In response to: Bissonette J. (2008) Adherence: a concept analysis. Journal of Advanced Nursing 63(6), 634–643.


Patient adherence

In the article entitled ‘Adherence: a concept analysis’ in the May 2008 issue of Journal of Advanced Nursing 63(6), pp. 634–643, the author, Janice M. Bissonnette, presents an excellent review on the topic of adherence. Bissonnette seeks to clarify the concept by including past and present definitions as well as discussing the lack of a patient centred definition of care and foundational framework about the topic of patient adherence. The article examines the transition in terminology from compliance to adherence to concordance while revealing the inadequacies of appropriately defining this phenomenon. In my practice, I find adherence to be a very important issue. Patients need to be active participants in their care. As nurses how often have we scripted, ‘patient is non-compliant’ without addressing the factors or circumstances for his or her behaviour. This article helps bring to the forefront the importance of identifying how patient’s feelings affect decisions concerning his/her health care and in turn affect the nurse’s ability to help patients reach a desired level of wellness. At this time in nursing history, as nurses step back to evaluate our role, as we strive to develop new nursing theories and frameworks, as we explore new ways of knowing, it is essential that we not miss the obvious. Nursing care is directly related to our patient’s cooperation, ability and desire to enter into a dynamic relationship directed toward achieving improved health. This article supports the need for additional patient centred research as we advance toward evidence based practice.