Construct · 3 fields · 5 citations
One name. Different field. Different construct. One map.
● jingle · one word, three constructs Nearest construct by meaningadhesioncompare the meaningsEvery construct on the map is compared with every other by the meaning of its definitions, and the closest one is surfaced here. The nearest construct to adherence is adhesion.
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Adherence to long-term therapies is the extent to which a patient's behaviour, taking medication, following a diet, or changing a habit, corresponds to recommendations agreed with a clinician. The World Health Organization report edited by Sabaté (2003) and the taxonomy of Vrijens and colleagues (2012) both make the referent a patient's dosing behaviour over time, split into starting the regimen, taking each dose as prescribed, and continuing until the course ends. The word is chosen against compliance, which implies passive obedience to a doctor's orders, because adherence assumes the patient assented to the plan. What is at stake is one person's behaviour relative to an agreed regimen, not the physical sticking of one material to another and not the faithful delivery of a protocol by a clinician.[1][2][3]
In surface engineering, adherence, more often called adhesion, is the strength with which a coating, film, or bonded layer stays attached to the substrate beneath it. Mittal (1976) separates basic adhesion, the interfacial bonding forces themselves, from practical adhesion, the force or energy an actual test must supply to detach the layer. The referent is a physical interface between two solids, and the unit is a force, an energy, or a pass and fail rating obtained in the laboratory by pull-off, scratch, peel, or tape tests. Nothing about anyone's willingness enters into it; a coating that adheres well is one that resists being pulled from its surface, which bears no relation to a patient following a regimen or a therapist delivering a manual.[4]
In implementation science, fidelity, also called protocol or treatment adherence, is the degree to which an intervention is delivered as its designers intended. Carroll and colleagues (2007) treat adherence as the core of fidelity: whether the content, coverage, frequency, and duration of what was actually delivered match the manual. The referent is a provider's or study's delivery of a protocol, judged by an observer against a specification, not a patient's own behaviour and not a physical bond. This meaning is easily confused with medication adherence because both live in health research, but one asks whether the clinician did what the protocol said and the other asks whether the patient did what was agreed, and a study can show high delivery fidelity and low patient adherence at the same time.[5]
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