Goal Setting and Treatment Adherence Among Patients With Chronic Illness and Depressive Symptoms: Applying a Patient-Centered Approach

Abstract

Objective:Poor treatment adherence is a major problem among individuals with chronic illness. Research indicates that adherence is worsened when accompanied by depressive symptoms. In this preliminary study, we aimed to describe how a patient-centered approach could be employed to aid patients with depressive symptoms in following their treatment regimens.Methods:The sample consisted of 14 patients undergoing antiretroviral therapy (ART) for HIV who reported clinically-significant depressive symptoms. Participant ratings of 23 treatment-related statements were examined using two assessment and analytic techniques. Interviews were conducted with participants to determine their views of information based on the technique.Results:Results indicate that while participants with optimal adherence focused on views of treatment associated with side effects to a greater extent than participants with poor adherence, they tended to relate these side effects to sources of intrinsic motivation.Conclusion:The study provides examples of how practitioners could employ the assessment techniques outlined to better understand how patients think about treatment and aid them in effectively framing their health-related goals.

The impact of cognitive impairment on self‐regulatory styles in breast cancer survivors

“…It has been well‐established that depression can impair cognition and lead to greater functional deficits, 16,17 poor engagement in healthy behaviours 34 and worse health outcomes 17 . Further, those with depression have also been found to have higher levels of extrinsic self‐regulation 14,15 . However, we found that even after adjusting for depression, CI was still associated with greater levels of extrinsic self‐regulation.…”

“…Conversely, extrinsic self‐regulation, which refers to motivation derived from controlled reasons or external sources, 12 is linked with more risky, less healthy behaviours, as well as nonadherence to treatment 12,13 . Higher levels of extrinsic self‐regulation are also more prevalent in those with affective disorders, such as depression, which can further increase risk for poor health outcomes 14,15 …”