Sirur Ruth, Richardson Julie, Wishart Laurie, Hanna Steven
Ruth Sirur, BHScPT, MSc: School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada.
Physiother Can. 2009 Spring;61(2):68-77. doi: 10.3138/physio.61.2.68. Epub 2009 May 12.
The purpose of this article is to apply theoretical frameworks to adherence behaviour and to guide the development of an intervention to increase adherence to prescribed home programmes.
Delivering an effective intervention requires establishing one that is evidence based and of adequate dosage. Two-thirds of patients who receive home exercise prescriptions do not adhere to their home programme, which may contribute to their physiotherapy's being ineffective. The mediating concepts of self-efficacy (SE) and outcome expectations (OE) are common to the five relevant theories used to explain adherence to exercise: the health belief model, protection motivation theory, theory of reasoned action, theory of planned behaviour, and social cognitive theory.
CONCLUSION/RECOMMENDATIONS: Few intervention studies with any theoretical underpinning have examined adherence to exercise. Even fewer have been designed to affect and measure change in the theoretical mediators of SE and OE in patient populations. Physiotherapists must consider increasing adherence as a component of effective physiotherapy. Ongoing research is needed to increase our understanding of adherence to prescribed home programmes and to design interventions to affect theoretical mediators for increasing adherence.
本文旨在将理论框架应用于依从行为，并指导制定一项干预措施，以提高对规定家庭锻炼计划的依从性。
实施有效的干预措施需要建立一个基于证据且剂量充足的措施。接受家庭锻炼处方的患者中有三分之二不遵守其家庭锻炼计划，这可能导致他们的物理治疗无效。自我效能感（SE）和结果期望（OE）这两个中介概念在用于解释锻炼依从性的五个相关理论中很常见：健康信念模型、保护动机理论、理性行动理论、计划行为理论和社会认知理论。
结论/建议：很少有具有任何理论基础的干预研究考察过锻炼依从性。设计用于影响和测量患者群体中SE和OE这两个理论中介变量变化的研究更少。物理治疗师必须将提高依从性视为有效物理治疗的一个组成部分。需要进行持续研究，以加深我们对遵守规定家庭锻炼计划的理解，并设计干预措施来影响理论中介变量以提高依从性。
