THE IMPACT OF health belief ON THE ADHERENCE OF HIV ADULT MALE PATIENTS TO THEIR MEDICATIONS IN WASHINGTON DC.
Adherence to medical advice refers to a somewhat more informed and equitable decision by a consumer to stick with appropriate medical orders as prescribed, or medical treatment. The introduction of highly active antiretroviral therapy (HAART) has transformed treatment of HIV infection by improving the clinical course of the disease and substantially reducing the HIV/AIDSs associated morbidity and mortality rates (Phil 1996).
However, even modest and occasional non-adherence can greatly diminish the benefits of treatment and lead to serious personal and public health consequences. Suboptimal adherence that is taking less than ninety percent to ninety five percent of prescribed doses is associated with increased risk of adverse clinical outcomes which includes increased viral replication and the development of drug resistant HIV strains that host clinically significant health-related setbacks.
The widely used theoretical framework for explaining health-related behaviors is the health belief model (HBM) which was developed in the 1950s by social psychologists Rosenstock,Hochbaum, and Kegelswhile working in the American Public Services. It attempts to explain and predict health behavior by focusing on the attitudes and beliefs of individuals. The model has been studied within the context of variety of health problems. These health problems and complications include; cancer, heart disease, diabetes and the most recently researched disease is HIV. The health belief model is derived from a very well-established body of psychological and behavioral theory and hypothesis that health behaviors mainly depend mainly on the desire to avoid illness and belief that certain actions will prevent or alleviate the disease. Since then, HBM has been adapted to explore a variety of long-term and short term health behaviors, including sexual risk behaviors and the transmission of HIV and aids. Another issue that is equally important to adherence is medical compliance. This refers to the patients following of orders in accordance to recommendation and prescription given by the doctor.
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Importance of medical sociology
Medical sociology is the sociology of health and illness as a whole main function is to examine the interaction between society and health. The main objective is to see how social life has impact on morbidity and mortality rate (Phil 1996).
Health and illness is discussed in relation to social institution such as family employment and school. The sociology of medicine limits its concern to the patient-practitioner relationship and the role of health professionals in the society. It covers sociological pathology (causes of disease and illness), reasons for seeking particular types medical aid and patient compliance or noncompliance with medical regimes. Health or lack of health was merely attributed to biological or natural conditions. However, sociologists have demonstrated that the spread of diseases is heavily influenced by social-economic class of the individual, ethnic traditions/beliefs and other cultural factors. Where medical research might need statistics on a disease, a sociological perspective on an illness provide insight on what external factors caused by the patient who contracted the disease and became ill.
Medical sociology deals with three areas: conceptualization, the study of measurement, and social contribution. The prevalence and response to different disease varies by culture. By looking at bad health, researchers can look at different social regulations or controls. By looking at the number of people who have been treated, one is able to know whether they are both willing and able to use health services provided to them. It also sheds light pertaining the infected people’s view of their illness.
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In Washington DC, within a great deal of time, mortality statistics has taken the place of morbidity because people typically die from degenerative conditions and the age in which they die, sheds light on their life time health. This has over time produced many limitations when looking at the pattern of sickness but sociologists in Washington dc look at various data before analyzing the distribution. In Washington DC, the life-expectancy is higher than in the neighboring underdeveloped and developing countries. Correlations have also been found between mortality, sex, and age. Very young and old males are more susceptible to sickness and death than the average-aged men. However, men are likely to have better health than women; they have a shorter lifespan in comparison to women. Sociological research has found that autonomy and control in the workplace are vital factors in the etiology of heart disease in Washington DC, especially among men and one cause is an effort-rewarding imbalance. Various studies have shown that pension rights affects the mortality differences between retired social economic statuses. This is whereby the women cope with lower pension rights than the men. This issue leads to stress among the retired men causing health problems. These men view themselves as liabilities to the society and have no single reason as to why they should be living hence they hardly adhere to the medical prescriptions of the physicians.
Social factors play a significant role in the human functioning in the context of disease or illness. Medical sociology helps to show how social factors such as socioeconomic factors, culture, poverty, technology and religion can influence health. It is very important to handle the social factors because the patients perceptions of health and threat to the disease and barriers in social environment appear to influence the likelihood that a patient will engage in health promoting or treatment behaviors, such as proper taking of medication as administered by the physician, proper diet or nutrition and physical activities.
... the war against HIV-AIDS will strengthen and one day this disease will be conquered. Until then, however, people will have to overcome ... 1). Another effort that helps HIV-AIDS victims is Patches for Hope, which provides medications for HIV-AIDS victims in Cambodia. They also provide ... the spread of HIV-AIDS in a given population based on factors such as the number of sexual partners people had and the ...
The elderly patients with disease are sometimes affected by these factors. Physical factors like; loss ofsight and hearing can prevent the patient from being able to read the prescriptions or to hear clearly as the doctor explains the dosage. This can lead to non-adherence to these medications.
When a patient is diagnosed with HIV, it is so difficult to accept the condition. This leads the patient to habits like drug abuse, alcoholism, depression (Jacky 2006).
When a patient indulges in these practices its difficult for them to adhere to the medication.
Statistics in sociological medicine have shown that patients from a low-income earning family and lower social classes are more likely to die of disease attacks and infections than the individual from the established economic background. This is due to lack of finances to purchase the recommended medications and required nutrients from nutritional foodstuffs.
Culture on the other hand promotes completely discourage the adherence to medication and influence health belief especially on disease like HIV. This is because HIV is viewed as a result or the outcome of immorality without the people putting into consideration other causes of HIV (Helman & Cecil 2007).
This entitles an individual to just keep quite and view the disease as a secret in order to avoid the public judgment.
Technological changes in the Washington dc has led to great impact to medical adherence. This is because most of the treatment is undertaken by use the new technology. The aged believe that only the younger generation that have better access to technology. Not being conversant with the technology, some aged males either look for people to help them out to access medicine prescribed for them while others even completely withdraw from the treatment. On the other side, technology has its benefits as it has improved counseling services and also discovery of more friendly medication services.
... treatments and medications. “Some important issues that nurses are bringing to the forefront in today’s world include implementing strategies to keep HIV patients ... such as diabetes, liver disease, obesity and elder care” (Kirton, 2007, p. 58). The Global Fund to fight AIDS, Tuberculosis and Malaria ...
Religious beliefs related to the health conditions may hinder treatment and adherence. Some believe that it is not good to use any medication, instead, they just pray and believe that they are going to be healed. Explaining the importance of use of medications is viewed as blasphemy and anyone who uses the medicine is said to betray the religion. Others have a specific hospital where they go and mistrust all other hospitals and their attendants. Powerful metaphors have been mobilized around AIDS to enhance stigmatization. The word plague, for example (derived from the Latin form plaga for collective calamity) is the principal metaphor by which the epidemic is known in modern society, the develop mentalist 2007.This conception of the disease contributes to the resonance of the inexorability and inescapability of HIV-infection. It also produces laxity on individual protection. Such thinking has been fostered by some religious leaders who have come to see the presence of HIV/AIDS as a fulfillment of apocalyptic prophecy. A sign for the end of time and a general punishment for immorality. Compliance and adherence is negligible if any.
This is one of the major diseases affecting Washington dc. In the year 2008, roughly 2 million people had died from this disease. A number of people that are drug users share needles which could cause HIV infection. Also, unprotected sex mostly in homosexuals can be found around Washington DC. In recent past, HIV diagnosis and treatment of HIV was very expensive and therefore was mostly available for the rich. The poor believed and accepted that treatment was only for the rich people. However the government has changed this by offering generic AIDS prescriptions that are less expensive. This aid from the government has had positive results; fifty percent decrease in mortality rates sixty to eighty percentage decreases in morbidity rates and a seventy percent decrease of hospitalized infected people.
However, in very remote areas in Washington dc, people believe in traditional healers. These people therefore don’t believe in taking the antiretroviral medication recommended by the doctors. Instead, they take traditional herbs. Resistance to use and adhere to the recommended medication increases their mortality rates as compared to the more civilized societies that use the drugs. The government has made a great attempt to create awareness to those communities in 1996 transformed the treatment of HIV and AIDS, improving the quality and prolonging the lives of many infected people. HIV (Acquired immunodeficiency Virus) is the virus that is believed to cause aids. AIDS (Acquired Immune Deficiency Syndrome) is the collection of illnesses or symptoms that ultimately results to death. Antiretroviral (ARVs)drugs or highly Active Antiretroviral Therapy (HAART) is the treatment that has been applied to combat the virus in an effort to slow down the progression of AIDS and to probably prolong or extend the life of the individual who has been infected with the virus, by providing free HIV counseling and testing. The introduction of antiretroviral drugs (ARVS) However, only a negligible number of people here dare to undergo the voluntary counseling and testing. Statistics show that there has been a number of shortcomings related to HIV testing; panic and stroke and even death to those who test positive and commit suicide, (Conrad 2007).
... from the disease. Many Companies are providing AIDS treatment for their staff at an additional increased cost. As health workers get infected health care system ... how it spreads. By the time a patient was diagnosed with the disease they were already in the last stages and ... Between 2003 and 2005 the number of people receiving treatment for HIV/AIDS in sub-Saharan Africa increased more than eight-fold ...
These losses of deaths are mainly caused by isolation by the members of the society. The people have therefore decided to stick to their health care system and the government in turn has provided and implemented an indigenous health system to help strengthen their health care. Their health policies are centered on family and community well-being, by focusing on the strategies of the prevention health strategies. Stigma and discrimination
Stigma constitutes prejudice, categorization, differentiation, discrimination and stereotyping. AIDS is referenced with phobia, fear, isolation and shame the develop mentalist (2007).Many male adults fail to adhere to the medication because of fear of stigma and discrimination associated with HIV/AIDs. The traditional belief that ‘associating with HIV positive individuals’ leads to its contraction’ has no scientific basis. It has however made many people to hide their status, and usually avoid any topic or issue related to that. This is due to the fear of stigma and discrimination by friends and family members as well as divorce to couples. This hinders from getting proper medication. After a while, the cd4 cells count goes below the normal level hence weakens the body immunity to an extent that the patient or victim is prone to opportunistic diseases such as Tuberculosis, Diarrhea, cold among others which results to his death. At times the culture gives more attention to the females as compared to the males. This is also one of health belief that influence male treatment and adherence to medication
... but incentivize for health results. While EHRs are beneficial for physicians they are equally beneficial for patients. The ability ... V., & Furukawa, M.F. (2012). Physician adoption of electronic health record technology to meet meaningful use objectives: 2009-2012 ... the incidence of wrong order/wrong patient errors wile using the computerized physician order entry component of information systems ...
The doctor – patient relationship
The doctor patient relationship is central to the practice of health care and is essential for the delivery of high quality health care in the diagnosis and treatment of HIV and aids, (Chesney 2000).
It forms one of the contemporary medical ethics. Doctors are advised to maintain a professional rapport with their patients’ dignity and to respect their privacy. For efficient treatment, a patient must be confident in the competence of their physicians and must feel that they can confide in him or her. The quality of the patient-physician relationship is important to both parties. This is because the better the relationship in terms of mutual respect, knowledge, trust, shared values and perspectives about the disease, the better the amount and quality of information about the patients disease will be transferred on both parties. This enhances accuracy of diagnosis of the disease and increases the patient’s knowledge about the disease. Where such a relationship is poor, the physician’s ability to make a full assessment of the disease is compromised and the patient is more likely to distrust the diagnosis and the proposed treatment resulting to decreased compliance to actually follow the medical advice. The patient also, due to miss-trust might not give all the symptoms of the disease due to the fear that the physician might expose their health status to a third party.
Family health belief
The HIV/aids victims need a lot of support from the family. The support should be in form of spiritual, material and physical assistance. The family members may encourage the victim spiritually by providing words or scriptures of encouragement relevant to the person’s religious beliefs. This inspires the person and gives him/her a sense of belonging and a desire to live longer. This insight also helps the victim to maintain moral values expected of him in the society. The material support is also needed for the person to carry on smoothly. This is because the person needs money for purchasing various requirements to meet his/her rising needs. For instance, this person may need the money for transport to hospitals and some to buy his/her medications. This person still needs a balanced diet, in order to get the necessary nutrients for the body, for the maintenance of the body immune system. Physically, this person needs love like any other person in order for them to forget all the threats of the disease. This facilitates and enhances his/her working conditions; as emotionally disturbed are not able to perform their duties the right way. The families’ perception of the disease also affects the people’s adherence to the medication, if the family views the disease as catastrophic; the patient gets frustrated and may lose hope in adhering to the medication (Cocker ham& William 2001).
If the family members on the other hand don’t place judgment on the victim, but helps him through, he easily overcomes the sorrow of the disease and is able to comply and adhere to the treatment. Mutual support from the spouse is also very important as this is the most intimate person.
In Conclusion, for efficient treatment the various factors discussed above should be put into consideration. Social factors are the main cause of either adherence or non-adherence medical behavior. In any treatment, a physician should take a step further and know of these factors so as to decide whether to administer the medication or to first offer counseling and try to chain the patients stand and view point. The physician should ensure that confidentiality is maintained between him and the patient. If he/she realizes that there is no confidentiality, then the physician should avoid anything that might be making the patient suspicious and that might be building the mistrust between him and the patient. He should ensure this even before offering any treatment. After gaining the patients full trust and confidence, the physician can now go on and prescribe the treatment. The patients who fully trust and confide with their physicians adhere and comply with the medications (Chesney 2000).
It is important to recognize that non-adherence is common and that it should be expected in all patients receiving antiretroviral therapy. It is difficult to accurately note the patients that do not adhere to their medication. So therefore, it is wise for the doctors to ask the patients with histories of substance use about adherence, similarly, lack of education, homelessness, and mental illness are not necessarily predictors of non-adherence, but they warrant extra attention and support.
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