• Journal of Korean Academy of Nursing
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• v.46 no.4
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• pp.598-609
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• 2016

Purpose: The purpose of this study was to examine effects of a dietary program based on self-efficacy theory on dietary adherence, physical status and quality of life (QoL) in hemodialysis patients. Methods: A non-equivalent control group pre-post test design was used. The intervention group received the dietary program for 8 weeks from August 4 to September 26, 2014. The control group received only usual care. Results: ANCOVA showed that dietary adherence (F=64.75, p <.001) was significantly different between the two groups. Serum albumin (F=12.13, p =.001), interdialytic weight gain (F=56.97, p <.001), calories (F=15.80, p <.001) as physical status indices were significantly different, but serum potassium (F=2.69, p =.106) and serum phosphorus (F=1.08, p =.303) showed no significant difference between the two groups. In terms of health-related QoL, the physical component scale (F=10.05, p =.002) and the mental component scale (F=16.66, p <.001) were significantly different between the two groups. In addition, in terms of diet related QoL, diet level (F=35.33, p <.001) and satisfaction level (F=15.57, p <.001) were significantly different between the two groups, but dietary impact level (F=1.23, p =.271) was not significantly different. Conclusion: Findings show that the dietary program based on self-efficacy theory is an effective nursing intervention program to improve adherence to diet, and to maintain physical status and QoL for hemodialysis patients.

• 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.

• Journal of agricultural medicine and community health
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• v.40 no.1
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• pp.9-20
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• 2015

Objectives: This study aimed to explore the persistence and adherence to secondary preventive medication of stroke patients after discharge and to assess the reasons for persistence and nonadherence. Methods: Four hundred twenty-nine patients with stroke were surveyed to determine their behaviors from discharge. Reasons for stopping medications were ascertained. Persistence was defined as continuation of all secondary preventive medications prescribed at hospital discharge, and adherence as continuation of prescribed medications according to health care provider instructions. Results: Of the 429 patients, 86.5% were treatment persistent and 41.2%(non-intentional nonadherence=39.4%, intentional nonadherence=19.4%) were adherent. Independent predictors of persistence included having experience about health education. Independent predictors of non-intentional nonadherence were modified Rankin Scale(mRS) (Exp(B)=2.858, p=0.001) and health education experience (Exp(B)=0.472, p=0.032), and independent predictors of intentional nonadherence were mRS (Exp(B)=2.533, p=0.006), depressive symptoms (Exp(B)=1.113, p=0.016), beliefs about medications questionnaire(necessity, Exp(B)=0.879, p=0.011, concern, Exp(B)=1.098, p=0.019). Conclusions: Although up to one-ninth of stroke patients continued secondary prevention medications, nonadherence is common. Several potentially modifiable patient, provider, and system-level factors associated with persistence and adherence may be targets for future interventions. Specially, interventions to improve adherence should target patients' beliefs about their medication.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.364-372
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• 2010

Purpose : Good adherence of caregivers is essential for successful health outcomes in the treatment of childhood asthma. The purpose of this study was to identify the factors contributing to good adherence of maintenance treatment in children with well-controlled asthma. Methods : Children with well-controlled asthma being treated with a daily controller for at least 3 months in Korea University Anam Hospital were selected. Their caregivers who had good adherence to maintenance treatment were recruited. Qualitative study through in-depth interviews was conducted with 18 caregivers who agreed to the study. Results : The 18 caregivers (mean age, 40.0 years) consisted of 15 mothers, 2 grandmothers, and 1 father. The resulting consensus were identified and grouped into 2 domains: the caregiver/patient aspect with 8 theme factors and the treatment aspect with 4 theme factors. The main theme factors in the caregiver/patient aspect were enabling participation in physical activities and exercise (77.8%), perceptions regarding asthma and the need for long-term treatment (50.0%), and perceived value of the medications outweighing the risk of side effects (38.9%). The main theme factors in the treatment aspect were trust in the physician (77.8%), general satisfaction with the manner and attitude of the physician (77.8%) and verification of the necessity of further treatment by performing tests (38.9%). Conclusion : Efforts to improve caregivers' adherence to the treatment of childhood asthma must include a range of factors related to both caregiver/patient aspects and treatment aspects. Among all of these factors, it may be most important to establish a physician-caregiver partnership.

• Journal of the Korean Data and Information Science Society
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• v.28 no.5
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• pp.1027-1041
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• 2017

Hyperlipidemia, the status of blood with high level of low-density lipoprotein cholesterol (LDL-C), is known as a main cause of coronary artery diseases such as myocardiac infarction or brain infarct. Statin is the representative prescription to hyperlipidemia and the effects of it depend on the patient's individual conditions such as health-caring habits or adherence to medication. The main effect of statin is reducing LDL-C, which should reach the target range based on National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) guideline. In this research, the reduction of LDL-C and attainment to patient's target range are considered effects of statin. The association between factors - individual conditions and adherence to medication of patients - and the effects of statin is analyzed with National Health Insurance Service-National Sample Cohort (NHIS-NSC).

• Journal of Periodontal and Implant Science
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• v.46 no.4
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• pp.266-276
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• 2016

Purpose: The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease. Methods: Overall, 103 patients referred for implant treatment from 2000 to 2012 were randomly enrolled. The study sample consisted of 421 conventional-length (>6 mm) non-turned titanium implants that were evaluated clinically and radiographically according to preestablished clinical and patient-related parameters by a single investigator. A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level. Results: The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 (41.1%) and 19 (4.5%) implants, respectively. Age (${\geq}65$ years), patient adherence (professional hygiene recalls <2/year) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores. The logistic regression analysis indicated that age (P=0.001), patient adherence (P=0.03), the absence of keratinized tissue (P=0.03), implants placed in pristine bone (P=0.04), and the presence of peri-implant soft-tissue recession (P=0.000) were strongly associated with the event of peri-implantitis. Conclusions: Within the limitations of this study, patients aged ${\geq}65$ years and non-adherent subjects were more prone to develop peri-implant disease. Therefore, early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health, especially in older patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.133-137
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• 2014

Background: Today, breast cancer is increasing in nearly all societies. Currently, cancers are the third leading cause of death in Iran after cardiovascular diseases and accidents. Of the cancers, breast cancer is spreading particularly rapidly among Iranian women. Negative effects of discontinuation of care on patient survival have been well documented. Inhibiting or facilitating factors affecting continuity of care at different stages of the patient care continuum should be identified. Materials and Methods: The current study implemented a qualitative method that provided tools to examine factors in detail. This study was conducted on 22 women, undergoing surgery and chemotherapy after being diagnosed with breast cancer. Content analysis was the technique adopted. Results: The effective factors in continuity of care from the patients' perception, based on the participant statements, were classified into three categories of evaluation of symptoms, psychological reactions, and care triggers with several subcategories. Conclusions: According to the outcomes of the current study, it can be noted that, the patient experiences can be brought into use by health-care professionals and assist them in providing patient sand their families with adequate consulting services. It can also provide an opportunity for making interventions tailored to the community culture, and closer adherence of patients to the prescribed treatments.

• Journal of Korean Academy of Nursing
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• v.46 no.6
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• pp.881-893
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• 2016

Purpose: The purpose of this study was to develop a heart health diary to promote self-care ability among patients with heart failure (HF), and to identify the diary's effect on self-care adherence, self-efficacy, and physical activity. Methods: A randomized control-group pretest-posttest design was adopted using block randomization. A calender-typed health diary was developed and it included a self-care checklist and education information on HF management. The experimental group were given guided counseling and education for 8 weeks and wrote a daily health diary during that period. Data were collected from the outpatient department of a tertiary medical center from February to April 2016. To verify the hypotheses, data for the experimental group (n=28) and control group (n=33) were analysed using the independent t-test with SPSS/WIN 21.0. Results: At the end of 8 weeks the experimental group had significantly higher scores for self-care adherence (t=-2.48, p =.016) and exercise related self-efficacy (t=-3.44, p =.001) compared to the control group. Conclusion: The findings show that the application of a patient-directed heart health diary is an effective nursing intervention for improving HF patients' self-care adherence and exercise self-efficacy. Strategies to promote dietary self-efficacy are necessary along with further studies including repeated research with an increasing intervention period. Healthcare providers need to encourage the utilization of a health diary for HF patients as a tool for evaluation and for implementation that leads to self-care.

• Research in Community and Public Health Nursing
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• v.23 no.4
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• pp.438-445
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• 2012

Purpose: Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not. Methods: A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system. Results: After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not. Conclusion: This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

• The Journal of Korean Medicine
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• v.41 no.2
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• pp.80-95
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• 2020

Objectives: The purpose of this study is to assess the quality of the Journal of Korean medicine case reports. Methods: Case reports published in the Journal of Korean Medicine from January 2015 to March 2020 were selected by using Oriental Medicine Advanced Searching Integrated System (OASIS) and the journal search system of the Korean Medical Association (https://www.jkom.org). The quality of the case reports was assessed using the Consensus-based Clinical Case Reporting Guideline Development (CARE) guidelines. Results: 33 case reports were selected for the assessment. Based on the CARE guidelines, 61.54% of the case reports included necessary information, but the quality level was uneven. More than 60% of the reports were missing data regarding 'Discussion of the strengths and limitations in your approach to this case', 'Intervention adherence and tolerability', 'Timeline', 'Medical, family, and psychosocial history including relevant genetic information', 'Patient perspective or experience', 'Adverse and unanticipated events', 'Administration of intervention', and 'De-identified demographic information and other patient specific information'. In most reports of over 90%, data regarding 'Diagnostic challenges', 'Intervention adherence and tolerability', and 'Key word' were not included. Conclusions: Efforts are needed to improve the quality of case reports in the Journal of Korean Medicine, and it is necessary to develop appropriate guidelines for case reporting for the Journal of Korean Medicine. In addition, all articles submitted to the Journal of Korean Medicine are to be complied with submission instructions and CARE guidelines.