Behavior of person and/or caregiver that fails to coincide with a
health-promoting or therapeutic plan agreed on by the person
(and/or family and/or community) and health-care professional. In
the presence of an agreed-on, health-promoting or therapeutic plan,
person’s or caregiver’s behavior is fully or partially nonadherent and
may lead to clinically ineffective or partially ineffective outcomes
• Behavior indicative of failure to progress
• Complications or evidence of exacerbation of signs and symptoms
• Failure to keep appointments and adhere to treatment regimen
• Objective indications (e.g., laboratory tests, physiologic markers)
• Access to, convenience of care
• Cultural/spiritual values
• Client–provider relationships
• Developmental and personal
• Individual health coverage
• Provider communication skills,
• Health beliefs
credibility; continuity; teaching
• Knowledge of regimen
• Motivational forces
• Complexity, intensity
• Involvement of members in
• Cost, ﬁnancial ﬂexibility, and
duration of plan
• Social value regarding plan
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Emotional status
The patient will
• Identify factors that inﬂuence noncompliance.
• Demonstrate level of compliance that maintains safety.
• Contract to perform speciﬁc behaviors.
• Use support systems to modify noncompliant behaviors.
SUGGESTED NOC OUTCOMES
Acceptance: Health Status; Adherence Behavior; Compliance Behav-
ior; Symptom control; Treatment Behavior
INTERVENTIONS AND RATIONALES
Determine: Assess patient’s perception of health problem, treatment
regimen and history of compliance, obstacles to compliance, ﬁnancial
resources, ethnicity, and religious inﬂuences. Assessment information
may help select appropriate interventions.
Perform: Provide an environment that is nonjudgmental. This
demonstrates unconditional respect for the patient.
Contract with the patient to practice only nonthreatening behav-
iors. This involves the patient in a formal commitment and gives the
patient a sense of personal control.
Inform: Teach self-healing techniques to both the patient and family
such as meditation, guided imagery, yoga, and prayer. These
techniques promote self-reliance.
Teach principles of good nutrition for patient’s speciﬁc condition.
Understanding importance of nutrition will encourage compliance.
Inform patient about diagnosis. Understanding essential informa-
tion needed to perform skills or give self-care increases compliance.
Demonstrate skills needed by patient to comply with treatment regi-
men to reinforce patient’s conﬁdence in ability to replicate.
Attend: Provide opportunities for the patient to discuss reasons for
noncompliance. The willingness of the nurse to listen allows the
patient the ability to listen to his or her own reasoning.
Help patient clarify his or her values about the importance of fol-
lowing a treatment plan to determine appropriate interventions.
Acknowledge patient’s right to choose not to comply with
prescribed regimen to respect autonomy. Control over patient’s
actions is legitimate only when dangerous to self or others. Offer
Use support systems to reinforce negotiated behaviors. Support
from the family and friends help foster compliance.
Manage: When medically appropriate, support patient’s cultural
beliefs towards medical practices to demonstrate respect; and refer
to a member of the clergy or a spiritual counselor.
Refer family to community resources and support groups to pro-
mote compliance with modiﬁcation of behavior. If patient’s situation
is complicated by lack of ﬁnancial resources, contact agencies that
may offer help with costs of medical treatment.
SUGGESTED NIC INTERVENTIONS
Coping Enhancement; Counseling; Decision-Making Support; Health
Education; Patient Contracting; Self-Modiﬁcation Assistance; Self-
Riegel, B., et al. (2006, May–June). A motivational counseling approach to
improving heart failure self-care mechanisms of effectiveness. Journal of
Cardiovascular Nursing, 21(3), 232–241.