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January 1987

Compliance: The Dilemma of the Chronically Ill,

Author Affiliations

Stanford, Calif

Arch Intern Med. 1987;147(1):25. doi:10.1001/archinte.1987.00370010031005

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


This book reflects the experiences of a group of clinical psychologists working with a variety of medical patients in a large general hospital. Its complex focus is the result of several convictions, shared by the authors, that noncompliance is (1) a nonspecific symptom, (2) a multifactorial process generally unresponsive to a unifactorial solution, and (3) frequently a conscious, self-affirmative choice of independence and personal value.

Eight authors contribute 11 chapters that emphasize the special situations of the chronically ill, such as indirect self-destructive behavior, quality of survival, family relationships, staff perceptions of noncompliance, physician-patient communication, cognitive-behavioral relationships, and societal contributions to noncompliance. Their explicit audience consists of physicians and staff, both those in training and those in established practices, who harbor unrealistic and often self-defeating expectations and approaches in dealing with noncompliance. Collectively, they bemoan many health professionals' attitudes of treating patients as a "homogeneous group whose behavior should be

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