DOI QR코드

DOI QR Code

복합만성질환을 가진 노인의 우울, 사회적지지가 약물복용이행에 미치는 영향

Impact of Depression and Social Support on Medication Adherence in Older Adults with Multimorbidity

  • 김지은 (대전보훈병원.아주대학교 간호대학) ;
  • 박진희 (아주대학교 간호대학.간호과학연구소) ;
  • 유미애 (아주대학교 간호대학.간호과학연구소) ;
  • 서은지 (아주대학교 간호대학.간호과학연구소)
  • Kim, Ji Eun (Daejeon Veterans Hospital, Daejeon.Ajou University College of Nursing) ;
  • Park, Jin-Hee (College of Nursing.Research Institute of Nursing Science, Ajou University) ;
  • You, Mi Ae (College of Nursing.Research Institute of Nursing Science, Ajou University) ;
  • Seo, Eun Ji (College of Nursing.Research Institute of Nursing Science, Ajou University)
  • 투고 : 2022.08.05
  • 심사 : 2022.08.29
  • 발행 : 2022.08.31

초록

Purpose: Medication adherence in older adults with multimorbidity is critical for self-care. The purpose of this cross-sectional study was to identify the factors that influence medication adherence in older adults with multimorbidity. Methods: The patients were 116 adults 65 or older with three or more chronic diseases. The data were collected from December 2020 to April 2022 in outpatient clinics at a hospital in Daejeon. Results: The mean scores of depression, social support, and medication adherence were 16.18± 6.74 (of 30), 41.06± 6.56 (of 60), and 4.69± 1.85 (of 8) points, respectively. Patients with low adherence comprised the most with 75 patients (64.7%). Influencing factors on medication adherence were depression (β= -.35, p= .007) and family support among social support (β= .29, p= .006). Conclusion: Among older adults with multimorbidity, lower depression as well as higher family support, results in higher medication adherence. It is necessary to develop a practical strategy toward improving medication adherence, by sensitively managing the degree of depression, as well as strengthening family support.

키워드

참고문헌

  1. Shin SR. Age differences in the financial burden of catastrophic healthcare expenditure between young-old and old-old. Journal of the Korea Consumer Agency. 2019;50(2):89-120. http://doi.org/10.15723/jcps.50.2.201908.89
  2. Korea Centers for Disease Control and Prevention. Chronic disease status and issues-1st ed [Internet]. Cheongju: Korea Centers for Disease Control and Prevention; 2018 [cited 2022 May 29]. Available from: https://www.kdca.go.kr/board/board.es?mid=a20602010000&bid=0034&cg_code=C15.
  3. Statistics Korea. 2021 Senior citizen statistics [Internet]. Daejeon: Statistics Korea; 2021[cited 2022 May 29]. Available from: https://kostat.go.kr/wnsearch/search.jsp.
  4. World Health Organization. World health statistics 2017: monitoring health for the SDGs, sustainable development goals [Internet]. Geneva: World Health Organization; 2017 [cited 2022 May 26]. Available from: https://www.who.int/publications/i/item/9789241565486.
  5. Korea Institute for Health and Social Affairs. Survey on the condition of the elderly in 2020 [Internet]. Sejong: Korea Institute for Health and Social Affairs; 2020 [cited 2022 May 12]. Available from: https://www.kihasa.re.kr/publish/report/view?type=policy&seq=37736.
  6. Jeong HJ, Bae JH. The influence of health literacy and social-support on medication adherence in eldery with chronic disease. Journal of Digital Convergence. 2018;16(7):419-428. https://doi.org/10.14400/JDC.2018.16.7.419
  7. Parker L, Moran GM, Roberts LM, Calvert M, McCahon D. The burden of common chronic disease on health-related quality of life in an elderly community-dwelling population in the UK. Family Practice. 2014;31(5):557-563. http://doi.org/10.1093/fampra/cmu035
  8. Tourkmani AM, Al Khashan HI, Albabtain MA, Al Harbi TJ, Al Qahatani HB, Bakhiet AH. Medication adherence among patients in a chronic disease clinic. Saudi Medical Journal. 2012;33(12):1278-1284.
  9. Gater A, Heron L, Abetz-Webb L, Coombs J, Simmons J, Guilhot F, et al. Adherence to oral tyrosine kinase inhibitor therapies in chronic myeloid leukemia. Leukemia Research. 2012;36(7):817-825. http://doi.org/10.1016/j.leukres.2012.01.021
  10. Al-Ramahi R. Adherence to medications and associated factors: a cross-sectional study among Palestinian hypertensive patients. Journal of Epidemiology and Global Health. 2015;5(2):125-132. http://doi.org/10.1016/j.jegh.2014.05.005
  11. Jung SJ, Tak SH. Medication non-adherence and related factors of older adults who use polypharmacy based on medication adherence model. The Journal of the Korea Contents Association. 2019;19(12):398-406. http://doi.org/10.5392/JKCA.2019.19.12.398
  12. Malhotra S, Karan RS, Pandhi P, Jain S. Drug related medical emergencies in the elderly: role of adverse drug reactions and non-compliance. Postgraduate Medical Journal. 2001;77(913):703-707. http://doi.org/10.1136/pmj.77.913.703
  13. Ma C. A cross-sectional survey of medication adherence and associated factors for rural patients with hypertension. Applied Nursing Research. 2016;31:94-99. http://doi.org/10.1016/j.apnr.2016.01.004
  14. Park SM, Kang YH. Symptom experience, self-efficacy, depression, and medication adherence in patients with chronic obstructive pulmonary disease. Journal of Korean Clinical Nursing Research. 2017;23(2):170-178. http://doi.org/10.22650/JKCNR.2017.23.2.170
  15. Gu L, Wu S, Zhao S, Zhou H, Zhang S, Gao M, et al. Association of social support and medication adherence in chinese patients with type 2 diabetes mellitus. International Journal of Environmental Research and Public Health. 2017;14(12):1522. http://doi.org/10.3390/ijerph14121522
  16. Tang HY, Sayers SL, Weissinger G, Riegel B. The role of depression in medication adherence among heart failure patients. Clinical Nursing Research. 2014;23(3):231-244. http://doi.org/10.1177/1054773813481801
  17. Grenard JL, Munjas BA, Adams JL, Suttorp M, Maglione M, McGlynn EA, et al. Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis. Journal of General Internal Medicine. 2011;26(10):1175-1182. http://doi.org/10.1007/s11606-011-1704-y
  18. Eisele M, Harder M, Rakebrandt A, Boczor S, Marx G, Blozik E, et al. Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study. Family Practice. 2020;37(5):695-702. http://doi.org/10.1093/fampra/cmaa042
  19. Turan GB, Aksoy M, Ciftci B. Effect of social support on the treatment adherence of hypertension patients. Journal of Vascular Nursing. 2019;37(1):46-51. http://doi.org/10.1016/j.jvn.2018.10.005
  20. Kim HK, Choi MN, Kim SS. Self-care, social support, and biological markers in liver transplant recipients. Korean Journal of Adult Nursing. 2015;27(2):170-179. http://doi.org/10.7475/kjan.2015.27.2.170
  21. Jeon HO, Kim BY, Kim HS, Chae MO, Kim MA, Kim AR. Factors influencing medication adherence and status of medication use of the elderly with chronic disease taking non-opioid analgesics. Journal of Korean Biological Nursing Science. 2017;19(1):18-29. http://doi.org/10.7586/jkbns.2017.19.1.18
  22. Sheikh JI, Yesavage JA. 9/Geriatric depression scale (GDS): recent evidence and development of a shorter version. Clinical Gerontologist. 1986;5(1-2):165-173. http://doi.org/10.1300/J018v05n01_09
  23. Jung IK, Kwak DI, Joe SH. A study of standardization of Korean form of geriatric depression scale (KGDS). Journal of Korean Geriatirc Psychiatry. 1997;1(1):61-72.
  24. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. Journal of Personality Assessment. 1988;52(1):30-41. http://doi.org/10.1207/s15327752jpa5201_2
  25. Shin JS, Lee YB. The effects of social supports on psychosocial well-being of the unemployed. Korean Journal of Social Welfare. 1999;37:241-269.
  26. Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. Journal of Clinical Hypertension. 2008;10(5):348-354. http://doi.org/10.1111/j.1751-7176.2008.07572.x
  27. Min SH, Kim JI. Construction of explanatory model for medication adherence in older people with chronic disease. Journal of Korean Academy of Fundamentals of Nursing. 2012;19(4):463-473. https://doi.org/10.7739/jkafn.2012.19.4.463
  28. Al-Hajje A, Awada S, Rachidi S, Zein S, Bawab W, El-Hajj Z, et al. Factors affecting medication adherence in Lebanese patients with chronic diseases. Pharmacy Practice. 2015;13(3):590. http://doi.org/10.18549/PharmPract.2015.03.590
  29. Kim JH, Lee SH. Polypharmacy in geriatrics and beers criteria. Korean Journal of Family Practice. 2020;10(6):407-417. https://doi.org/10.21215/kjfp.2020.10.6.407
  30. Jeong HS, Kim OS. Anxiety, depression and health behavior of elderly with chronic diseases. Health & Nursing. 2013;25(2):35-46.
  31. Pruchno RA, Wilson-Genderson M, Heid AR. Multiple chronic condition combinations and depression in community-dwelling older adults. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. 2016;71(7):910-915. http://doi.org/10.1093/gerona/glw025
  32. De Maria M, Vellone E, Durante A, Biagioli V, Matarese M. Psychometric evaluation of the multidimensional scale of perceived social support (MSPSS) in people with chronic diseases. Annali dell'Istituto Superiore di Sanita. 2018;54(4):308-315. http://doi.org/10.4415/ANN_18_04_07
  33. Kim NH, Lim SY. Convergence study on diabetes self-management knowledge, social support, educational needs of the diabetes in rural elderly. Journal of the Korea Convergence Society. 2017;8(3):79-89. http://doi.org/10.15207/JKCS.2017.8.3.079
  34. Lim JH. The relationship among depressive symptoms and chronic diseases in the elderly. Journal of Digital Convergence. 2014;12(6):481-490. http://doi.org/10.14400/JDC.2014.12.6.481
  35. Warner LM, Schuz B, Aiken L, Ziegelmann JP, Wurm S, Tesch-Romer C, et al. Interactive effects of social support and social conflict on medication adherence in multimorbid older adults. Social Science & Medicine. 2013;87:23-30. http://doi.org/10.1016/j.socscimed.2013.03.012
  36. Lee JI, Kim SY. Factors influencing death anxiety in the aged. Journal of Korean Public Health Nursing. 2011;25(1):28-37. http://doi.org/10.5932/JKPHN.2011.25.1.028
  37. Kim YJ. The Effects of an education program on the knowledge of medication and prevention of depression in the elderly with chronic disease at a local community. Journal of Korean Academy of Community Health Nursing. 2011;22(4):399-408. https://doi.org/10.12799/jkachn.2011.22.4.399
  38. Ruppar TM, Delgado JM, Temple J. Medication adherence interventions for heart failure patients: a meta-analysis. European Journal of Cardiovascular Nursing. 2015;14(5):395-404. http://doi.org/10.1177/1474515115571213
  39. Yu SH, Kang JH. Effects of a medication adherence promotion program in breast cancer patients under adjuvant hormonal therapy. Korean Journal of Adult Nursing. 2020;32(3):223-234. https://doi.org/10.7475/kjan.2020.32.3.223