title: Patient accounts for noncompliance with diabetes self-care regimens and physician compliance-gaining response.
abstract: The purpose of this study was to identify diabetics' accounts for medical noncompliance, physicians' compliance-gaining strategies elicited in response to those accounts, and to examine the relationship between accounts and compliance-gaining strategies. Telephone surveys of diabetics from Kentucky and Tennessee assessed patient perceptions of physician-patient communication during their last diabetes treatment-related appointment. Eighty-four patients were able to provide categorical data for analysis. Patient account strategies for noncompliance were coded as concessions, excuses, justifications, and refusals. Physician compliance-gaining strategies were coded as positive-regard, negative-regard, or neutral-regard strategies. Results showed the most common patient account was concession (33%), then excuse (23%), justification (22%), and refusal (7%). The most common physician compliance-gaining strategy was neutral regard (54%), then positive regard (31%) and negative regard (15%). Results also indicated that patient account and physician compliance-gaining strategy were related. Specifically, concession accounts from patients elicited a subsequent neutral-regard compliance-gaining strategies from the physician in 76% of concession cases. Results also show that justifications were most likely to elicit neutral- (52%) or positive-regard (43%) strategies. Implications for physician practice and future research are discussed.
authors.affiliation: Department of Communication, Wake Forest University, P.O. Box 7347, Reynolda Station, Winston Salem, NC 27109-7347, USA. helmed@wfu.edu
authors.forename: Donald W
authors.initials: DW
authors.lastname: Helme
authors.forename: Nancy Grant
authors.initials: NG
authors.lastname: Harrington
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003299:Cooperative Behavior; D003922:Diabetes Mellitus, Type 1 / Q000517:prevention & control / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D009042:Motivation; D017008:Negotiating; D010817:Physician-Patient Relations; D011340:Problem Solving; D012648:Self Care / Q000379:methods / Q000523:psychology*; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013714:Tennessee; D016312:Treatment Refusal / Q000523:psychology*; D035502:Trust