DOI QR코드

DOI QR Code

Influence of Social Support and Health Literacy on Treatment Adherence in Hemodialysis Patients

혈액투석환자의 사회적 지지와 건강정보이해능력이 치료순응도에 미치는 영향

  • Received : 2020.03.31
  • Accepted : 2020.07.03
  • Published : 2020.07.31

Abstract

This study was a descriptive research study for hemodialysis patients to survey the effects of social support and health literacy on treatment adherence. The subjects of this study were 140 hemodialysis patients aged over 40 years who had been receiving treatment for more 1 year in artificial kidney rooms at two general hospitals in Y city. The data were collected from November 1, 2019 to December 31, 2019 and were analyzed using descriptive statistics, t-tests, one-way ANOVA, Scheffe test, Pearson's correlation coefficients, and multiple regression with the SPSS/WIN 26.0 statistical program. The results of this study show that social support (family, friends, medical staff) and health literacy (functional, communication, critical) were positively correlated with treatment adherence. The variables affecting treatment adherence in hemodialysis patients were identified by social support and health literacy with 69.6% explanatory power. To improve the treatment adherence of hemodialysis patients, it is necessary to develop education programs to improve health literacy based on social support.

본 연구는 주기적으로 혈액투석을 시행하고 있는 환자를 대상으로 사회적 지지와 건강정보이해능력의 정도를 파악하고 치료순응도에 미치는 영향을 조사하기 위해 시도된 서술적 연구이다. 연구대상자는 지방 Y시에 소재한 2개 종합병원 인공신장실에 등록된 혈액투석 치료를 받은 지 1년이 경과 한, 만 40세 이상 투석환자 140명이며, 자료수집기간은 2019년 11월 1일부터 12월 31까지이다. 수집된 자료는 SPSS/WIN 26.0 프로그램을 이용하여 빈도와 백분율, 평균과 표준편차, t-test, one-way ANOVA, Scheffe test, Pearson의 상관계수, 다중회귀분석을 실시하였다. 연구 결과, 사회적 지지 하위영역인 가족 지지는 친구 지지와 의료인 지지에 비해 치료순응도에 더 유의한 영향을 주는 것으로 나타났다. 건강정보이해능력에 있어 세 가지 하위영역인 기능적, 의사소통, 위기 건강정보이해능력 모두가 치료순응도와 매우 높은 상관관계를 보여 건강정보이해능력이 높을수록 치료순응도가 높은 것으로 나타났다. 사회적 지지와 건강정보이해능력은 치료순응도에 유의한 영향을 미치는 변수로 나타났고 69.6%의 높은 설명력을 보였다. 따라서 혈액투석환자의 치료순응도를 증진시키기 위해서는 사회적 지지를 기반으로 건강정보이해능력을 향상시키는 교육을 제공하는 프로그램 개발이 필요하다.

Keywords

References

  1. Lim SH, Song HS, Analyses of the Studies on Chronic Renal Failure(CRF) Related Quality of Life Published in Korea: 2010-2017, Asia-pacific journal of multimedia services convergent with art, humanities, and sociology. vol. 8, no. 10, pp. 671-680, 2018. DOI: https://doi.org/10.21742/AJMAHS.2018.10.08.
  2. Kim YJ, Kwon SH, The Experience of Life Reconstruction in Hemodialysis Patients with Chronic Renal Failure, Journal of digital convergence, vol. 15, no. 9, pp. 321-333, 2017. DOI: https://doi.org/10.14400/JDC.2017.15.9.321
  3. The Korean Society of Nephrology, Current Renal Replacement Therapy in Korea, The Korean Society of Nephrology, pp. 1-17, 2019.
  4. Suh SR, Cho IH. Influence of hemodialysis patient's stress and acceptance on their psychosocial adaptation and quality of life, The Journal of the Korea Contents Association, vol. 14, no. 11, pp. 829-37, 2014. DOI: https://doi.org/10.5392/JKCA.2014.14.11.82
  5. Jang HS, Lee CS, Yang YH. Influence of uncertainty and uncertainty appraisal on self-management in hemodialysis patients, Journal of Korean Academy of Nursing. vol. 45, no. 2, pp. 271-9, 2015. DOI: https://doi.org/10.4040/jkan.2015.45.2.271
  6. Paul L. Kimmel and Rolf A. Peterson. Depression in Patients with End-Stage Renal Disease Treated with Dialysis: Has the Time to Treat Arrived? Clinical Journal of American Society of Nephrology, vol. 1, no. 3, pp. 349-352, May 2006. DOI: https://doi.org/10.2215/CJN.00890306
  7. Gong M.S, Study on the hope and resilience of hemodialysis patients, Ewha Research Institute of Nursing Science Healthy Nursing, vol. 21, no. 1, pp. 24-37, 2009.
  8. Koo WS. Lee SK, Kim YS, Pack I.S. Ki SY, Chang YS, Yoon YS & Bang BK., Assessing the adequacy of hemodialysis with urea kinetic modeling, Koreann Journal of Nephrology, vol. 10, no. 4, pp. 555-562, 1991.
  9. Min, HS, Lee, EJ, A Study of the Relationship between Compliance with Therapeutic Regimens and Physiological Parameters of Hemodialysis Patients, Journal of Korean Academy Nursing Research., vol. 36, no. 1, pp. 64-73, 2006. https://doi.org/10.4040/jkan.2006.36.1.64
  10. Kahn, R. L, Aging and social support:Aging from to death, Interdisciplinary Perspective, West View Press[115], 1979.
  11. Rodin, G, Quality of life in adult with insulin -dependent diabetes mellites, Phychother Psychosom, vol. 54, no. 2-3, pp. 132-139, 1990. https://doi.org/10.1159/000288387
  12. Kim KS, Choi ES, Factors Affecting Family Function of Family with the Elderly Dementia, Journal of the Korean data analysis society, vol. 12, no. 2, pp. 717-731, 2010.
  13. Miller JF. Coping with chronic illness:overcoming powerless, 3rd edit; philadelphia:F.A. David, [201], 2000.
  14. Kim JE, Measuring the level of health literacy and influence factors: targeting the visitors of a university hospital's outpatient clinic, Journal of Korean Clinical Nursing Research, vol. 17, no. 1, pp. 27-34, 2011.
  15. Mo MH, Chung BY. Influencing factors on uncertainty of patients undergoing chemotherapy for lung neoplasms, Journal of the Korea Academia-Industrial cooperation Society, vol. 18, no. 4, pp. 248-59, 2017. DOI: https://doi.org/10.5762/KAIS.2017.18.4.24
  16. Gil CR, Sung GM, Difficulties of treatment adherence in adult patients with hemodialysis, Korean journal of rehabilitation nursing, vol. 21, no. 2, pp. 71-82, 2018. DOI: https://doi.org/10.7587/kjrehn.2018.71
  17. Lee YK, Son BK, The Relationship between Therapeutic Compliance and Emotional Variables in the Patients on Maintenance Hemodialysis, Korean Neuropsychiatric Association, vol. 37, no. 5, pp. 869-877, 1998.
  18. An Na, The effect of health literacy and self-efficacy on Hypertensive elderly's Treatment Adherence, Master's thesis, Chungnam National University, pp. 43-45, 2016.
  19. Shin JS, Lee YB, Study on the Influence of Social Support on the Psychosocial Welfare of the unemployed, Korean Journal of social welfare, vol. 37, no. 1, pp. 241-269, 1999.
  20. Ishikawa, H., Takeuchi, T., & Yano, E., Measuring functional, communicative, and critical health literacy among diabetic patients. Diabetes Care, 31(5), 874-879, 2008. DOI: https://doi.org/10.2337/dc07-1932
  21. Kristian Indino, Rebecca Sharp and Adrian Esterman, The effect of health literacy on treatment adherence in maintenance haemodialysis patients: a cross-sectional study, Renal Society of Australasia Journal, vol. 15, no. 1, pp.11-18, 2019. DOI: https://doi.org/10.33235/rsaj.15.1.11-18
  22. Song ES, Study on the knowledge about hemodialysis and compliance of patient role behavior in hemodialysis patients, Master's thesis, chosun University, pp. 11-15, 2017.
  23. So NS, A study on the correlation between perceived social support and hope of hemodialysis patients. Master's thesis, Kyung Hee University, pp. 26, 2003.
  24. Kim SA, A study on the correlation between perceived social support and the vocational rehabilitation needs of hemodialysis patients, Master's thesis, Inwha University, pp. 30, 2007.
  25. Noh SB, Lim HN, Lee MH, Kim DR, The effect of social support and resilience on sick role behavior of hemodialysis patients, Journal of the Korea Convergence Society, vol. 10, no. 5, pp. 385-395, 2019. DOI: https://doi.org/10.15207/JKCS.2019.10.5.385
  26. Kang SH, Kim IJ, Family characteristics, social support, function and compliance of patient role behavior of long term hemodialysis patients, The Korean Journal of Rehabilitation Nursing, vol. 22, no 1, pp. 58-66, 2019. DOI: https://doi.org/10.7587/kjrehn.2019.58
  27. Lee JY, A study on effectiveness of dietary self-efficacy, dietary knowledge and social support for exercise diet compliance of patients on hemodialysis, Master's thesis, Yonsei University, pp. 40, 47, 2007.
  28. Jung EJ, A study the relation between dietetic treatment compliance of the patient on hemodialysis and self-efficacy, social support, and dietary knowledge, Master's thesis, Hallim University, pp. 32, 2011.
  29. Lee WJ(2016), Relationships among healthy literacy, disease-related knowledge and compliance with treatment instructions in patients on hemodialysis, Master's thesis, Korea National Open University, pp. 43, 2016.
  30. Shin KM, Chu SH, Jang YS, Kang SM. Relationships between Health Literacy, Knowledge and Self-Care Behaviors in Elderly Patients with Heart Failure, Journal of Korean clinical nursing research, vol. 22, no. 1, pp. 28-37, 2016. DOI: https://doi.org/10.22650/JKCNR.2016.22.1.28
  31. Jeong HJ, Bae JH, The influence of healthy literacy and social-support on medication adherence in eldery with chronic disease, Journal of Digital Convergence, vol. 16, no. 7, pp. 419-428, 2018. DOI: https://doi.org/10.14400/JDC.2018.16.7.419
  32. Jung JH, Park NH, Shin SY, Influence of health literacy and diabetes knowledge for diabetes self care activities in low income elderly diabetes mellitus, Journal of Korean Academy of Community Health Nursing, vol. 25, no. 3, pp. 217-224, 2014. DOI: https://doi.org/10.12799/jkachn.2014.25.3.217
  33. Oh JH, Park EO, The impact of health literacy on self-care behaviors among hypertensive elderly, Korean journal of health education and promotion, vol. 34, no. 1, pp. 35-45, 2017. DOI: https://doi.org/10.14367/kihep.2017.34.1.35
  34. Lee SJ, The Effects of Health Literacy and Unmet Needs for Health Care on Health Promotion Behavior of the Elderly in Community, Master's thesis, Konyang University, pp. 29, 2019.
  35. Min ES, Huh MH, Predictors of Compliance in Hypertensive Patients, Journal of Korean Academy of Fundamentals of Nursing, vol. 19, no. 4, pp. 474-482, 2012. DOI: https://dx.doi.org/10.7739/jkafn.2012.19.4.474
  36. Choi YS, A Study On The Relationship between perceived Social Support, and Compliance with Sick Role Behavior in Elderly Hemodialysis Patients, Master's thesis, Hanyang University, pp. 36, 2008.
  37. Kwak MS, Resilience-related Factors of Dialysis Patient, Master's thesis, Dankook University, pp. 32, 2016.
  38. Cho YM, Seo YH, Park MJ, Relationship between uncertainty in illness, subjective healthy status, and compliance with sick role behavior according to levels of healthy literacy in hemodialysis patients, Korean Society of Adult Nursing, vol. 30, no. 4, pp. 37-446, 2018. DOI: https://doi.org/10.7475/kjan.2018.30.4.437