• Title/Summary/Keyword: Noncompliance

Search Result 51, Processing Time 0.115 seconds

Influence of Non-compliance of Treatment and Family Support on Depression in Diabetic Patients with Hypoglycemia (저혈당을 경험한 당뇨병 환자의 치료지시 불이행, 가족지지가 우울에 미치는 영향)

  • Son, Hye Gyeong;Jeong, Kyeong-Sook
    • The Journal of the Korea Contents Association
    • /
    • v.18 no.6
    • /
    • pp.518-528
    • /
    • 2018
  • This study was to identify the effective factors on the Depression in Diabetic patients with hypoglycemia. This study used 119 questionnaires from Diabetic patients with hypoglycemia in B city to collect data from October 1, 2015 to March 15, 2016. Data were analyzed by SPSS 20.0 program using descriptive statistics, t-test, ANOVA, Scheffe's test. Pearson's correlation coefficient and Stepwise Multiple Regression. The Depression in Diabetic patients with hypoglycemia showed a positive correlation with Non-Compliance of Treatment(r=42, p<.001), a negative correlation with Family support(r=-.38, p<.001). According to the result of multiple regression analysis, the significant factors influencing depression were Family support(${\beta}=-.29$, p<.001), Drug therapy(${\beta}=.21$, p=.020), Dietetic therapy(${\beta}=.23$, p=.014), Monthly average income over 3,000,000won (${\beta}=-.20$, p=.014), Monthly average income 2,000-3,000 thousand(${\beta}=-.17$, p=.033), it was explained by 30.0%. Based on these findings, it is suggested to develop and apply a family support program to reduce the depression of diabetic patients with hypoglycemia.

Modified Docetaxel and Cisplatin in Combination with Capecitabine (DCX) as a First-Line Treatment in HER2-Negative Advanced Gastric Cancer

  • Bilici, Ahmet;Selcukbiricik, Fatih;Demir, Nazan;Ustaalioglu, Bala Basak Oven;Dikilitas, Mustafa;Yildiz, Ozcan
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.15 no.20
    • /
    • pp.8661-8666
    • /
    • 2014
  • Background: Docetaxel and cisplatin in combination with fluorouracil (DCF) regimen is accepted to be one of the standard regimens in the treatment of advanced gastric cancer. However, substantial toxicity has limited its use in daily clinical practice. Therefore, modification of DCF regimens, including introduction of capecitabine has been investigated to improve the safety profiles. In the present study, the efficacy and toxicity of a regimen with a modified dose of docetaxel and cisplatin in combination with oral capecitabine (DCX) was evaluated in untreated patients with HER2-negative advanced gastric cancer. Materials and Methods: Fifty-four patients with HER2-negative locally advanced or metastatic gastric cancer were included in this cohort. Patients received docetaxel $60mg/m^2$ plus cisplatin $60mg/m^2$ (day 1) combined with capecitabine $1650mg/m^2$ (days 1-14) every 3 weeks. Treatment response, survival, and toxicity were retrospectively analyzed. Results: The median age was 54 years (range: 24-76). The majority of patients (70%) had metastatic disease, while 11 patients (21%) had recurrent disease and underwent curative gastrectomy, and 5 patients (9%) had locally advanced disease (LAD). The median number of DCX cycles was 4. There were 28 partial responses and 11 complete responses, with an overall response rate of 72%. Curative surgery could be performed in four patients among five with LAD. At the median follow-up of 10 months, the median progression-free survival (PFS) and overall survival (OS) of the entire cohort of patients were 7.4 and 12.1 months, respectively. Dose modification was done in 12 patients due to toxicity in 8 and noncompliance in 4 patients. The most common hematological toxicity was neutropenia, which occurred at grade 3-4 intensity in 10 of 54 patients (27.7%). Febrile neutropenia was diagnosed only in two cases. Conclusions: DCX regimen offers prominent anti-tumor activity and considered to be effective first-line treatment with manageable toxicity for patients with HER2-negative advanced gastric cancer.

Analysis of Factors Affecting Nontherapeutic INRs in Korean Outpatients with Mechanical Heart Valves (인공심장판막 치환환자의 치료범위를 벗어난 INR 원인분석)

  • Lee Ju Yeun;Jeong Young Mi;Lee Myung Koo;Kim Ki-bong;Ahn Hyuk;Lee Byung Koo
    • Journal of Chest Surgery
    • /
    • v.38 no.11
    • /
    • pp.746-760
    • /
    • 2005
  • Background: Following the implantation of heart valve prostheses, it is important to maintain therapeutic INR to reduce the risk of thromboembolism. The objectives of this study were to determine the causes of nontherapeutic INRs, and to identify the factors associated with nonadherences to warfarin therapy in Korean outpatients with prosthetic heart valves managed by a pharmacist-run anticoagulation service (ACS). Material and Method: A retrospective chart review was completed for all patients enrolled in the ACS at Seoul National University Hospital from March, 1997b to September, 2000. The data on 868 patients (5,304 visits) who were at least 6 months post-valve replacement were included. All possible causes of nontherapeutic INRs were documented for each patient visit. The association of covariates to noncompliance was investigated by univariate analysis. Result: The reasons for nontherapeutic INRs were identified as follows: inadequate dosage adjustment $(21\%)$, nonadherences to dosing regimen $(13\%)$, drug/herbal interactions $(12\%)$, changes in diet $(7\%)$, and indeterminate cause $(42\%)$. Younger age, shorter duration of ACS and longer duration of warfarin therapy were associated with nonadherence. Conclusion: In this study, nonadherence and interactions between diet and medications were found to be important factors influencing nontherapeutic INRs. Longer duration of enrollment in the ACS affected the adherence to warfarin therapy Positively whereas younger age and longer duration of warfarin therapy affected negatively.

Nurse's Power and Tactics in Nursing Practice (간호사의 업무수행상의 권한과 행사전략)

  • Han, Hye-Ja
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.5 no.1
    • /
    • pp.23-37
    • /
    • 1999
  • This study is to understand and to describe the power that a nurse experiences on nursing practice and then. to present a basic data for nurse's power-development, power improving and empowering. Ethnography was used to understand and to describe experience on exercising various powers occurred on nursing practice. and to analyze and to understand the meaning of a nurse's power. The objects was nurses. Ten nurses who have more than three year's experience were selected as objects from Cuniversity's hospital in Seoul from May of 1996 to August of 1997 through in-depth interview. participant observation, and phone interview. Instruments werw a portable recorder and field notes. I described a case appeared in a data using Agar's 'Pencil and scissors' method right after collecting materials. Then, Idescribed a theme discovered commonly. Followings are the results of the study. 1. There were three categories of relationships with main objects when nurses exercised their power on their practices: a therapeutic caring relationship with patients, a relationship of companion, vertical cooperation, and a constituent person with a doctor, and a relationship of cooperation, and a constituent person with administrative workers and medical technicians. 2. There were many types of nurse's power, tactics and various patient's responses about them. 1) Types of nurse's power to patients were giving information, controling environment, helping for cure, emotional support, and performing discretion. 2) Nurse's tatics for performing power were positive tactics neutral tactics, and negative tactics. 3) Patient's responses were appeared as compliance and noncompliance. Compliance were agreeing. taking nurse's advice, trusting, understanding, being admitted, exposuring himself, and appreciating. 3. There were types of nurse's power and performing tactics. 1) Types of power to a doctor were advice, informing, demanding and mediation. 2) Performings of tactics to a doctor were positive tactics, neutral tactics, and negative tactics. 3) Doctor's responses were appeared as accepting and unaccepting. Acceptings were taking in and appreciating, and unacceptings were denying nurse's advice and authoritative. 4. There were types of nurse's power and tactics about administrative workers and medical technicians and responses about them. 1) Types of power about administrative workers and medical technicians were suggestions and demands. 2) Power performings tactics were positive tactics.neutral tactics, and negative tactics. 3) Responses of administrative workers and medical technicians about nurse's power performing were appeared appeared as accepting and unacce pting. Acceptings were taking in, and unacceptings were denying. Therefore, it can be said that types of nurse's power and performing tactics on nursing practice and nurse's power based on responses of a patient, a doctor, an administrative worker, and a medical technicians are power or influence for agreeing, taking advice, trusting, understanding, exposuring himself, appreciating, and taking in to objects. The results of this study helped to understand nurse's power. I expect that this study will improve nure's power by using expert power, referent power, and legitimate power effectively among powers acmpanied with the origin and that nurses make ef-ort to improve professional knowledge and human nature so that they use this study as a chance to develope expert nursing practice.

  • PDF

Compression Plate Fixation with Autogenous Bone Graft for Humerus Shaft Nonunion (상완골 간부 불유합에 대한 금속판 고정 및 자가골 이식술)

  • Cho, Chul-Hyun;Song, Kwang-Soon;Bae, Ki-Cheor;Kim, In-Kyoo;Kwon, Doo-Hyun
    • Clinics in Shoulder and Elbow
    • /
    • v.12 no.1
    • /
    • pp.33-37
    • /
    • 2009
  • Purpose: To evaluate the results of the compression plate fixation and autogenous bone graft in the management of humerus shaft nonunion. Materials and Methods: Eighteen cases were treated for humerus shaft nonunion using compression plate fixation and an autogenous iliac bone graft. The mean follow-up period was 28 months. Bony union was confirmed from the serial radiographs and the clinical outcomes were assessed according to ASES scoring system. Results: In 12 cases of initial plate fixation, the causes of nonunion were 6 cases of inadequate plate length, 2 with a broken plate, 2 with screw loosening, 1 infection and 1 noncompliance of a psychiatric patient. In 3 cases of initial intramedullary fixation, the cause of nonunion was a distraction of the fracture site. In 3 cases of external fixation, the cause of nonunion was inadequate fixation. All cases showed bony union after an average of 24 weeks. The clinical outcomes were 11 excellent, 6 good and 1 fair. Conclusion: In the treatment for nonunion, compression plate fixation with autogeneous bone graft after complete removal of the fibrous and necrotic tissue is believed to give satisfactory results.

Evaluation on the Efficiencies of Local Exhaust Systems and Airborne Concentrations of Total Chromium, Hexa-valent Chromium and Nickel in Some Electroplating Plants (일부 영세 도금사업장의 국소배기성능과 공기중 총크롬, 6가 크롬 및 니켈농도와의 관계분석)

  • Park, D.U.;Park, D.Y.;Shin, Y.C.;Oh, S.M.;Chung, K.C.
    • Journal of Korean Society of Occupational and Environmental Hygiene
    • /
    • v.3 no.1
    • /
    • pp.68-77
    • /
    • 1993
  • To evaluate efficiencies of the local exhaust systems installed in chromiun and nickel eletroplating tanks, specifications of each tank and general performances of the local exhaust systems were measured in 16 electroplating plants from July 3 to November 24, 1992. Airborne concentrations of total chromium, hexa-chromium and nickel were also measured, Most of the local exhaust systems installed in electroplating plants were inadequately designed. Average capture velocities of local exhaust systems in chromium and nickel tanks were 0.45 m/sec and 0.29 m/sec. Average slot velocities in chromium and nickel tanks were 7.30 m/sec and 2.87 m/sec repectively. Both average capture and solt velocities were in noncompliance with the standards recommened by American Conference of Governmental Industrial Hygienists (ACGIH) and National Institute for Occupational Safety and Health (NIOSH), Exhausted air volume was insufficient in all local exhaust systems surveyed. Worker exposure levels to total chromium, hexa-chromium and nickel were $43.0{\mu}g/m^3$, $1.7{\mu}g/m^3$ and $9.3{\mu}g/m^3$, which were below the Korean Standard and U.S. Occupational Health and Safety Administration (OHSA) Permissible Exposure Limit(REL). However, Worker exposure level to hexa-chromium exceeded the NIOSH Recommended Exposure Limit(REL) of $1{\mu}g/m^3$. As the result of Scheffee's multiple comparions, worker exposure levels to all metals were significantly different between two groups by the management state of existing local exhaust systems (p<0.05). However, Difference between a group with local exhaust systems which were poorly managed and another group without local exhaust system was satatistically non-significant.

  • PDF

A study on the impacts of infection control education on dental hygienists' perceptions for hepatitis type B and their practices to prevent infection (감염관리교육이 서울지역 치과위생사의 B형 간염에 대한 인식 및 감염방지행위 실천에 미치는 영향에 관한 연구)

  • Kim, Bo-Young;Park, Ji-Man;Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
    • /
    • v.52 no.4
    • /
    • pp.287-297
    • /
    • 2014
  • Purpose: The purpose of this study is to examine the impacts of infection control education on dental hygienists' perceptions for hepatitis B and their behaviors. Materials and methods: Study participants were chosen by random selection among dental hygienists working in Seoul, Korea. A total of 150 questionnaires were sent out for the survey from April 2013 to May 2013, of which 140-excluding incomplete responses-were used for the study. Chi-square tests and t-tests were used (SPSS 19.0), and post-hoc analysis was performed as well. The maximum significance level was 0.05. Results: Average 1.53 times infection control education was taken, but dental hygienists' perceptions for hepatitis B and their behaviors did not show statistical differences whether the education was done or not. Practices to prevent infection showed differences depending on categories, especially disinfection and sterilization were well performed by educated group. The most common reasons for not taking the education and noncompliance with infection prevention guidelines are lack of time and opportunity due to busy schedule. Conclusion: 1. The more highly educated, the greater number of patients per day, and the greater size of hospitals, the better infection control education was conducted. 2. Although hepatitis B is one of the most common chronic liver diseases in Korea, no significant correlation between perceptions of hepatitis B and infection control education was found. 3. Dental hygienists who received infection control education performed more efficient practices for protection against infections than those who did not.

A Study Analyzing Nursing Diagnoses and Nursing Interventions used in a Demonstration Home Care Project (가정간호 시범사업 간호진단 및 간호중재 분석 연구)

  • Suh, Mi-Hae;Lee, Hae-Won;Chun, Choon-Young
    • The Korean Nurse
    • /
    • v.34 no.5
    • /
    • pp.52-67
    • /
    • 1996
  • As home care in developing and becoming part of the health care delivery system in Korea, it is necessary to examine the use of nursing diagnoses and related nursing interventions with a view to increasing the standardization of nursing recording. This study was done to examine the nursing diagnosis and related nursing interventions used in home care. Data were collected using a chart review of the nursing notes written for the home care given to 38 patients who had pulmonary diseases or traumatic brain or spinal cord injuries and who had received home care as part of a demonstration home care project in a college of Nursing in Seoul. Early on in the project discussions as to format and use to nursing diagnosis was done and a tool was developed based on Gordon's eleven functional catergories with the addition of categories to cover family and environment. This tool was used in the data collection. Data included nursing diagnosis, etiologies and interventions. Real numbers and percentages were used in the analysis. The results show that the most frequently used diagnoses were in the category of physical function (75.6%), followed by the category of emotional and social function (21.8%). The least frequently used category was the one for family and environment (2.6%). The order of the frequency of recorded nursing interventions was the same, 82.3% for physical function, 16.2% of emotional and social function and 1.5% for family and environment. Under the category of physical functioning the most frequently used nursing diagnoses were related to mobility (62.2%), nutrition (23.6%) and elimination (11.9%). The frequencies of nursing interventions for these three diagnostic categories were 69.8%, 16.0% and 10.8% respectively. For emotional and social functioning, the most frequently used diagnoses were for cognition-perception (37.1%), self-perception (30.6%) and perception of health (23.7%). The ordering of the frequency of nursing interventions varied slightly. The most frequently used interventions were for the category of self-perception (31.7%) followed by cognition-perception (24.1%) and perception of health (22.9%). Looking at individual diagnoses, it was found that within the categroy of physical functioning, the most frequently used diagnosis was "impaired physical mobility" (29.5%) and this diagnosis involved 43.9% of the interventions. This was followed by "ineffective breathing pattern" (19.4%) with 17.7% of interventions, and "alteration in nutrition, less than body requirements" (11.2%) with 8.1% of the interventions. For the emotional social category, noncompliance was the most frequently used nursing diagnosis (18.2%) with 19.2% of the interventions. This was followed by "anxiety" (13.4%) with 13.6% of the interventions and by "knowledge deficit" (13.4%) but with only 5.5% of the interventions. The other diagnoses and interventions did not follow this pattern of frequency. Although there were a large number of diagnostic and intervention events, the number of actual diagnoses and interventions used were relatively small ranging from six interventions for "knowledge deficit" to 40 interventions for "imparied physical mobility". From this it can be concluded that the results of this study could be used as basic data for the development of standardized charts with respect to nursing diagnosis and interventions for clients with pulmonary disease and clients with traumatic brain or spinal cord injuries. Interventions that were direct care activities (1178) were much more frequent that education (430), and assessment and observation (148). There were also few diagnoses or interventions related to the family and the environment. This suggests two areas that need to be developed in home care and that need to be considered in the development of standardized records for use in home care.

  • PDF

A Study for Investigating of Predictors of Compliance for Preventive Health Behavior. -centered on early detection of cervical cancer- (예방적 건강행위 이행의 예측인자 발견을 위한 연구-자궁암 조기발견을 중심으로-)

  • 이종경
    • Journal of Korean Academy of Nursing
    • /
    • v.12 no.1
    • /
    • pp.25-38
    • /
    • 1982
  • As technological civilization and medical science has developed, standards of living have imp-roved and human life expectancy has been extended. But the incidence and mortality rate of cancer have been gradually increasing due to the pollution of the environment. Even though cancer is still a great threat to human beings, the etiology and appropriate cure forcancerhavenotyetbeendiscovered. The early detection and treatment of cancer is urgently needed. This study concentrates on the health behavior of woman regarding the papanicolau smear for early detection of cervical cancer. It was done in order to provide a direction for scientific health education materials by investigating predictors of preventive health behavior. The subjects for this study were made up of 54 woman, who comply with preventive health practices(compliant) who attended the Cervical Cancer Center of Y University Hospital in order to have tests for early detection of cervical cancer and 54 woman who did not comply with preventive health practices (noncompliant) selected from 100 housewives of I apartment, Kang Nam Ku, Seoul. The study method used, was a questionnaire for the compliance group and an interview for the noncompliance group. The period for data collection was from October 13th to October 24th. 1981. Analysis of the data was done using percentages, T-test, Pearson Correlation and Stepwise Multiple Regression. The results of study were as follows: 1. The hypotheses tested were based on the health belief model; 1) The first hypothesis,“The compliant may have more knowledge of the cervical cancer than the noncompliant”was rejected(T=-1.86, p>.05) 2) The second hypothesis,“The compliant may have a higher severity of cervical cancer than the noncompliant”was accepted (T=5.41, p<.001) 3) The third hypothesis, “The compliant may have a higher susceptability to cervical cancer than the noncompliant”was accepted(T=3.51, p<.01). 4) The fourth hypothesis,“The compliant may have more beneHt than cost'from the cervical cancer tests than the noncompliant" was accepted(T=7.46, p<.001). 5) The fifth hypothesis,“The compliant may have more health concern than the noncompliant”. was accepted(T=3.39, p<.01). These results show that severity, susceptability, benefit(over cost) and health concern influence the preventive health behavior in this Study. 2. In the correlation among variables, it was found that the knowledge of cervical cancer and the benefit(over cost) of preventive health behavior were negatively correlated(r=-2.75, p<.01), Severity of cervical cancer and benefit (over cost) of preventive health behavior were positively correlated(r=.280, p<.01), severity and susceptability of cervical cancer were positively correlated(r= .238, p<.01), benefit(over cost) and health concern were positively correlated(r= .299, p<.01). The benefit(over cost) may be raised by increasing the severity and health concern. Therefore the compliance rate of woman may be raised through health education by increasing the benefit(over cost) of the individual. 3. The Stepwise Multiple Regression between health behavior and predictors. 1) The factor“Benefit(over cost)”could account for preventive health behavior in 34.4% of the sample(F=55.6204 P<.01). 2) When the factor“Severity”is added to this, it accounts for 44.3% of preventive health behavior(F=41.679, p<.01). 3) When the factor“Susceptability”is also included, it accounts for 46.7% of preventive health behavior(F=30.373, p<.01). 4) When the factor “Health concern”is included, it accounts for 48.1% of preventive health behavior(F=23859, p<.05). This means that other factors appear to influence preventive health behavior, since the combination of variables explains only 48.1% of the Preventive health behavior. Therefore further study to investigate the predictors of preventive health behavior is necessary.

  • PDF

A Study on the Relationship between the Tax Evasion Factors and the Tax Evasion Inclination of Value Added Tax in Korea (부가가치세 포탈요인과 포탈성향에 관한 실증적 연구)

  • Kim, Beom-Jin;Ham, Young-Bok
    • Korean Business Review
    • /
    • v.14
    • /
    • pp.1-30
    • /
    • 2001
  • To prevent the VAT evasion and to form a sound VAT paying culture, we can draw the policy directions for government as follows: First, it is necessary to strengthen the tax supervision of small business and the administration of tax sources of cash-income industry. Second, the tax-deductible rate of the received tax invoices should be increased in a short-term base, and a simplified taxation system should be abolished in a long-term base. Third, in cases a trader has not received a tax invoice, an additional tax should be applied. Forth, to issue the tax invoice faster and conveniently, it is requested to introduce a new system which issues electronic card of registration when a businessman applies for his/her business registration. Fifth, to make tax standard transparent, it is desirable to punish the violator, relating to credit card regulations, stricter than present and to enforce the electronic bookkeeping. Sixth, for the reduction of noncompliance rate and creating a climate for autonomous, faithful tax return, it is necessary to expand and intensify tax investigation. And also it is necessary to make the level of penalty tax higher up and the level of criminal punishment less down, to keep up tax audit coverage. Seventh, a trader who is eligible for simplified taxation, whose tax base is under 12,000 thousand won, should not be required to pay the value added tax. But it is desirable to cut down them for the fairness of tax burden. Eighth, the effective date of the revised tax law should be fixed. Ninth, it is necessary to reinforce publicity and to educate on tax system and administration, for reducing tax evasion or tax avoidance and encouraging faithful tax return. Tenth, as the tendency of VAT evasion of distribution industry turns out to be the highest, it is requested not only to intensify tax administration on them but also to establish system and incentives, for introducing information system in distribution industry(introducing POS system, computerization of transaction record, establishing EDI between traders).

  • PDF