RESUMO
Patients' low adherence to medical treatment in chronic illnesses is one of the biggest public health problems. Numerous studies attend to the diverse factors associated with patient adherence. However, little research has been done to explore patients' reasons for non-compliance from their own point of view. In this article, we aim to understand patient non-adherence using dialogical self-theory and qualitative research methods. We interviewed 51 hypertensive patients to explore their anti- and pro-adherence motivations. Results show that most patients adhere and non-adhere to different aspects of treatment programs (medication, exercise, diet) according to the way they construct meaning to those activities. Also, our findings support the notion that patients' non-adherent behavior aims to preserve important values such as self-esteem, autonomy, affiliation, well-being, freedom, and health (or that more adherence is not worth the extra effort). We discuss the therapeutic relevance of empathically understanding patients' worldview and implicit beliefs.
Assuntos
Anti-Hipertensivos/uso terapêutico , Comportamentos Relacionados com a Saúde , Hipertensão/psicologia , Hipertensão/terapia , Motivação , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Hipertensivos/administração & dosagem , Dieta , Exercício Físico , Feminino , Nível de Saúde , Humanos , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Autonomia Pessoal , Pesquisa Qualitativa , Medição de Risco , AutoimagemRESUMO
Los estudios de las características de la adolescente embarazada y el seguimiento de su hijo se han concentrado en las primeras etapas del desarrollo. El período de post-parto inmediato e instalación de la lactancia ha recibido menos atención. Este momento es privilegiado para el establecimiento del apego madre-hijo y la detección precoz de elementos de riesgo para la salud del binomio. Se realizó un estudio por entrevista en el "Centro de Atención al Adolescente del Hospital Pereira Rossel. Montevideo Uruguay" a una muestra de 80 puérperas de 11 a 17 años en los dos o tres primeros días después del nacimiento del hijo. Los resultados muestran el vínculo satisfactorio de la madre adolescente con el recién nacido, la presencia de la pareja de la adolescentes y el apoyo familiar que recibe, así como la alta frecuencia de lactancia sin dificultad. Se valora la intervención precoz con fines preventivos, protegiendo la autoestima de la madre y favoreciendo las posibilidades de interacción madre-hijo
The studies on pregnant adolescents and their children focalize the first steps of child development. The early past partum period and the inicial lactation process, has received less attention by investigators. This is a privilege period to observe the early mother-child attachment and to detect risk factors of both. T'he study was done, at the "Centro de Atención al Adolescente del Hospital Pereira Rossel. Montevideo Uruguay". A sample of an interview was developed in a sample of 80 postpartum adolescents between 11 and 17 years old, 2 or 3 days after hospital delivery. The results shown the adecuate family support given to this teenager. It was shown the high proportion of lactation without troubles. These results are influenced by the prococious preventive intervention, supporting the self time of the pregnant adolescents that stimulate the adecuate mother-new born relationship