The effect of privacy management and immediacy on patient compliance



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Patient compliance is an important outcome of effective patient and provider interaction. There are many different ways to define compliance. This study focused on how a patient adheres to a provider’s medical recommendations and directives. The most widely early accepted definition of compliance comes from Haynes and Taylor (1979) who state that compliance is “the extent to which a person’s behavior in terms of taking medications, following diets or executing other lifestyle changes coincides with medical or health advice” (p.1). Patients who are compliant will likely enjoy a more positive outcome of interaction with their provider, better health outcomes, and a higher level of trust. The term compliance for many signifies an underlying authoritarian tone on the part of the health care givers and a yielding submission by clients (Simmons, 1992). Patient compliance can be viewed as an attitude and as a behavior (Cameron C., 1996). Compliance as an attitude is willingness or intention to follow health prescriptions. Compliance as a behavior is related to the actual carrying out of prescriptions (Davis, 1968) or instructions. Patient compliance could be better facilitated by two constructs: immediacy and disclosure. Immediacy is the degree of perceived physical or psychological closeness one feels for another (Mehrabian A., 1967). These are usually sets of behaviors which communicate social accessibility (Goffman , 1964). Disclosure is the act of revealing personal information about oneself to another (Collins & Miller, 1994, p. 457). Disclosure should play a large role in a patient’s ability to comply because disclosure of information helps a provider understand the health care needs of the patient. Overcoming possible barriers of non-disclosure and non-immediate behavior, the patient can be more fully equipped to communicate effectively, thus ensuring the optimal health care being given and received. Applying immediacy and disclosure to this study will help to understand how a patient can be encouraged to be more compliant. Communication Privacy Management theory created by Dr. Sandra Petronio (Petronio, 2004) will be introduced and will acknowledge how patients disclose information to their provider within the communication interaction. It is the goal of this study to further the research on the patient-provider interaction using Petronio’s communication privacy management theory, to provide a framework for effective patient-provider communication by looking at levels of immediacy and disclosure within the patient-provider interaction. Immediacy and disclosure should go together when understanding the construct of patient compliance because patients should feel comfortable with disclosing information to their provider and not holding back on personal boundaries. CPM explains that the more information a patient discloses to a co-owner (a provider) the more information a patient will receive back to become compliant to a regimen given by a provider.



Communication in medicine, Patient compliance, Doctor-patient partnership, Privacy