ply with drug therapy and other treatment protocols. Patient adherence, also patient compliance, as the term implies, is the name given to the action-oriented willingness of patients to abide by doctors' instructions, including but not limited to medication regimens and other activities and features of recovery and health maintenance. These instructions may involve the performance of specific actions by patients and caregivers, who may be professional nurse practitioners or family caregivers (Williams & Others, 2000). Where TB is concerned, the problems of convincing affected populations that are socially or economically marginalized of the need to adhere to treatment plans remain acute, since failure to get treatment only further feeds the TB epidemic. Gostin says that the main problem in this regard is the breakdown in social support services, as well as heightened civil-liberties concerns with regard to such matters as enforced confinement or quarantine of patients.
Despite the defunding of health-care support services that began in the 1980s (from which the public health system has never fully recovered), the persistence of TB among already vulnerable populations calls for effective methods of intervention in cases with a view toward ensuring patient compliance. Gostin says that bringing TB under control will require "effective compliance-enhancing policies including incentives, social support, education, counseling, drug treatment, housing and employment programs, and better interpersonal communication" (1993, p. 280). Each of these suggestions would require appropriate funding, and any suggestion that entails an interface between patient and the health-care system would undoubtedly entail staffing of nursing personnel, since nurses are routinely the point of communication between patient and system. It follows that communication effectiveness is an important aspect of nursing practice. Accordingly, research into strategies for ...