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Scandinavian Journal of Public Health
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Patient adherence in an individualized rehabilitation programme: A clinical follow-up

Lena Oldfors Engström

Department of Health and Society, Division of Physiotherapy, Faculty of Health Sciences, Linköping, Sweden, lena.oldfors.engstrom{at}ihs.liu.se

Birgitta Öberg

Department of Health and Society, Division of Physiotherapy, Faculty of Health Sciences, Linköping, Sweden

Aims: This investigation aims to describe patients with longstanding pain who did not complete their participation and/or participated infrequently in physiotherapy (PT) treatment based on their own activity and responsibility, and in addition to understand the phenomenon of adherence from a behavioural theoretical perspective. Methods: The phenomenon compliance/adherence was studied in relation to health locus of control (HLC) factors and health belief (HB) variables. Outcome measures were based on a questionnaire answered by all patients before the beginning of treatment. Definitions of adherence were completed treatment period and exercise frequency respectively. Patients completing treatment were compared with those who did not. Exercise frequencies of those completing treatment were also studied. Results: Those who did not complete treatment reported higher pain intensity, higher Oswestry score, and worse general health than those completing treatment. Results also showed that those who exercised once a week or less often valued the significance of healthcare treatment less, perceived higher pain intensity, presented a higher Oswestry score, worse general health, more pain locations, lower expectations, were younger and almost solely women, than those who exercised more often. Conclusions: Individuals exercising irregularly were above all women. This fact needs further investigation. Individuals' belief in treatment effects is of significance to adherence. Adherence is a comprehensive concept and depending on how we look at it we find different populations.

Key Words: adherence • behavioural exercise therapy • compliance • health belief • health locus of control • longstanding pain • physiotherapy • primary health care

Scandinavian Journal of Public Health, Vol. 33, No. 1, 11-18 (2005)
DOI: 10.1080/14034940410028299
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