Glaucoma is a potentially blinding chronic disease requiring life-long commitment to medical therapy. Failure to adhere to anti-glaucoma treatment may lead to disease progression and visual loss. This study surveyed the adherence to glaucoma eye drop and eye drop instillation technique of glaucoma patients and analyzed the improvement of the adherence and installation technique after patient education for eye drop instillation instructions. Collected responses were statistically analyzed using Kruskal-Wallis test, Mann-Whitney test, Chi-square test, Fisher's exact test, Spearman's correlation coefficient, or one sample proportion test. The survey after patient education for proper eye drop instillation revealed that, even if the patients experienced the adverse effect of their eyes getting dry, they used the eye drop more regularly. They were better at instillation techniques like putting the eye drop inside the eye, and also avoiding applying too much medication or touching their eye with the eye drop bottle. Also, when the patients were divided into groups based on etiologic division, there was difference among groups regarding which category they answered has improved. The result showed improvement in adherence to glaucoma eye drop and eye drop instillation technique after patient education, implicating that patient education is an important aspect of eye care for glaucoma patient and helps them participate in the proper management.
Iron is an essential element for almost all living organisms. The possible role of iron for growth, adherence and cytotoxicity of Entamoeba histolytica was evaluated in this study. The absence of iron from TYI-S-33 medium stopped amebic growth in vitro. However, iron concentrations in the culture media of 21.4-285.6 ${\mu}M$ did not affect the growth of the amebae. Although growth was not retarded at these concentrations, the adhesive abilities of E. histolytica and their cytotoxicities to CHO cell monolayer were correlated with iron concentration. Amebic adhesion to CHO cell monolayers was significantly reduced by low-iron ($24.6{\pm}2.1%$) compared with $62.7{\pm}2.8\;and\;63.1{\pm}1.4%$ of amebae grown in a normal-iron and high-iron media, respectively. E. histolytica cultured in the normal- and high-iron media destroyed $69.1{\pm}4.3%\;and\;72.6{\pm}5.7%$ of cultured CHO cell monolayers, but amebae grown in the low-iron medium showed a significantly reduced level of cytotoxicity to CHO cells ($2.8{\pm}0.2%$). Addition of divalent cations other than iron to amebic trophozoites grown in the low-iron medium failed to restore levels of the cytotoxicity. However, when E. histolytica grown in low-iron medium were transferred to normal-iron medium, the amebae showed completely restored cytotoxicity within 7 days. The result suggests that iron is an important factor in the adherence and cytotoxicity of E. histolytica to CHO cell monolayer.
Objectives: Acceptability of patients towards obesity treatment program is associated with better weight loss outcomes. The purpose of this study was to review previously published study results of the predictive factors associated with patients' acceptability in obesity treatment. Methods: Authors searched for the articles related to acceptability reported as continuation, attendance and adherence, published from 2011 to 2018 found on Pubmed, Scopus, Research Information Sharing Service, and Koreanstudies Information Service System. A total of 23 articles were finally selected. From the study results, unchangeable and changeable predictors were extracted, and these predictors were examined according to detail categories. Results: Regarding the continuation of the treatment, unchangeable factors such as younger age, lower educational level, male sexuality and lower accessibility to physical activity predicted lower continuation. Furthermore, changeable factors such as early and half weight loss, better accessibility to the treatment and financial incentives for retention predicted higher continuation rate. Greater degree of attendance was predicted by unchangeable factors such as economical affordability, and changeable predictors such as half weight loss and proximity to the clinic. Main factors of adherence to the recommendation were unchangeable predictors such as weight loss experience, and changeable predictors such as more physical activity and appropriate dietary habits. Negative psychological state predicted lower continuation, attendance and adherence rate. Conclusions: Our review results suggest that unchangeable and changeable predictors of acceptability of patients should be carefully examined during treatments of obesity.
Significant advances in the diagnosis and medical care of children with chronic kidney disease (CKD) are major reasons for the better survival rates of children and adolescents with CKD than the survival rates reported in previous decades. These patients are reaching adulthood, and therefore require a transition to adult medical care. This transition phase is well-recognized to be associated with considerably increased morbidities and medical problems, such as non-adherence, graft loss after transplantation, and loss to follow-up. Low adherence increases morbidity and medical complications and contributes to poorer qualities of life and an overuse of the health care system. However, these tragic outcomes may be avoidable through a structured and well-defined transition program. In the last decade, there has been increasing interest to resolve these medical and psychological problems that occur during the transfer of young adult patients from pediatric to adult renal units. The aims of a successful transition from pediatric to adult medical care include enhancing the individual development of better health-competence and stabilizing, or even improving, the state of health. This review will focus on various aspects of the transition phase of adolescents who have CKD or who underwent kidney transplantation from pediatric to adult nephrology care.
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.
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.
Chu, Sang Hui;Ko, Il Sun;Lee, Won Hee;Yoo, Ji Su;Kang, Seok-Min;Jung, Ha Yoon;Kim, Doo Ree;Ahn, Ji Hyeon;Lee, Yoon Ju
Journal of Korean Biological Nursing Science
/
v.14
no.3
/
pp.193-202
/
2012
Purpose: The purpose of this study was to explore socio-demographic, clinical and psychological factors associated with medication adherence among patients with chronic heart failure (CHF). Methods: In a cross-sectional survey, 133 patients with CHF who had visited a clinic located in Seoul participated. Medication adherence (MA) was measured using a single item visual analogue rating scale (VAS). Barriers and attitudes toward adherence, and depression were measured using a structured questionnaire. Medical records were reviewed to identify their clinical characteristics. Multivariate logistic regression was performed identify factors affecting medication adherence. Results: About one third of participants (31.1%) reported their MA as 100%. Overall attitudes on MA were highly positive and 49 (36.8%) of participants were depressive. MA was associated with significantly barriers (p<.001), attitudes (p<.001), age (p<.001), and duration of disease (p<.001). The high adherent group had significantly less barriers than other groups (OR=.389, p=0.02). Conclusion: This study indicates that barriers and attitudes toward MA were the most important factors affecting their adherence to HF medication. To improve MA for patient with CHF, the nursing strategies which can lead poor adherent patients to their optimal level should be developed.
Coronary artery disease(CAD) is associated with a high risk of recurrence and an increased mortality rate upon recurrence. Consequently, there is a need for continuous health behavior recommendations from medical staff. Therefore, a study was conducted on 219 patients hospitalized for coronary angiography. The study aimed to investigate the influence of medical staff recommendations on exercise adherence among CAD patients. In conclusion, regular exercise(RE) recommendation(OR 3.52, p=.036) and dietary advice from medical staff(OR 6.48, p=.022), having high exercise self-efficacy(OR 1.36, p=.001) positively affected RE adherence. Therefore, medical staff should strengthen personalized recommendations for RE and healthy diets, as well as develop exercise self-efficacy enhancement programs to encourage patient participation. Future research is recommended to explore the impact of the degree and method of medical staff recommendations on self-management practices among CAD patients.
Purpose: This study was to ascertain whether there are differences in health care utilization and expenditure for Type I Medical Aid Beneficiaries before and after applying Copayment. Methods: This study was one-group pretest posttest design study using secondary data analysis. Data for pretest group were collected from claims data of the Korea National Health Insurance Corporation and data for posttest group were collected through door to-door interviews using a structured questionnaire. A total of 1,364 subjects were sampled systematically from medical aid beneficiaries who had applied for copayment during the period from December 12, 2007 to September 25, 2008. Results: There was no negative effect of copayment on accessibility to medical services, medication adherence (p=.94), and quality of life (p=.25). Some of the subjects' health behaviors even increased preferably after applying for copayment including flu prevention (p<.001), health care examination (p=.035), and cancer screening (p=.002). However, significant suppressive effects of copayment were found on outpatient hospital visiting days (p<.001) and outpatient medical expenditure (p<.001). Conclusion: Copayment does not seem to be a great influencing factor on beneficiaries' accessibility to medical services and their health behavior even though it has suppressive effects on outpatients' use of health care.
Purpose: In this study an examination was done of the effect of self-efficacy promoting vestibular rehabilitation (S-VR) on dizziness, exercise self-efficacy, adherence to vestibular rehabilitation (VR), subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness in patients with vestibular hypofunction. Methods: This was a randomized controlled study. Data were collected 3 times at baseline, 4 and 8 weeks after beginning the intervention. Outcome measures were level of dizziness, exercise self-efficacy, and level of adherence to VR. Subjective and objective vestibular function, vestibular compensation and the recurrence of dizziness were also obtained. Data were analyzed using Windows SPSS 21.0 program. Results: After 4 weeks of S-VR, there was no difference between the groups for dizziness, subjective and objective vestibular functions. However, exercise self-efficacy and adherence to VR were higher in the experimental group than in the control group. After 8 weeks of S-VR, dizziness (p =.018) exercise self-efficacy (p <.001), adherence to VR (p <.001), total-dizziness handicap inventory (DHI) (p =.012), vision analysis ratio (p =.046) in the experimental group differ significantly from that of the control group. The number of patients with recurring dizziness were higher in the control group than in the experimental group (p <.001). Conclusion: The results indicate that continuous 8 weeks of S-VR is effective in reducing dizziness, and improving exercise self-efficacy, subjective vestibular function and adherence to VR. Objective vestibular function and vestibular compensation were also improved in the experimental group at the end of 8 weeks of S-VR.
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