• Journal of Korean Academy of Fundamentals of Nursing
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• v.26 no.1
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• pp.52-61
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• 2019

Purpose: The aim of this study was to examine the mediating effect of self-efficacy in the relationship of physical and psychological symptoms to exercise adherence in patients with heart failure. Methods: The participants in this study were 186 patients with heart failure in two hospitals located in Busan. The measures included questions about general and disease characteristics, physical symptoms, psychological symptoms, self-efficacy for exercise, and exercise adherence. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, simple and multiple regression using Baron and Kenny steps for mediation. Results: There were significant differences in age, gender and comorbidity on exercise adherence. There were also significant correlations among physical and psychological symptoms, self-efficacy for exercise, and exercise adherence. Self-efficacy for exercise showed partial mediating effects in the relationship between physical symptoms and exercise adherence. Conclusion: Based on the findings of this study, the enhancement of self-efficacy for exercise may positively affect the exercise compliance of the patients with health failure, even while they are experiencing physical symptoms. Therefore, it is necessary to develop effective strategies to enhance self-efficacy for exercise.

• Korean Journal of Community Nutrition
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• v.20 no.2
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• pp.129-140
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• 2015

Objectives: We examined the association between the adherence to dietary guidelines for breast cancer survivors and health-related quality of life in a cross-sectional study of Korean breast cancer survivors. Methods: A total of 157 women aged 21 to 79 years who had been diagnosed with stage I to III breast cancers according to the American Joint Committee on Cancer (AJCC) and had breast cancer surgery at least 6 months before the baseline were included. We used a Korean version of the Core 30 (C30) and Breast cancer 23 (BR23) module of the European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC-QLQ), both of which have been validated for Koreans. Participants were asked about their adherence to dietary guidelines for breast cancer survivors, suggested by the Korean breast cancer society, using a 5-point Likert scale. We summed dietary guideline adherence scores for each participant and calculated the least squares means of health-related quality of life according to dietary guideline adherence scores using the generalized linear model. Results: Breast cancer survivors who had higher adherence to dietary guidelines for breast cancer survivors had lower constipation scores than those with lower adherence (p for trend=0.01). When we stratified by the stage at diagnosis, this association was limited to those who had been diagnosed with stage II or III breast cancers. Also, sexual functioning scores increased significantly with increasing adherence scores of dietary guidelines among those with stage II or III breast cancers (p for trend < 0.001). However, among those who had been diagnosed with stage I, higher scores of dietary guidelines were associated with higher scores of pain (p for trend=0.03) and breast symptoms (p for trend=0.05). Conclusions: Our study suggested that the health-related quality of life levels of breast cancer survivors are associated with the adherence to dietary guidelines and may differ by the stage of the breast cancer.

• Physical Therapy Rehabilitation Science
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• v.5 no.2
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• pp.53-62
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• 2016

Objective: The aim of this systematic review was to investigate for effective strategies to improve home exercise program (HEP) adherence in vestibular rehabilitation (VR). Design: Systematic review. Methods: A systematic review was conducted to identify effective strategies used to improve HEP adherence of patients in VR. Six databases, Academic Search Premier, Cochrane Library, CINAHL, PUBMED, PsycINFO, and Web of Science were searched from their inception to December 31, 2015. The keywords used for search were 'home program', 'home intervention', 'compliance', 'adherence', 'vestibular rehabilitation', 'motion sickness', and 'motion sensitivity'. Results: A total of eight studies were selected to be included in the review. There was 95.2% agreement between the two reviewers who reviewed the studies using a quality assessment tool. The overall inter-rater agreement (${\kappa}$=0.73) showed good agreement between the reviewers. Strong evidence was identified for 3 major categories of effective HEP adherence strategies, 1) providing patient with written summary of HEP; 2) asking patient to maintain a record of HEP and symptoms; and 3) providing tele-rehabilitation in form of email and/or telephone support along with in person treatment sessions. Also, based on strong evidence, computerized technology was not found to be superior to other strategies for improving patients' HEP adherence in VR. Conclusions: The effective strategies for improving HEP in VR include written summary of exercise, maintenance of log of HEP and symptoms and tele-rehabilitation along with in person treatment sessions.

• Research in Community and Public Health Nursing
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• v.22 no.3
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• pp.290-301
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• 2011

Purpose: This study is a descriptive research intended to clarify the medication status of community-dwelling elders and to identify factors affecting their medication adherence. Methods: Data were collected using questionnaires and interviews from 101 subjects who had taken prescribed drugs for at least 7 days sampled among elderly people using home care nursing at a general hospital in Seoul. Results: According to the results of this study, medication adherence measured by pill counting was 88.3% and that measured by self-reporting was 94.6%. There were statistically significant differences in medication adherence according to major disease (p=.006), the number of admissions (p=.032), the number of drugs (p=.051), the frequency of medication (p=.026), and depression (r=-.205). In addition, depression was found to be a significant variable explaining the medication adherence with explanatory power 3.8% (p=.035). Conclusion: The presence of depression affected the elderly subjects' the medication adherence. Therefore, more concern and educational approaches are required to encourage elderly people to comply correctly with medication regimens particularly for elderly patients who have a malignant or long-lasting disease or who have to take multiple drugs or maintain a daily dosing frequency.

• Preventive Nutrition and Food Science
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• v.17 no.4
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• pp.254-260
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• 2012

This study surveyed dietary intake and adherence to the Korean national dietary guidelines in Korean adolescents. To elucidate basic data for use in nutrition education, which aims to improve adolescent compliance with the national dietary guidelines and to increase the intake of dietary fiber, we evaluated the sources of fiber in adolescent diets. This study included 182 male and 212 female students from 2 middle schools in the Jeonju province. From November 15~20, 2011, we surveyed the students for general characteristics, adherence to the Korean national dietary guidelines, and dietary intake. Dietary fiber intake was $16.57{\pm}6.95$ g/day for male students and $16.14{\pm}7.11$ g/day for female students. The food groups that contributed most to dietary fiber intake were (in descending order) cereals, vegetables, seasoning, and fruits. The fiber-containing food items consumed most were cabbagekimchi, cooked rice, instant noodles, and cabbage. Based on adherence to the Korean national dietary guidelines, the vegetable-based intake of dietary fiber in groups 1 (score 15~45), 2 (score 46~52), and 3 (score 53~75) were $4.41{\pm}2.595$ g/day, $4.12{\pm}2.692$ g/day, and $5.49{\pm}3.157$ g/day, respectively (p 0.001). In addition, the total intake of dietary fiber varied significantly among the three groups (p 0.001) as follows: Group 1, $14.99{\pm}6.374$ g/day; Group 2, $15.32{\pm}6.772$ g/day; and Group 3, $18.79{\pm}7.361$ g/day. In this study, we discovered that adherence to the Korean national dietary guidelines correlates with improved intake of dietary fiber. Therefore, marketing and educational development is needed to promote adherence to the Korean national dietary guidelines. In addition, nutritional education is needed to improve dietary fiber consumption through the intake of vegetables and fruits other than kimchi.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7207-7213
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• 2013

Background: Despite the efficacy of regular mammograms, the incidence and mortality rate of breast cancer have been increasing in China. Insufficient studies on the factors affecting mammography adherence in Chinese married women have been conducted. The purpose of the present study was to explore the factors associated with adherence to guidelines for regular mammography among Chinese married women. Materials and Methods: The participants were recruited conveniently and included Chinese and Korean Chinese women who were married, living at Yanbian City in China. Demographic information, status regarding eight risk factors of breast cancer, health responsibility, and perceived benefits/barriers of mammography were obtained. Descriptive analyses, t-test, and multivariate analysis were performed. Hierarchical logistic regression was conducted to explore the factors associated with regular mammography adherence in Chinese and Korean Chinese subgroups. Results: About 24% of the sample population was adherent in going for regular mammography. The adherent group was significantly more educated, had more children, and had a lower proportion experiencing early menarche and a greater menopausal proportion than the non-adherent group. The final model using logistic regression analysis showed that being Chinese [OR=2.199 (1.224-3.951)], having no or one child [OR=4.879 (1.835-12.976)], early menarche [OR=3.515 (1.057-11.694)], being menopausal [OR=3.120 (0.965-10.088)], aged 40-49 [OR=2.374 (1.099-5.124)], having low education [OR=0.400 (0.211-0.765)], and perceiving greater benefits in doing mammography [OR=1.080 (1.014-1.151)] were significantly associated with mammography adherence, after controlling for covariates. Conclusions: Sociocultural sensitive intervention for minorities should be emphasized when improving the adherence of regular mammography. Intervention tailored for women with lower education should be delivered and the benefits of mammography should be propagated to women in rural areas of China.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.127-134
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• 2017

This study investigated empirically the structural relationship of golf participants' basic psychological needs, exercise emotion, and exercise-adherence behavior. Using two-hundred thirty questionnaires, the results were as follows. First, golf participants' autonomy, competence, and relatedness had a significant impact on the positive emotions. On the other hand, only competence lowered the negative emotions, and the other variables did not have a significant impact. Second, golf participants' autonomy, competence, and relatedness increased the exercise-adherence behavior. Third, golf participants' positive emotion increased the exercise-adherence behavior but a negative emotion decreased it. In terms of the indirect effect, golf participants' autonomy, competence, and relatedness influenced the exercise-adherence behavior, which was mediated by exercise emotion. This study is useful to sports participants interested in real value and a happy life through exercise-adherence behavior.

• Journal of Korean Biological Nursing Science
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• v.19 no.1
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• pp.18-29
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• 2017

Purpose: This study investigates the status of medication use of the elderly with chronic disease taking non-opioid analgesics and attempts to identify factors influencing medication adherence. Methods: Data were collected from September 1 to October 19, 2016. A structured questionnaire was used for face-to-face interview with a convenience sample of 161, elderly people with chronic disease taking non-opioid analgesics. The survey included questions about status of medication use, medication adherence, symptom experience, depression and family function. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficients, and stepwise multiple regression with IBM SPSS 23.0 program. Results: The mean score of medication adherence of the elderly with chronic disease was $4.48{\pm}2.35$. Experiences of side effects (${\beta}=.31$, p< .001), use of over-the-counter pain medication (${\beta}=.19$, p= .009), and family function (${\beta}=.16$, p= .031) were identified as significant predictors. The final model explained 18.0% of the variation of medication adherence of the elderly with chronic disease taking non-opioid analgesics (F= 12.30, p< .001). Conclusion: Therefore, as a strategy to improve medication adherence of the elderly with chronic disease, therapeutic intervention should be developed to improve family function and to manage with personalized plans considering experiences of side effects and use of over-the-counter pain medication.

• Korean Journal of Clinical Pharmacy
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• v.26 no.2
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• pp.128-136
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• 2016

Objective: This study was to explore the association between having a usual source of care and adherence to medicines in patient with chronic diseases. Methods: The 2012 Korea Health Panel was used as a data source. We analyzed 4,418 respondents that were diagnosed with chronic diseases and utilized health care services. Non-adherence to medication, a dependent variable, was defined as "not taking the medicines that were prescribed for treating chronic disease" or "not following the direction for medication". Whether having a usual source of care or not was used as a key independent variable, which was defined as having a regular site or a regular doctor for medical test, treatment, and consultation. Sex, age, education level, marital status, income, the type of health insurance, the number of chronic disease and CCI (Charlson Comorbidity Index) were included as covariates in the analysis. We conducted a multivariate logistic regression. Results: Totally, 30 percent of respondents reported to experience non-adherence to medication. Having a usual source of care was significantly associated with lower non-adherence to medication regardless its type, which is a regular doctor (OR=0.61, 95% CI=0.53-0.70) or a regular site (OR=0.67, 95% CI=0.58-0.78). Furthermore, having a usual source of care was associated with both of medication persistence (OR=0.66, 95% CI=0.54-0.81) and compliance (OR=0.65, 95% CI=0.56-0.76). Conclusion: Our results showed the possibility that usual source of care is able to conduct a positive role in improving adherence to medication with better management of chronic disease.

• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.665-672
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• 2015

Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.