Promoting patient cooperation with exercise programs: linking research, theory, and practice.

Managing patient-nonadherence with prescribed exercise regimens is not an uncommon task for physical therapists working with individuals with arthritis. Yet little is known about the factors that influence patient adherence with exercise programs or therapist knowledge and use of theoretically based adherence management techniques. Survey research with physical therapists and patients was used to provide a database for further insight into the barriers experienced in implementing exercise programs in clinical practice. In this paper, we suggest that the cooperation with an exercise regimen is mediated by the patient's belief system and requires a therapeutic process of mutual inquiry, problem solving, and negotiation between the therapist and patient. Concepts from research, theory, and practice are integrated into a Process Model for Patient-Practitioner Collaboration for use in clinical practice.

[1]  F. Krusen,et al.  PHYSICAL THERAPY APPLIED AT HOME FOR ARTHRITIS: A FOLLOW-UP STUDY, WITH A SUPPLEMENTARY SUMMARY OF THE SEDIMENTATION RATE OF ERYTHROCYTES IN TWO HUNDRED AND TWENTY-NINE CASES OF ARTHRITIS , 1943 .

[2]  Bender Lf,et al.  Problem of home treatment in arthritis. , 1957 .

[3]  M. Becker,et al.  Sociobehavioral Determinants of Compliance with Health and Medical Care Recommendations , 1975, Medical care.

[4]  Davis Lj,et al.  Medical recommendations--followed or ignored? Factors influencing compliance in arthritis. , 1976 .

[5]  G. L. Engel.  The need for a new medical model: a challenge for biomedicine , 1977 .

[6]  G. Bole,et al.  Family support, health beliefs, and therapeutic compliance in patients with rheumatoid arthritis. , 1979, Patient counselling and health education.

[7]  R. Carkhuff.  The skills of helping: An introduction to counseling skills , 1979 .

[8]  I. Ajzen,et al.  Understanding Attitudes and Predicting Social Behavior , 1980 .

[9]  T. Garrity,et al.  Medical compliance and the clinician-patient relationship: a review. , 1981, Social science & medicine. Part E, Medical psychology.

[10]  E. Bartlett,et al.  Behavioral diagnosis: a practical approach to patient education. , 1982, Patient counselling and health education.

[11]  M. Robin DiMatteo,et al.  Achieving Patient Compliance , 1982 .

[12]  A. Jette,et al.  Improving patient cooperation with arthritis treatment regimens. , 1982, Arthritis and rheumatism.

[13]  R. Haynes,et al.  A critical review of compliance studies in rheumatoid arthritis. , 1984, Arthritis and rheumatism.

[14]  H. Leventhal.  The role of theory in the study of adherence to treatment and doctor-patient interactions. , 1985, Medical care.

[15]  A. Bandura.  Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[16]  Hicks Je.  Compliance: a major factor in the successful treatment of rheumatic disease. , 1985 .

[17]  D. Turk,et al.  Facilitating treatment adherence , 1987 .

[18]  K. Lorig,et al.  Arthritis patient education: a review of the literature. , 1987, Patient education and counseling.

[19]  M. Mahowald,et al.  The Minnesota Arthritis Training Program: emphasis on self-management, not compliance. , 1988, Patient education and counseling.

[20]  E. Bartlett.  The Stepped Approach to Patient Education , 1988, The Diabetes educator.

[21]  J. Trostle.  Medical compliance as an ideology. , 1988, Social science & medicine.

[22]  The effect of patient-practitioner interaction on compliance: a review of the literature and application in rheumatoid arthritis. , 1988, Patient education and counseling.

[23]  L. Bradley,et al.  Adherence with treatment regimens among adult rheumatoid arthritis patients: current status and future directions. , 1989, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[24]  P. Benner,et al.  The Primacy of Caring: Stress and Coping in Health and Illness , 1989 .

[25]  W. Agras.  Understanding compliance with the medical regimen: the scope of the problem and a theoretical perspective. , 1989, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[26]  S. Wegener.  Adherence: are we preaching the truth? , 1989, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[27]  J. Dunbar,et al.  Compliance measurement with arthritis regimen. , 1989, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[28]  L. Gerber.  Exercise and arthritis. , 1990, Bulletin on the rheumatic diseases.

[29]  F M Ross,et al.  Patient compliance--whose responsibility? , 1991, Social science & medicine.

[30]  J. Knibbe,et al.  Patient compliance with exercise: Different theoretical approaches to short-term and long-term compliance☆ , 1991 .

[31]  K. Shepard,et al.  Attribute dimensions that distinguish master and novice physical therapy clinicians in orthopedic settings. , 1992, Physical therapy.

[32]  P. Dexter.  Joint exercises in elderly persons with symptomatic osteoarthritis of the hip or knee. Performance patterns, medical support patterns, and the relationship between exercising and medical care. , 1992, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[33]  D. Blake,et al.  Patient non-compliance: deviance or reasoned decision-making? , 1992, Social science & medicine.

[34]  G. Kok,et al.  Correlates of exercise compliance in physical therapy. , 1993, Physical therapy.

[35]  E. Schned.  Future care of rheumatoid arthritis in a managed care environment. , 1993, Bulletin on the rheumatic diseases.

[36]  M. Liang,et al.  Biopsychosocial contributions to the management of arthritis disability. Blueprints from an NIDRR-sponsored conference. , 1993, Arthritis and rheumatism.

[37]  K. Lorig,et al.  Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. , 1993, Arthritis and rheumatism.