• Korean Circulation Journal
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• 제52권1호
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• pp.1-33
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• 2022

In primary prevention for cardiovascular diseases, there are significant barriers to adherence including freedom from symptoms, long latency for therapeutic benefits, life-long duration of treatment, and need for combined lifestyle changes. However, to implement more systematic approaches, the focus on adherence improvement needs to be shifted away from patient factors to the effects of the treatment team and healthcare system. In addition to conventional educational approaches, more patient-oriented approaches such as patient-centered clinical communication skills, counseling using motivational strategies, decision-making by patient empowerment, and a multi-disciplinary team approach should be developed and implemented. Patients should be involved in a program of self-monitoring, self-management, and active counseling. Because most effective interventions on adherence improvement demand greater resources, the health care system and educational or training system of physicians and healthcare staff need to be supported for systematic improvement.

• 여성건강간호학회지
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• 제7권3호
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• pp.393-406
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• 2001

The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach $\alpha$ .8176), 8 items of need of education(Chronbach $\alpha$ .8836), 3 items of pain (Chronbach $\alpha$ .9252), and 3 items of discomfort (Chronbach $\alpha$ .8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was $4.25{\sim}4.64$. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain ($r=.752^{**}$) and weak positive correlation between discomforts and the level of educational need($r=.308^*$). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.