Compliance to medication

Theory Paper
Introduction
Compliance to medication is a significant issue in provision of patient care. Adherence to medication refers to the degree which the patient complies with the prescribed medication. Compliance of medication is a serious issues in patients diagnosed with psychiatric disorders which require comprehensive nursing interventions. Patients diagnosed with psychiatric disorders are prescribed long term medication to help alleviate the mental disorders. For instance, depression dosage takes up to 12 months. Because of long medication schedule associated with most mental health issues, many patients do not observe strict compliance to prescription. Several factors are associated with non-compliance of medication including failure to understand instructions, social stigma, routine challenges, forgetfulness, cost concerns, and distress about side effects (Yap, Thirumoorthy & Kwan, 2016, p.65). However, different interventions have been established to solve the issue of non-adherence. These intervention approaches include enhancing patient education experience, education the patient on benefits of the treatment, implementing a joint decision making, appraisal of patient’s medication attitude, and healthcare personnel empathy. It is important to address factors associated with non-adherence of medication in order to accomplish the desired patient outcomes. This paper seeks to explore medication compliance to patients with mental disorders.
Phenomenon of Interest
Factors which affect compliance of medication among mental ill patients can be categorized into five; clinical disorder features, clinical expertise, medication characteristics, treatment setting, and patient characteristics. Clinical disorder features include depression, schizophrenia, comorbid anxiety, and chronicity. Clinical expertise is involves knowledge of psychotherapy and pharmacology as well as mental health personnel empathy. Medication characteristics include complex medical regime and sensitivity of patients to side effects. Treatment settings involve specialty office and inpatient versus outpatient. The patient characteristics affecting compliance include socio-economic considerations, attitude towards treatment and illness, as well as social status. Laugesen and Yuan (2015) argue that the prevalence for non-compliance is rampant in elderly population and accounts for 75% of all the non-compliance cases. This high prevalence is attributed frequent change of doses and alteration of schedules, abuse and overuse, as well as forgetfulness. Attaining the desired patient care is a collaborative affair between the psychotherapists, psychiatrist, patient, the patient’s family. Each of this parties play an important role in ensuring adherence to the prescribed treatment. Non-compliance results in additional medical costs associated with prescription pull out effects. The extra cost linked to non-compliance may include administration of a new set of prescription (Lam & Fresco, 2015).
Fawcett’s Meta-paradigm of Nursing
The Fawcett’s Meta-paradigm was introduced to formulate a nursing theory that contained basic principles and knowledge to guide future nurses’ in their practice. The metaparadigm identifies the concepts central to the nursing discipline relating them to the assumptions of the world view. The metaparadigm of nursing includes the concepts of person, environment, health, and nursing that are all intertwined (Blais, 2015). The nursing metaparadigm contributes to the conceptual framework that guide healthcare providers in performing critical thinking process in daily experiences in healthcare settings. Fawcett’s Metaparadigm of Nursing can be used to address the issue of non-compliance in patients with mental disorders.
Concepts of Metaparadigm
Human beings
Human being are perceived as open energy fields with special life experiences. As suggested by this paradigm, human beings are different and greater than some of their parts and are unpredictable from knowledge of their parts. As holistic beings, humans are multidimensional, sentient, dynamic, unique, and capable of self-responsibility, aesthetic appreciation, creativity, and abstract reasoning. Empathy, language, caring and other aspects patterns of communication are elements of individually high levels of diversity and complexity and facilitate an individual to increase knowledge of self and environment (Bhui, 2017). Human are regarded valued individuals to be understood, nurtured, and respected with the right to make informed choices concerning their health. This paradigm can help nurse and other care give to observe compliance of medication in patients with mental disorders because they are prone to forgetting taking their prescribed medicine.
Environment
The environment is the geography and landscape of human social experience. It entails the context or setting of experience as daily life and involves variations in quality, time and space. This geography entails personal, national, global, social and beyond. Besides, environment also includes societal expectations, customs, mores, values and beliefs (Lam & Fresco, 2015). The environment is mutual process in energy field and is hypothesized as an arena in which patient encounter the lived experiences of health, threats to wellness, caring relationship, and aesthetic beauty. The dimensions that affect health include developmental, historical, cultural, psychological, and physical processes as well as the economic and political aspects of social world. This paradigm relates to the context of experience in everyday life and the issue of non-compliance of medication among patients with mental disorders. The social environment in which this people live affects their compliance to drugs. For instance, lack of close care givers taking care of these patients can lead to high rates of non-compliance.
Health
Health is defined by the perception of an individual across the life span. It is both a dynamic and synthesis of wellness and illness. This perception focuses on the entire nature of the patient in moral, aesthetic, social, and physical realms. Health is relational and conceptual. In this view, wellness is the lived experience of similarity between one’s realities and one’s possibilities and is grounded on caring and feeling cared for. Ill-health is refers to the lived experience of dysfunction or loss that can be intervened by caring relationships (Bahramnezhad, Asgari, & Afshar, 2015). Every individual has different approach to stress and coping. The level or status of health is an expression of joint interactive process between an individual and the environment. This paradigm relates to patient compliance of drugs because the health status of nurse’s client significantly affects adherence to prescribed medication. For instance, mental disorders are associated with high rates of non-compliance.
Nursing Practice
Nursing is the art and science of comprehensive care and is guided on the values of responsibility, choice and freedom. Nursing science is a discipline of knowledge founded on research, theory development and logical analysis. The art of nursing practice is realized through medical interventions and creative use of nursing knowledge in delivery of patient care. Nurses use clinical judgment and critical thinking to provide evidence-based care to patients, families, communities and aggregates to achieve an optimal level of patient wellness in diverse nursing environments. As moral ideal of nursing, human caring is the central focus of professional practice (Blais, 2015). This paradigm relates to patient’s compliance of medication and involves concern and empathy of patient’s lived experience. The nurse as a person is involved as an active partner in promoting compliance to treatment among his or her patients.
Grand Nursing Theory
Nursing theories provides a conceptual framework under which the important principles and components of nursing practice can be identified. Nursing theories form a fundamental instrument used to guide, improve and explain the practice of nursing. The idea that nursing should be guided by disciplinary theory, incorporate the beliefs of patient and families, and be founded on the best empirical evidence should is among the core beliefs of nursing. Example of grand theorists whose work has significantly impacted the discipline of nursing include Jean Watson, Myra Levine, Peplau, and Virginia Henderson. One thing these theorists share in common is that they were all patient centered (Smith & Parker, 2015). This section explores Jean Watson theory of human caring in relation to non-compliance of medication in patients with mental disorders.
Jean Watson’s theory of explain the principle and science of caring. Caring is a concept that reflects a protective, supportive, non-judgmental, and respectful attitude while it contributes to the process of healing. Watson theory states that caring goes beyond transcends and physical care into a more spiritual realm whereby the patient and nurse establish a transpersonal caring relationship. This transpersonal relationship prompts both the nurse and the patient to promote healing. As it relates to the metaparadigm of nursing, Watson’s theory focuses on the relationship between the patient and nurse (Revels, Goldberg & Watson, 2016, p.234). Watson theory emphasizes on the idea that when a patient and a nurse are brought together in a conducive environment they are able to establish a spiritual relationship. Borrowing from Watson’s theory, I would view poor compliance of medication among patients with mental disorder as an issue which nurses and other health care professionals should consider for improvements. Guided by Watson’s theory of human caring, nurses and other healthcare care professionals can help address high rates of medication non-compliance through personalized patient care (Drevenhorn, 2018).
Middle Range Theory
Middle range theories are instrumental in addressing problem encountered in nursing practice especially those affecting vulnerable populations. Despite the fact that middle theories address definite phenomenon in nursing practice, they have wide range of applications in practice settings. This section seeks to explore Bandura’s Social cognitive theory and how it relates to poor medication compliance in patients with mental disorders. According Bandura’s Cognitive theory, cognitive processing is a form of reflective thinking that help people to set their behavior standards and then generate important skills to achieve behavioral goals. In his theory, Bandura asserts that self-efficacy is a critical mediator within the triad of interchange of cognition, behavior, as well as other environmental/personal influences (Stacey, et al. 2015). Bandura suggested to elements of self-efficacy: outcome expectations and self-efficacy expectations. Bandura explained outcome expectations as a person’s projection that a particular behavior results in a certain income. He also highlighted outcome expectations as one’s belief that they can successfully pursue a certain behavior to come up with an anticipated outcome. A person may believe that a particular behavior results in a certain outcome, however, may or may not have the belief that they can successfully sustain the behavior.
Another concept proposed in Bandura’s cognitive theory is self-efficacy sources that work in a reciprocal manner (1) physiological feedback, verbal persuasion, vicarious experience, and enactive attainment. These concepts are centered on the paradigm of human beings in the nursing practice.
Physiological Feedback
In his theory, Bandura asserts that a person’s judgment of their ability to successfully make changes is depended on their response and acknowledgement to physiological indicators such as anxiety. If the individual faces adverse physiological symptoms, he or she is less likely to get involved in the behavioral change process (Stacey, et al. 2015).
Verbal Persuasion
Bandura asserts that verbal persuasion as influencing individuals through verbal suggestion to begin thinking that they can successfully contribute to behavioral changes. Bandura argues that verbal persuasion is less effective compared to enactive attainment. Since a person may not authentically experience success with the change and the disconfirming experience may easily derail the change.
Vicarious experience
In his cognitive theory, Bandura defines various experience as expectations which that are sourced from seeing others undergo behavioral change without experiencing negative consequences. Bandura asserts that an individual ought to have a clear performance of the behavioral change.
Enactive attainment
In his theory, Bandura defines enactive attainment as individual actual performance or mastery of the behavior. Bandura acknowledges that a person’s pattern of success and failure, environment of the behavioral, amount of effort required, and behavioral change have on self-efficacy. Bandura conceptualized that mastery an individual behavior change can possess a carry-over effect in implementation of other behavioral changes.
The cognitive theory will guide in identifying behaviors changes that prompt non-compliance of medication among patients with mental disorders. Nursing interventions can be used to promote compliance of medication among patients with mental disorders. Assisting patient to improve compliance of prescribed medicines. Empathetic and professional communication is critical when helping patient to improve compliance. The Bandura’s cognitive theory relates to Jean Watson theory of human caring by emphasizing on the behavior of an individual in delivery of patient care.
Complexity Science
Complexity science is not a single theory but rather it is an emerging interdisciplinary paradigm. Complexity science evaluates systems encompassed of diverse and multiple agents and seeks to unveil the dynamics and principles that affect how such systems evolve and maintain order. The complexity science provides critical concepts and tools for solving challenges likely to be encountered in healthcare in the 21st century (Braithwaite, et al. 2017). Clinical practice, professional development, education, research, and information management are interdependent and built around interacting and multiple adjusting systems. New conceptual framework that incorporate intuitive, creative, emergent, and dynamic view of the world must first replace traditional approach to solving healthcare concerns and embrace new strategies of responding to health issues (Anthony & Vidal, 2018).
The complex adaptive system that relates to poor medication compliance among patients with mental disorders is organizational complexities with communication to help promote compliance. Healthcare providers play a critical role in helping behavior changes with a goal an ultimate goal of promoting patient compliance to medication. These professionals can employ different communication approaches to counsel their patients on the benefits associated with good adherence of medication. Besides, healthcare professionals can liaise with relatives and caregivers of patients with mental disorder and encourage them to observant on medication compliance of their loved one.
Conclusion
Compliance to medication is a significant issue in provision of patient care. Compliance of medication is a serious issues in patients diagnosed with psychiatric disorders which require comprehensive nursing interventions. Several factors are associated with non-compliance of medication including failure to understand instructions, social stigma, routine challenges, forgetfulness, cost concerns, and distress about side effects. However, different interventions have been established to solve the issue of non-adherence. The Fawcett’s Meta-paradigm was introduced to formulate a nursing theory that contained basic principles and knowledge to guide future nurses’ in their practice. The metaparadigm of nursing includes the concepts of person, environment, health, and nursing that are all intertwined. . Fawcett’s Metaparadigm of Nursing can be used to address the issue of non-compliance in patients with mental disorders. Nursing theories provides a conceptual framework under which the important principles and components of nursing practice can be identified. Guided by nursing theories, nurses and other healthcare care professionals can help address high rates of medication non-compliance through personalized patient care. Complexity science is not a single theory but rather it is an emerging interdisciplinary paradigm. The complex adaptive system that relates to poor medication compliance among patients with mental disorders is organizational complexities with communication to help promote compliance.
References
Anthony, M. K., & Vidal, K. (2018). Innovative Approach to Reconstruct Bedside Handoff: Using Simple Rules of Complexity Science to Promote Partnership With Patients. Journal of nursing care quality, 33(2), 128-134.
Bahramnezhad, F., Asgari, P., & Afshar, P. F. (2015). A Review of the Nursing Paradigm. Open Journal of Nursing, 5(01), 17.
Bhui, K. (2017). Cultural neuroscience: a meta-paradigm for psychiatry?
Blais, K. (2015). Professional nursing practice: Concepts and perspectives. Pearson.
Braithwaite, J., et al. (2017). Complexity Science in Healthcare-Aspirations, Approaches, Applications and Accomplishments: A White Paper. Macquarie University
Drevenhorn, E. (2018). A Proposed Middle-Range Theory of Nursing in Hypertension Care. International Journal of Hypertension, 2018.
Lam, W. Y., & Fresco, P. (2015). Medication adherence measures: an overview. BioMed Research International, 2015.
Laugesen, J., & Yuan, Y. (2015). The impact of internet health information on patient compliance: a research model and an empirical study. Journal of medical Internet research, 17(6).
Revels, A., Goldberg, L., & Watson, J. (2016). Caring Science: A Theoretical Framework for Palliative Care in the Emergency Department. International Journal for Human Caring, 20(4), 226-242.
Smith, M. C., & Parker, M. E. (2015). Nursing theories and nursing practice. FA Davis.
Stacey, F. G., James, E. L., Chapman, K., Courneya, K. S., & Lubans, D. R. (2015). A systematic review and meta-analysis of social cognitive theory-based physical activity and/or nutrition behavior change interventions for cancer survivors. Journal of Cancer Survivorship, 9(2), 305-338.
Yap, A. F., Thirumoorthy, T., & Kwan, Y. H. (2016). Medication adherence in the elderly. Journal of Clinical Gerontology and Geriatrics, 7(2), 64-67.

“We Have the Best Writing Experts in the Industry” Click on the place order button at the top right corner of this page