An Essay on Improving Compliance in Illiterate Adults
Abstract
Compliance is defined as the extent to which a patient's behavior (in terms of taking medications, following diets, or executing lifestyle changes) coincides with medical or health advice Haynes and Sacket, 1979). Non-compliance with prescribed preventive medical regimens is one of the most important factors hindering health care in Africa and other developing countries today. In developing countries where most of the population is still illiterate and superstitious, compliance with Western medical regime is difficult to achieve (Scherwitz, 1978). Non-compliance can also be related to the lack of understanding which is compounded in the black indigenous cultural context by the absence of knowledge of chronic diseases such as hypertension and diabetes (Unterhalter, 1979). Scientific medicine has proven effective for some diseases, but most of the people continue to be distrustful of the white man's medicine. Many people believe more in healers and home remedies based on cultural beliefs (Hautman, 1979). Superstitious beliefs keep people from seeking medical care until they are seriously ill. A collaborative relationship between folk and scientific practitioners might provide people with a health care system that is both acceptable and comprehensive, and one that they can abide by. Researchers can make an effort to analyze the active ingredients of folk medicine and scientific practitioners can try to adjust health care to the illiterate cultures. Combining herbal folk treatment with Western medicine may one day offer patients the best of both worlds. With this perspective in mind, I would like to focus on the comprehensive aspects of health care that would promote compliance in a largely illiterate population. Some of the cultural factors affecting compliance will be discussed within the Becker's Health Belief Model (Haynes, 1979), along with its relevance and implementation for nursing. The strategies of patient education in conjunction with tailoring will be discussed as a means of improving compliance within an adult illiterate population. Tailoring refers to a process of fitting the prescribed regimen and intervention strategies to specific patient characteristics and circumstances (Dunbar at al, 1980).