• Title/Summary/Keyword: Adherence of outpatient treatment

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A Study of Effectiveness of Outpatient Treatment Orders and Compliance with Outpatient Treatment (외래치료 명령제의 실효성과 외래 치료 순응도에 관한 연구)

  • Jang, Seung-Ho;Park, In-Hwan;Lee, Sang-Yeol;Roh, Suhee;Seo, Jeong-Seok
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.46-55
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    • 2017
  • Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

Validation of the Korean Version of the End-Stage Renal Disease Adherence Questionnaire (한국어판 말기신부전 환자의 치료순응도 측정 도구의 타당도와 신뢰도 검증)

  • Kim, Youngmee;Park, Young Mi
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.307-316
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    • 2012
  • Purpose: The purpose of this study was to develop and test psychometric properties the Korean version of the End-Stage Renal Disease Adherence Questionnaire (KESRD-AQ). The ESRD-AQ, a 46-item, multidimensional, self-administrated questionnaire which was developed to assess treatment adherence to hemodialysis (HD) attendance, medications, fluid restrictions, and diet prescription among patients on maintenance hemodialysis, has been validated. Methods: The KESRD-AQ was developed by performing both translation and backtranslation. The content validity and test- retest reliability of the KESRD-AQ were evaluated by establishing item-level content validity index (I-CVI) and intra-class correlation coefficients (ICC), respectively. Construct validity was assessed by adopting a known-group analysis comparing adheres and non-adherers using Mann-Whitney U Test. Results: 41 Korean-American patients with ESRD on HD from 3 outpatient dialysis centers in California participated in the study. The KESRD-AQ showed excellent content validity (average I-CVI=.96) and test-retest reliability (ICC=.917, p=.004). The construct validity indicated that the KESRD-AQ distinguished adheres and non-adheres (p=.02~.047). Conclusion: The KESRD-AQ is a valid and reliable instrument to measure treatment adherence.

Factors Affecting Patient Experience with Outpatient Care (외래 환자경험에 영향을 주는 요인)

  • Kim, Kyoung-Hoon
    • Health Policy and Management
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    • v.31 no.2
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    • pp.207-216
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    • 2021
  • Background: Good patient experience is positively associated with adherence to treatment recommendations, better clinical effectiveness, and health outcomes. This study aims to find out the key factors affecting positive patient experience to improve the quality of care using nationally representative survey data. Methods: The data was collected from the 6th National Health Nutrition Survey in 2015. Four patient experience items were investigated for patients with visiting outpatient care over the past year. Positive patient experience was defined as a case of responding always or usually yes. The t-test, chi-square test, and multiple logistic regression were performed to determine the key factors affecting the outpatient experience. Results: More than 80% of the respondents reported their care experience as positive excluding doctor spending enough time during the consultation. Male, poor health status, and single/divorced, and the longer time interval between outpatient care visit and survey were found to be significantly correlated with negative care experiences in the multiple logistic regression. Patients who received outpatient care at the oriental medicine clinic had a positive experience compared to those received outpatient care at the general hospital. However, patient factors including age, income, job, and insurance type had no significant association with patient experience. Conclusion: Health care providers should prioritize patients who report negative patient experiences and implement management decisions to improve the patient experience.

Factors Affecting Treatment Adherence of Kidney Transplantation Recipients (신장이식 환자의 치료지시이행에 영향을 미치는 요인)

  • Lee, Jung A;Kim, Young A;Cho Chung, Hyang-In
    • The Journal of the Korea Contents Association
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    • v.19 no.2
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    • pp.619-628
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    • 2019
  • This study is an explanatory research conducted to analyze the influencing factors of treatment adherence in kidney transplant recipients. The subjects were 132 renal transplant recipients who visited the outpatient department in a university hospital. Data were collected from July 17, 2017, to August 22, 2017, and analyzed using SPSS WIN 24.0. Frequency, percentage, mean and standard deviation, variance analysis, correlation, and regression analysis were performed. The results of the study showed that there was a significant difference in the treatment adherence based on the age, religion, and the time passed since kidney transplantation. The study also found that the treatment adherence had significant positive correlations with social support (r=.54, p<.001), family support (r=.43, p<.001), health provider's support (r=.57, p<.001), and self-care knowledge (r=.21, p=.015). The factors influencing the treatment adherence were health provider's support, the time passed since kidney transplantation, spouse, and religion. The final explanatory power of the model was 41.9%. In conclusion, intervention strategies should be introduced to promote the support of healthcare providers in order to improve the adherence of the kidney transplantation patients.