TY - JOUR
T1 - Patient accounts for noncompliance with diabetes self-care regimens and physician compliance-gaining response
AU - Helme, Donald W.
AU - Harrington, Nancy Grant
PY - 2004/11
Y1 - 2004/11
N2 - The purpose of this study was to identify diabetics' accounts for medical noncompliance, physicians' compliance-gaining strategies elicited in response to those accounts, and to examine the relationship between accounts and compliance-gaining strategies. Telephone surveys of diabetics from Kentucky and Tennessee assessed patient perceptions of physician-patient communication during their last diabetes treatment-related appointment. Eighty-four patients were able to provide categorical data for analysis. Patient account strategies for noncompliance were coded as concessions, excuses, justifications, and refusals. Physician compliance-gaining strategies were coded as positive-regard, negative-regard, or neutral-regard strategies. Results showed the most common patient account was concession (33%), then excuse (23%), justification (22%), and refusal (7%). The most common physician compliance-gaining strategy was neutral regard (54%), then positive regard (31%) and negative regard (15%). Results also indicated that patient account and physician compliance-gaining strategy were related. Specifically, concession accounts from patients elicited a subsequent neutral-regard compliance-gaining strategies from the physician in 76% of concession cases. Results also show that justifications were most likely to elicit neutral- (52%) or positive-regard (43%) strategies. Implications for physician practice and future research are discussed.
AB - The purpose of this study was to identify diabetics' accounts for medical noncompliance, physicians' compliance-gaining strategies elicited in response to those accounts, and to examine the relationship between accounts and compliance-gaining strategies. Telephone surveys of diabetics from Kentucky and Tennessee assessed patient perceptions of physician-patient communication during their last diabetes treatment-related appointment. Eighty-four patients were able to provide categorical data for analysis. Patient account strategies for noncompliance were coded as concessions, excuses, justifications, and refusals. Physician compliance-gaining strategies were coded as positive-regard, negative-regard, or neutral-regard strategies. Results showed the most common patient account was concession (33%), then excuse (23%), justification (22%), and refusal (7%). The most common physician compliance-gaining strategy was neutral regard (54%), then positive regard (31%) and negative regard (15%). Results also indicated that patient account and physician compliance-gaining strategy were related. Specifically, concession accounts from patients elicited a subsequent neutral-regard compliance-gaining strategies from the physician in 76% of concession cases. Results also show that justifications were most likely to elicit neutral- (52%) or positive-regard (43%) strategies. Implications for physician practice and future research are discussed.
KW - Adherence
KW - Compliance
KW - Compliance-gaining
KW - Diabetes
KW - Physician-patient communication
UR - http://www.scopus.com/inward/record.url?scp=7644224499&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=7644224499&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2003.10.004
DO - 10.1016/j.pec.2003.10.004
M3 - Article
C2 - 15530766
AN - SCOPUS:7644224499
SN - 0738-3991
VL - 55
SP - 281
EP - 292
JO - Patient Education and Counseling
JF - Patient Education and Counseling
IS - 2
ER -