1. Developing a Suite of Resources to Improve Patient Adherence to Compression Stockings: Application of Behavior Change Theory
- Author
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Bar L, Marks D, and Brandis S
- Subjects
compression stockings ,adherence ,behavior change theory ,behavior change wheel ,com-b model ,theoretical domains framework ,venous leg ulcers ,Medicine (General) ,R5-920 - Abstract
Laila Bar,1,2 Darryn Marks,3 Susan Brandis1 1Department of Occupational Therapy, Bond University, Faculty of Health Science and Medicine, Robina, Queensland, Australia; 2Department of Occupational Therapy, Gold Coast University Hospital, Southport, Queensland, Australia; 3Department of Physiotherapy, Bond University, Faculty of Health Science and Medicine, Robina, Queensland, AustraliaCorrespondence: Laila Bar, Department of Occupational Therapy, Level 4, Bond Institute of Health and Sport, 2 Promethean Way, Robina, Queensland, 4226, Australia, Tel +61 413 855 090, Email laila.bar@student.bond.edu.auPurpose: Poor patient adherence to compression stockings remains a difficult and pervasive problem for clinicians, with costly repercussions for patients and health-care systems. The purpose of this paper was to describe the application of behavior change theory to the systematic development of a suite of resources, aimed at improving patient adherence to wearing compression stockings.Methods: Employing a non-empirical approach, behavior-change theory was used to develop an innovative intervention as part of a multi-phase project. Target behaviors, barriers and potential enablers were identified in relation to stocking adherence. An impact-likelihood matrix for behavior prioritization was used to identify possible areas for intervention within occupational therapy outpatient clinics. Selection of suitable resources and their consequent development were based on a narrative and problem-solving process by a panel of clinical experts.Results: Of 14 potential domains embedded in the Theoretical Domains Framework, the key target behaviors and barriers were associated with eight domains. Michie’s Behavior Change Wheel revealed recommendations in six subdivisions and of these, four intervention functions were selected by the panel, based on their potential impact and likelihood of adoption in clinical practice. Findings led to the development of a suite of resources comprising a new questionnaire, a clinical decision tree, augmented by clinical answer sheets corresponding to each of the barriers.Conclusion: Application of behavior change theory informed the design of a behavior change intervention comprising an integrated suite of resources for novice and experienced clinicians.Practice Implications: These novel resources have potential to improve patient adherence to compression stockings and consequently generate health-care savings through reduced need for wound care products, and medical interventions with translation to other settings and conditions requiring compression stockings. Patient outcomes will likely be improved with reduced pain, improved quality of life and earlier resumption of usual occupations.Keywords: compression stockings, adherence, behavior change theory, Behavior Change Wheel, COM-B model, Theoretical Domains Framework, venous leg ulcers
- Published
- 2023