Describe what psychologists have learned about types of non-adherence and reasons why patients do not adhere to medical advice.

Mark scheme

Marking points from the official mark scheme (Oct/Nov 2020). The mark or mark type is shown in brackets.

1. [2] Types of non-adherence: Not making lifestyle changes (e.g., diet), not following short-term advice (e.g., pill-taking), not engaging in preventative measures (e.g., condoms), and failing to attend follow-up appointments.
2. [2] Problems of non-adherence: Lack of health improvement, new health problems from un-taken drugs, financial costs of missed appointments, danger from unused drugs (e.g., to children), and wasted medication costs.
3. [2] Rational non-adherence (Bulpitt, 1994): Patients make a reasoned cost-benefit decision not to adhere, often overestimating risks and underestimating benefits (e.g., hypertension patients focused on minor drug risks while ignoring significant benefits).
4. [2] Health Belief Model (Becker & Rosenstock, 1979): Predicts health decisions are rational, based on perceived vulnerability, perceived severity, and self-efficacy. Modifying factors (culture, education, perceived benefits/barriers, perceived threat, cues to action) interact to predict preventive health actions.
5. [4] Named issue – Generalisability: Theories and research often reflect a Western medical perspective, overlooking cultural factors (tradition, spirituality, alternative medicines). Trust in practitioners, access to healthcare (free vs. insurance, geographical), and potential gender bias (Bulpitt) vary, limiting generalisability.
6. [2] Individual and situational factors: Evaluating whether explanations emphasize internal patient characteristics or external environmental/social influences.
7. [2] Cost effectiveness: Assessing the financial implications of non-adherence and the cost-benefit of interventions.
8. [2] Other evaluative points: Usefulness of findings (e.g., for healthcare providers), or critical examination of methods for measuring non-adherence.