Regarding Alma I would first plan my approach to make her feel important in her care and respected. I would make eye contact, smile, introduce myself and clearly explain to the patient all my actions before doing them to attempt to build a rapport. I would assess the patient's beliefs, daily activities, current behaviors, treatments and environment. All keeping in mind that this patient may take time to accept me as someone she wants to trust. Issues and experiences are going to be very important to analyze to get to underlying reasons the patient acted like this. I also would make sure to assess patient understanding of medical history, and current medicatons. I would speak clearly, slowly, and in normal tone repeating as necessary to the patient as needed. However, I would aim for patient centered care and involvement, since the reading says the patients that are complaint are just following instruction rather than making a choice I would much rather follow strategies that empower the patient to be active in health care. Collaboration is between the patient, physician, nurses, pharmacist, dietician and any other provider that is part of the care team. Effective communication and collaboration between health professional and patient, guided by factual information and experience of the health professional, allows patients to make informed choices about an agreed upon recommendation (Falvo, 2011). Outcomes are more favorable when patient centered care and collaboration are applied. Research suggests strategies that can be rememebered by the pneumonic "SIMPLE" S= Simplifying regimen characteristics such as adjusting medications (time, dosage, frequency), matching the patient with activities of daily living, using reminders of changes in routine (medication reminders, excercise ot routine reminders, medication boxes with daily routine planned out) Imparting knowledge= distributing written pamphlets, or handouts. Discussing with care team (nurse, physician, pharmacist). Analyzing patient knowledge and M= Modifying patient beliefs- Assessing perceived susceptibility, severity, benefit, and barriers. Rewarding, tailoring, and contingency contracting P= Patient and family- providing patient with clear messages and active listening. Including the patient in decisions regarding care. Sending reminders or follow up via email, phone, call or mail. L= Leave the bias- Tailoring the education to patients' level of understanding E-Evaluate adherence- Patient self reporting is most common. Pill counting or logging of activities. "Clinicians can optimize behavior change by ensuring that the patients (1) perceive themselves to be at risk due to lack of adoption of healthy behavior (perceived susceptibility), (2) perceive their medical conditions to be serious (perceived severity), (3) believe in the positive effects of the suggested treatment (perceived benefits), (4) have channels to address their fears and concerns (perceived barriers), and (5) perce.

1. Regarding Alma I would first plan my approach to make her
feel important in her care and respected. I would make eye
contact, smile, introduce myself and clearly explain to the
patient all my actions before doing them to attempt to build a
rapport. I would assess the patient's beliefs, daily activities,
current behaviors, treatments and environment. All keeping in
mind that this patient may take time to accept me as someone
she wants to trust. Issues and experiences are going to be very
important to analyze to get to underlying reasons the patient
acted like this. I also would make sure to assess patient
understanding of medical history, and current medicatons. I
would speak clearly, slowly, and in normal tone repeating as
necessary to the patient as needed. However, I would aim for
patient centered care and involvement, since the reading says
the patients that are complaint are just following instruction
rather than making a choice I would much rather follow
strategies that empower the patient to be active in health care.
Collaboration is between the patient, physician, nurses,
pharmacist, dietician and any other provider that is part of the
care team. Effective communication and collaboration between
health professional and patient, guided by factual information
and experience of the health professional, allows patients to
make informed choices about an agreed upon recommendation
(Falvo, 2011). Outcomes are more favorable when patient
centered care and collaboration are applied.
Research suggests strategies that can be rememebered by the
pneumonic "SIMPLE"
S= Simplifying regimen characteristics such as adjusting
medications (time, dosage, frequency), matching the patient
with activities of daily living, using reminders of changes in
routine (medication reminders, excercise ot routine reminders,
medication boxes with daily routine planned out)

2. Imparting knowledge= distributing written pamphlets, or
handouts. Discussing with care team (nurse, physician,
pharmacist). Analyzing patient knowledge and
M= Modifying patient beliefs- Assessing perceived
susceptibility, severity, benefit, and barriers. Rewarding,
tailoring, and contingency contracting
P= Patient and family- providing patient with clear messages
and active listening. Including the patient in decisions regarding
care. Sending reminders or follow up via email, phone, call or
mail.
L= Leave the bias- Tailoring the education to patients' level of
understanding
E-Evaluate adherence- Patient self reporting is most common.
Pill counting or logging of activities.
"Clinicians can optimize behavior change by ensuring that the
patients (1) perceive themselves to be at risk due to lack of
adoption of healthy behavior (perceived susceptibility), (2)
perceive their medical conditions to be serious (perceived
severity), (3) believe in the positive effects of the suggested
treatment (perceived benefits), (4) have channels to address
their fears and concerns (perceived barriers), and (5) perceive
themselves as having the requisite skills to perform the healthy
behavior (Atrja, Bellam, &Levy, 2005)."
Reference:
Atreja, A., Bellam, N., & Levy, S. R. (2005). Strategies to
enhance patient adherence: making it simple.
MedGenMed : Medscape general medicine
,
7

3. (1), 4.
Falvo, D. (2011). Effective Patient Education: A Guide to
Increased Adherence. Retrieved from
https://www.gcumedia.com/digital-resources/jones-and-
bartlett/2010/effective-patient-education_a-guide-to-increased-
adherence_ebook_4e.php
REPLY2
There are many different efforts that could be taken in order to
use collaboration to assist in compliance with a patient as
difficult as Alma.The first effort could be integrating the family
member, significant other or caretaker in with the patient
education and treatment plan.This would give Alma someone
that she trusts involvement in her care, which would be
supplemental support in ensuring Alma remained compliant in
her care, especially post-procedurally when Alma will need to
follow after care instructions to avoid complications.Another
source of collaboration is a multi-disciplinary approach.This
type of care would require the collaboration and coordination
among healthcare professionals involved in Alma’s care such as
the general practitioner, pharmacists, health insurers and other
practitioners involved in her care.Not only would all of her
healthcare providers be aligned in her care, it alleviates some
risk of polypharmacy and any conflict of interests between
providers.Having a health insurer involved in the collaboration
can reduce dispersion in care that could result in higher costs,
which would ultimately decrease the cost strain on the
patient.Finally, it would be of most importance to ensure Alma
was part of the collaboration so that she felt empowered in her
decision-making and was an active participant in her treatment
plan.Combining all factors of this collaboration would help
ensure that Alma was compliant in her procedure and post-

4. procedural medications.
References:
Costa, E., Giardini, A., Savin, M., Menditto, E., Lehane, E.,
Laosa, O., . . . Marengoni, A. (2015, September 14).
Interventional tools to improve medication adherence: Review
of literature. Retrieved October 06, 2020, from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4576894/