Developing a Dynamic Model of Treatment Perceptions

Abstract

A description of factors influencing perceptions of nonpharmacological treatment was derived inductively from interviews with people receiving chiropractic treatment for back pain, using grounded theory analysis. A theoretical model linking these factors was constructed, and was tested using interview data from a longitudinal study of people undertaking exercise therapy for dizziness. The model highlights the potential for reciprocal interactions between abstract beliefs relevant to illness and treatment and concrete experiences of therapy, and for interactions between perceptions of symptom change and of therapist competence. Therapist communication may modify abstract illness/treatment models and symptom perceptions, thus mediating effects of concordance on adherence and placebo effects.

Treatment appraisals and beliefs predict adherence to complementary therapies: A prospective study using a dynamic extended self‐regulation model

“…The extended dynamic common-sense model predicts that, in addition to the psychological factors investigated in this study, people's perceptions of health change influence their ongoing use of treatment (Yardley et al, 2001). Had we operationalised this part of the model we might have explained a greater proportion of variance in adherence behaviours.…”

“…The items were derived from previous qualitative work (Yardley et al, 2001) and were rated on 7-point likert scales. Eighty one people (recruited from the same clinics as this study) participated in a pilot study to test the questionnaire's factor structure, concurrent validity and internal consistency.…”

Measuring barriers to adherence: validation of the problematic experiences of therapy scale

“…The PETS was initially developed based on clinical experience to be used in research trials immediately prior to selfreported adherence questions with the hope that it would reduce socially desirable responding. Therefore, although the item development was influenced by early literature and research [9,[38][39][40], the items were not developed from a systematic review of literature or specific patient-based research carried out for that purpose. Therefore, the PETS may not capture all the factors relevant to perceived reasons for non-adherence.…”

“…The Problematic Experiences of Therapy Scale (PETS) is a brief quantitative measure that was developed based on clinical experience and research to reflect the most commonly reported reasons for discontinuing therapy given by patients undergoing self-managed home-based rehabilitation [9,[38][39][40]. Although the PETS has been reported to be associated with adherence [10], the psychometric properties of the measure have not yet been published.…”

Why consumers maintain complementary and alternative medicine use: A qualitative study

“…[50][51][52][53][54][55] Some qualitative work also suggests that the benefits experienced from CAM can encourage further CAM use, while the financial cost of CAM and a perceived lack of effectiveness can limit it. 51;56-60 Yardley and colleagues 61 showed how patients' perceptions of chiropractic are shaped through dynamic interactions between concrete experiences (of symptomatic relief and commentary from their practitioner) and abstract beliefs (about treatment and illness). Finally, models of CAM use in cancer illustrate the iterative and dynamic nature of CAM decision-making, and show how patients' decisions to start, continue, and stop using CAM are closely entwined with the cancer trajectory.…”