PATIENT INITIATIVE AND RESPONSIBILITY - POTENTIAL EFFECT ON TREATMENT AND CONTROL OF DISEASE - CASE OF GONORRHEA

This study investigates the effectiveness (in terms of rates of reinfection) of encouraging gonorrhea patients in public treatment facilities to become more involved in disease prevention and control. Two approaches to interviewing patients that require different levels of patient participation in disease control are compared (epidemiological case-finding versus motivational-responsibility interviewing). The issue of patient participation is viewed in the context of the actualities of venereal disease treatment as this responsibility is met in public clinics, with such features as heavy caseloads, brevity of treatment time and many stigma-associated factors acting both on patient and medical practitioner and other clinic staff members. The theoretical framework is based on contemporary conceptions about the partially contrary motivations and interests in general of patient and practitioner when they meet in the medical treatment setting. Results indicate that reinfection rates are lower for male patients (but not female patients) receiving the motivational-responsibility interview. Alternative explanations for the interview group-reinfection relationship are considered, and possible reasons for the lack of a relationship among women are suggested. It is concluded that efforts aimed at increasing patient involvement can be effective in gonorrhea prevention and control. © 1979.