, impact of illness experiences), which resulted in different types of action patterns: (1) the assertive actor , (2) the unconscious avoider , and (3) the inconsistent actor . The types of action patterns do not refer to any implications for adherence. The patients’ action does not indicate their preferred model of doctor–patient interaction or their acceptance of taking medication. Conclusion Adherence must not be seen as meaningless behaviour, which can simply be learned, but rather as the result of subjective experiences on living with hypertension and the ability to accept the diagnosis and its treatment. Practice implications It is premature to initiate therapy straight after the diagnosis, before the patient is prepared to take the tablets. 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| subjects | Adherence Adult Aged Antihypertensive Agents - therapeutic use Assertive Biological and medical sciences Doctor-Patient interactions Doctors Fear Female Health Knowledge, Attitudes, Practice Humans Hypertension Hypertension - drug therapy Hypertension - psychology Information Seeking Behavior Internal Medicine Male Medical sciences Medication Adherence Middle Aged Miscellaneous Nursing Patient perspectives Physician-Patient Relations Primary care Primary Health Care Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative Research Sickness Impact Profile Unconscious |
| title | Accepting the unacceptable: Medication adherence and different types of action patterns among patients with high blood pressure |
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