Perceived threat in compliance and adherence research.

Within the broader agenda of adherence research, health beliefs have been identified as being significant predictors of adherence. Specifically, perceived threat as a health belief has received considerable attention in compliance and adherence research from multiple perspectives in multiple patient populations. The purpose of this paper is to analyze the concept of perceived threat as it relates to treatment adherence through a series of perspectives: conceptual, methodological, and empirical. Analysis of the literature reveals that there is lack of consistency in operationalization of perceived threat as it relates to treatment adherence. Perceived threat is most commonly cited in studies that focus on health beliefs or utilize a stress and coping paradigm. Instruments have been developed with items that measure perceived threat. Measures of threat occur primarily through uni-dimensional measures that do not reflect the inter-relatedness of the threat experience to personal and contextual factors. Future research examining perceived threat from a cognitive appraisal perspective, where both primary and secondary appraisals can be examined, may provide additional insight into factors affecting treatment adherence.