Fig. 2.

The dynamic process of illness progression. Explanatory model (EM), which is composed of the various notions about condition and its treatment that are held by all those engaged in the clinical process. The EM scope was determined based on the interactions among social context, distress/disease impact, and disease severity. The strength of adherence was determined by the treatment response to different treatment modalities. In other words, each treatment modality competes with the others. This is because people may choose to use different treatment modalities at the same time to cope as their condition progresses, particularly with regard to chronic illnesses.

DI, distress/disease impact; SC, social context/culture; Tx, treatment; TR, treatment response.