• Title/Summary/Keyword: 약물치료 이행

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Relationship between Warfarin Related Knowledge, Self Efficacy and Medication Adherence of Patient with Prosthetic Heart Valve Replacement (인공심장판막치환 환자의 와파린 관련 지식, 자기효능감 및 약물복용이행도의 관계)

  • Kil, A-Ram;Shin, Yong Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.1
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    • pp.584-592
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    • 2020
  • 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.

Factors Influencing Medication Adherence in Hypertensive Patients (일 지역 고혈압 환자의 약물치료 이행의 영향요인)

  • Seo, Yeong-Mi
    • Research in Community and Public Health Nursing
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    • v.21 no.1
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    • pp.82-91
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    • 2010
  • Purpose: The purpose of this study was to identify factors that influence medication adherence in patients with hypertension. Methods: One hundred sixty two patients with hypertension who visited the outpatient clinics of health centers in J City participated in the study. Data were collected through a questionnaire survey done from January 9 to February 25, 2008. To analyze the sample survey data, descriptive statistics, t-test, ANOVA, Scheffe's test, and multiple regression analysis were performed with SPSS/WIN 12.0. Results: Significant factors that affect medication adherence in patients with hypertension were autonomous motivation, competence, health status, and sex. These variables explained 24% of medication adherence (F=12.48, p<.001). Conclusion: The results indicate that in order to improve the medication adherence of patients with hypertension it is important to develop nursing programs that focus on autonomous motivation and competence and to give consideration to differences in health status and sex. Also further studies are needed to confirm autonomous motivation related to health behavior in patients with hypertension.

The Mediating Effect of Regimen Distress in the Relationship between Medication Adherence and Glycemic Control in Men with Type 2 Diabetes Mellitus (제2형 당뇨병 성인 남성 환자의 약물치료 이행과 혈당 조절 수준 간에 치료 스트레스의 매개효과)

  • Seo, Yeong-Mi;Choi, Won-Hee
    • Journal of East-West Nursing Research
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    • v.22 no.2
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    • pp.170-177
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    • 2016
  • Purpose: The purpose of this study was to examine the mediating effect of regimen distress in the relationship between medication adherence and glycemic control in men with type 2 diabetes. Methods: A total of 116 patients with type 2 diabetes was recruited for the cross-sectional survey design. Data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using Baron and Kenny steps for mediation. Results: The mean score for medication adherence was 6.32, and the mean glycemic control level (HbA1c) was 7.47%. The mean score was 2.37 for regimen distress. There were significant correlations among medication adherence, regimen distress, and HbA1c. Regimen distress had a partial mediating effect (${\beta}$=.22, p=.005) in the relationship between medication adherence and HbA1c (Sobel test: Z=2.47, p=.013). Conclusion: Regimen distress was found to be associated with glycemic control in men with type 2 diabetes. Based on the findings of this study, nursing intervention programs focusing on decreasing regimen distress are highly recommended to improve level of glycemic control in patients with type 2 diabetes.

The Effects of Planned Discharge Nursing in Compliance, Knowledge, and Nursing Service Satisfaction for Patients having Video-Assisted Thoracoscopic Surgery (계획된 퇴원 간호 중재가 기흉 수술 환자의 약물복용 및 치료 지시 이행도, 질병에 대한 지식과 간호 만족도에 미치는 효과)

  • Lee, Won Jin;Bang, Yun Yi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.11
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    • pp.121-129
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    • 2019
  • This study aimed to develop a planned discharge nursing intervention guideline for patients with pneumothorax, and to examine its influence on drug compliance, knowledge about disease, compliance level with therapeutic regimen, and nursing satisfaction. Methods: The planned discharge nursing intervention guideline was developed based on comprehensive literature reviews and clinical experiences. Patients having video-assisted thoracoscopic surgery at a single general hospital were allocated to either intervention (n=30) or control group (n=29). Participants in the intervention group were administered planned discharge nursing intervention thrice, 30 minutes each, by a cardiovascular nurse. Standard care was provided to patients in the control group. Data were collected from March, 2010 to December, 2010. Results: Participants in the intervention group presented statistically significant improvement in drug compliance (t=-2.05, p=0.044), pill count (t=-2.61, p=0.011), knowledge about disease (t=-4.39, p=0.001), and nursing satisfaction (t=-4.13, p=0.001). No significant difference in compliance levels was observed with standard therapeutic regimen. Conclusion: Planned discharge nursing intervention can be successfully implemented for patients undergoing thoracoscopic surgery. Further research is required to evaluate long-term effects like complication or relapse.

Patients' Knowledge and Medication Adherence to Adjuvant Hormonal Therapy for Breast Cancer Treatment (유방암 환자의 호르몬치료에 대한 지식과 약물복용이행에 관한 연구)

  • Jo, Yeong Mi;Kwon, In Gak
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.234-242
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    • 2015
  • Purpose: The purpose of this study was to investigate the levels of knowledge and medication adherence to hormonal therapy (HT) and to identify the factors influencing medication adherence for patients with breast cancer. Methods: Data were collected from 136 patients undergoing adjuvant HT for breast cancer in 3 general hospitals from July 1 to August 14 in 2014 using self-report questionnaires. Data were analyzed using descriptive statistics, independent t-test, ANOVA, $Scheff{\grave{e}}$ test, and multiple regression. Results: The average of knowledge about HT was $5.15{\pm}2.22$ (Max 9), and that of medication adherence was $5.76{\pm}1.65$ (Max 8). Younger age, shorter duration of HT, more active participation in decision making for treatment, positive perception for impacts of HT, and stronger belief in cure were influencing factors on higher adherence level. Age, duration of HT, and perception on the impacts of hormonal therapy, and belief in cure explained 25.2% of the adherence. Conclusion: To improve the treatment adherence to hormonal therapy, patient education and involvement in decision making, and the tailored intervention for the patients with older age, and long treatment period of HT are needed. Additionally, the strategies for diminishing unintentional forgetting is necessary to be developed.

제제설계 및 Scale Up

  • Hong, Sun-Eon
    • Journal of Pharmaceutical Investigation
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    • v.13 no.3
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    • pp.115-125
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    • 1983
  • 제제설계란 제형의 설계 및 그에 따른 처방설정(formulation)을 의미하며 경험적인 제제방법 및 그 기술측면에서의 제제화는 주악 및 첨가물의 종류와 배합비율의 설정등 비교적 단순한 내용을 의미하지만 의약품은 실제적으로 인체에 적용되므로 치료설계상의 연구와 생물약제학적 검토에 의한 유효정과 안전성을 발휘할 수 있도록 설계가 되어야 한다. 또한 약물의 효력은 체내 특정부위에 특정농도의 약물분포가 필요하고, 일정시간 지속되는 것이 요구되므로 약용량도 중요하지만 약물투여 후의 흡수, 체내이행, 대사, 배설등의 상태를 파악하고 이에 미치는 부형제의 영향도 검토하여야 한다. 제제물리학적 측면에서 품질보증을 위하여 preformulation단계에서 주약의 물성검토, 첨가제의 사용량, interaction 및 혼합순서 등과 처방설정 단계에서 제제화에 사용되는 기계장치의 특성 및 능력, 제제화 후의 포장용기 및 포장상태에서의 안정성 등도 면밀히 검토하여야한다. 제제설계란 단순한 dosage form의 design만이 아니고 유효성이 높고, 부작용이 적은 제제를 합리적으로 만드는 기술과 정보의 종합관리로 scale up과정에서 원료, 기계장치, 제조방법, 작업자 등에 의한 품질변동 요인을 극소화하고, 공정의 초기단계에서 즉시 조정될 수 있는 종합관리 system이 필요하다.

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Well-being of young and middle aged diabetic patients with medication according to combination of non-pharmacological treatment: a path analysis (청장년층 약물치료 당뇨환자의 비약물적치료 병행 여부에 따른 웰빙: 경로분석)

  • Kim, Sun-Kyung;Kim, Yu-Mi;Kim, Sun-Ae
    • Journal of the Korea Convergence Society
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    • v.11 no.6
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    • pp.401-410
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    • 2020
  • The purpose of this study was to investigate predictors and mediating effects of physical activity and nourishment regulation on well-being among young and middle aged patients on DM medication and to compare between those with non-pharmacological treatment and those without. Data were obtained from 2017 community health survey including 1,480 DM patients with oral medication in the age between 20 and 49. Using SPSS 25.0 and AMOS 25.0, path analysis was performed to explore the association between personal factors (socio-economic status, health habit, eating habit and compliance of health examination) and well-being, along with mediating effects of physical activity. Results demonstrated the different mediating role of physical activity. In medication only group, there was no direct effect of physical activity and no indirect effect of personal factors. Direct effect of physical activity and indirect effects of predictors were found in those with non-pharmacological treatment group. When developing strategies to enhance well-being of young and middle aged diabetic patients, proper reflection of their age specific traits and disease management capability are essential.

Clinical Analysis of Children with Transitory Minimal Change Nephrotic Syndrome (MCNS) to Focal Segmental Glomerulosclerosis (FSCS) (미세변화형 신증후군(MCNS)으로부터 국소성 분절성 사구체 경화증(FSGS)으로 이행된 환아의 임상양상)

  • Lee Ji Eun;Yook Jinwon;Lee Eui Seong;Kim Ji Hong;Kim Pyung-Kil;Chung Hyun Joo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.17-24
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    • 2000
  • Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. However in FSGS, there is poor prognosis with initial therapy and shows higher rate of progression to chronic renal failure and relapse after kindney transplantation. We have experienced 8 patients who were diagnosed as MCNS on initial renal biopsy and then progressed to FSGS on follow-up biopsy. So we have investigated their clinical course and risk factors for transition of MCNS to FSGS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of 296 cases of MCNS and FSGS that were diagnosed from January 1988 to May 1999. We classified them into 3 groups according to the histopathologic finding; MCNS, FSGS, MCNS progressed to FSGS in follow-up biopsy. Results: The number of children was 296 cases comprising 241 cases($81.4\%$) showing MCNS, 8 cases($2.7\%$) transition group, 47 cases($15.9\%$) FSGS. The mean onset age was $6.0{\pm}2.6$years in MCNS, transition group $8.3{\pm}2.3$years, FSGS $7.2{\pm4.3$years, and the gender (M:F) ratio was 3.7:1 in MCNS, 3:1 in transition group, 1.8:1 in FSGS. Comparing the presence of initial hematuria, hypertension,24 hour urine protein, serum albumin, serum creatinine, there were significant difference between the transition group and the FSGS group in the following points; 24hour urine protein $684:342mg/m^2/hr$(P<0.05), serum albumin 1.92: 2.47g/dL(P<0.05), serum cholesterol 494:343mg/dL(P<0.05). Refractoriness to steroid therapy was 13.3$\%$ in MCNS. $12.5\%$ in transition group, $29.6\%$ in FSGS; significantly higher in FSGS(P<0.05). Immunosuppressant therapy was performed in $58.5\%$ of MCNS, $100\%$ in transition group, $80.8\%$ in FSGS; transition group showed significantly higher .ate(P<0.05) comparing with MCNS. Mean number of relapse and duration from onset to first relapse showed no significance difference between these groups. Conclusion: 249 patients with MCNS have been followed and $3.2\%$ (8 patients) of them has shown change in pathologic diagnosis from MCNS to FSCS. The risk factor for transition could not be found. Our results point to the need for a follow-up biopsy to certify the possibility of transition to FSCS in some MCNS cases with refractory cases to steroid therepy, frequent relapsing cases, or in case of no remission in spite of vigorous immunosuppressant therapy.

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A Survey of Blood Glucose Testing, Medication, Diet, and Exercise Adherence in Korean Patients with Type2 Diabetes (당뇨병환자의 자가혈당검사, 약물, 식이 및 운동 치료지시이행)

  • Kim Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.2
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    • pp.181-186
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    • 2003
  • Purpose: The purpose of this study was to investigate the adherence to diabetes control recommendations (blood glucose testing, medication, diet, exercise) in patients with type 2 diabetes at home and to analyse the correlation between adherence and blood glucose level. Method: Participants, numbering 214, were recruited from the endocrinology outpatient department of a tertiary care hospital in an urban city. The data were collected by a self report adherence questionnaire. Glycosylated haemoglobin (HbA1c) was determined by the high-performance liquid chromatography technique and fasting blood glucose was analyzed by the glucose oxidase method. Result: Medication adherence was higher than diet or exercise adherence. The frequency of blood glucose testing was lower for middle school graduates than college graduates. Diet adherence was significantly lower for participants who were obese, who did not have a spouse, and who had hyperglycemia. Medication and diet adherence were negatively correlated with HbA1c. Conclusion: A diet education program should be developed for patients with type 2 diabetes who are obese, who do not have a spouse, and who have hyperglycemia.

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Compliance Level with Therapeutic Regimen of Medication and Life Style among Patients with Hypertension in Rural Communities (일 농촌지역 고혈압 환자의 치료적 요법의 이행수준 - 약물복용과 생활습관을 중심으로 -)

  • Ahn, Yang-Heui
    • Journal of Korean Public Health Nursing
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    • v.21 no.2
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    • pp.125-133
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    • 2007
  • Purpose: To identify the compliance level with therapeutic regimen among patients with hypertension residing in rural communities. Method: A descriptive-retrospective research design was employed. One hundred patients with hypertension using 8 Primary Health Care Posts under W Public Health Center were randomly recruited on the basis of being over 35 years of age. After obtaining written consent, the patients underwent direct interviews with a structured questionnaire carried out by 8 public health practitioners. Descriptive statistics and binary logistic regression were utilized. Results: In a binary logistic regression model adjusted for age, sex, education, income, and occupation, those who were receiving medication (OR=5.34), were undergoing a weight control program (OR=4.45), restricted alcohol (OR=9.93), or smoking cessation (OR=25.59) as recommended by medical or health professionals were more compliant (p<.05) while those under a low salt diet, exercise, and stress management were not significant statistically (p>.05). Conclusions: Further research should be conducted to validate these findings so as to facilitate the development of nursing intervention strategies for improving the compliance of hypertensive patients in respect to medication and life style modification.

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