Nurse's Pocket Guide

NONCOMPLIANCE
school/workplace issues, involvement in legal system may
unconsciously affect client’s decision making.
• Assess availability/use of support systems and resources.
• Be aware of nurses’/healthcare providers’ attitudes and behaviors
toward the client. (Do they have an investment in the
client’s compliance/recovery? What is the behavior of the
client and nurse when client is labeled “noncompliant”?)
Some care providers may be enabling client, whereas others’
judgmental attitudes may impede treatment progress.
NURSING PRIORITY NO.2.To assist client/SO(s) to develop strategies
for dealing effectively with the situation:
• Develop therapeutic nurse-client relationship. Promotes
trust, provides atmosphere in which client/SO(s) can freely
express views/concerns. Adherence assessment is most successful
when conducted in a positive, nonjudgmental
atmosphere.
• Explore client involvement in or lack of mutual goal setting.
Client will be more likely to follow-through on goals he or
she participated in developing.
• Review treatment strategies. Identify which interventions in
the plan of care are most important in meeting therapeutic
goals and which are least amenable to compliance. Sets priorities
and encourages problem solving areas of conflict.
• Contract with the client for participation in care. Enhances
commitment to follow-through.
• Encourage client to maintain self-care, providing for assistance
when necessary. Accept client’s evaluation of own strengths/
limitations while working with client to improve abilities.
• Provide for continuity of care in and out of the hospital/care
setting, including long-range plans. Supports trust, facilitates
progress toward goals.
• Provide information and help client to know where and how
to find it on own. Promotes independence and encourages
informed decision making.
• Give information in manageable amounts, using verbal, written,
and audiovisual modes at level of client’s ability. Using
client’s style of learning facilitates learning, enabling client
to understand diagnosis and treatment regimen.
• Have client paraphrase instructions/information heard.
Helps validate client’s understanding and reveals misconceptions.
• Accept the client’s choice/point of view, even if it appears to
be self-destructive. Avoid confrontation regarding beliefs to
maintain open communication.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
476 Cultural Collaborative Community/Home Care