Journal of the Korea Academia-Industrial cooperation Society
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v.21
no.7
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pp.656-666
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2020
This study was a descriptive research study for hemodialysis patients to survey the effects of social support and health literacy on treatment adherence. The subjects of this study were 140 hemodialysis patients aged over 40 years who had been receiving treatment for more 1 year in artificial kidney rooms at two general hospitals in Y city. The data were collected from November 1, 2019 to December 31, 2019 and were analyzed using descriptive statistics, t-tests, one-way ANOVA, Scheffe test, Pearson's correlation coefficients, and multiple regression with the SPSS/WIN 26.0 statistical program. The results of this study show that social support (family, friends, medical staff) and health literacy (functional, communication, critical) were positively correlated with treatment adherence. The variables affecting treatment adherence in hemodialysis patients were identified by social support and health literacy with 69.6% explanatory power. To improve the treatment adherence of hemodialysis patients, it is necessary to develop education programs to improve health literacy based on social support.
Purpose: This study was to estimate the effectiveness of an intervention program using the trans-theoretical model on the stages of change, the process of change, decisional balance, self-efficacy, the levels of medication adherence, and blood pressure difference. Methods: A similar experiment was conducted using a nonequivalent control group pre- and post-test design. The study subjects were 108 hypertensive patients. The program was administered to the experimental group while educational materials were given to the control group. Descriptive analysis, 2-test, t-test, and repeated measures ANOVA were used with SPSS 17.0 to analyze collected data. Results: After treatment with this program, the experimental group showed stage of change ($x^2=52.917$, p<.001), cognitive (F=13,528, p<.001), behavioral process of change (F=10.808, p<.001), benefits (F=5.569, p=.012), loss of medication adherence (F=15.661, p<.001), self-efficacy (F=5.407, p=.011), levels of medication adherence (F=51.442, p<.001). Conclusion: There was a significant improvement in the experimental group who participated in the TTM medication adherence intervention program. Given that this intervention program motivated and stimulated hypertensive patients to adhere to the prescribed medications, the TTM medication adherence intervention program is expected to be an effective and practical intervention method for health improvement.
Objectives: Acceptability of patients towards obesity treatment program is associated with better weight loss outcomes. The purpose of this study was to review previously published study results of the predictive factors associated with patients' acceptability in obesity treatment. Methods: Authors searched for the articles related to acceptability reported as continuation, attendance and adherence, published from 2011 to 2018 found on Pubmed, Scopus, Research Information Sharing Service, and Koreanstudies Information Service System. A total of 23 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to detail categories. Results: Regarding the continuation of the treatment, unchangeable factors such as younger age, lower educational level, male sexuality and lower accessibility to physical activity predicted lower continuation. Furthermore, changeable factors such as early and half weight loss, better accessibility to the treatment and financial incentives for retention predicted higher continuation rate. Greater degree of attendance was predicted by unchangeable factors such as economical affordability, and changeable predictors such as half weight loss and proximity to the clinic. Main factors of adherence to the recommendation were unchangeable predictors such as weight loss experience, and changeable predictors such as more physical activity and appropriate dietary habits. Negative psychological state predicted lower continuation, attendance and adherence rate. Conclusions: Our review results suggest that unchangeable and changeable predictors of acceptability of patients should be carefully examined during treatments of obesity.
Choi, Hyo Yoon;Oh, Im Jung;Lee, Jung Ah;Lim, Jisun;Kim, Young Sik;Jeon, Tae-Hee;Cheong, Yoo-Seock;Kim, Dae-Hyun;Kim, Moon-Chan;Lee, Sang Yeoup
Korean Journal of Family Medicine
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v.39
no.6
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pp.325-332
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2018
Background: Hypertension is a major contributor to the global disease burden of cardiovascular and cerebrovascular disease. The aim of this study was to determine demographic and clinical factors associated with adherence to antihypertensive medication. Methods: From August 2012 to February 2015, we recruited 1,523 Korean patients with hypertension who visited family physicians. The study was conducted in 24 facilities located in urban and metropolitan areas. Of these facilities, two were primary care clinics and 22 were level 2 or 3 hospitals. Adherence was assessed using the pill count method; a cut-off value of 80% was used as the criterion for good adherence. Sociodemographic and lifestyle factors were compared between the adherent and nonadherent groups using the chi-square test for categorical variables and t-test for continuous variables. Binary logistic regression analysis was performed with medication adherence as the outcome variable. Results: Of the 1,523 patients, 1,245 (81.7%) showed good adherence to antihypertensive medication. In the multivariate logistic analysis, age ${\geq}65$ years, exercise, treatment in a metropolitan-located hospital, being on ${\geq}2$ classes of antihypertensive medication and concomitant medication for diabetes, and a family history of hypertension or cardiovascular diseases were associated with good adherence. Patients who had a habit of high salt intake were less adherent to medication. Conclusion: Multiple classes of antihypertensive medications, concomitant medication, and exercise were associated with good adherence to antihypertensive medication, and high salt intake was associated with poor adherence to antihypertensive medication. These factors should be considered to improve hypertension control.
Sang Hyun Ihm;Kwang-Il Kim;Kyung Jin Lee;Jong Won Won;Jin Oh Na;Seung-Woon Rha;Hack-Lyoung Kim;Sang-Hyun Kim;Jinho Shin
Korean Circulation Journal
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v.52
no.1
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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.
Objectives: This study adopted a qualitative method to explore the layman's beliefs and experience concerning high blood pressure and its management in order to develop a strategy to increase adherence to proper medical treatment. Methods: Semi-structured interviews that focused on personal experiences with hypertension and its management were conducted with 26 hypertensive patients. The participants were selected according to a BP above 140/90 mmHg (hypertension stage 1), based on the seventh report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure (JNC-VII). The interviews lasted for approximately 30 minutes (range: 20-60 minutes). The resulting questions were formulated into open-ended questions. The interview questionnaire was composed 17 items to examine non-adherence to treatment and 19 items to examine adherence to treatment. Results: Most participants recognized that the direct cause of high blood pressure was unhealthy behavior rather than inheritance. Thus, the hypertensive patient believed they could recover their blood pressure to a normal level through removing the direct cause of hypertension (weight reduction, diet, exercise) instead of taking drugs. The reasons for these statements were that the drugs for controlling hypertension are not natural or they are artificial, and they may have side effects, and drugs are not treatment for the root cause of hypertension. Most of the hypertensive patients chose to manage their behaviors as soon as they knew their blood pressure was high. Therefore, we should not divide the subjects into two groups according to their taking drugs or not, but they should be divided into two groups according to their willingness or not to manage their condition. Conclusions: For developing a strategy for an individual approach to hypertension management, we need to develop a client-centered attitude and strategy. That is, we need to tailor our approach to individual cases to avoid generalizations and stereotyping when developing an adherence increasing strategy.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.31
no.4
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pp.13-21
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2018
Objectives : This study was aimed to find significant prognostic factor of inpatients with severe atopic dermatitis (AD) who treated in a Traditional Korean Medicine (TKM) hospital. Methods : A retrospective review of medical records of 39 patients with severe AD who hospitalized for more than 7days was performed. All patients were treated with acupuncture, herbal decoction and herbal wet wrap dressing. Therapeutic effect was assessed by difference of objective SCORing of Atopic Dermatitis index (${\Delta}OSI$) at admission and at discharge. Patients were divided into two groups: improvement group (${\Delta}OSI{\leq}5$) and no-improvement group (${\Delta}OSI>5$), and clinical characteristics, severity, infectious complication, serum total IgE, eosinophil counts, adherence and concomitant treatment were investigated. Results : There were 7 cases in no-improvement group. There was no significant difference in OSI or infectious complication between the two groups. Also, there was no significant difference in total serum IgE and eosinophil counts, which are known to be related to severity of AD. However, the proportion of adherence group was significantly lower in no-improvement group than improvement group. Conclusions : This study suggest that treatment adherence is a significant prognostic factor for treatment outcome in inpatients with severe atopic dermatitis. If the adherence to treatment is improved, the therapeutic effect of hospitalization would increase in spite of severe AD or infectious complication.
Han, Jin-Ok;Yim, Jun;Im, Jeong-Soo;Lee, Hee Young;Park, Jong Heon;Oh, Dae-kyu
Health Policy and Management
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v.25
no.2
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pp.90-96
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2015
Background: This study aimed to research on how adherence and blood control could make a difference when it comes to develop complications. Methods: The study's subjects were 255,916 patients who were newly diagnosed with hypertension in 2009 using data collected by National Health Insurance Cooperation. Patients are considered as a group under adherence if visit days and prescription days are more than 300 days. Patients are considered to have successfully controled their hypertension based on actual value measured by National Health Insurance Cooperation and the study takes a look at whether they were diagnosed with complications of cerebrocardiovascular disease in 2012. Chi-square test and logistic regression was used to analyze. Results: Patients who were able to control their hypertension show 0.80 times chance of developing cerebrovascular disease, and 0.89 times chance of developing cardiocerebrovascular disease. The group of adherence shows lower chance of developing complication in general than the group of non-adherence. Conclusion: The study revealed that hypertension's constant treatment could control the blood pressure and prevent complications. It is important that encourages patients to effort for persistent treatment for reducing complication.
After kidney transplantation, immunosuppressive medication is essential to enhance the quality of life and survival of the transplanted patient. To promote the medication adherence, subjects are required to have converged attitude with open mind. Medication adherence will depend on the attitude of the psychosocial characteristics and treatment guidelines. The purpose of this study was to identify the specific types and characteristics of medication adherence in the view of kidney transplanted patients. Q-methodology, a technique for extracting subjective opinions, was used. Forty participants completed the Q-sort activity, rating each statement relative to the others. The collected data were analyzed by QUANL PC program. Four types of medication adherence of kidney transplanted patients were identified: 'positive lifestyle management type', 'vigilant appearance management type', 'somber oblivion type', 'vigilant family support type'. Through the identification of attitudes to medication adherence, repeated and individualized medication adherence program will help to prevent graft rejection.
BACKGROUND/OBJECTIVES: The current study examined trends in adherence to dietary recommendations and compared the levels of adherence between diagnosed and undiagnosed subjects with type 2 diabetes mellitus (T2DM) in Korea over the past 14 years. SUBJECTS/METHODS: Data were collected from the 1998-2012 Korea National Health and Nutrition Examination Surveys (KNHANES). Diagnosed diabetes was defined as giving a positive response to questions about awareness of the disease, a physician's diagnosis of diabetes, or medical treatment for diabetes, whereas undiagnosed diabetes was defined as having a fasting glucose level ${\geq}126mg/dl$. Assessment of adherence level was based on 6 components of dietary guidelines, considering meal patterns and intake levels of calories, carbohydrates, vegetable/seaweed, sodium, and alcohol. The participants received 1 point if they met the criteria for each of the 6 components, and the total possible score ranged from 0 to 6 points. Multivariate generalized linear regression was performed, taking into account the complex survey design. RESULTS: Among all diabetic patients aged 30 years or older, the proportion of diagnosed diabetes increased dramatically, from 40.9% in 1998 to 75.9% in 2012 (P for trend < 0.001). The overall adherence levels to dietary recommendations were low and did not significantly differ between diagnosed and undiagnosed subjects with T2DM for all survey years. Several improvements were observed, including increased adherence to maintaining sufficient vegetable/seaweed consumption (increased from 0.12 to 0.16 points) and limiting sodium intake (increased from 0.12-0.13 points to 0.19-0.24 points; P for trend < 0.001), while adherence to maintaining moderate alcohol consumption decreased. CONCLUSIONS: Analysis of data collected by the KNHANES indicates that Korean T2DM patients have poor adherence to dietary recommendations and maintenance of a healthy lifestyle, regardless of disease awareness. This finding suggests that development of practical, evidence-based guidelines is necessary and that provision and expansion of educational programs for T2DM patients is critical after diagnosis.
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