The Health Belief Model

Factors Influencing Patient Compliance

Introduction

Half of medical advice is not taken up.

£100 million of prescribed medication is discarded every year, at least.

Compliance with screening or preventative programmes is essential for their effectiveness.

Health Belief Model

Health Motivation.

Perceived vulnerability.

Perceived costs and benefits.

Perceived Seriousness.

Health Motivation

The individual’s general interest in health matters, which may correlate with personality, social class, ethic group, religion etc etc.

Perceived Vulnerability

How vulnerable or threatened a patient feels him / herself to be to a particular disease.

Perceived Costs and Benefits

The individual’s estimation of the benefits of treatment weighed against cost, risks and inconvenience.

Perceived Seriousness

Trigger factors such as alarming symptoms, advice from family or friends, messages from the media, disruption of work or play.

Health Beliefs About Illness or Symptoms

Difficult to elicit.

Patients frightened of looking foolish or ignorant.

Patients may be reluctant to “waste a doctors time” with personal attitudes.

Health Beliefs About Illness or Symptoms

Avoid direct questions e.g. “What do you think will happen if you don’t get your blood pressure checked?”

Indirect questions helpful:“What is going through your mind?”

“What does your wife / husband think?”

Etc etc.

Checklist

Elicit patient’s health beliefs.

Reinforce positive attitudes to health.

i.e. praise for giving up smoking for a period in the past, don’t dwell on the fact they re-started.

Checklist

Counter myths and negative attitudes.

Inform patient about causes and prognosis.

Checklist

Plan an appropriate course of action to suit his/her needs and lifestyle.

Don’t ask them to give up cigarettes, alcohol and sexual promiscuity all at once !