Noncompliance - Knowledge Deficit; Patient Education
NANDA: A patient's informed decision not to adhere to a therapeutic recommendation; failure to follow prescribed treatment plan
The fact that a patient has attained knowledge regarding the treatment plan does not guarantee compliance. Failure to follow the prescribed plan may be related to a number of factors. Much research has been conducted in this area to identify key predictive factors. Several theoretical models, such as the Health Belief Model, serve to explain those factors that influence patient compliance. Patients are more likely to comply when they believe that they are susceptible to an illness or disease that could seriously affect their health, that certain behaviors will reduce the likelihood of contracting the disease, and that the prescribed actions are less threatening than the disease itself. Factors that may predict noncompliance include past history of noncompliance, stressful lifestyles, contrary cultural or religious beliefs and values, lack of social support, lack of financial resources, and compromised emotional state. People living in adverse social situations, such as battered women, homeless individuals, those living amid street violence, the unemployed, or those in poverty may purposefully defer following medical recommendations until their acute socioeconomic situation is improved. The rising costs of health care, and the growing number of uninsured and underinsured patients often forces patients with limited incomes to choose between food or medications. The problem is especially complex for elder patients living on fixed incomes but requiring complex and costly medical therapies.