SOCIOBEHAVIORAL DETERMINANTS OF COMPLIANCE WITH HEALTH AND MEDICAL CARE RECOMMENDATIONS
SOCIOBEHAVIORAL DETERMINANTS OF COMPLIANCE WITH HEALTH AND MEDICAL CARE RECOMMENDATIONS
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DOI：
10.1097/00005650-197501000-00002
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发表时间：
1975-01-01
期刊：
影响因子：
3
通讯作者：
MAIMAN, LA
中科院分区：
文献类型：
--
作者：
BECKER, MH;MAIMAN, LA
在过去的二十年中，发表了数百篇文章、社论和评论，描述了个人不遵守健康和医疗建议对护理质量造成的巨大破坏性影响。虽然许多研究都旨在确定导致依从性差的因素，但过去的研究往往侧重于容易测量的患者、治疗方案或疾病的特征，不幸的是，这些特征通常既不可预测也不可改变。本文系统地回顾了有关患者接受推荐健康行为的文献，试图找到已被证明可以一致预测依从性的社会心理和相关变量。审查表明，某些健康信念（特别是个人对疾病的脆弱性和严重性的估计，以及对护理功效的信心）、与健康相关的动机、对建议行动的心理和其他成本的看法、医患关系的各个方面以及社会影响是当前干预和进一步探索最有成效的维度。基于早期的表述，提出了一个假设模型，该模型结合了这些元素来解释和预测合规行为。进一步的研究应该通过标准化问卷和分析技术，针对各种人群、环境和方案采用前瞻性实验设计，以评估修改模型变量的实际尝试的能力，从而提高依从性。
Over the past two decades, hundreds of articles, editorials, and commentaries have been published describing the considerable disruptive effects on quality of care of individual noncompliance with health and medical advice. While much research has been directed at determining factors responsible for poor compliance, past studies have tended to focus upon easily measured characteristics of the patient, regimen, or illness which, unfortunately, are usually neither predictive nor alterable. This paper systematically reviews the literature on patient acceptance of recommended health behaviors, attempting to find social-psychological and related variables which have proven to be consistent predictors of compliance. The review suggests that certain health beliefs (especially personal estimates of vulnerability to, and seriousness of, the disease, and faith in the efficacy of care), health-related motivations, perceptions of psychological and other costs of the recommended action, various aspects of the doctor-patient relationship, and social influence are the most productive dimensions for present intervention and further exploration. Building upon an earlier formulation, an hypothesized model is presented which combines these elements for explaining and predicting compliance behavior. Further research should, with standardized questionnaires and analysis techniques, employ prospective, experimental designs for a variety of population groups, settings, and regimens, to evaluate the ability of practical attempts to modify the model variables and thus enhance compliance.