• 제목/요약/키워드: Treatment Compliance

검색결과 444건 처리시간 0.021초

폐쇄성 수면무호흡증 환자의 지속적 상기도 양압술 순응도 (Compliance of Nasal Continuous Positive Airway Pressure in Patients with Obstructive Sleep Apnea Syndrome)

  • 최종배;이승희;정도언
    • 수면정신생리
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    • 제13권1호
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    • pp.27-32
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    • 2006
  • 목 적:이 연구는 폐쇄성 수면무호흡증의 치료에 사용되는 지속적 상기도 양압술(nCPAP)의 순응도를 조사하고, 순응도를 좌우하는 요인을 파악하여 치료에 도움이 되게 하고자 시행되었다. 방 법:1995년 1월부터 1999년 4월까지 서울대학교병원 신경정신과 수면다원검사실에서 nCPAP 처방압력 측정 검사를 받은 모든 환자 120명을 대상으로 하였다. 환자들의 의무기록을 열람하여 연령, 성별, 학력, 체중, 신장, 호흡장애지수, 평균 산소포화도, nCPAP 처방 압력, 이비인후과 수술여부, 주간 졸림 여부, 고혈압의 병력 등을 조사하였고, 환자들을 외래에서 직접 면담하거나 주소지로 전화하여 nCPAP의 구입여부, 현재 nCPAP 치료 여부, 사용기간, nCPAP 중단 이유 등을 조사하였다. 결 과:대상 환자 120명 중 83명에서 정보를 얻을 수 있었다. 83명 중 60명은 nCPAP 기기를 구입하였고 23명은 nCPAP을 구입하지 않았는데, nCPAP 기기를 구입한 환자들은 주간 졸림증이 있었고 학력이 높았다. nCPAP 기기를 구입한 60명 중에 지금까지 사용하고 있는 환자들은 26명(43.3%)이었고 나머지 34명(56.7%)은 사용을 중단하였는데, 가장 큰 중단 사유는 마스크의 불편(26.5%)이었고, 그밖에 소리가 시끄러움(17.6%), 다른 방법으로 해결(17.6%), 코가 막히고 입이 마름(11.8%) 등의 순이었다. 치료를 중단한 환자들 중 25명(73.5%)이 치료를 시작한 후 3개월을 넘기지 못하고 중단하였으며, 31명(91.2%)이 1년 내에 그만 두었다. nCPAP을 6개월 미만으로 사용한 25명(41.7%)과 6개월 이상 사용한 35명(58.3%)간에 성별, 연령, 호흡장애지수, 평균산소포화도, 처방압력, 이비인후과 수술 여부, 체질량지수, 고혈압의 병력, 주간졸림 여부, 학력 등을 비교하였는데, 주간 졸림 여부에서만 의미 있는 차이가 있었고, 나머지 변수에서는 차이가 없었다. 결 론:이 연구를 통해서 우리는 nCPAP 순응도가 외국의 연구에 비해 다소 낮고, 초기 주간 졸림의 여부가 nCPAP의 장기 사용에 의미있는 영향을 미친다는 것을 알게 되었다. 또한 초기 3개월 이상 지속적으로 사용하는 환자들이 장기적으로 사용할 가능성이 높았다. 이 결과를 바탕으로 우리는 폐쇄성 수면무호흡증에 nCPAP 치료를 할 때 환자를 적절히 선택하고 교육을 지속적으로 해야 nCPAP 순응도를 높일 수 있다고 제안한다.

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고혈압 환자들의 순응도와 건강행태의 관계 (Study on Health Behavior of Hypertensive Patients and Compliance for Treatment of Antihypertensive Medication)

  • 김주연;이동배;조영채;이석구;장성실;권윤형;이태용
    • 농촌의학ㆍ지역보건
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    • 제25권1호
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    • pp.29-49
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    • 2000
  • 충남 천안시의 30세 이상 인구에서 표본추출된 7,030명 중 조사된 5,372명에 대하여 고혈압의 유병률을 파악하고, 이들 중 의료기관에서 고혈압으로 진단을 받은 후의 치료순응과 행태의 차이를 파악하기 위하여 1998년 10월 16일부터 12월 19일까지 조사한 결과는 다음과 같다. 1. JNC VI의 고혈압 1도 기준에 의한 고혈압 유병률은 남자 49.8%, 여자 38.8%로 남자가 높았으며, 연령별 고혈압 유병률은 남녀 모두 50대까지는 연령이 증가함에 따라 증가하다가 그 이후는 완만하게 증가하는 양상을 보였다. 2. 교육수준별 고혈압 유병률은 남자의 경우 학력에 따라 차이가 크지 않았으나, 여자의 경우 초등학교 이하 49.8%, 중졸 37.6%, 고졸 24.9%, 대졸 19.6%로 학력이 높아질수록 낮아지는 경향을 보였다. 가구당 월평균수입별 고혈압 유병률은 수입에 관계없이 일정하였으며, 직업별 고혈압 유병률은 무직에서 전문·관리직에 비하여 상대적으로 높았다. 비만도별 고혈압 유병률은 남녀 모두 과체중에서 세장형, 정상체중 군에 비하여 높았다(p<0.01). 3. 고혈압 가족력이 있는 군의 고혈압 유병률은 58.5%로 가족력이 없는 군의 46.7% 보다 높았으나(p<0.01), 여자는 가족력이 있는 군이 38.5%, 없는 군이 38.9%로 비슷하였다. 콜레스테롤 수치별 고혈압 유병률은 콜레스테롤의 수치가 240 mg/dl 이상에서 남자 64.0%, 여자 52.4%로 240 mg/dl 미만의 남자 48.9%, 여자 37.6%보다 높았다(p<0.01). 혈당의 고혈압 유병률은 남녀 모두 혈당치가 증가할수록 높아졌고, 200 mg/dl 이상부터는 크게 높아졌다. 4. 의료기관에서 고혈압으로 진단받은 사람 중 치료순응군은 61.1%, 치료비순응군은 38.9%이었으며, 현재의 혈압분포는 고혈압이 치료순응군에서 79.8%, 치료비순응군 81.1%로 두 군이 비슷하였다. 5. 연령별 치료순응도는 남녀 모두 치료순응군이 치료비순응군에 비하여 연령이 많았고, 학력은 치료비순응군에서 높았다(p<0.01). 직업별 치료순응도는 남자의 경우 치료순응군은 무직에서 높았으나, 치료비순응군은 단순 노무, 사무 기술직에서 높았으며(p<0.01), 여자는 직업에 따라 치료순응도의 차이가 없었다. 6. 가구당 월수입별 치료순응도는 남자의 경우 치료비순응군이 치료순응군에 비하여 수입이 높았으며(p<0.01), 여자는 차이가 없었고, 가족력별 치료순응도는 남녀 모두 차이가 없었다. 7. 치료순응과 관련된 행태 중 운동의 규칙성은 남자의 경우 치료순응군이 83.7%, 치료비순응군이 62.2%로 치료순응군에서 높았으나(p<0.05), 여자는 차이가 없었다. 주관적 건강 상태가 나쁘다고 생각하는 경우가 남녀 모두 치료순응군에서 높았으며(p<0.01), 흡연을 하는 사람과 흡연랑은 남자의 경우 치료비순응군에서 높았으며(p<0.01), 여자는 두 군간에 차이가 없었다. 8. 음주를 하는 사람은 남녀 모두 치료비순응군에서 높았으며(p<0.05), 음주횟수는 두 군간에 차이가 없었으며, 체질량지수, 체중측정의 규칙성, 체중조절방법, 운동여부, 육류섭취와 식염섭취, 혈중 콜레스테롤과 혈당은 치료순응도과 관계가 없었다. 9. 치료를 위한 비약물요법 실천은 남자의 경우 치료순응군이 13.2%, 치료비수응군이 2.5%로 치료순응군이 높았으며(p<0.01), 여자도 치료순응군 10.6%, 치료비순응군 0.8%로 치료순응군에서 높았다. 결론적으로 고혈압 유병률이 매우 높아 순환기계질환에 미칠 영향이 매우 클 것이며, 치료순응도에 따른 치료효과를 높이고, 건강증진을 위하여 건강행태변화를 유도하여야 할 것이다. 그러므로 이를 위한 보건교육과 홍보 등의 확대와 지속적인 관리대책을 세우는 것이 필요하다고 본다.

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『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 대황황련사심탕(大黃黃連瀉心湯) 투여 후 혈압이 안정된 고혈압 증례 보고 (Efficacy of Daehuanghuanglianxiexin-tang in stabilization of hypertension patient's blood pressure)

  • 최재영;이숭인;이성준
    • 대한상한금궤의학회지
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    • 제10권1호
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    • pp.125-132
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    • 2018
  • Objective : The purpose of this study is to review a case of hypertension. The patient was 41 years, a male. We stabilized blood pressure after administration of Daehuanghuanglianxiexin-tang. In this paper, we review the interpretation of Shanghanlun by analyzing the patient's progress, diagnosis, treatment. Methods : Blood pressure changes have been monitored during the period. Additionally, We have observed the patients' compliance and accompanied symptom by the timeline analysis. Results : According to Shanghanlun disease pattern identification diagnostic system, Wediagnosed a Greater yang disease. The patient was treated with Daehuanghuanglianxiexin-tang for 2 months. Daehuanghuanglianxiexin-tang was able to control blood pressure to under 120mmhg / 80mmhg. During the treatment period, the accompanied symptom Stiffness and pain in posterior neck has improved, patient's compliance was good, and symptoms improved without significant complication Conclusions : Taking of the Daehuanghuanglianxiexin-tang makes patient's blood pressure controlled to safe and stable range and eases the discomfort of posterior neck pain.

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신장이식환자를 위한 능력증강교육프로그램 효과 (The Effects of an Empowerment Education Program for Kidney Transplantation Patients)

  • 김성희;유혜숙
    • 대한간호학회지
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    • 제47권4호
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    • pp.445-455
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    • 2017
  • Purpose: This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance. Methods: The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes. Results: Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84, p=<.001) and 4 weeks after (t=-4.51 p=<.001) the program, whereas self-care ability (t=5.81, p=<.001), (t=5.84, p=<.001) and compliance (t=5.07, p=<.001), (t=5.45, p=<.001) were significantly higher. Conclusion: Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients.

환경보강 유방자가검진 프로그램의 효과 (The Effects of Breast Self-examination Program Enriched Environmentally among Healthy Women)

  • 박경연;김소희
    • 여성건강간호학회지
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    • 제16권2호
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    • pp.105-115
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    • 2010
  • Purpose: The purpose of this study was to determine the effects of an environmental enrichment program on barrier, benefit, confidence, and compliance of breast self-examination in women at 3 months after instruction. Methods: Nonequivalent control group pretest-posttest design was conducted among 62 healthy women. Data were collected through the self-reported questionnaires from December 2008 to March 2009. Women were assigned to one of two treatment groups: (a) no-support of environmental enrichment with the instruction control group; (b) the support of environmental enrichment with the instruction experimental group. All women received the same instruction on breast self-examination once a week for two weeks. Data were analyzed with paired t-test, McNemar test and ANCOVAs of controlling for age run using SPSS/WIN 17.0. Results: The experimental group was significantly lower than control group on perceived barrier (F=5.91, p=.02) and higher than control group on compliance of breast self-examination (F=4.57, p=.04) after environmental enrichment program. However the environmental enrichment program did not make significant differences on benefit (F=0.01, p=.91) and confidence (F=0.77, p=.38). Conclusion: Findings suggest that the environmental enrichment should be needed to support women's breast self-examination and expanded for compliance of breast self-examination to promote the secondary prevention of women breast cancer.

냉매부문 온실가스 감축을 위한 외부감축사업 활용에 관한 조사 연구 - CDM, 캘리포니아 상쇄제도를 중심으로 - (A Study on the Application of Offset Project for GHG Emission Reduction in Refrigerant Sector - CDM, California Compliance Offset Program -)

  • 박연화;인은정;김홍록
    • 한국기후변화학회지
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    • 제7권3호
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    • pp.283-288
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    • 2016
  • In this study, applicability of GHG ETS Offset Program in Korea for a refrigerant sector was analyzed by reviewing foreign management policy and project status in progress related to refrigerants in the disposal stage. In order to derive the implication of the domestic Offset Program, it was looked into approved offset projects and certified offset credits current state in Korea. Offset Program has approved 22 methodologies up to the present, so it is necessary to enhance the accessibility to GHG reduction in various industrial sector including the refrigerant sector by developing appropriate methodologies. In this study firstly, it was investigated that management regulation of countries are managing the refrigerants in the disposal stage such as United States, Japan, Australia. Secondly, of CDM methodologies there were two methodologies associated with the refrigerant reduction(treatment), which were decomposition HFC-23 and destruction of HFC-134a. Also there were a non-registered methodology about destruction of HFC-134a of end of life vehicles. Lastly, in California according to Compliance Offset Program, there was Compliance Offset Protocol in ODS Projects that provided eligible conditions. Based on the review, it was examined the possible conditions for domestic offset project for refrigerant sector

간호대학생의 중동호흡기증후군에 대한 지식, 태도 및 예방행위 실천 간의 관계 (Correlation between Knowledge, Attitude, and Compliance of Preventive Behaviors regarding Middle East Respiratory Syndrome among Nursing Students)

  • 박진희;장수정;최수진
    • Journal of Korean Biological Nursing Science
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    • 제20권4호
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    • pp.252-260
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    • 2018
  • Purpose: This study aimed to investigate the relationships between the level of knowledge, attitude and compliance of preventive behaviors of the Middle East respiratory syndrome (MERS) among nursing students. Methods: The study sample consisted of 219 nursing students. Through the use of a structured questionnaire, data collection was conducted from June 1st to June 30th 2015. The descriptive statistics, independent t-tests and Pearson's correlation coefficient were employed to analyze the data. Results: The score of the MERS-related knowledge was 9.15 out of 13. The participants had a positive attitude toward the MERS. The level of MERS-related knowledge was high in the case of temporary school closure or break in clinical practice because of the clinical training in hospitals that MERS occurred (t= 2.42, p= .016). The compliance level of the preventive behavior for MERS was high in female students (t= -2.11, p= .036), in the case of temporary school closure or break in clinical practice due to the clinical training in hospitals that MERS occurred (t = 3.29, p= .001), and in students that had MERS-related education for prevention (t = 2.80, p= .006). The MERS-related knowledge was positively correlated with the level of compliance for preventive behavior (r= .18, p= .009). Conclusion: To prevent MERS infection in nursing students, the level of knowledge on MERS should be enhanced so that they can practice preventive behaviors against it. Additionally, the MERS infection control education should include etiology and treatment products based on the MERS response guideline issued by the Centers for Korea Disease Control and Prevention.

국제투자분쟁에서 중재사례를 통해 본 공정.공평대우의 기준 (The Fair and Equitable Treatment Standards through the Arbitral Award Cases under International Investment Disputes)

  • 최영주;황지현
    • 무역상무연구
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    • 제57권
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    • pp.61-78
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    • 2013
  • The purpose of this study is to clarify the standard of fair and equitable treatment. Although most international investment treaties prescribe fair and equitable treatment that is the obligation to provide fair and equitable treatment to foreign investor, there is no clear definition and specific elements of fair and equitable treatment. Through the arbitral award cases we can find that tribunals have interpreted to include six principles; Due process & Protection from denial of justice, Good faith, Reasonableness & Nondiscrimination, Compliance with contractual obligation, Full protection and security, Transparency & Protection of the investor's legitimate expectations. This study suggest that host countries and investors focus on international trends concerning investment disputes in order to avoid future disputes. So future disputes can be prevented and prepared in advance.

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이온 실화처리한 Ni-Cr-Mo강의 저온파괴인성에 관한 연구 (A Study on the Low Temperature Fracture Toughness of Ion-nitrided Ni-Cr-Mo Steel)

  • 오세욱;윤한기;문인철
    • 한국해양공학회지
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    • 제1권2호
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    • pp.101-112
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    • 1987
  • Fracture toughness characterization in the transition region is examined for heat-treated and ionnitrided Ni-Cr-Mo steel. After heat treatment for the specimens of Ni-Cr-Mo steel, organizations of specimens-specimens which are heat-treated and ion-nitrided for 4 hours at 500 .deg. C and 5 torr in 25%N/dub 2/-75%H/sub 2/mixed gas-, hardness variety, and X-ray diffraction pattern of the ion-nitriding compound layer are observed. Fracture toughenss test of unloading compliance method were conducted over the regions from room trmperature to -70.deg. C. The compound layer was consisted of r'=Fe/sub 4/N phase and ion-nitrided layer's depth was 200mm from surface. The transition regions of heat-treated and ion-nitrided specimens were about -30.deg. C and -50.deg. C, respectively. The transition region of ion-nitrided specimens is estimated less than that of heat-treated one, and this is the effect of ion-nitriding.

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유비쿼터스 투약 감시를 위한 스마트 투약 팩 (A Smart Drug/Medicine Pack for u-Medication Monitoring)

  • 박장환;이태수;김영철
    • 제어로봇시스템학회논문지
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    • 제12궈1호
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    • pp.23-27
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    • 2006
  • As a pervasive healthcare application to help medication of elderly patients, the smart compliance monitors have been recently proposed. In this paper, we present a new smart drug/medicine pack (SDP) for ubiquitous medication monitoring, for which the packaging is either paper packet or blister pack. This ubiquitous compliance monitor is composed of several SDPs and a Bluetooth equipped PDA phone. The SDP is a wireless module that monitors the medication consumption unobtrusively by transmitting the sensed data of 'drug removal' events to the medical center and by reminding patients when they take a dose on their mobile phone. The communication between SDP modules and PDA is realized via Bluetooth. The PDA is basically embedded to indicate the medication record and to alert every prescribed medication time during treatment. Experimental results show that the proposed system works exactly when the SDPs are far within about 2 [m] from PDA.