This is one of my favourite topics. I talk over the " compliance " issue more than any other subject and with a massive wide variety of people. For me its one of the hardest factors to "make sense" of, because really in black and white terms failure to do something that has been suggested to you as health beneficial is only going to cause your problems later down the line. Its sad in a way and frustrating for both client and trainer and I still have trouble understanding the root of this issue. I heard a recent story about a recovering heart attack patient who was not taking his prescribed medication because he didn't like pills, compliance here was a potential life and death issue .I guess people are so complex there is no one particular reason why this situation existed. Maybe he just didn't see the benefit, to most it appears black and white, take the pill, live, don't take the pill , potentially die.
However, there is growing consensus among researchers that the behavior of the health care provider has a significant influence on patient adherence. Specifically, the health care professional’s ability to communicate and explain information while expressing warmth and concern for the patient appears to be associated with increasing patient adherence. Which from a personal training perspective makes the job just that little bit harder. Some people just don't see the benefit of " extra " anything or indeed " less " of something , getting them to even go to bed 30 mins earlier is like asking them to amputate an arm...we have become so stuck in out habits that all change however small is resisted. However small amounts of change can bring big returns.
WE TALK ABOUT IT A LOT
But on a more individual level I have clients that ask me for " 5 Minute " programmes of exercises they can do daily, how often do they follow through and do it, sadly almost never. I discuss these issues with a Lifestyle Coach and to sum up our joint thoughts would translate to something like this..instead of me (trainer ) telling you WHAT to do, but that both the trainer and the client should work together to come up with a compliancey solution. Instead of being told what to do we need to find or create new thought patterns,or habits, in affect we have 2 people working on one problem, not one telling the other what to do !
We discuss sleep and mainly the lack there of. I can find any client 100 articles promoting the benefits of sleep, I can send these articles to my clients..I can find no research ( haven't really looked ) promoting a lack of sleep and its benefits. However, people may still not see the value in sleep and you then may have to look for the reasons... " why" .. ." Why do you not value sleep"? Its the a matter of understanding the clients sleep beliefs and the disregard for it may come from elsewhere in that persons life and history.
It appears that what people value most they do most, when it becomes the most important thing to that person they may end up complying. From a trainers standpoint we want everyone to comply with what we suggest and if that persons belief system is different to ours then we have difficulty in understanding why people do what they do. Perhaps the best way forward is to simply say " what can I do today thats going to help me towards my goals?" Do something, small , simple and achievable...
One thought that goes through my head is we just don't love ourselves enough , then I found this quote which sums it all up
"You can search throughout the entire universe for someone who is more deserving of our love and affection than you are yourself, and that person is not to be found anywhere. You, yourself, as much as anybody in the entire universe, deserve your love and affection." – Buddha
SOME INFO FROM THE UK.
- up to 90% of diabetes patients do not take their medication well enough to benefit from that medication
- 33-50% of some cancer patients take less of their anti-cancer medicine than required.
- only 75% of coronary heart disease (CHD) patients take sufficient medicine for it to be effective.
- Up to 75% of hypertensive patients do not adhere to their medicine.
- 41-59% of mentally ill patients take their medication infrequently or not at all.
- 33% of patients with schizophrenia don’t take their medicine at all, and 33% are poorly adherent.
- Less than 27% depressed patients adhere to their medication
In the UK, the societal impact of such high levels of non-compliance is significant:
- 110,000 people per year die prematurely from coronary heart disease that is largely preventable. Death rates are three times higher in manual workers than among managers.
- If CHD patients adhered to their medication, each year 40,000 – 50,000 fewer people would have a stroke and 25,000 would not have a heart attack.
- 25% of cancer patients have to cut back on food shopping to cover the extra costs of cancer.
- 70% of patients with advanced cancer suffer with pain, very often in conjunction with other symptoms such as nausea, vomiting, loss of appetite, anxiety, depression, sleeplessness, and confusion, amongst other symptoms.
- 1,400 people die from asthma attacks each year, 90% of which are avoidable
The most common causes for lack of adherence appear to be aging, lack of education, lack of information about the benefits ( of taking the prescribed medicine) and on, I also read that between 20 and 30 % of prescriptions in the US go unfilled.