What patient compliance issues are evident in this scenario?
What patient
compliance
issues are evident in this
scenario?
Scenario 3—Physical Therapy
Nathan is a healthy man in his early 40s. He works out regularly and does not smoke. Dr. Wechsler is speaking to Nathan in his office regarding the results of his annual physical.
“Nathan, your results are generally good except for your triglycerides and cholesterol. They are off the chart. For someone who is so conscious of how to stay healthy, you have ignored everything we know about elevated lipids.”
“Listen, doc,” Nathan says, smiling. “Everything else looks good, right? No one ever died from high cholesterol. I wouldn’t worry about it.”
Dr. Wechsler hands Nathan a brochure that appears to discuss the significance of elevated lipids and says, “Read this, Nathan. Perhaps you will gain an appropriate perspective from it. Triglycerides are a form of fat in the bloodstream. People with high triglycerides often have high cholesterol, which puts you at risk for coronary artery disease and diabetes. You will have to make some major changes in your diet and perhaps take a lipid-lowering agent. You should remove red meat and foods high in sugar from your diet.”
Nathan looks at the doctor with dismay, thinking about how much he loves Monday’s steak night at his favorite restaurant.
The doctor provides Nathan with a diet sheet and a prescription for a lipid-lowering agent after discussing the changes that need to be made. Nathan thanks the doctor and leaves the office. When he gets into his car, Nathan throws the diet sheet in the back seat, saying to himself, “I got one life; I’m not giving up steak night.”
What patient
compliance
issues are evident in this scenario?
What communication problems are contributing to the patient’s lack of compliance?
How might the caregiver improve communication in a way that would promote patient compliance?
what is this homework for? do you not understand what compliance is or good communication?
The compliance issues are obvious – he doesn’t think that there is anything wrong with him, he doesn’t want to give up his favourite food, he thinks of himself as healthy.
The doctor used too much technical language and didn’t check if the patient had any concerns, or if he even understood what he was on about.
they didn’t talk together about a plan to improve his cholesterol.Given this information you should at least be able to answer the last one yourself. but when it comes to the exams you will fail, cos yahoo answers won’t be there to help you out
The patient compliance issues are pretty obvious. It’s obvious that he will not comply with any dietary changes. He makes it clear first by saying he doesn’t believe high lipid levels are dangerous. He is then resistant to information to the contrary, which is almost the universal first reaction. But the doctor’s form of communication is obviously not appropriate for him either. The doctor talks to the patient as if he already understands the terminology he is using. He needs to dumb it down a lot, make it simple. And he can’t expect to get his point across in one five minute office visit. He should schedule a visit with a dietitian for the patient.
But what I really don’t understand is, if the patient’s lipids are “off the chart”, why is he sending him home without a prescription for a statin? In the first place, off the chart readings are often in indication of genetic hyperlipidemia, not diet, and he should be treated for it quickly. Diet takes time to change levels and he needs the help now.
But the main thing the doctor should know is, patients often don’t react to information the first time you tell them. It needs to be repeated at least three times before it begins to sink in, so he shouldn’t expect immediate results.
Edit: I agree with Sally, though. I’ve answered it for you this time, but unless you learn to think critically, you won’t make it through nursing school, let alone NCLEX.
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