• 제목/요약/키워드: Self-care compliance

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A Meta-Analysis on Factors Related to Quality of Life in Heart Transplant Recipients (심장이식 수혜자의 삶의 질 관련 요인에 대한 메타분석)

  • Jang, Mi Ra;Im, Se Rah;Choi, Mona
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.251-264
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    • 2019
  • Purpose: This study was a systematic review and meta-analysis to explore the factors related to quality of life in heart transplant recipients. Methods: To identify studies that suggested the factors related to the quality of life in heart transplant recipients, we searched the articles published from 1974 to November 2018 using Six databases, PubMed, CINAHL, EMBASE, Cochrane, KMBASE and RISS. A total of 22 studies were selected out of 5,234 for the systematic review and meta-analysis on the basis of the PRISMA flow. The quality of study was assessed by assessment tool form the NIH and meta-analysis was performed using the 'R 3.5.2' version to analyze the correlated effect sizes. Results: Factors related to quality of life in heart transplant recipients were categorized into six domains based on the health-related quality of life model introduced by Ferrans: individual, environmental, biological function, symptoms, functional status, and general health perception. In the meta-analysis, 34 factors were used and 17 factors having significant effect sizes were as follows: self-efficacy, demoralization, perceived control, current occupational status, age, marital status, health promotion life style in the individual characteristics; stress in environmental characteristics; physical function status, creatinine level, left ventricular ejection fraction (LVEF) in biological function; anxiety, depression, symptom frequency and distress in symptoms domain; coping, self-care compliance in functional status. Conclusion: The findings indicate that the multi-dimensional factors influencing the quality of life in heart transplant recipients and provide the evidence for developing effective interventions for improving the quality of life of recipients.

Factors that Influence Awareness of Breast Cancer Screening among Arab Women in Qatar: Results from a Cross Sectional Survey

  • Donnelly, Tam Truong;Al Khater, Al-Hareth;Al-Bader, Salha Bujassoum;Al Kuwari, Mohammed Ghaith;Malik, Mariam;Al-Meer, Nabila;Singh, Rajvir;Fung, Tak
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.23
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    • pp.10157-10164
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    • 2015
  • Background: Breast cancer is the most common cancer among women in the State of Qatar. Due to low participation in breast cancer screening (BCS) activities, women in Qatar are often diagnosed with breast cancer at advanced stages of the disease. Findings indicate that low participation rates in BCS activities are significantly related to women's low level of awareness of breast cancer screening. The objectives of this study were to: (1) determine the factors that influence Qatari women's awareness of breast cancer and its screening activities: and (2) to find ways to effectively promote breast cancer screening activities among Arabic speaking women in Qatar. Materials and Methods: A multicenter, cross-sectional quantitative survey of 1,063 (87.5% response rate) female Qatari citizens and non-Qatari Arabic-speaking residents, 35 years of age or older, was conducted in Qatar from March 2011 to July 2011. Outcome measures included participant awareness levels of the most recent national recommended guidelines of BCS, participation rates in BCS activities, and factors related to awareness of BCS activities. Results: While most participants (90.7%) were aware of breast cancer, less than half had awareness of BCS practices (28.9% were aware of breast self-examination and 41.8% of clinical breast exams, while 26.4% knew that mammography was recommended by national screening guidelines. Only 7.6% had knowledge of all three BCS activities). Regarding BCS practice, less than one-third practiced BCS appropriately (13.9% of participants performed breast self-examination (BSE) monthly, 31.3% had a clinical breast exam (CBE) once a year or once every two years, and 26.9% of women 40 years of age or older had a mammogram once every year or two years). Awareness of BCS was significantly related to BCS practice, education level, and receipt of information about breast cancer and/or BCS from a variety of sources, particularly doctors and the media. Conclusions: The low levels of participation rates in BCS among Arab women in this study indicate a strong need to increase awareness of the importance of breast cancer screening in Qatari women. Without this awareness, compliance with the most recent breast cancer screening recommendations in Qatar will remain low. An increased effort to implement mass media and public health campaigns regarding the impact of breast cancer on women's health and the benefits of early detection of breast cancer must be coupled with an enhanced participation of health care providers in delivering this message to Qatar population.

Family Support: a Review of Nursing Literature on its Trends and Implementations (가족지지개념을 다룬 국내 간호연구 분석)

  • Park, Shin-Ae;Kang, Kyung-Sook;Jeong, Mi-Young;Cha, Nam-Hyun;Kim, Soon-Young
    • Research in Community and Public Health Nursing
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    • v.12 no.3
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    • pp.639-646
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    • 2001
  • The purpose of this study is to analyze the trend of nursing research related to family support and to provide an effective direction for future research by conducting a review of the Korean nursing literature from 1980 to 2000. A total of 73 studies were analyzed with the following results. 1) The number of studies related to family support has been rapidly increasing since 1984, and 77% of those were conducted in the 1990s. 48 studies, 65% of those analyzed. were degree-based research including 4 doctoral theses (4%) and 45 master's theses (62%). 2) Based on the objective frame of study types developed by Lee et al. (991), the types of studies were analyzed: 56 studies, 76.6% of those reviewed, belonged to factor-relating: 9 studies (12.4%) belonged to factor-isolating: 7 studies (9.6%) belonged to situation-producing: and only 1 study (1.4%) belonged to situation-relating research, respectively. 3) In terms of research design, most studies of analyzed (90.4%) were conducted by non-experimental design, and 7 studies (9.6%) were conducted by experimental design. But, qualitative research related to family support was not found. 4) In terms of research subjects, target populations of experimental studies were patients with arthritis, mental disorder, tuberculosis, coronary artery disease and hypertension. In correlational studies, 51 studies, 69.9% of those analyzed, were conducted to patients with renal failure, cancer and hemiplegia, and 5 studies (6.8%) were conducted to aged people and adolescents. 5) Study concepts used in correlational studies were quality of life, anxiety and depression, self-esteem, hope, role behavior, compliance and self-care activities. The quality of life was most often used among studies with 12.5% of those analyzed. 6) Nursing interventions, including diet therapy, family involving education and supportive care, used in experimental studies mostly showed positive effects on client involvement and home health improvement. However, the nursing interventions of mental health rehabilitation and resistance exercise showed neutral and negative results. The findings of this study provide evidence that more empirical research including experimental or qualitative studies should be conducted actively to improve nursing practice related to family support. Also, to promote more diverse nursing interventions, a family assessment tool especially for Korean families needs to be developed.

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Attitudes toward, and Practice of Hand Washing by Student Nurses in Clinical Practice (간호대학생의 임상 실습에서의 손씻기 수행 및 태도 조사)

  • Ko Il-Sun;Kang Kyu-Sook;Song In-Ja;Park Jin-Hee;Youk Shin-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.9 no.2
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    • pp.165-179
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    • 2002
  • Purpose: This descriptive study was done to evaluate the attitude and practice of hand-washing by student nurses. Method: The subjects of the study were 463 senior and junior undergraduate student nurses and RN-BSN students. The questionnaire was developed by the researchers Data were collected from Oct. 16 to Dec. 20. 2001. and analysed by SPSS/WIN. General characteristics. attitude and practice were analyzed by frequency and percentage and differences in attitude and practice according to grade and practice setting were analyzed with $x^2$ test, t-test or ANOVA. Result: 1) The mean frequency of hand-washing was 6.63. Senior students washed more frequently than junior students. 2) The reasons for non-compliance were 'not being accustomed', 'forgetting', and 'not accessible'. 3) The mean time for hand-washing was 23.79 sec., less than the stated appropriate time of 42 18 sec. 4) 90% of the students washed their hands 'after contacting excretions and contaminated items' and few washed 'before giving care to the client'. 5) Most students washed hands rotationally rubbing with soap and water. 6) While washing, they removed their rings more often than their watches. 7) Soap bar (52.8%) and paper towel (69.6%) were most frequently used as decontaminating agent and drying method, but detergent solution (74.2%) and paper towels (60%) were considered as the most appropriate agent and method. 8) Hand-washing was perceived important generally 'to protect from cross-infection'. 'to protect one-self' and 'the most cost effective'. 9) All students responded nurses should practice 'hand-washing.'

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A Delphi Survey on Performance Indicators of Korean Advanced Practice Nurses (전문간호사 성과지표에 관한 델파이 조사)

  • Kim, Keum Soon;Kang, Ji Yeon;Kim, Bok Ja;Lee, Young Hee;Lee, Eun Nam
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.131-143
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    • 2010
  • Purpose: The purpose of this survey was to identify a set of performance indicators for Korean APNs (Advanced Practice Nurses). Methods: A convenience sample of 78 APNs working in 2 leading hospitals in south Korea participated in the three-round Delphi survey. In the first round, subjects were asked to propose performance indicators to evaluate the effectiveness of their practice. They rated the relevancy of each indicator during the second round. In the final round of survey, subjects rated the relevancy of indicators again in the light of second round's overall results and they also were asked to check on current and future use of indicators. Results: After 5 months of three-round Delphi survey, 60 performance indicators were identified. In regard to relevancy, the 10 highly ranked indicators were patient satisfaction, self-care ability, expertise of service, family satisfaction, nurse satisfaction, satisfaction in nursing education, advanced nursing service count, education for patient/ family, education for nurse, and compliance. Advanced nursing service count, education for patient/ family, and education for nurse are currently used as indicators by more than 70% of respondents. Conclusion: Additional research is needed to identify subsets of performance indicators for specialized areas and to determine the validity and sensitivity of indicators.

The Effects of Aroma Self Massage in Hands on Pain, Depressive Mood and Anxiety in Breast Cancer Patients (유방암 환자의 통증, 우울 및 불안 증상 조절에 아로마 자가 치료의 효과)

  • Sohn, Keun-Joo;Kim, Myung-Ja;Lee, June-Young;Lee, Jae-Bok;Kim, Su-Hyun;Kim, Jong-A;Jung, Hoe-Hyun;Choi, Seung-Wan;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.8 no.1
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    • pp.18-29
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    • 2005
  • Purpose: Aroma therapy is one modality of alternative medicine. It was well known to have an analgesic, antidepressive and anxiolytic effects. This study is designed to investigate the effect of aroma self hand massage on vital signs, pain, depression, anxiety and stress in breast cancer patients. Methods: 32 female patient over 20 years old were divided into two groups by a non-blinded randomized controlled method. Patient in the aroma group (n=15) massaged their hands twice a day using aroma oil by themselves in their home for 2 weeks. However, those in control group (n=17) had not received my intervention during the study periods. Pain intensity, state anxiety, depression and stress of subjects were evaluated three times (0, 1, 3 weeks) using Visual Analogue Scale (VAS, $0{\sim}10cm$), State Trait Anxiety Inventory (STAI), Beck Depression Inventory Scales (BDIS), Brief Encounter Psychosocial Instrument (BEPSI revised edition). Also the change of patients' accompanying symptoms after aroma massage were analyzed using a structured questionnaire. Results: Pain Intensity decreased in the aroma group compared with control group (VAS changes $-0.83{\pm}1.01\;vs\;0.38{\pm}0.86$, P=0.005). The numbers of accompanying symptoms (P=0.044), depression score (P=0.001) and anxiety score (P=0.008) were significantly decreased in the aroma group, while in control group they increased after 2 weeks. However, the stress score showed no significant changes in both groups ($0.05{\pm}0.85\;vs\;0.04{\pm}0.20$, P=0.1519). The depression, anxiety and stress score showed negative correlation with compliance of aroma massage, but statistically no significant. The systolic blood pressure was a little increased in aroma group ($4.53{\pm}14.43\;vs\;0.0{\pm}7.22$, P=0.026), but was not significant clinically. Patients in the aroma group complained of several symptoms such as headache (20%), paresthesia (6.75%) and nausea (6.7%). However, there were no drop-out patients for those side effects. Conclusion: Aroma self massage during two weeks in breast cancer patients alleviates the pain intensity, depression and anxiety significantly.

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The Fiduciary Duties of Doctor in Clinical Trials (임상시험에서 의사의 선량한 관리자의 주의의무)

  • Lee, Jiyoun
    • The Korean Society of Law and Medicine
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    • v.21 no.2
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    • pp.163-207
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    • 2020
  • Korea has been positioned as the leading country in the industry of clinical trials as the clinical trail of Korea has developed for the recent 10 years. Clinical trial has plays a significant role in the development of medicine and the increase of curability. However, it has inevitable risk as the purpose of the clinical trial is to prove the safety and effectiveness of new drugs. Therefore, the clinical trial should be controlled properly to protect the health of the subjects of clinical trial and to ensure that they exercise a right of self-determination. In this context, the fiduciary duties of doctors who conduct clinical trials is especially important. The Pharmaceutical Affairs Act and the relevant regulations define several duties of doctors who conduct clinical trials. In particular, the duty to protection of subjects and the duty to provide information constitute the main fiduciary duties to the subjects. Those are essentially similar to the fiduciary duties of doctors in usual treatment from the perspective of the values promoted by the law and the content of the law. Nonetheless, clinical trials put more emphasis on the duties to provide explanation than in usual treatment. Further research and study are required to establish the concrete standard for the duty of care. However, if the blind pursuit of higher standards for the duty of care or to pass the burden of proof to doctors may result in disrupting the development of clinical trials, limiting the accessibility of patients to new treatment and even violating the principle of sharing damage equally and properly. In addition to these duties, the laws of clinical trials define several duties of doctors. Any decision on whether the violation of the law constitutes the violation of the fiduciary duty and justifies the demand for compensation of damages should be based on whether relevant law aims to protect the safety and benefit of subjects, even if in an incidental way, the degree to which such violation breaches the values promoted by the law and the concrete of violation of benefit of law, the detailed acts of such violation. The legal interests of the subjects can be protected effectively by guaranteeing compliance with those duties and establishing judicial and administrative controls to ensure that the benefit of subjects are protected properly in individual cases.

Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis (혈액투석을 실행중인 말기 신부전 환자의 식사관련 삶의 질(Diet-Related Quality of Life)과 식사요법 실천도, 건강관련 삶의 질 및 위장관 증상과의 관련성 연구)

  • Lee, JinJu;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.46 no.2
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    • pp.137-146
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    • 2013
  • The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

A study on oral discomfort in gynecological cancer patients undergoing chemotherapy (화학요법을 받는 부인암환자의 구강불편감에 관한 연구)

  • 정재원
    • Journal of Korean Academy of Nursing
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    • v.25 no.2
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    • pp.372-389
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    • 1995
  • The frequency with which administration of chemotherapy for gynecological cancer treatment is used has increased along with the use of surgery and radiotherapy Among the various side effects of chemotherapy, stomatitis causes a problem of function and sensation in the oral cavity. This oral discomfort can be categorized into two components ; perceived oral symptoms and observed oral symptoms. If the oral problem continues, it may cause infection, bleeding and nutritional deficiencies. As a result of this condition, compliance with the treatment process can be affected as well as the prognosis for the cancer patients. But as the oral discorrfort usually appears after chemotherapy, it is often not reported to the health care personnel as a patient problem. Without problem identification of the oral discomfort and ability to assess the problem, effective intervention cannot be planned. Therefore, this study was conducted to identify the pattern and the degree of oral discomfort due to cancer chemotherapy and thus to provide data for identification of the patient problem and for nursing assessment. The design of this study was a longitudinal de-scriptive study The subjects were in - patients who received chemotherapy under the diagnosis of gynecological cancer between Mar. 15, 1994 and May 15, 1994 at a general hospital in Seoul, Korea. The number of subjects was 64 and they were divided into two groups, one of 41 (A : 5FU & Neoplatin), the other of 23(B : Neoplatin, Cytoxan, Adriamycin), according to the treatment regimen. The data were collected for 24 days using self-re-port instruments. The instruments were the 「Perceived Oral Symptom Assessment Tool」 and 「Observed Oral Symptom Assessment Tool」 developed by this researcher. Data were analyzed using the SPSS-PC program, ANOVA, t-test, paired t-test and the Pearson Correlation Coefficient were applied. The results of this study are as follows : 1. In A regimen the peak time for perceived oral symptom scores was the fifth day after chemotherapy, and the tenth day for observed oral symptom scores. Both of the problems started on first day of chemotherapy and were not resolved completely until the 24th day after treatment. 2. In B regimen, the peak time for perceived oral symptom scores was on the seventh day after chemotherapy, and the eighth day for observed oral symptom scores. It was noted that perceived oral symptom scores were higher than observed oral symptom scores consistently for 24 days. Both also started on first day of chemotherapy, and were not resolved completely until the 24th day after chemotherapy. 3. There were no differences statistically in perceived oral symptom scores between A and B regimen. The loss of appetite and xerostomia caused the most severe discomfort in both of these two groups. 4. The were no differences statistically in observed oral symptom scores between the A and B regi moil. In the A regimen, the highest observed symptom scores were the lips, gingiva, tongue and buccal membrane in that order. But in the B regimen, the highest observed symptom scores were tongue, lips, buccal membrane and gingiva in that order. 5. In A regimen, the patients who had gingival edema and dentures had significantly higher perceived oral symptom scores. And those who had gingival edema and bleeding, foul odor and aphthous stomatitis had significantly higher observed oral symptom scores. 6. In B regimen, the patients who had the experience of stomatitis in the last course of chemotherapy had significantly higher perceived oral symptom scores. Those who had gingival edema had significantly higher observed oral symptom scores. 7. In the A regimen there was no correlation between lab values for lymphocytes and albumin with perceived oral symptom scores and observed oral symptom scores. In the B regimen, there was a significant negative correlation between lymphocytes and albumin with the observed oral symptom scores, but not between perceived oral symptom scores and lymphocytes and albumin values. In conclusion, the nurse should expect that the patient undergoing chemotherapy will complain severely about subjective discomfort and before objective physical change is observed. Also the patients who have chronic oral problems such as dentures, gingival edema and bleeding, foul odor, aphthous stomatitis will complain of severe oral discomfort due to chemotherapy.

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