Motivationsbarrieren und Motivationskonzepte Bd. 1: Motivation, Motivationsdefizite und ihre empirische Erhebung ; Bericht der wissenschaftlichen Begleitung und des Projekttraegers zum Projekt 'Qualifizierung aelterer ArbeitnehmerInnen in d. neuen Bundeslaendern aus d. Metall- u. Elektroindustrie'

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Motivation and Diabetes: Time for a Paradigm Shift? - A Position Paper -

Non-adherence to treatment recommendations for patients with diabetes is widespread. This applies to medication as well as recommendations for a healthy lifestyle with appropriate physical activity, a healthy diet, and, if necessary, an end to smoking and weight control. Disregard of these recommendations has been shown to increase the risk of diabetes complications, morbidity and premature mortality. Physicians ' responses to this patient behavior include increased efforts to improve adherence to therapy and often result in a feeling of resignation in the long term. Research efforts focus on an increasing number of interventions to improve therapy adherence, with the results of meta-analyses indicating only moderate success. This position paper presents a practice-oriented approach for discussion that aims to improve the problems described. We reflect on the different roles and responsibilities of patients on the one hand and physicians and other professional groups (diabetes counsellors, nurses, and psychotherapists) on the other. A new classification of different types of non-adherence to therapy is proposed. These constitute the starting point for a practice-related algorithm for the medical handling of the different types of non-adherence, in which the roles and responsibilities of practitioners and patients are explicitly clarified. Thereby no adherence to therapy of patients is pushed. Rather, the aim is for patients to make an informed and responsible decision for or against a doctor's suggestion and for this to be accepted by the physician so that frustrations on both sides are avoided. Finally, theses regarding motivation problems in diabetes will be presented for discussion