Nurses and ‘difficult’ patients: negotiating non-compliance
Article first published online: 14 JUL 2003
Journal of Advanced Nursing
Volume 43, Issue 3, pages 281–287, August 2003
How to Cite
Russell, S., Daly, J., Hughes, E. and Hoog, C. o. (2003), Nurses and ‘difficult’ patients: negotiating non-compliance. Journal of Advanced Nursing, 43: 281–287. doi: 10.1046/j.1365-2648.2003.02711.x
- Issue published online: 14 JUL 2003
- Article first published online: 14 JUL 2003
- Received for publication 11 December 2002 Accepted for publication 20 March 2003
- social model of health;
- patient-centred care;
- clinical decision-making
Background. There is a large body of nursing literature on patient non-compliance. While some articles address non-compliance as a patient problem to be resolved by nursing interventions, there is also a growing number that critique this approach. This reflects the discomfort many nurses feel about the practice of labelling patients as non-compliant.
Aim. The aim of this discussion paper is to build on the critical nursing literature to offer an alternative to the interventions commonly directed at patients who do not follow health care advice. This alternative approach locates patients within their social context and focuses on those who adapt health care advice to fit with their beliefs, life situation and circumstances. The aim is to encourage nurses to learn about how health care treatments affect patients’lives, and not merely their health.
Method. Specific nursing articles were reviewed to demonstrate the ways in which the concept of compliance is used within the nursing literature. These articles were then used to support an argument that promotes a patient-centred approach to health care.
Conclusion. A patient-centred approach involves transferring power and authority away from health care professionals and towards patients. We encourage nurses to take a leadership role by changing the way in which health care is delivered towards a focus on patients’lives. Learning about patients’ lives may assist nurses to offer health information to patients that is more relevant and, therefore, useful.