Social Support

Jack et al. (2010) has found in his systematic review that low levels of family or social support are barriers to patients’ adherence. This finding is further supported by another review (Conraads et al., 2012), which concludes that inadequate social support would lead to a feeling of isolation, and reduce one’s motivation to follow prescribed treatments. This review also suggests that other social factors, such as being divorced, living alone, and having less support to be brought to facilities, negatively influence one’s access to health services, which would in turn, reduce one’s adherence to treatments.

Many simple and effective strategies can help to increase social support and improve one’s adherence to rehabilitation. Social support could come from families, friends, neighbors, co-workers, or community members. Seeing peers attending and adhering exercises has been shown to improve one’s self-efficacy to follow treatment plans (Tierney et al., 2012). Involving partners in the rehabilitation may also help to increase the patient’s motivation (Fekete et al., 2006). A key facilitator to improve social support is to engage patients’ families and friends. Health LEADS Australia (HLA) suggests that it is a clinician’s responsibility to create a positive and engaging environment for people to participate in. One of the hallmarks of great leaders is the ability to communicate and develop strong beliefs (Giuliani, 2002). Clinicians should try to excite people with their vision, bring people aboard and earn their support.

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To create a truly engaging environment, clinicians need to understand each patient’s different health journey and needs (Baron, 2009). Leaders are sometimes followers, and effective leaders know how to follow (Northouse, 2011). This concept indicates that leaders should motivate and attract people through identifying and customising to each client’s different life circumstances. Therefore, clinicians should work collaboratively with patients and carers to identify their needs and plan treatments that best suit their availability.

Leadership is more than a set of skills, and relies on multiple subtle personal qualities, such as humility, and enthusiasm (Northouse, 2011). A review by Vahdat et al. (2014) finds that limitations of health professionals themselves including a lack of cultural awareness and communication skills, can inhibit the creation of an engaging environment. Therefore, health leaders should self-reflect and seek strategies to address their limitations. This allies with the focus of ‘leads self’ in the HLA (Health Workforce Australia, 2013). Great clinicians have to undergo a process of personal understanding and self-discovery to find their weakness and improve accordingly (Rooke & Torbert, 2005).

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Moreover, a change of health systems may be required, such as increasing funding for transportation support if a lack of social support to get to the facilities is the key barrier. While the aim of HLA is to build a people focused health system that is effective and equitable for both patients and clinicians, the lack of social support and inequity in accessing health services needs to be addressed (Sebastian et al., 2013).

 – JH


Baron, S. (2009). Evaluating the patient journey approach to ensure health care is centred on patients. Nursing times, 105(22), 20-23.

Fekete, E. M., Stephens, M. A. P., Druley, J. A., & Greene, K. A. (2006). Effects of spousal control and support on older adults’ recovery from knee surgery. Journal of Family Psychology, 20(2), 302.

Giuliani, R. W. (2002). with Ken Kurson. Leadership.

Jack, K., McLean, S. M., Moffett, J. K., & Gardiner, E. (2010). Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review. Manual therapy, 15(3), 220-228.

Northouse, P. G. (2011). Introduction to leadership: Concepts and practice. Sage.

Rooke, D., & Torbert, W. R. (2005). Seven transformations of leadership. harvard business review, 83(4), 66-76.

Sebastian, A., Fulop, L., Dadich, A., Fitzgerald, A., Kippist, L., & Smyth, A. (2014). Health LEADS Australia and implications for medical leadership. Leadership in Health Services, 27(4), 355-370.

Tierney, S., Mamas, M., Woods, S., Rutter, M. K., Gibson, M., Neyses, L., & Deaton, C. (2012). What strategies are effective for exercise adherence in heart failure? A systematic review of controlled studies. Heart failure reviews, 17(1), 107-115.

Vahdat, S., Hamzehgardeshi, L., Hessam, S., & Hamzehgardeshi, Z. (2014). Patient involvement in health care decision making: a review. Iranian Red Crescent Medical Journal, 16(1).


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