Most efforts to improve tuberculosis treatment adherence target the patient and his or her behavior. This study examined the effects of behavioral modification training for these patients. Based on Bandura's behavioral principles of modeling, intervention strategies using a video program were devised to elicit specific patient target behaviors considered to improve patients' adherence to tuberculosis treatment regimens. A random assignment, two-group(experimental group and control group) research design including 81 subjects was used. The main outcomes measured were pill taking measured with the Medication Event Monitoring System(MEMS) Medication Cap, patients' self-efficacy, and their knowledge of tuberculosis. The findings are as follows : 1) There was a significant difference between the experimental group and the control group in patients' feelings of self-efficacy. That is, the patients who received the behavior modification program showed greater feeling of self-efficacy to initiate and change their behavior for the tuberculosis treatment regimen than the patients who did not receive the program(t=3.51, p=0.01). 2) There was a significant difference between the experimental group and the control group in patients' knowledge of tuberculosis. That is, the patients who received the behavior modification program showed higher level of knowledge of tuberculosis than the patients who did not receive the program(t=2.15, p=0.03) 3) There was a significant difference between the experimental group and the control group in patients' adherence to tuberculosis treatment regimens. That is, the patients who received the behavior modification program showed greater adherence to the treatment regimens than the patients who did not receive the program(t=5.11, p=0.00). The study findings provided useful insights into nursing practice, particularly in planning intervention strategies aimed at enhancing patients' adherence in tuberculosis that may also be relevant to other chronic diseases with patient adherence problems.
Background : To improve medication adherence in elderly patients, the role of pharmacists in teambased services has been highlighted in the literature. However, not much is known about the role and the service elements involved in comprehensive geriatric programs in South Korea. This study was designed to describe the current status of medication adherence in geriatric patients based on the comprehensive geriatric assessment program and analyze the predictive factors for medication adherence in a tertiary teaching hospital. Methods : A retrospective cohort study was performed using electronic medical records of 247 patients from March 1st, 2015 to August 31st, 2015. Medication adherence and the types of non-adherence were also collected. Predictive factors for adherence were evaluated by including factors related to demographics, medications, illness, and patterns of medical usage. Results : The mean age of the study population was 81.2 years (range 65~98 years) and they were taking 9.7 drugs on an average (SD 5.0 drugs). The overall rate of non-adherence was 34%. About 48% of the patients had any forms of assistance in the medication administration. The most common type of non-adherence was "self-adjustment". The multivariate analyses revealed that age (adjusted odds ratio, 0.87 [95% CI, 0.80-0.96]; p 0.05) and the number of inappropriate medications (adjusted odds ratio, 0.59 [95% CI, 0.40-0.89]; p 0.05) were strong predictors for non-adherence. Conclusions : These results indicate that strategic considerations of the predictors of non-adherence should be improved in medication counseling services targeting elderly patients.
Purpose: The objective of this study was to evaluate adherence to self-care and identify associated factors in outpatients with Heart Failure (HF). Methods: Using a cross-sectional design, a convenience sample of 249 outpatient clinic patients were recruited at S university hospital. Between October 2009 and December 2009, data were collected through questionnaires and medical record review. Results: The total mean score of adherence to self-care was $18.07{\pm}3.56$ out of a possible 45 points. Among self-care dimensions, adherence to medication and low salt diet was high, while lower adherence was reported in contact with health professionals if symptoms such as weight gain, edema and fatigue were presented. Multivariate analysis adjusted for other socio-demographic and clinical factors showed that disease knowledge related to heart failure (p<.001) and left ventricular ejection fraction (p=.027) were independent predictors of adherence to self-care. These factors explained 23% of total variance in the adherence to self-care. Conclusion: Heart failure patients with higher disease knowledge and those who have good systolic function may be more likely to engage in adherence to self-care than those with lack of disease knowledge and low contractility. Further research is needed to confirm these results and identify other predictors of adherence to self-care.
Purpose : The purpose of this study was to investigate the effects of the education using short messaging service(SMS) on fasting blood sugar(FBS) and diabetes adherence. Method : Forty-five diabetic patients being assessed pre and post intervention was used to assess the effectiveness of the education. Participants were requested to input the FBS and 2 hours post-prandial blood sugar everyday in http://www.biodang.com by cellular phone or wire Internet. The goal of the education was to lower FBS and keep diabetes adherence. The education was applied to the for 12 weeks. The education consisted of continuous education and reinforcement of diet, exercise, medication adjustment, as well as frequent self-monitoring of blood glucose levels. The education performed weekly. All medication adjustments were communicated to the participants' doctor. FBS and diabetes adherence were measured before and after the education. Results : The education using SMS of cellular phone had decrease FBS and increase oral medication taking, exercise, foot care, and hypoglycemia preparation adherence.
Purpose: Shift work disrupts the synchronization between the human biological clock and the environment. Sleep disturbances are common for shift work nurses, and may threaten patient safety. This study was done to investigate the sleep characteristics and medication errors (ME) of intensive care unit (ICU) nurses who work shifts, and ascertain if there is an association between these factors. Methods: Data were collected using a self-report questionnaire from 126 ICU nurses on three shifts. Collected data included their sleep characteristics including sleep patterns and sleep disturbances, and ME for the past 2 weeks. Results: There were significant differences in sleep duration and sleep latency according to shift. Day shift nurses had the shortest sleep duration, and their sleep latency was the longest (about 49 minutes) compared to nurses on evening and night shifts; 54% reported sleep disturbances, 16% experienced ME, and among these nurses 50% were on the night shift. Logistic regression analysis revealed significant associations between nurses' sleep duration and ME (adjusted OR 0.52 [95% CI 0.32-0.85]). Conclusions: The results confirmed that shift work nurses in the ICUs experience sleep disturbance, and that less sleep is associated with ME.
ㆍPurpose: This study was performed to investigate the initial conservative treatment for TMD patients using careful counselling and medication prospectively.
ㆍMaterials and Methods: Careful counselling and medication were performed in 51 TMD patients and 27 patients had follow-up check 2 months or more. Diagnosis of TMD was based on medical history and, physical and radiographic examination. TMD included masticatory disorder, internal derangement, degenerative joint disease, inflammatory joint disorder. and problems resulting from extrinsic trauma. All patients had chief complaints of TMJ pain, mouth-opening limitation. joint noise, and/or referred pain. We counselled and explained to the patient about the pathogenesis, etiologic factors, diagnosis and treatment plan for abut 10 minutes. We prescribed nonsteroidal anti-inflammatorv analgesic(Somalgen) and amitriptyline 10mg per day for 2 weeks. We informed the patient of the attention sheet and taught self-exercise of jaw. The patient were assessed by answering the questionnaire of subjective evaluation of TMD & maxillofacial pain. Questionnaire of an activity limitation. Questionnaire of a jaw function, and Questionnaire for the evaluation of TMD.
ㆍResults: In questionnaire for the evaluation of TMD, 88.5% of 26 patients answered that the treatment was efficacious. 71.4% of 21 patients answered no problem in everyday life. There were significant differences between pretreatment and final follow-up in the evaluation of the subjective pain in the following sections: opening widely, chewing, resting, morning, masticatory muscle, and temporal portion(SAS program, paired T-test, P = 0.05).
ㆍConclusions: Considerate counselling and proper medication could be significantly effectve in the initial treatment of TMD.
Purpose: This study was to develop and evaluate an individualized education program based on self-efficacy for patients with kidney transplantation in Korea. Methods: A nonequivalent control group pretest-posttest design was used. The participants consisted of 43 patients who underwent kidney transplants at one hospital in Seoul, from July 2012 to April 2013. The experimental group received an individualized education based on self-efficacy in the hospital and follow-up telephone consultation in the 2nd and 3rd week after discharge. The control group received a routine discharge education. Knowledge, self-efficacy, and compliance related to kidney transplant were measured and analyzed by frequency, average, Mann-Whitney U test, Fisher's exact test, independent t-test, and ${\chi}^2$-test using SPSS WIN 20.0. Results: Significant differences were found in self-efficacy between the experimental group and the control group. But no significant differences were found in knowledge and compliance between two groups. The scores of several items on monitoring health status in compliance were higher in the experimental group than those of the control group. Conclusion: The results of this study demonstrate the fact that an education program based in self-efficacy for patients with kidney transplant would be effective in improving self-efficacy and the ability to monitor their health status.
The purpose of this study was to test the effect of a diabetic education program using the self-efficacy theory on the self-care behavior and glucose metabolism. The subjects of the study consisted of 25 NIDDM patients who had participated with a diabetic education program from June 23 to July 14. 1999. The research design was one-group pretest-posttest design. The pretest included measuring. self-care behavior and 2PPBS. the diabetic education program was conducted to the group for 4weeks. After the diabetic education program. the posttest included remeasuring of self-care behavior and 2PPBS. Wilcoxon signed rank test was used for the significence of the differences between values before and after the diabetic education program. The results are as follows. The diabetic education program was effective in increasing the score of the self-care behavior in exercise but was not effective in increasing the score of the self-care behavior in diet, test and medication. The diabetic education program was not effective in decreasing the levels of glucose metabolism.
Background: The appropriate use of drugs is very important for a healthy life, as appropriate medication must be taken correctly for successful treatment of a disease. The purpose of this study was to investigate the self-efficacy between health status and drug abuse behavior. Methods: The subjects of this study were selected from 15 workshops located in Seoul, Incheon, Daejeon, and Chungnam, and, convenience sampling was conducted for each employee between September, 2017 and October 2017. A total of 204 questionnaires were analyzed. The questions evaluated health status, self-efficacy, drug abuse behavior, and general characteristics. Results: First, there was no difference in health status according to the general characteristics of the subjects. The self-efficacy varied according to gender, educational background, and monthly income, but not by marital status and residence area. In addition, drug abuse behaviors differed according to gender, residence area, and monthly income, but not by marital status and education level. Second, drug abuse behavior negatively correlated with health status and self-efficacy. Third, regression analysis showed that the self-efficacy between the health status and drug abuse behavior had a partially mediating effect. Conclusion: In patients with poor health status, it is necessary to increase their self-efficacy to reduce reduce drug abuse. Therefore, regular education programs targeting efficacy and drug knowledge are required in the community.
Purpose: The purpose of this study is to develop and evaluate a joint health self-management program for knee osteoarthritis elders in communities. Methods: This program was developed based on the IMB (information-motivationbehavioral skills) model. The program methods include education, setting and achieving goals, sharing experiences, telephone counseling, and self-monitoring. The topics of the program include joint assessment, exercise, massage, joint protection, medication, depression management, diet, and healthcare approach. The research was conducted following the principles of the nonequivalent control group pretest-posttest design. Participants were 26 subjects in the experimental group, and 27 subjects in the control group. The experimental group participated in the self-management program, and the control group received general education. Results: Both post-test scores of personal motivation, social motivation, behavior skill, self-management behavior, joint pain, joint stiffness, physical function disability, right knee extension, left knee extension, and depression were significantly different between the experimental group and the control group. Conclusion: The results of the study can be used to develop and standardize a systematic joint health self-management program. Further research is highly recommended to develop a strategy to continuously facilitate self-management of osteoarthritis patients' procedures.
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