[From Roland Ernst (2003.12.07.1238)]
21:38 in Europe - I hope I wrote the right time for you
Thank you very much for your answers. It took me several month to find out what is so clear to you - compliance works most of the time with a black box patient who should follow a causal input-output reaction. I found out that there is something like adherence - but for me it seems that still the docs play a very important role in this concept. In the meantime I had discussions with my system theory professor (who works a lot with literature of Luhmann = socilogy). Talking to him I had the idea that if I would ask 50 different patients why they complied or not they would maybe tell me 50 different stories. So why should there be a variable for predicting compliance? For you it is clear that most compliance studies create an illusion about the 50 different patient´s stories. Thank you very much - I am very impressed.
After that I thought about just asking patients why they comply or not - but I realized that I would only measure the patients´ attributions. So finally I decided I have to find a good model for predicting from the patients understanding and purpose, … their compliance
and after that find out (by interviewing these patients) why in some cases the prediction didn´t work (for instance because of unexpected life events). That is what I want to do and the reason why I am looking for a good model.
Rick - I tried to get your paper via my journal server but the journal “ergonomics” is not listed. Actually I have big problems in getting PCT literature - most of the journals are not listed. It would be very nice of you if you could send me the article.
During the following weeks I will have the chance to be part in a data collecting project about patients agenda - doctor patient relationship and compliance. Maybe we could veryfy your findings or model
with our data. I will stay in contact.
Thank you very much
all the best
Roland
···
–Ursprüngliche Nachricht-----
Von: Control Systems Group Network (CSGnet) [mailto:CSGNET@listserv.uiuc.edu]Im Auftrag von Rick Marken
Gesendet: Sonntag, 07. Dezember 2003 19:58
An: CSGNET@listserv.uiuc.edu
Betreff: Re: Prediction of adherence
[From RIck Marken (2003.12.07.1100)]
Kenny Kitzke (2003.12.07)–
Hi Roland. Welcome to CSGNet. You have asked a great question...
PCT/HPCT explains quite well why adherence is so disappointing and unpredictable. Basically, other goals internal to the patient interfere or conflict with the doctor's therapy instructions given to the patient...
No doctor can understand all the possible desires that reside within the mind and spirit of the patient. Sometimes the patient's preferences align in a way where adhering to the doctor's therapy is also what the doctor ordered. It creates an illusion that the doctor can give a therapy in a way that _causes_ the patient to adhere all the time...
Well, that is a few thoughts off the top of my head.
And excellent thoughts they are,too, Kenny.
Wonderful post! Thanks.
Best
Rick
Richard S. Marken
marken@mindreadings.com
Home 310 474-0313
Cell 310 729-1400
[From Rick Marken (2003.12.07.1255)]
Roland Ernst (2003.12.07.1238)
Rick - I tried to get your paper via my journal server but the journal "ergonomics" is not listed. Actually I have big problems in getting PCT literature- most of the journals are not listed.
Actually, _Ergonomics_ is a British human factors journal; it's not really part of the PCT literature. It's a fairly major journal so it's likely to be in your library. But I will be happy to send you a PDF version of the paper tomorrow when I get to work.
During the following weeks I will have the chance to be part in a data collecting project about patients agenda - doctor patient relationship and compliance. Maybe we could veryfy your findings or modelwith ourdata. I will stay in contact.
That would be great. Thanks.
Best
Rick
···
---
Richard S. Marken
marken@mindreadings.com
Home 310 474-0313
Cell 310 729-1400
[From Bruce Gregory (2003.12.07.1655)]
\ Roland Ernst (2003.12.07.1238)
21:38 in Europe - I hope I wrote the right time for you
Thank you very much for your answers. It took me several month to find out what is so clear to you - compliance works most of the time with a black box patient who should follow a causal input-output reaction. I found out that there is something like adherence - but for me it seems that still the docs play a very important role in this concept. In the meantime I had discussions with my system theory professor (who works a lot with literature of Luhmann = socilogy). Talking to him I had the idea that if I would ask 50 different patients why they complied or not they would maybe tell me 50 different stories.
They seem not to be controlling for compliance. If you control for compliance, you normally do not fail. The 50 different patients are telling you what they are controlling for, in lieu of controlling for compliance.
Bruce Gregory
"Everything that needs to be said has already been said. But since no one was listening, everything must be said again."
Andre Gide
···
On Dec 7, 2003, at 3:40 PM, Roland Ernst wrote:
X-Mailer: CommuniGate Pro WebUser Interface v.4.1.5
Message-ID: <web-12781535@biosnet.at>
MIME-Version: 1.0
Content-Type: text/plain; charset="ISO-8859-2"
Content-Transfer-Encoding: 8bit
[From Roland Ernst (2003.12.08.0841)
THANK YOU ALL FOR YOUR REPLIES!!
Dear Bruce Gregory,
even if the patients are all controlling for compliance
(you are right - which is not controlled in a lot of
studies) doesn´t the PCT also accept that the patients
would tell 50 different stories about internal (physical,
psychical) and external (social, ...) disturbances?
Roland
···
From: "Roland ERNST" <office@rolandernst.com>
Subject: AW: WG: Prediction of adherence
To: 'CSGNET@listserv.uiuc.edu'
Date: Mon, 08 Dec 2003 15:40:45 +0100
-----Ursprüngliche Nachricht-----
Von: Control Systems Group Network (CSGnet)
[mailto:CSGNET@listserv.uiuc.edu]Im Auftrag von Bruce
Gregory
Gesendet: Sonntag, 07. Dezember 2003 22:56
An: CSGNET@listserv.uiuc.edu
Betreff: Re: WG: Prediction of adherence
On Dec 7, 2003, at 3:40 PM, Roland Ernst wrote:
[From Bruce Gregory (2003.12.07.1655)]
\ Roland Ernst (2003.12.07.1238)
21:38 in Europe - I hope I wrote the right time for you
Thank you very much for your answers. It took me several
month to find out what is so clear to you - compliance
works most of the time with a black box patient who should
follow a causal input-output reaction. I found out that
there is something like adherence - but for me it seems
that still the docs play a very important role in this
concept. In the meantime I had discussions with my system
theory professor (who works a lot with literature of
Luhmann = socilogy). Talking to him I had the idea that if
I would ask 50 different patients why they complied or not
they would maybe tell me 50 different stories.
They seem not to be controlling for compliance. If you
control for compliance, you normally do not fail. The 50
different patients are telling you what they are
controlling for, in lieu of controlling for compliance.
Bruce Gregory
"Everything that needs to be said has already been said.
But since no one was listening, everything must be said
again."
Andre Gide