• 제목/요약/키워드: Treatment Compliance

검색결과 444건 처리시간 0.024초

Comparison of Treatment Compliance and Nutritional Outcomes among Patients with Nasopharyngeal Carcinoma with and without Percutaneous Endoscopic Gastrostomy during Chemoradiation

  • Peerawong, Thanarpan;Phungrassami, Temsak;Pruegsanusak, Kovit;Sangthong, Rassamee
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5805-5809
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    • 2012
  • Aims: The study aimed to compare treatment compliance and nutritional outcomes in nasopharyngeal carcinoma (NPC) patients during chemoradiation. Methods: Clinical information of patients with NPC that underwent chemoradiation during 2004-2009 were retrieved from the hospital database and retrospectively reviewed. Patients were categorised into a prophylactic percutaneous endoscopic gastrostomy (PPEG) group and a non-PPEG group. Clinical information including treatment compliance, weight, haematological and renal toxicity was compared. Results: A total of 219 patients were reviewed and categorised into PPEG (n=77) and non-PPEG (n=142). Significant differences in absolute percentage weight loss between groups were found from the $3^{rd}$ cycle of chemotherapy. There were 24.2, 20.3 and 24.8% in the third, the fourth and the fifth cycles of chemotherapy, respectively. Migration of grade 2 to grade 3 weight loss was obviously seen in the $3^{rd}$ cycle as well. A significant difference of grade 3 or more hypokalemia was found with values of 14.3% and 50% in the PPEG and non-PPEG groups, respectively. Other toxicity parameters and treatment compliance were not different between the groups. Conclusions: Use of PPEG resulted in decreased severe weight loss, reduced migration from grade 2 to grade 3 weight loss and reduced hypokalaemia. However, benefits in treatment compliance could not be detected. So consideration of PPEG in NPC patients requires care.

유역하수도 공공하수처리시설의 방류수 수질 준수농도 설정방안 연구: 진위천 수계를 중심으로 (A study on Determination Method of the Compliance Concentration of Effluent Limitation from Public Sewage Treatment Works in the Jinwee-stream Watershed Sewer System)

  • 정동환;조양석;김영석;안경희;정현미;권오상
    • 상하수도학회지
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    • 제29권4호
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    • pp.493-502
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    • 2015
  • In accordance with the Watershed Sewer System Maintenance Plan enforced on February 2, 2013, the different compliance concentration of effluent limit be applied to effluent discharged from public sewage treatment works(PSTWs) in each watershed on the basis of water quality thereof. With the introduction of watershed sewer system, it is necessary to set the compliance concentration of effluent limit for PSTWs situated in the watershed, by region and PSTW size, to achieve water quality criteria for regional watersheds or target water quality under TMDL program. Watershed Environmental Agencies establish the Watershed Sewer System Maintenance Plan and set the compliance concentrations of effluent limit for PSTWs under the plan. The agencies plan to apply tougher effluent BOD concentration limits in Class I to IV areas. Effluent BOD concentration limits will be toughened from 5~10 mg/L to 3 mg/L in class II~III areas, from 10mg/L to 5mg/L in class IV areas. Uniform application of effluent BOD concentration limits to PSTWs in the watershed sewer system need to be complemented considering type of sewage treatment technology employed and watershed characteristics. Therefore, this study presents method to determine the compliance concentration of effluent limit from PSTWs in the watershed.

폐암환자의 치료순응도에 영향을 미치는 요인 (Factors Influencing the Therapeutic Compliance of Patients with Lung Cancer)

  • 채상철;박재용;김정석;배문섭;신무철;김건엽;김창호;손상균;감신;정태훈
    • Tuberculosis and Respiratory Diseases
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    • 제45권5호
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    • pp.953-961
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    • 1998
  • 연구배경: 폐암은 현재 우리나라에서 암사망의 가장 흔한 원인의 하나로 인식되고 있다. 많은 의료인들이 현재 폐암치료에 대해 회의적인 견해를 가지고 있음에도 불구하고 폐암치료의 점진적인 발전과 더불어 폐암환자의 생존률도 조금씩 향상되고 있음은 주지의 사실이다. 그러나 많은 수의 환자들은 여러가지 요인들에 의해 적절한 치료를 거부하거나 포기하는 실정이다. 폐암환자에 있어 치료 순응도에 영향을 미치는 요인을 평가하고 치료순응도를 향상시킬 수 있는 방안을 마련하고자 본 연구를 시행하였다. 방 법: 1989년 1월부터 1996년 12월까지 경북대학교 병원에서 원발성 폐암으로 진단된 환자 1141명 가운데 비교적 의무기록이 충실하고 활도도가 ECOG기준으로 grade 0-III인 903명을 대상으로 하였다. 나이, 성별, 흡연력, 음주력, 종교유무, 배우자유무, 직업과 학력등의 인구학적 특성 및 사회경제적 특성과 증상유무, 조직형, 병기, 수행상태 등의 병적특성에 따른 치료순응도를 후향적으로 분석하였다. 결 과: 치료순응률은 1989-1990년 57.3-61.3%에서 1995-1996년 64.2-67.5%로 연도에 따라 증가하는 경향이 있었다. 치료순응도는 연령, 교육수준, 직업과 유의한 상관관계가 있었으며, 성별, 배우자유무, 흡연력에 따른 치료순응도의 차이는 없었다. 증상을 가진 경우보다 무증상인 환자의 치료순응도가 유의하게 높았으며, 수행상태가 양호할수록 치료순응도가 유의하게 높았다. 소세포암에 비해 비소세포암에서 치료순응도가 유의하게 높았으나, 비소세포암가운데 병기 I기와 II기를 제외하였을 경우 조직형에 따른 치료순응도의 차이는 없었다. 소세포암과 비소세포암 모두에서 진행된 병기일수록 치료순응도가 유의하게 낮았다. 결 론: 폐암환자들의 치료순응도는 64%로 매우 낮았으며, 특히 교육수준과 병기가 치료순응도와 가장 밀접한 관계가 있었다. 따라서 이와같은 요인들이 있는 환자들의 경우 폐암과 치료과정에 대한 교육이 필요할 것으로 생각된다. 본 연구에서는 인적 사회경제적 특성과 병적 특성을 중심으로 치료순응도를 조사하였으나 향후 치료에 대한 환자의 인식도와 치료의 부작용과 같은 치료 특성과 환자-의사관계 풍이 순응도에 미치는 영향과 순응도가 낮은 환자들을 대상으로 교육프로그램을 실시하여 순응도의 향상을 가져올 수 있는지에 관한 전향적인 연구가 필요할 것으로 생각된다.

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노인 당뇨병 환자의 당화혈색소, 허리/엉덩이둘레, 허리/허벅지둘레 및 치료지시이행과의 관계 (A study on relationship between HbA1c, WHR, WTR and compliance in elderly diabetes mellitus patients)

  • 유용권;송민선
    • 가정∙방문간호학회지
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    • 제22권1호
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    • pp.14-21
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    • 2015
  • Purpose: The purpose of this study was to identify relationships between HbA1c (Glycosylated Hemoglobin), WHR (Waist hip ratio), WTR (Waist thigh ratio) and compliance in elderly diabetes mellitus patients aged 65 years or over. Method: We conducted a survey and measured HbA1c, WHR, WTR in a total of 180 elderly patients with diabetes from 5 May 2014 to 30 May 2014. The data were analyzed by t-test, ANOVA, and Pearson's Correlation Coefficient using the SPSS program. Results: There were no significant differences in diabetes-related characteristics for HbA1c, WHR and WTR. However, patients with a family history had low compliance scores (p=.004). Furthermore, patients who visited the hospital regularly had higher compliance scores than patients who visited hospital when they were sick (p<.001). Patients with diabetic complications had low treatment compliance scores (p=.001). In addition, WHR and WTR (r=0.47, p<.001). and WHR and compliance (r=0.15, p=.045) showed positive correlation. Conclusion: For elderly diabetes mellitus patients, diabetes-related characteristics and compliance were highly related, so it is necessary to improve compliance for managing diabetes mellitus.

혈액투석 환자의 역할행위이행 영향요인 (Factors Influencing Sick Role Behavior Compliance in Patients on Hemodialysis)

  • 전현미;유혜숙
    • 기본간호학회지
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    • 제26권1호
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    • pp.23-31
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    • 2019
  • Purpose: This study was a descriptive survey research to identify the factors that influence sick role behavior compliance in patients on hemodialysis. Methods: Structured surveys were used to collect data from 170 patients who are on hemodialysis three times a week through outpatient care at a university hospital located in G City using tools measuring resilience, family support, and sick role behavior compliance. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and Stepwise multiple linear regression. Results: The results showed that factors that influenced sick role behavior compliance in the subjects were in the order of family support (${\beta}=.27$, p<.001), age (${\beta}=.27$, p<.001), and resilience (${\beta}=.23$, p=.003). Resilience, family support, and sick role behavior compliance were positively correlated. Factors influencing hemodialysis patients' sick role behavior compliance included family support, age, and resilience. These variables explained 30.2% of the variance in sick role behavior compliance. Conclusion: Based on these results, care intervention and the development of a training program that involves family in the treatment plan and process to support and encourage patients are needed to increase the sick role behavior compliance in patients on hemodialysis.

성인교정환자의 내외통제소재와 치료협조도에 대한 연구 (Relationship between locus of control and treatment compliance in adult orthodontic patients)

  • 이신재
    • 대한치과교정학회지
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    • 제32권2호통권91호
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    • pp.71-78
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    • 2002
  • 보편적인 교정치료의 적기로 알려진 청소년기가 지나 성인 연령이 되어서야 교정치료를 목적으로 내원한 성인교정환자의 정신-심리학적 특성을 파악하기 위하여, 성인 312명, 청소년 765명, 총 1077명을 대상으로 두 가지 종류의 내외통제소재(locus of control) 척도를 측정한 후 연령군, 성별, 술자(교정의)에 의한 환자 협조도 평가, 진료보조원(치과위생사)에 의한 협조도 평가에 따라 분류한 후, 각각의 내외통제소재의 특성을 비교 분석하였다. 연구 결과 교정 환자들은 일반인에 비해 내적통제 경향을 보였으며, 성인은 청소년군에 비해 내적통제 경향을 보였고, 성인과 달리 청소년군은 여자가 남자보다 오히려 더 높은 내적통제 경향을 나타내었다. 협조적으로 분류된 성인환자는 외적통제 경향을 지닌 쪽이었지만, 청소년 환자는 내적통제 경향을 지닌 환자가 협조적인 환자로 분류되었다. 진료보조원은 술자에 비해 성인군에 대하여 더 호감을 보였으며, 전체적으로는 술자 측 분류에 비해 협조 불량군의 빈도가 높았다. 이러한 결과를 토대로 교정치료시에 반드시 필요한 환자측의 치료협조도를 미리 예측 가능하게 하기 위한 방편으로 내외통제소재척도와 같은 정신-심리학적 검사가 진단 자료의 일부로써 유용성을 지닐 수 있는 것으로 생각되었다.

초기 조건과 복약 순응도에 따른 비만 치료 영향 인자 분석 (Analysis of Factors Influencing Obesity Treatment according to Initial Condition and Compliance with Medication)

  • 한지연;박영재
    • 한방비만학회지
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    • 제19권1호
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    • pp.31-41
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    • 2019
  • Objectives: The purpose of this study was to investigate the effects of gender, age, body weight, muscle mass, fat mass, body mass index (BMI), metabolism, and compliance with medication on weight loss in obese adults. Methods: We reviewed the medical records of 178 patients who were visited to the Korean Oriental Clinic for 3~6 month and had obesity treatment using Gamitaeumjowee-tang from April 2017 to May 2017. We conducted a paired T-test, correlation coefficient and decision tree to analyze factors influencing obesity treatment. Results: The results of correlation analysis showed that initial weight (kg), initial fat mass (kg), BMI ($kg/m^2$), compliance with medication (%), Original Harris-Benedict Equation, Revised Harris-Benedict Equation and The Mifflin St Jeor Equation was significantly correlated to weight loss (kg) (P<0.001). As a result of constructing the decision tree model, it showed that over 5% weight loss of their initial weight (n=154) was related with initial BMI ($kg/m^2$), compliance with medication (%) and initial muscle mass (kg). In case of over 5 kg weight loss of their initial weight (n=131), it was related with initial BMI ($kg/m^2$), compliance with medication (%) and final BMI ($kg/m^2$). Conclusions: This study suggests that weight loss may be affected by initial factors and that initial factors can be used for obesity treatment.

청소년기 교정환자의 치료 협조도와 연관된 요소에 관한 연구 (A study on the factors associated with treatment compliance in adolescent orthodontic patients)

  • 김진이;차봉근;이남기
    • 대한치과교정학회지
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    • 제34권2호
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    • pp.177-188
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    • 2004
  • 교정치료 시기의 적기이며 내원 환자의 많은 부분을 차지하고 있는 청소년기 교정환자의 치료 협조도에 영향을 미치는 요소들에 대해 파악하고자 강릉대학교 치과병원 교정과에서 10개월 이상 동적 치료를 받은 중학교 1학년 이상, 고등학교 3학년 이하 남녀 청소년 60명 (남자 23명, 여자 37명)을 대상으로 인구학적 변인에 따른 치료 협조도를 비교하고 성별, 학령, 치료 협조도에 따른 교정적 태도 척도, 교정용 내외통제소재 척도를 측정, 비교 분석하여 다음과 같은 결과를 얻었다. 1. 교정용 내외통제소재 척도를 조사 분석한 결과 외적통제-부모의 항목에서 성별에 따라 유의한 차이가 인정되었으며(p<0.05) 남학생이 여학생보다 높은 외적통제-부모의 양상을 나타내었다. 2. 교정용 내외통제소재 척도를 조사 분석한 결과 협조적인 환자 군과 비협조적인 환자 군간에 외적통제-부모 항목에서 유의성 있는 차이가 인정되었으며(p<0.05) 교정치료에 대해 협조적인 군에서 외적통제-부모에 대한 인식이 보다 높았다. 3. 교정 치료를 권유하거나 치료받기를 결정한 사람과 치료시의 협조도 사이에는 통계적으로 유의한 차이가 인정되었으며(p<0.05) 환자 자신의 결정에 의한 경우 가장 높은 협조도를 나타내었다. 4. 치료기간과 협조도 사이에 유의한 차이가 인정되었으며 (p<0.05) 치료기간이 길어질수록 협조도는 지속적으로 감소하였다. 5. 교정적 태도 척도를 조사 분석한 결과 성별, 중학생과 고등학생간, 협조적인 환자군과 비협조적인 환자군 사이 에 통계적으로 유의한 차이가 없었다. 6. 교정치료 시 협조정도와 한자의 성별, 연령, 가족관계, 부모의 직업 및 학력, 학업성적, 양치횟수 등의 변인과는 통계적으로 유의한 차이가 인정되지 않았다.

새로이 발견된 고혈압 환자들의 약물치료 및 생활양식 개선의도와 순응도와의 관계 (The Relationship between Treatment Intention and Compliance in Newly Detected Hypertensive Patients)

  • 배상수;이석구
    • Journal of Preventive Medicine and Public Health
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    • 제34권4호
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    • pp.417-426
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    • 2001
  • Objectives : To analyse the psychosocial factors associated with hypertension management(drug treatment and life style modification) of newly detected cases and to understand and assess their behavioral intention or behaviors. Methods : The survey area was a combined urban and rural area in Chungnam province, Korea, and the sampling method was cluster sampling. Study subjects included 541 newly detected cases of hypertension rated above stage 2 by JNC-VI from a community survey. The first survey was applied to 383 of these patients in order to discern their psychosocial characteristics. A follow-up survey was given to 345 persons with an 11-month interval following monthly telephone counseling concerning medication and life style modification by trained nurses. The final study subjects for analysis comprised 271 persons after excluding cases of incomplete data and change of address. Results : Among the 85(33.2%) new patients who had intended to undergo drug treatment, 30(35.3%) persons were treated with antihypertensive agent after 11 - month interval, while among the patients with no intention to receive treatment, only 36(21.1%) persons were treated. Hypertensive patients with a high intention score revealed a high score in life style modification compliance as well. Seventy three percent of the variance of behavioral intention to undergo hypertension management was explained by the patients attitude toward performing the behavior and subjective norm associated with behaviors related to the theory of reasoned action in structural modeling. Actual behaviors related positively with behavioral intention. The coefficient of determination was 0.255. Conclusion : Improving the compliance level of hypertensive patients in respect to drug treatment or life style modification requires a build up of positive behavioral intention, and caregivers must pay more attention to eventually converting behavioral intention to actual behaviors.

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Four months of rifampicin monotherapy for latent tuberculosis infection in children

  • Oh, Chi Eun;Menzies, Dick
    • Clinical and Experimental Pediatrics
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    • 제65권5호
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    • pp.214-221
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    • 2022
  • Diagnosing and treating latent tuberculosis infection (LTBI) is an important part of efforts to combat tuberculosis (TB). The Korean guidelines for TB published in 2020 recommend 2 LTBI regimens for children and adolescents: 9 months of daily isoniazid (9H) and 3 months of daily isoniazid plus rifampicin. Isoniazid for 6-12 months has been used to effectively treat LTBI in children for over 50 years. However, a long treatment period results in poor patient compliance. This review summarizes pediatric data on the treatment completion rate, safety, and efficacy of 4 months of daily rifampicin (4R) and evaluates the pharmacokinetics and pharmacodynamics of rifampicin in children. The 4R regimen has a higher treatment completion rate than the 9H regimen and equivalent safety in children. The efficacy of preventing TB is also consistent with that of 9H when summarizing reports published to date. A shorter treatment period could increase patient compliance and, therefore, prevent TB in more patients. By using an effective, safe, and highly compliant regimen for the treatment of children with LTBI, we would become one step closer to our goal of eradicating TB.