Patient accounts for nonadherence: A critical window into the patient experience |
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| Affiliation: | 1. Communication, Culture and Technology Program, The McDonough School of Business, Georgetown University, Washington DC, USA;2. Department of Communication, University of Dayton, Dayton, OH, USA;3. Department of Family Medicine, Georgetown University Medical Center, MedStar Medical Group, Washington DC, USA;4. Communication, Culture and Technology Program, Georgetown University, Washington DC, USA;5. Department of Family Medicine, Georgetown University Medical Center, MedStar Georgetown University Hospital, Washington DC, USA;1. Department of Medicine, Cooper University Hospital, Camden, NJ, USA;2. Department of Urology, Indiana Health University Hospital, Indianapolis, IN, USA;1. Department of Communication, Michigan State University, 404 Wilson Rd., Room 456, East Lansing, MI 48823, USA;2. Department of Communication, Seoul National University, Seoul, Republic of Korea |
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| Abstract: | ObjectivesThis paper explores patient use of excuses to better understand the patient experience during clinical interactions.MethodsA content analysis of 32 residents treating 99 different patients was used to reveal accounts of nonadherence. Using grounded theory, these accounts were coded into types and then reduced using a Q-sort.ResultsAnalysis revealed 163 accounts of nonadherence. When questioned about their adherence to treatment, 68% of patients offered at least one account for nonadherence during the visit. These accounts were coded into fourteen types and then the Q-sort identified four types of accounts: healthcare system failures, treatment failure, situational exigencies, and self-directed. Of the accounts offered, 7% of the patients provided 6 or more accounts and 25% provided between 3 and 5 accounts.ConclusionsThe examination of excuses provides a unique way to gain insight into how patients communicate with their physicians. Patient accounts ranged from those where patients indicated adherence was within their control (self-directed) and accounts outside their control (healthcare system failure, treatment failure, and situational exigency).Practice implicationsThe types of accounts of nonadherence patients could provide doctors insight into the patient experience. Recognizing these types could allow opportunities for doctors to develop communication strategies for encouraging patient adherence. |
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| Keywords: | Doctor and patient interaction Excuses Patient adherence patient accounts |
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