JAN JOURNAL OF ADVANCED NURSING
JAN FORUM
Your views and letters
In response to: Bissonette J. (2008) Adherence: a concept analysis. Journal of Advanced Nursing 63(6),
634–643.
Patient adherence
In the article entitled ‘Adherence: a concept analysis’ in the May
2008 issue of Journal of Advanced Nursing 63(6), pp. 634–643,
the author, Janice M. Bissonnette, presents an excellent review
on the topic of adherence. Bissonnette seeks to clarify the
concept by including past and present definitions as well as
discussing the lack of a patient centred definition of care and
foundational framework about the topic of patient adherence.
The article examines the transition in terminology from compli-
ance to adherence to concordance while revealing the inadequa-
cies of appropriately defining this phenomenon. In my practice,
I find adherence to be a very important issue. Patients need to be
active participants in their care. As nurses how often have we
scripted, ‘patient is non-compliant’ without addressing the
factors or circumstances for his or her behaviour. This article
helps bring to the forefront the importance of identifying how
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patient’s feelings affect decisions concerning his/her health care
and in turn affect the nurse’s ability to help patients reach a
desired level of wellness. At this time in nursing history, as nurses
step back to evaluate our role, as we strive to develop new
nursing theories and frameworks, as we explore new ways of
knowing, it is essential that we not miss the obvious. Nursing
care is directly related to our patient’s cooperation, ability and
desire to enter into a dynamic relationship directed toward
achieving improved health. This article supports the need for
additional patient centred research as we advance toward
evidence based practice.
Janet Petit
Graduate Student
Towson University, 7560 Greenwood Drive,
Highland, MD, USA
e-mail: jpsboys@aol.com
Ó 2009 Blackwell Publishing Ltd