Adherence: a matter of self-efficacy and power

J Adv Nurs. 1997 Jul;26(1):132-7. doi: 10.1046/j.1365-2648.1997.1997026132.x.


This paper examines the relationship between self-efficacy and social power (expert and referent) and how the application of this relationship, leads to client adherence and compliance. Referent power is defined, including methods that health care professionals may use to develop and apply referent power. Expert power is defined and addressed in the context of referent power, self-esteem and self-efficacy as a means of promoting adherence. Self-efficacy as a concept is defined and explored in the context of social power. The relationships between self-efficacy and social power (expert and referent) are shown as important determinants of adherence and compliance. The theory of the application of referent and expert power in relationship with self-efficacy has been compared with an effective programme, yielding high compliance, at Western Psychiatric Institute and Clinic, showing the theory's relevance and applicability in determining compliance. Explored are the reasons for non-compliance in the elderly population and how the theory model can remedy these detriments for compliance. The empowerment of elderly patients through the application of this theory to medication compliance is examined. The determination of adherence and compliance is shown by the application of the relationship between self-efficacy and both expert and referent power.

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care
  • Communication
  • Depression / drug therapy
  • Depression / nursing
  • Depression / psychology
  • Humans
  • Nurse-Patient Relations
  • Patient Compliance / psychology*
  • Power, Psychological*
  • Self Concept*