Amdie Fisseha Zewdu, Sawhney Monakshi, Woo Kevin
School of Nursing, University of Gondar, Gondar, Ethiopia.
School of Nursing, Queen's University, Kingston, Ontario, Canada.
Patient Prefer Adherence. 2022 Apr 29;16:1131-1139. doi: 10.2147/PPA.S362706. eCollection 2022.
Chronic disease prevention and management requires a lifelong commitment and adherence to lifestyle modifications, monitoring of symptoms, medication use, and other forms of therapy. Treatment adherence is a crucial and complex concept in patient care provision, and it requires the voluntary active involvement of patients for the best possible outcome. Multiple factors, which may or may not be under the patient's control, can influence treatment adherence. However, adherence or non-adherence to a certain treatment is predominantly influenced by one's sense of agency, values, beliefs, attitudes, and willpower. It is evident that mental states appear to influence patients' decision-making, and the best treatment outcome occurs when a patient identifies their goals, needs, and desires and exercises their decision-making and free will during the course of receiving care. The role of healthcare providers is critical in promoting treatment adherence, thereby enhancing patient outcomes. Thus, this paper highlights the importance of promoting a sense of agency and integrating patients' values, beliefs, attitudes, and intentions during the provision of healthcare. It is indispensable to recognize the individual's ability and initiative to control and manage their illness in the face of challenging socioeconomic and cultural reality. On logical grounds, it is not enough to appreciate the value of free will and mental states, it is also essential to empower and cultivate an individual patient's willpower to make a well-informed, free decision based on their mental state for the most optimal treatment outcomes.
慢性病的预防和管理需要终身的投入，并坚持生活方式的改变、症状监测、药物使用及其他治疗形式。在患者护理中，治疗依从性是一个关键且复杂的概念，为实现最佳效果，需要患者自愿积极参与。多种因素（有些可能在患者控制范围内，有些则不然）会影响治疗依从性。然而，对某种治疗的依从或不依从主要受个人的能动感、价值观、信念、态度和意志力影响。显然，心理状态似乎会影响患者的决策，当患者在接受护理过程中明确自身目标、需求和愿望，并行使其决策和自由意志时，会取得最佳治疗效果。医疗服务提供者在促进治疗依从性从而改善患者治疗效果方面的作用至关重要。因此，本文强调在提供医疗服务过程中促进能动感以及整合患者的价值观、信念、态度和意图的重要性。面对具有挑战性的社会经济和文化现实，认识到个人控制和管理自身疾病的能力及主动性是必不可少的。从逻辑上讲，仅仅认识到自由意志和心理状态的价值是不够的，赋予并培养个体患者基于自身心理状态做出明智、自由决策以实现最佳治疗效果的意志力也至关重要。
