Home health nurses' view of promoting medication adherence among community-dwelling elderly patients
Home health nurses are key healthcare providers in all communities, and they have valuable insights on issues such as promoting medication-adherence among community-dwelling elderly patients. Evidence shows that poor adherence to prescribed medication (s) leads to negative health outcomes among community-dwelling elderly patients. Although home health nurses are recognized stakeholders in health care delivery, their perspectives on promoting medication adherence among their elderly patients is sparse in existing literature. The purpose of this study was to describe the views of home health nurses on promoting medication adherence among community-dwelling elderly patients and to explore the sociocultural contexts for the formation of these home health nurses’ views. The study utilized Fairclough’s (2003) critical discourse analysis (CDA) methodology. Data analyzed included 13 in-depth interviews with home health nurses and analysis of four official documents relevant to medication adherence promotion among community-dwelling elderly patients. The five categories identified from the interview analysis include: (a) medication adherence promotion as providing nursing care, (b) medication adherence promotion as engaging patients/caregivers, (c) medication adherence promotion as requiring multiple reinforcements, (d) medication adherence promotion as preventing adverse outcomes, and (e) medication adherence as requiring team effort. The four categories that emerged from analysis of the documents were: (a) monitoring medication compliance, (b) monitoring medication safety, (c) notifying the physician, and (d) communicating with patient/caregiver. Four out of the five categories representing home health nurses’ views on promoting medication adherence among their elderly patients converged with the language of the official documents examined in this study. Only the category of medication adherence promotion as requiring multiple reinforcements did not converge with the language used in these official documents. Nurse educators may use the findings from this study to enhance the behavioral health component of the nursing education curriculum. The findings from this study can also spur research that evaluates the influence of co-pays on patients’ adherence to prescribed brand-name medications. Policy makers may use the findings from this study to develop and enact policies that promote efficiency among healthcare providers as they manage elderly patients’ medication regimen.
Home health nurses, Medication adherence promotion, Community-dwelling elderly patients, CDA, Critical discourse analysis, Norman Fairclough, Discourse theory, Habermas critical social theory, NVivo.
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