title: Kitchen table wisdom: a Freirian approach to medication adherence.
abstract: Most interventions to promote medication adherence are based on psychological theories of individual behavior. In contrast, this article describes the theory and practice of a socially based adherence intervention that is guided by the educational principles of Paolo Freire. This approach asserts that adherence is influenced by the patient's social context and attempts to improve adherence through identifying social constraints on adherence behavior. The program builds on the traditions of patient education through home nursing visits. Using a dialectic process of dialogue and problem solving and working with a team that includes a nurse and a peer-educator, patients are encouraged to act to change their social environment to support their desire to achieve high levels of medication adherence. This strategy does not replace, but rather supplements, traditional methods of understanding individual patient behavior and allows the patient and the nurse to consider potential solutions to adherence challenges in the larger social context.
authors.affiliation: Yale School of Nursing, CT, USA.
authors.forename: Ann B
authors.initials: AB
authors.lastname: Williams
authors.forename: Jane D
authors.initials: JD
authors.lastname: Burgess
authors.forename: Karina
authors.initials: K
authors.lastname: Danvers
authors.forename: Janice
authors.initials: J
authors.lastname: Malone
authors.forename: Subrena D
authors.initials: SD
authors.lastname: Winfield
authors.forename: Lois
authors.initials: L
authors.lastname: Saunders
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use; D003142:Communication; D003152:Community Health Nursing / Q000458:organization & administration; D003299:Cooperative Behavior; D015658:HIV Infections / Q000188:drug therapy* / Q000451:nursing / Q000523:psychology; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration; D006792:House Calls; D006801:Humans; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000458:organization & administration*; D010358:Patient Participation / Q000523:psychology; D010379:Peer Group; D011209:Power, Psychological; D011340:Problem Solving; D011582:Psychological Theory; D011588:Psychology, Educational; D011593:Psychology, Social; D012646:Self Administration / Q000379:methods / Q000523:psychology; D012931:Social Environment; D012944:Social Support; D013664:Teaching Materials
chemical_list: D019380:Anti-HIV Agents