Browsing by Subject "Patient compliance"
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Item Behavior contracting and attention: a study of the management of dietary compliance in hemodialysis patients(Texas Tech University, 1985-12) Marchioni, Perry MNot availableItem Compliance with Lubbock Cleft Palate Team recommendations, 1980 to 1983(Texas Tech University, 1984-05) Wilson, Beth MinickThe child born with a cleft of the lip and/or palate will be faced with many obstacles to overcome. The effects of a congenital cleft will "vary with the type and extent of the anomaly, the age of the individual, his hearing, his environment, his intelligence, his personal characteristics, the management provided for him, and the combinations of circumstances that influence any individual" (Wells, 1971, p. 116). Thus, the management of children who present oralfacial malformations requires the efforts of many professionals through an interdisciplinary team approach.Item Diabetes management and personal interests(Texas Tech University, 1984-12) Havins, William HowardProblems in the management of Type I Diabetes Mellitus have been addressed in previous literature using models of psychopathology. It is suggested that the use of models of psychopathology in investigations of diabetes management problems is inappropriate since the use of such models is predicated on the assumption that poor diabetes management is indicative of psychopathology. The present study sought to determine if a model of normal behavior, developed by John L. Holland (1973), could better explain problems in diabetes management. The present study attempted to gather data from 240 male and 240 female diabetes patients by seeking the participation of 143 physicians in five states. Twenty-seven physicians agreed to participate in the study, offering to gather data from a total 4651 patients (1065 patients per month). Seven physicians actually returned completed data (N = 99; male = 50, female = 49). Data gathered from each subject included a single glycosylated hemoglobin measure, a blood test that gives an estimate of individuals' levels of diabetes management for the previous 90-120 days, done on the same day that patients completed copies of Holland's "Self-Directed Search" (1977), a paper-and-pencil type interest inventory that assesses individuals' interests and self-estimates of skills and abilities in each of the six areas included in Holland's theory of personality (1973). Because of the small amount of data received from physicians, present data were analyzed and compared to data from a pilot study (Havins, Winer, Wysocki, Bourgeois & Varma, 1982) to determine if relationships between glycosylated hemoglobin measures and patients' scores on the "Self-Directed Search" were consistent. These relationships were not found to be consistent between samples. On the basis of the present comparisons there is no support for the idea that Holland's theory of normal behavior can explain problems in Type I diabetes mellitus management. Reasons for failure to find such a relationship are discussed.Item Diabetes meal management(Texas Tech University, 1987-12) Penturf, Mary Ellen HiseThe purpose of this study was to develop a diabetic meal management instructional videotape to enhance and improve comprehension of the diabetic exchange system by food personnel. Subjects were assigned to three groups according to occupational and educational level. Sample size for the groups was 30, each having a treatment and control subgroup. Group 1 was composed primarily of registered or consulting dietitians. Group 2 was composed of food service supervisors, and Group 3 was primarily dietary managers and head cooks. Knowledge was measured by a pre- and post-test instrument after viewing the 16-minute videotape. A significant interaction was found between video and group, with group 3 having a mean increase of 12 points post-video treatment. This group had the lowest level of education and pre-test scores, and thus was aided the greatest by viewing the video program. A voluntary game for subjects was used to evaluate Calorie and exchange estimations for two meals, varying in Calorie level. Subjects generally underestimated Calorie and number of exchanges prior to viewing the videocassette program and raised their scores slightly after the video treatment. This videotape will be a useful tool for improving the serving of diabetic diets by food service personnel as well as for enhancing dietary compliance of newly diagnosed diabetic individuals.Item The impact of pharmacist provision of medication therapy management (MTM) on medication and health-related problems, medication knowledge, and medication adherence among Medicare beneficiaries(2008-08) Moczygemba, Leticia Rae, 1978-; Barner, Jamie C.This study used the Andersen Model for Health Services Utilization to examine a pharmacist-provided telephone MTM program among Medicare Part D beneficiaries. Predisposing (age, gender, race) and need factors (number of medications, number of chronic diseases, medication regimen complexity) were assessed. The health behavior, MTM utilization, distinguished the intervention and control groups. The health outcomes were change in number of medication-related problems, change in medication adherence [using the medication possession ratio (MPR)], and change in total drug costs. Medication knowledge, medication adherence (using the Morisky Scale), and patient satisfaction were also measured in the intervention group. The intervention and control groups were not significantly different in age (71.2 ± 7.5 vs. 73.9 ± 8.0 years), number of medications (13.0 ± 3.2 vs. 13.2 ± 3.4), number of chronic diseases (6.5 ± 2.3 vs. 7.0 ± 2.1), and medication regimen complexity [21.5 (range 8 – 43) vs. 22.8 (range 9 – 42.5)], respectively. For the subset of problems that was evaluated in the intervention and control groups, 4.8 (± 2.7) and 9.2 (± 2.9) problems were identified at baseline and 2.7 (± 2.3) and 8.6 (± 2.9) problems remained at the 3-month follow-up, respectively. Cost-related and preventative care needs and drug-drug interactions were the three most common problems identified. Multivariate regression analysis revealed that the intervention group had significantly more problems resolved (p < 0.0001) when compared to the control group, while controlling for predisposing and need factors. Significantly fewer problems were resolved (p = 0.01) as number of diseases increased and significantly more problems were resolved (p = 0.01) as medication regimen complexity increased. There were no significant predictors of change in MPR or total drug costs from baseline to the 3-month follow-up. Medication knowledge and medication adherence measured by the Morisky scale did not change significantly from baseline to the 2-week follow-up. However, patients were very satisfied with the service. A pharmacist-provided telephone MTM program was an effective method for identifying and resolving medication and health-related problems. A longer follow-up period may be necessary to detect the impact of pharmacist provision of MTM on adherence, total drug costs, and knowledge.Item Marital relationships and stress in couples with a diabetic spouse(Texas Tech University, 1987-05) Barr, EugeniaThe purpose of this study was to examine factors related to marital satisfaction and dietary adherence for adult, married diabetics and their spouses. Using general systems theory as a conceptual base, four hypotheses were organized and tested according to McCubbin and Patterson's (1982) Double ABC-X Model of stress and coping. Variables examined were diagnosis, gender, education, income, and perception of the disease on four marital measures and one dietary measure. Each of the variables was examined across five testing times during the twenty-two week study. Twenty-four married couples having a diabetic spouse participated in the study. Participants were between the ages of 21 and 65 and were residing in the West Texas area. Throughout the study, participants completed several marital and dietary self-report measures (including the Marital Adjustment Test, Locke-Wallace, 1959; modified Spouse Observation Checklist, Weiss, 1975; Areas of Change Questionnaire, Weiss & Birchler, 1975; and two-day food diaries), were visited weekly in their home at a mealtime by a team of trained observers, and were given specific dietary regimens to follow. Each couple participated for eleven consecutive weeks, then were met for a follow-up interview and debriefing.Item Outpatient compliance with the various aspects of a multidisciplinary chronic pain management program(Texas Tech University, 2000-08) Vanecek, Robert JosephThe current study sought to differentiate patients who were compliant with 4 aspects of treatment (invasive medical, management of medications, psychotherapy, and physical therapy) offered at a multidisciplinary pain clinic from those who were not. Participants included 100 residents of West Texas who were treated on an outpatient basis Results indicated that participants were less willing to consider psychotherapy relative to other forms of treatment and that the initial sessions of psychotherapy and physical therapy were attended less often than appointments for medical interventions More persons arrived for office visits to receive prescriptions than arrived for invasive procedures. Discriminant function analyses (DFAs) indicated that being older, more educated and rating oneself as more willing to consider psychotherapy predicted initial compliance with psychotherapy. Compliant patients were less likely to be Caucasian than noncompliant patients Patients who were initially compliant with physical therapy had rated themselves as less disabled and were more likely to be African American. Self-rated willingness was positively related to initial compliance with invasive procedures Patients who attended initial office visits were younger, had higher premorbid income and had rated themselves as more willing to consider the use of medications DFAs were conducted to separate persons who continued beyond an initial session from those who did not No variable predicted continued compliance with psychotherapy Being older, more angry, having higher premorbid income and rating self as more disabled predicted continued compliance with physical therapy Education was positively related to continued invasive procedures beyond the first Medicaid insurance type was more in common among patients returning for office visits The results suggest that patients do not fully endorse the idea of multidisciplinary care and suggest that compliance must be studied independently for each form of intervention offeredItem Physician communicator style and patient satisfaction(Texas Tech University, 1985-12) Buller, Mary KleinNot availableItem The effect of privacy management and immediacy on patient compliance(2012-05) Smith, Toby; Scholl, Juliann C.; Hughes, Patrick C.; Punyanunt-Carter, Narissa M.Patient compliance is an important outcome of effective patient and provider interaction. There are many different ways to define compliance. This study focused on how a patient adheres to a provider’s medical recommendations and directives. The most widely early accepted definition of compliance comes from Haynes and Taylor (1979) who state that compliance is “the extent to which a person’s behavior in terms of taking medications, following diets or executing other lifestyle changes coincides with medical or health advice” (p.1). Patients who are compliant will likely enjoy a more positive outcome of interaction with their provider, better health outcomes, and a higher level of trust. The term compliance for many signifies an underlying authoritarian tone on the part of the health care givers and a yielding submission by clients (Simmons, 1992). Patient compliance can be viewed as an attitude and as a behavior (Cameron C., 1996). Compliance as an attitude is willingness or intention to follow health prescriptions. Compliance as a behavior is related to the actual carrying out of prescriptions (Davis, 1968) or instructions. Patient compliance could be better facilitated by two constructs: immediacy and disclosure. Immediacy is the degree of perceived physical or psychological closeness one feels for another (Mehrabian A., 1967). These are usually sets of behaviors which communicate social accessibility (Goffman , 1964). Disclosure is the act of revealing personal information about oneself to another (Collins & Miller, 1994, p. 457). Disclosure should play a large role in a patient’s ability to comply because disclosure of information helps a provider understand the health care needs of the patient. Overcoming possible barriers of non-disclosure and non-immediate behavior, the patient can be more fully equipped to communicate effectively, thus ensuring the optimal health care being given and received. Applying immediacy and disclosure to this study will help to understand how a patient can be encouraged to be more compliant. Communication Privacy Management theory created by Dr. Sandra Petronio (Petronio, 2004) will be introduced and will acknowledge how patients disclose information to their provider within the communication interaction. It is the goal of this study to further the research on the patient-provider interaction using Petronio’s communication privacy management theory, to provide a framework for effective patient-provider communication by looking at levels of immediacy and disclosure within the patient-provider interaction. Immediacy and disclosure should go together when understanding the construct of patient compliance because patients should feel comfortable with disclosing information to their provider and not holding back on personal boundaries. CPM explains that the more information a patient discloses to a co-owner (a provider) the more information a patient will receive back to become compliant to a regimen given by a provider.