Compliance means to be cooperative, willing to follow Treatment Regimen.
Noncompliance means not cooperative, unwilling to follow Treatment Regimen.
The questions that arises is why will someone refuse treatment regimen?Why will someone refuse to cooperate with their plan of care.Why will you reject something that will make you better. Something that will keep you healthy and possibly prolong your life?
Here are Some Reasons:
“No English”.Some people will pretend that they do not understand English to see what the healthcare professional might be saying about them.Which did not make sense but for them it made a lot of sense.We should use the language line to make sure that they understand.
Denial of the problem: Refusal to accept diagnosis but did nothing about it .Some are too proud of themselves that they will not confess that they don’t have the resources. Therefore they rather hope against hope until it is to late.Then BIBA to the Emergency Room.
Importance of Previous Experience:One good experience deserve another. Bad experience is always discouraging.
Lack of Adequate Support System: It is very important to reject “NO”for any unreliable answer. According to WHO about 125,000 people die within a year due to noncompliance.
Other Factors include negative attitude, lack of motivation, cultural and Beliefs System,Educational level, Gender and Marital Status.
Cost of Treatment : Most people cannot afford to pay for treatment, but has no solutions.
Age.This is one of the factors that can affect compliance,because patient is demented and does not comprehend the needs to cooperate. So families or other social support should be involved.
Language barrier.Patient does not understand.It is very difficult for both the patient and healthcare workers when patient does not understand.Language line can help or qualify interpreter.
Belief System.In Africa in those days there was the beliefs that Cancer, Diabetes, hypertension and Aids are “White man’s” disease.This is due to ignorance and lack of understanding.
People were living longer then due to lack of Stress,their means of livelihood was Agriculture, there was no Processed Food,live was simple.Everybody was their brother’s Keeper, caring for each other .
Then came the era of processed Food,Greed,Stress,Dishonesty.The Culture,Norms and Value System of the Ancestors were Relegated to the Background.
So you get what you paid.You want to emulate the Western World.You must have a system that are in place to move the Country forward with modernization. But unfortunately for people in Africa they have No Adequate Healthcare System to take care of their “New attitude”And the current Death Rate is alarming.They have no solutions, the Government are Corrupt through and through.The rich seek Treatment overseas and the Masses die of diseases, hunger,and starvation.
We did a health Fair over in Africa twelve years ago, in which one of the client blood pressure was over 200 Systolic and diastytolic of over 120.She said that she had no money for doctor’s visit,we paid for doctor visit and medications .But she ignored all warnings.Did not take her medications.According to her “high blood pressure did not kill my parents and will not kill me”. She died three weeks later.Some people will just believe what they want to believe which might be detrimental to their live.Did she know what killed her parents since there was no autopsy?
No she did not.
I have hoped against hope that one day,reality will set in and they will realize the truth and that day may be “Now”.
There are people in various parts of the world that don’t understand the disease process and don’t want or believe in it or care.And there are other people who understand and do the right thing.Health Promotion and Disease Prevention.So life expectancy in third world countries are low due poverty,access to health clinics,knowledge deficits, finance, substance abuse,age,belief systems and so many other factors.
Finance.someone people have no means of transportation to the clinics or money to buy the needed medications.
Nutrition.So many patients do not follow the right diet.For example the dialysis patients should avoid the three Ps which are potassium, phosphorus and protein.But they do not because so many of them cannot afford it.
Substance Abuse.Most often patients that abuse drug and alcohol don’t follow doctors orders, so they end up in Emergency Rooms.According to World Health Organizations most of the hospitals and Nursing homes admissions are due to noncompliance.
Nonchalant attitude.Some patients don’t care and they don’t see it as their problem.Rather it is the doctors and hospital problem.”Is their problem not my problem”
Frequent Flyers.The frequent flyers do not pay attention to their health,so they come to the hospital frequently only to go out and continue to do the same thing again,and again.
Homelessness.When you are homeless it becomes difficult if not impossible to take control of your health or your life.
Poverty. Poverty can be a disease.Seek help from all the right places.Do not give up.There is government hospitals, Meals on the Wheels,Public Transportation systems,Homeless Shelter, and various places that you can go to get help.
Nurses to Educate Patients.Educating the patients about their disease process ,and how to manage their health is very important. For example a diabetic patient need to have accucheck machine, and all the needed supplies to check their blood sugar.
Patients Education .Educate patients on the importance of compliance.Explain to patients and families the disease process and the need to comply.Because noncompliance can lead to so many problems.
Education,education with case scenarios for those who believe that it cannot happen to them because it can happen to anyone.Educate on Prevention and Health Promotion and also explain the pathophysiology of the body.
Involvement patients in their Plan of Care.
Patients should be involved in their plan of care.Encourage them to follow up with their doctors orders.Take medication as prescribed.
Family Involvement.Involve patients families. Educate them on how to take care of their love ones.
Financial support: Refer their to the proper department to help with payment.
Social Work and Case Manager should be involved to follow up with patients and make arrangement to help with supplies of important medications for one to three months supplies.Until patients can find their grounds.