한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제21권1호
  • /
  • Pages.584-592
  • /
  • 2020
  • /
  • 1975-4701(pISSN)
  • /
  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
권호 표지
DOI QR코드

DOI QR Code

인공심장판막치환 환자의 와파린 관련 지식, 자기효능감 및 약물복용이행도의 관계

Relationship between Warfarin Related Knowledge, Self Efficacy and Medication Adherence of Patient with Prosthetic Heart Valve Replacement

  • 투고 : 2019.09.18
  • 심사 : 2020.01.03
  • 발행 : 2020.01.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

본 연구는 와파린 약물 관련 지식, 자기효능감, 약물복용이행도의 관계를 파악하여 와파린 약물복용이행도를 높일 수 있는 교육의 필요성을 강조하고 효율적인 맞춤형 간호중재 프로그램 개발에 도움이 되고자 시행하였다. 연구방법은 서술적 상관관계 연구로 2018년 2월 21일부터 9월 30일까지 20세 이상의 성인을 대상으로 심장판막 수술을 받고 와파린을 복용한지 6개월 이상 된 외래 통원치료 환자를 대상으로 이루어졌다. 연구결과 와파린 약물관련 지식과 약물복용이행도에서 유의한 상관관계(r=.285, p=.004)를 보였다. 70세 미만에서 약물복용이행도는 와파린 약물관련 지식(r=.250, p=.046)과 자기효능감(r=.292, p=.019)에서 각각 양의 상관관계를 보였고, 70세 이상에서 약물복용이행도는 와파린 약물관련 지식(r=.358, p=.032)과 유의한 양의 상관관계가 있었다. 또한 약물복용이행도의 차이에서 70세 미만(7.24±1.30)과 70세 이상(7.09±1.00)에서 연령과 상관없이 큰 차이가 없었는데, 이는 고령화에도 불구하고 약물복용이행이 비슷한 수준으로 잘 유지된 것으로 볼 수 있어 어떤 요소가 70세 이상의 고령 환자의 약물복용이행도를 높게 유지하는 지 후속연구가 필요하겠다. 따라서 약물복용이행도를 향상시키기 위해서는 간호 교육 측면으로 1:1개별 교육프로그램, 코칭 프로그램을 개발하고, 간호 연구 측면으로 각 분야의 다양한 전문가가 연계되어 와파린 복용 교육에 대한 연구가 필요하다. 또한 시각적 측면으로 약물 교육에 대한 멀티미디어 효과에 대한 연구를 제언한다.

The purpose of this study is to explore the relationship between warfarin-related knowledge, self-efficacy, and medication adherence among patients who underwent heart valve replacement surgery. The patients who underwent heart valve surgery and warfarin therapy were included in this study. The data was collected by administering questionnaires, and the data was then analyzed using the SPSS WIN 22.0 program. There was a positive relationship between warfarin-related knowledge and the adherence to medication (r=.285, p=004). Medication adherence was also positively correlated with warfarin-related knowledge (r=.250, p=.046) and self-efficacy (r=.292, p=.019) for elderly patients under 70 years of age. Further, medication adherence of elderly patients over 70 years of age was correlated with only warfarin-related knowledge (r=.358, p=.032). The results of this study show that in order to improve medication adherence, elderly people should be provided with warfarin-related knowledge through individually tailored education and nursing interventions that strengthen self-efficacy, as well as the knowledge that is needed in the elderly group under 70 years old.

키워드

참고문헌

  1. S. B. Shim, "Knowing heart valve disease", Medical Information, Vol.10, pp.4-7, 2017.
  2. M. A. Marchand, M. R. Aupart, R. Norton, I. R. Goldsmith, L. C. Pelletier, M. Pellerin, T. Dubiel, W. J. Daenen, P. Herijgers, F. P. Casselman, M. P. Holden, T. E. David, "Fifteen-year experience with the mitral Carpentier-Edwards PERIMOUNT pericardial bioprosthesis", Annals of Thoracic Surgery, Vol.71, No.5 Suppl, pp.S236-239, 2001. DOI: https://dx.doi.org/10.1016/s0003-4975(01)02550-4
  3. I. Vesely, "The evolution of bioprosthetic heart valve design and its impact on durability", Cardiovascular Pathology, Vol.12, No.5, pp.277-286, 2003. DOI: https://doi.org/10.1016/S1054-8807(03)00075-9
  4. J. T. DiPiro, R. L. Talbert, G. C. Yee, G. R. Matzke, B. G. Wells, L. Michael Posey. "Pharmacotherapy: a pathophysiologic approach," McGraw-Hill Education, New York, 2017.
  5. Q. Almeida Gde, A. Noblat Lde, L. C. Passos, H. F. do Nascimento, "Quality of life analysis of patients in chronic use of oral anticoagulant: an observational study", Health Qual Life Outcomes, Vol.9, pp.91, 2011. DOI: https://dx.doi.org/10.1186/1477-7525-9-91
  6. S. M. Park, H. Son, J. Shin, Y. S. Sohn, K. Sun, Y. H. Choi, K. T. Kim, I. S. Lee, H. Kim, H. M. Kim, "The clinical results of heart valve replacements", Korean Journal of Thoracic and Cardiovascular Surgery, Vol.38, No.3, pp.204-213, 2005.
  7. S. Van Damme, K. Van Deyk, W. Budts, P. Verhamme, P. Moons, "Patient knowledge of and adherence to oral anticoagulation therapy after mechanical heart-valve replacement for congenital or acquired valve defects", Heart and Lung, Vol.40, No.2, pp.139-146, 2011. DOI: https://dx.doi.org/10.1016/j.hrtlng.2009.11.005
  8. F. G. Esmerio, E. N. Souza, T. L. Leiria, R. Lunelli, M. A. Moraes, "Constant use of oral anticoagulants: implications in the control of their adequate levels", Arquivos Brasileiros de Cardiologia, Vol.93, No.5, pp.549-554, 2009. DOI: https://dx.doi.org/10.1590/s0066-782x2009001100017
  9. A. I. Wertheimer, N. M. Chaney, T. Santella, "Counterfeit pharmaceuticals: current status and future projections", Journal of the American Pharmacists Association, Vol.43, No.6, pp.710-718, 2003. DOI: https://doi.org/10.1331/154434503322642642
  10. J. J. Gascon, M. Sanchez-Ortuno, B. Llor, D. Skidmore, P. J. Saturno, "Why hypertensive patients do not comply with the treatment: results from a qualitative study", Family Practice, Vol.21, No.2, pp.125-130, 2004. DOI: https://dx.doi.org/10.1093/fampra/cmh202
  11. A. Bandura, "Social foundations of thought and action: a social cognitive theory," Prentice-Hall, Englewood Cliffs, 1986.
  12. S. H. Min, J. I. Kim, "Construction of explanatory model for medication adherence in older people with chronic disease", Korean Journal of Fundamentals of Nursing, Vol.19, No.4, pp.463-473, 2012. DOI: https://dx.doi.org/10.7739/jkafn.2012.19.4.463
  13. J. J. Vlasnik, S. L. Aliotta, B. DeLor, "Medication adherence: factors influencing compliance with prescribed medication plans", Case Manager, Vol.16, No.2, pp.47-51, 2005. DOI: https://dx.doi.org/10.1016/j.casemgr.2005.01.009
  14. Statistics Korea. 2018 senior citizens statistics: a vibrant aging index. Statistics Korea, c2018 [cited 2018 September 27], Available From: http://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=370779 (accessed June 27, 2019)
  15. National Health Insurance Service. Heart-tight aortic valve stenosis, common in older people. National Health Insurance Service, c2017 [cited 2017 December 10], Available From: https://www.nhis.or.kr/menu/retriveMenuSet.xx?menuId=D4000 (accessed June 20, 2019)
  16. The Korean Senior Citizens Association. 2015 public discussions on raising the age of the elderly. The Korean Senior Citizens Association, c205 [cited 2015 May 26], Available From: http://www.koreapeople.co.kr/notice/notice_detail.asp?SEQ=2672&page=64&ColName=&strKeyWord=&L1=3&L2=1&BoardCode=102 (accessed June 23, 2019)
  17. M. A. Henriques, M. A. Costa, J. Cabrita, "Adherence and medication management by the elderly", Journal of Clinical Nursing, Vol.21, No.21-22, pp.3096-3105, 2012. DOI: https://dx.doi.org/10.1111/j.1365-2702.2012.04144.x
  18. S. M. Park, Y. H. Kang, "Symptom experience, self-efficacy, depression, and medication adherence in patients with chronic obstructive pulmonary disease", Journal of Korean Clinical Nursing Research, Vol.23, No.2, pp.170-178, 2017. '017.23.2.170 https://doi.org/10.22650/JKCNR.2017.23.2.170
  19. S. R. Jang, A study on the relationship between drug-related knowledge and sick role behavior of patients under anticoagulant therapy, Master's thesis, Yonsei University, Seoul, 2007.
  20. K. Lorig, A. Stewart, P. Ritter, V. Gonzalez, D. Laurent, J. Lynch. "Outcome measures for health education and other health care interventions," Sage Publications, Thousand Oaks, 1996.
  21. C. J. Kim, S. M. Chae, H. Yoo, "Psychometric testing of the Chronic Disease Self-Efficacy Scale-Korean Version (CDSES-K)", Journal of Transcultural Nursing, Vol.23, No.2, pp.173-180, 2012. DOI: https://dx.doi.org/10.1177/1043659611434059
  22. D. E. Morisky, A. Ang, M. Krousel-Wood, H. J. Ward, "Predictive validity of a medication adherence measure in an outpatient setting", Journal of Clinical Hypertension (Greenwich, Conn.), Vol.10, No.5, pp.348-354, 2008. DOI: https://doi.org/10.1111/j.1751-7176.2008.07572.x
  23. M. H. Jun, C. K. Lee, Y. H. Lee, Y. G. Park, S. M. Gang, "A study on the relationship between drug related knowledge, sick role behavior and quality of life of patients taking warfarin", Journal of Korean Clinical Nursing Research, Vol.20, No.1, pp.53-63, 2014. DOI: https://dx.doi.org/10.22650/JKCNR.2014.20.1.53
  24. S. Ederhy, A. Cohen, "Optimising stroke prevention in non-valvular atrial fibrillation", Expert Opinion on Pharmacotherapy, Vol.7, No.15, pp.2079-2094, 2006. DOI: https://dx.doi.org/10.1517/14656566.7.15.2079
  25. W. H. Jun, J. S. Park, A. S. Jeong, "The effect of education program by illness on perception of illness and knowledge of medication in psychiatric inpatients", Journal of East-West Nursing Research, Vol.17, No.2, pp.110-116, 2011. DOI: https://dx.doi.org/10.14370/jewnr.2011.17.2.110
  26. Y. J. Son, E. K. Song, "Impact of health literacy on disease-related knowledge and adherence to self-care in patients with hypertension", Korean Journal of Fundamentals of Nursing, Vol.19, No.1, pp.6-15, 2012. DOI: https://dx.doi.org/10.7739/jkafn.2012.19.1.006
  27. W. Bohanny, S. F. Wu, C. Y. Liu, S. H. Yeh, S. L. Tsay, T. J. Wang, "Health literacy, self-efficacy, and self-care behaviors in patients with type 2 diabetes mellitus", Journal of the American Association of Nurse Practitioners, Vol.25, No.9, pp.495-502, 2013.d DOI: https://dx.doi.org/10.1111/1745-7599.12017
  28. G. K. Singh, M. Siahpush, "Widening socioeconomic inequalities in US life expectancy, 1980-2000", International Journal of Epidemiology, Vol.35, No.4, pp.969-979, 2006. DOI: https://dx.doi.org/10.1093/ije/dyl083
  29. M. O. Kang, Quality of life side effect of antipsychotics attitude toward drug of mentally disordered, Master's thesis, Ewha Womens University, Seoul, 2010.
  30. H. F. Chen, Y. F. Tsai, Y. P. Lin, M. S. Shih, J. C. Chen, "The relationships among medicine symptom distress, self-efficacy, patient-provider relationship, and medication compliance in patients with epilepsy", Epilepsy & Behavior, Vol.19, No.1, pp.43-49, 2010. DOI: https://dx.doi.org/10.1016/j.yebeh.2010.06.007