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TMR Integrative Nursing  2018, Vol. 2 Issue (1): 12-17    DOI: 10.12032/TMRIN20180309
Concept Analysis     
Adherence-A concept analysis in the context of cardiac rehabilitation
Liu Hui1, Tian Xu2,*()
1Cardiac Care Unit, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
2Department of Gastroenterology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital & Chongqing Cancer Center,Chongqing, China.;
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Objective: To explore and identify the concept of adherence in the context of cardiac rehabilitation. This concept analysis will provide a framework for clinical decision-making and intervention to improve patients’ adherence to cardiac rehabilitation programme. Method: Walker and Avant’s framework was used to analysis the concept of adherence. Results: Adherence is defined as patients collaboration with health care provider, active involvement in the treatment regimen, and persistence in practice characterized by self-efficacy and relapse-prevention. Defining Attributes of adherence include collaboration relationship; self-efficacy promotion and relapse-prevention. Antecedents of adherence include health care provider’s prescription, illness perceptions, social-economic and environmental factors. Patients adherence to cardiac rehabilitation programme can improve clinical outcomes. However, there is no standard instrument to measure adherence. Conclusion:Based on the concept analysis, in order to improve patients’ adherence to cardiac rehabilitation, health care provider should invite patients active involvement in making rehabilitation plan and promote patients’ self-efficacy and prevention relapse.

Highlights  Highlights Three attributes of adherence have been identified in the literature, includingcooperative relationship; self-efficacy promotionand relapse-prevention. It clarified the concept of compliance and adherence and provide theoretical bases to the intervention programme which conduct to improve patients’ adherence to cardiac rehabilitation. Editor’s Summary Adherence is a key concept in nursing practice andimpacts the care of patients throughout the health caresystem. This study analyzed the concept of adherence in the context of cardiac rehabilitation.
Key wordsAdherence      Compliance      Persistence      Cardiac rehabilitation      Concept analysis     
Received: 10 January 2018      Published: 24 March 2018
Corresponding Authors: Tian Xu     E-mail:
Cite this article:

Liu Hui, Tian Xu. Adherence-A concept analysis in the context of cardiac rehabilitation. TMR Integrative Nursing, 2018, 2(1): 12-17.

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Figure 1 Antecedents, attributes and consequencesof adherence
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