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Family Practice Advance Access originally published online on September 28, 2007
Family Practice 2007 24(6):610-615; doi:10.1093/fampra/cmm057
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Conceptualization and measurement of resistance to treatment: the resistance to treatment questionnaire for people with diabetes

M Mishalia, YS Vaknind, H Omera and AD Heymannb,c

a Department of Psychology, Tel Aviv University, Tel Aviv
b Maccabi Healthcare Services, 27 Hamered Street, Tel Aviv
c Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
d Department of Psychology, Bar Ilan University, Ramat Gan, Israel

Correspondence to Dr AD Heymann, Maccabi Healthcare Services, 27 HaMered Street, Tel Aviv, Israel; Email: heymann_t{at}mac.org.il

Received 31 January 2007; Revised 11 July 2007; Accepted 18 August 2007.


  Abstract

Objective. This research describes the process of building a tool which allows assessment of resistance to treatment and its intensity among patients with diabetes.

Methods. This study was undertaken in Maccabi Health care Services a preferred provider health care organization. This is a multistage study using both qualitative and quantitative methods. A semi-structured interview using 14 key questions identified the reasons for resistance to treatment among 64 people with diabetes. A questionnaire was built based on these themes and then validated with a further 123 people with diabetes. A further validation was undertaken comparing our questionnaire with that of Kavookjian.

Results. This resulted in a four theme, 40-item questionnaire which can be administered in about 10 minutes. Resistance patterns and their intensity were different in each patient. This resistance questionnaire identifies the core reasons for non-compliance: lack of faith or dissatisfaction with the treatment or with the medical team, emotional reasons, specific problems or constraints and factors connected to despair and failure.

Conclusions. We present a tool 'The Resistance to Treatment Questionnaire' which may be used by medical personnel to identify the barriers to treatment for each individual and in turn improve patient compliance to treatment.

Keywords. Adherence, diabetes mellitus, patient education, resistance to treatment.

Mishali M, Omer H, Vaknin YS and Heymann AD. Conceptualization and measurement of resistance to treatment: the resistance to treatment questionnaire for people with diabetes. Family Practice 2007; 24: 610–615.


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