Doctor-Patient Communication for Adherence to Hypertension Treatment in Nepal

R. Sah, H. Khanal, D. Shrestha, B. Paudel, R. Gautam, Andrea M. Straus, R. Love
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引用次数: 0

Abstract

Effective doctor-patient communication is key to addressing the signifi cant issue of nonadherence to hypertension treatment in Nepal. Common clinical messages about hypertension are evaluated utilizing the framework of the Common-Sense Model of Self-Regulation for their role in shaping the patient models that underlie nonadherent behavior. Clinical communications and practices are recommended: to respectfully elicit and address patient reliance on self-identifi ed symptoms; to accompany warnings of hypertension’s serious consequences with specifi c individual action-plans for durable effects; to emphasize the necessity of long-term continuous treatment without creating fears of dependence and withdrawal effects or burdensome monitoring and counseling; to inform of side-effects while presenting medication as nontoxic and necessary for the body’s maintenance of a healthy balance. By acknowledging the patient as an active agent engaged in self-regulation and by employing culturally consonant concepts (often Ayurvedic), we can encourage accurate patientillness and treatment representations that guide medication adherence.
尼泊尔高血压治疗依从性的医患沟通
有效的医患沟通是解决尼泊尔高血压治疗不依从问题的关键。利用自我调节常识性模型的框架,对高血压的常见临床信息进行评估,以确定其在塑造非依从性行为基础的患者模型中的作用。临床沟通和实践建议:恭敬地引出和解决患者对自我识别症状的依赖;在警告高血压严重后果的同时,提出具体的个人行动计划,以取得持久效果;强调长期持续治疗的必要性,不要造成对依赖和戒断效应的恐惧,也不要造成繁重的监测和咨询;告知副作用,同时说明药物是无毒的,是维持身体健康平衡所必需的。通过承认患者是积极参与自我调节的主体,并采用与文化一致的概念(通常是阿育吠陀),我们可以鼓励准确的耐心和治疗表现,从而指导药物依从性。
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