• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.28-40
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• 2019

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

• Journal of Korean Academy of Nursing
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• v.47 no.4
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• pp.514-525
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• 2017

Purpose: The purpose of this study was to construct and test a structural equation model for Diabetes self-management (DSM) behavior and Quality of life (QoL) in older adults with diabetes who use Citizen Health Promotion Centers. The theory used this study was a combination of the Information-Motivation-Behavioral Model (IMB) and Self-Determination Theory (SDT) to reflect autonomous characteristics of participants. Methods: Data were collected from April 20 to August 31, 2015 using a self-report questionnaire. The sample was 205 patients with type 2 Diabetes who regularly visited a Citizen Health Promotion Center. SPSS 22.0 and AMOS 22.0 programs were used to analyze the efficiency of the hypothesized model and calculate the direct and indirect effects of factor affecting the participants' DSM behavior and QoL. Results: The supported hypotheses were as follows; 1) The variable that had a direct effect on QoL was health behavior adherence (${\gamma}=.55$, p=.007). 2) The variables that had a direct effect on DSM behavior were DSM information (${\gamma}=.15$, p=.023), DSM confidence (${\gamma}=.25$, p<.001), and autonomous motivation (${\gamma}=.13$, p=.048). 3) The variable that had a direct effect on DSM confidence was autonomy support (${\gamma}=.33$, p<.001). Conclusion: The major findings of this study are that supporting patient's autonomous motivation is an influential predictor for adherence to DSM behavior, and integrative intervention strategies which include knowledge, experience and psychosocial support are essential for older adults with diabetes to continue DSM behavior and improve QoL.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5993-6000
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• 2012

The purpose of this study was to analysis instruments, identify relevant factors and analyze the effect size of intervention studies in reference to adherence among hemodialysis patients. Electronic literature searches were conducted for PubMed, CINAH, RISS, Naver academic, KISS, NDSL, Nanet, Kci, DBpia and KoreaMed. Of 437 studies identified, 37 met inclusion criteria, and 5 were used to estimate effect size. As a results, total of 11 original instruments were found, 61 factors were considered as relevant factors for adherence. Types of intervention were individual education program, self-care program using SMS, E-mail, or telephone counseling, supportive care program and drug education program. The effect size using random model effect was high (d=1.04, 95% CI: 0.60, 1.49, p<.00001).

• Korean Circulation Journal
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• v.52 no.10
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• pp.785-794
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• 2022

Background and Objectives: Self-monitoring of blood pressure (SMBP) is a reliable method used to assess BP accurately. However, patients do not often know how to respond to the measured BP value. We developed a mobile application-based feed-back algorithm (SMBP-App) for tailored recommendations. In this study, we aim to evaluate whether SMBP-App is superior to SMBP alone in terms of BP reduction and drug adherence improvement in patients with hypertension. Methods: Self-Monitoring of blood pressure and Feed-back using APP in Treatment of UnconTrolled Hypertension (SMART-BP) is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App compared with SMBP alone. Patients with uncomplicated essential hypertension will be randomly assigned to the SMBP-App (90 patients) and SMBP alone (90 patients) groups. In the SMBP group, the patients will perform home BP measurement and receive the standard care, whereas in the SMBP-App group, the patients will receive additional recommendations from the application in response to the obtained BP value. Follow-up visits will be scheduled at 12 and 24 weeks after randomization. The primary endpoint of the study is the mean home systolic BP. The secondary endpoints include the drug adherence, the home diastolic BP, home and office BP. Conclusions: SMART-BP is a prospective, randomized, open-label, multicenter trial to evaluate the efficacy of SMBP-App. If we can confirm its efficacy, SMBP-App may be scaled-up to improve the treatment of hypertension.

• The Journal of the Korea Contents Association
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• v.14 no.7
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• pp.367-375
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• 2014

This study aimed to develop a valid and reliable self-management instrument for pre-dialysis patients with chronic kidney disease (CKD). A total of 143 patients with CKD recruited from a medical center completed the questionnaire. The dimension and items of self-management were composed by literature review. The items of self-management was evaluated using exploratory factor analysis and measures of reliability. Five factors were extracted and labelled adherence to treatment regimen and partnership, diet adherence, problem solving, health behavior, and pursuit of psycho-social health. The five factors accounted for 51.1% of total variance. Each factors showed acceptable internal reliability with Cronbach's alpha from 0.64-0.79. The developed self-management instrument can be useful in self control of their disease for patients with CKD, and both evaluating patients' self-management and developing intervention program for health care professionals.

• Journal of Korean Academy of Nursing
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• v.48 no.4
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• pp.389-406
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• 2018

Purpose: This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma. Methods: We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies. Results: Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence. Conclusion: The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.

• Journal of muscle and joint health
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• v.19 no.2
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• pp.223-232
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• 2012

Purpose: The purpose of this study was to examine the relationships among perceived health status, exercise self-efficacy, social support, and exercise compliance and factors influencing exercise compliance in older adults in an area. Methods: The sample consisted of 154 older adults who attended a senior welfare center in D metropolitan city. Data were collected from the 25th to the 31th of January in 2012. Results: The mean score for perceived health status was 2.94, 911.69 for exercise self-efficacy, 46.99 for social support, and 6.83 for exercise compliance. The highest score on social support domains was emotional support, followed by self-esteem, material, and informational support. There were significant correlations between perceived health status and exercise self-efficacy, between perceived health status and exercise compliance, between exercise self-efficacy and social support, between exercise self-efficacy and exercise compliance, between emotional support and exercise compliance. Findings of multiple regression indicated that only exercise self-efficacy significantly explained exercise compliance. Conclusion: Health care providers may need to develop various intervention program to promote exercise self-efficacy in order to influence on exercise compliance and adherence among older adults.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1385-1391
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• 2016

Background: To investigate the prevalence of and factors associated with performance of annual mammography by women above 40 years of age. Materials and Methods: This cross-sectional retrospective study was conducted at an oncology reference service in Southern Brazil from October 2013 to October 2014 with 525 women aged 40 years or older. Results: The prevalence of annual mammography was 54.1%; annual mammographic screening was performed for women without private medical insurance, who were under hormone replacement therapy and who had used contraception in the past. An association was found between non-performance of breast clinical and self-examination and non-performance of mammographic screening. Conclusions: Use of mammography for breast cancer screening in the public health care setting proved to be accessible; nevertheless, the proportion of screened women was low, and they exhibited poor adherence to the basic measures of care recommended for breast assessment. Thus, control of breast cancer requires implementing actions targeting the population most vulnerable to non-adherence to screening in addition to continuously monitoring and assessing that population to reduce the prevalence of this disease.

• The Journal of the Korea Contents Association
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• v.19 no.2
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• pp.619-628
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• 2019

This study is an explanatory research conducted to analyze the influencing factors of treatment adherence in kidney transplant recipients. The subjects were 132 renal transplant recipients who visited the outpatient department in a university hospital. Data were collected from July 17, 2017, to August 22, 2017, and analyzed using SPSS WIN 24.0. Frequency, percentage, mean and standard deviation, variance analysis, correlation, and regression analysis were performed. The results of the study showed that there was a significant difference in the treatment adherence based on the age, religion, and the time passed since kidney transplantation. The study also found that the treatment adherence had significant positive correlations with social support (r=.54, p<.001), family support (r=.43, p<.001), health provider's support (r=.57, p<.001), and self-care knowledge (r=.21, p=.015). The factors influencing the treatment adherence were health provider's support, the time passed since kidney transplantation, spouse, and religion. The final explanatory power of the model was 41.9%. In conclusion, intervention strategies should be introduced to promote the support of healthcare providers in order to improve the adherence of the kidney transplantation patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4445-4450
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• 2016

Background: This study explored perspectives of health-care providers on childhood cancer treatment in Kenya. Materials and Methods: A self-administered questionnaire was completed by 104 health-care providers in January and February 2013. Results: Seventy six percent of the health-care providers believed cancer to be curable. More doctors than other health-care providers had this positive opinion (p=0.037). The majority of health-care providers (92%) believed that most children with cancer will not be able to finish their treatment due to financial difficulties. They considered that prosperous highly-educated parents adhere better with treatment (88%) and that doctors adhere better with treatment for prosperous highly-educated parents (79%). According to 74% of health-care providers, quality of care is better for prosperous highly-educated parents (74%). Most health-care providers reported giving more explanation (71%), work with greater accuracy (70%) and use less difficult vocabulary (55%) to prosperous more educated families. Only 34% of health-care providers reported they feel more empathy towards patients from prosperous families. Reasons for non-adherence with the protocol according to health-care providers are: family refuses drugs (85%), inadequate supply of drugs at pharmacy (79%), child looks ill (75%), and financial difficulties of parents (69%). Conclusions: Health-care providers' health beliefs and attitudes differ for patients with families having high versus low socio-economic backgrounds.