Reasons for non adherence 3 and 4

• What are reasons 3 and 4 for non adherence

  Learned helplessness and lack of support
• Learned helplessness

  Part of being ill means repeatedly facing stressful situations that you cannot control.

  Therefore there is a serious risk that people who are ill learn to be helpless in these circumstances.

  The outcome is that even when there are opportunities to be in control, they’re not taken.
• Learned helplessness link with health

  Taking medication or changing a lifestyle choice is something that an individual has control over

  However in many cases the individual learns that the control makes no difference to their health

  Therefore, they no longer try to do anything to help.
• Learned helplessness link with health

  Whether we learn to be helpless or not depends on how we think about health and illness

  A person will lose motivation and become passive if they think about their behaviour in the following ways:“It’s all my fault because I just cant do these exercises”

  “There’s nothing I can do to get better”

  “I’ll never be organised enough to take my medication”
• Downward spiral:

  Someone experiencing learned helplessness may well become depressed and the depression itself makes non adherence more likely

  Non adherence makes the depression worse and reinforces learned helplessness which makes non-adherence more likely.
• Strengths of learned helplessness

  Interventions can target learned helplessness for example CBT
• Weakness of learned helplessness

  Lack of research support
• Lack of support- who helps us follow medical advice?

  Doctors- enlighten patients with the drawbacks of not following medical advice.

  Family and friends
• Support from significant others:

  Lack of practical support: Without a social network, a person might have no one to remind him to take medication, take them to appointments, show them how to access videos or support etc
• Lack of emotional support:


  Adherence is less likely when the person lacks people who can improve their mood or who can provide encouragement, rewards or a shoulder to cry on.

  However relationships with significant others can also be negative

  A lack of support may produce better outcomes for someone who needs to follow medical advice because they rely on more support from professionals.
• Support from health professionals: Lack of practical support

  Main type of support from health professionals is usually informational

  Health professionals are the experts on the benefits of adherence so a lack of information can lead to non-adherence
• Support from health professionals: Lack of emotional support

  Clients usually expect professionals to provide emotional support as well

  Most professionals consider this to be part of their role, however there might be a gap between what client expects and the professional provides

  The key factors is how the client perceives the support

  If for example they do not trust professional or that the communication is poor, they will perceive lack of emotional support.
• Strengths of lack of support

  Lack of support linked to non-adherence. Adherence is lower in people who live alone
• Weakness of lack of support

  Support from professionals is only one factor that impacts adherence