Exercise - Symposium

Lucy Yardley
Professor of Health Psychology, University of Southampton

Attitudes and adherence to treatment and rehabilitation
This talk examines the influences on attitudes and adherence to therapy using a theoretical framework developed around the concept of 'supported self-care'. 'Supported self-care' is a concept that embraces all the ways in which people try to enhance their well-being in relation to health, with support from a variety of sources, including family, therapists and the wider social community. It encompasses a broader understanding of the factors that influence healthcare experiences than concepts that give central prominence to the role of the therapist (such as 'compliance' and even 'concordance'). It is also less individualistic and less focused on rational behaviour than terms such as 'self-regulation' or 'self-management'. Some of the key elements of the dynamic process of supported self-care will be outlined in a broad framework which highlights the role of a) social influences and b) experiences of self-care over time. The relevance of these factors will then be illustrated by recent collaborative research into supported self-care. Firstly, social identity and social influence are shown to be central to understanding how self-care activities (exercising to prevent falls) can be presented to older people in ways that may have positive or negative effects on their wellbeing and their enthusiasm for these activities. Secondly, studies of adherence to therapy demonstrate how personal experiences of therapy may alter beliefs or behaviour, and lead to further engagement in or rejection of this form of self-care activity.