• Korean Journal of Adult Nursing
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• v.28 no.4
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• pp.415-423
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• 2016

Purpose: This study was designed to identify the structural relationships among psychosocial variables related to sick role behavioral compliance among patients undergoing hemodialysis. Methods: The subjects were 476 patients from seven major hospitals and twelve dialysis centers located in D and P cities. Data were collected using self-report questionnaires. Data analysis was done by using SPSS/WIN 18.0 and AMOS 18.0 programs for structural equation modeling, to estimate the hypothesized model. Results: This findings support that a modified path model is efficient and appropriate to explain sick role behavioral compliance among hemodialysis patients. These factors account for 80.1% of the variance of sick-role behavioral compliance among hemodialysis patients. The variables having direct effect on sick role behavioral compliance were knowledge related to hemodialysis, social support, attitude, self-efficacy and intention. Conclusion: The modified model explains the integration process of psychosocial and behavior variables for sick-role behavioral compliance among patients undergoing hemodialysis.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.127-137
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• 1996

This study was designed to identify the relationship of perceived self-efficacy and sick-role behavioral compliance in diabetic children. The forty-two diabetic children participating in this study were selected from outpatients. he period of data collection was August 8 to December 9, 1994. Collected data were analyzed by means of chi-square test, t-test, Pearson correlation using SPSS/P $C^+. The result are summarized as follows : 1. The mean score of perceived self-efficacy was 3. 21 that of sick-role behavioral compliance 3.17. 2. Perceived self-efficacy and sick-role behavioral compliance had a positive correlation which was statistically significant（r=0.77, p＜0.001）. 3. There were statistically significant difference in perceived self-efficacy according to age（p＜0. 01） and acknowledgment of prescribed calories in the diabetic diet（p＜0.001）. 4. There were statistically significant difference in sick-role behavioral compliance according to age （p＜0.01） and acknowledgment of prescribed calories in the diabetic diet （p＜0.001）. These results suggest that perceived self-efficacy is an important variable in the compliance of diabetic children. Nursing intervention needs to be directed at promoting perceived self-efficacy to maintain sickrole behavioral compliance for diabetic children. Therefore programs of nursing intervention should be revised in order to promote perceived self-efficacy in diabetic children.en.

• Korean Journal of Adult Nursing
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• v.23 no.3
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• pp.235-243
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• 2011

Purpose: This study was done to identify factors predicting sick-role behavioral compliance in hemodialysis patients. Methods: The subjects were 133 patients from outpatient dialysis clinics at seven major general hospitals located in D and P cities. Data were collected by self-report questionnaires. For data analysis, SPSS/WIN 14.0 program was utilized including one-way ANOVA, independent t-test, Pearson correlation coefficients, and stepwise multiple regression. Results: This study showed a positive correlation between sick-role behavioral compliance and social support (r=.29 p<.001), knowledge (r=.31 p<.001), self-efficacy (r=.52, p<.001) and age (r=.21, p=.015). The factors predicting sick-role behavioral compliance were self-efficacy (${\beta}$=.46), knowledge (${\beta}$=.25), and age (${\beta}$=.18). These factors accounted for 36% of the variance of sick-role behavioral compliance in hemodialysis patients. Conclusion: The results indicate that it is necessary to increase self-efficacy and knowledge in order to improve sick-role behavioral compliance in hemodialysis patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.2
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• pp.1328-1338
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• 2015

The purpose of the study was to examine the relationships between cognitive coping, sick role behavioral compliance, depression, and life satisfaction of hemodialysis patients based on the stress-coping model. The research is cross-sectional survey, 150 participants were recruited from 4 local clinics in Chungcheongbuk-do. As a results, the cognitive coping scores were significantly related to sick role behavioral compliance, depression, and life satisfaction. The coping strategies explained 20.5%, 10.5%, and 24.6% of the variances in sick role behavioral compliance, depression, and life satisfaction, respectively. The most powerful coping strategy was positive refocusing in sick role behavioral compliance, depression, and life satisfaction. The results of the study indicate that cognitive coping plays an essential role for psychological adaptation of hemodialysis patients. Therefore, the development and application of intervention program to improve adaption of hemodialysis patients are required.

• Research in Community and Public Health Nursing
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• v.8 no.1
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• pp.102-115
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• 1997

The purpose of this study was to determine an effect of the health camp program on self-efficacy, sick-role behavioral compliance and glucose metabolism in juvenile diabetes mellitus patients. The quasi -experimental study was designed using a nonequivalent control group pre-posttest design with the framework of Bandura's self-efficacy theory. Forty-two juvenile diabetes mellitus patients participating in this study were selected from outpatients. Of these, twenty-one were assigned to the experimental group and twenty-one to the control group. The period of data collection was from August 8 to December 9 in 1994. The health camp program for the experimental group was carried out over 6 days and the control group did not participate in the program. Collection data was analyzed by means of chi - square test, t - test, ANCOVA, Pearson correlation with SPSS /PC+. The result were summarized as follows: 1. The health camp program was effective in in-creasing the scores of self-efficacy for juven-ile diabetes mellitus patients. 2. The health camp program was effective in increasing the scores of sick - role behavioral compliance for juvenile diabetes mellitus patients. 3. The health camp program was not effective in decreasing the levels of glucose metabolism. 4. The more self-efficacy increased, the more sick - role behavioral compliance increased. 5. Boys showed the higher self-efficacy than girls and the group with diabetes patients whose family members are also patients, showed the higher self-efficacy and sick-role behavioral compliance than the group without diabetic patient among the family members. Thus, it can be concluded that the health camp program was a useful health intervention for juvenile diabetes mellitus patients.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.31 no.1
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• pp.66-76
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• 2024

Purpose: This study aimed to develop and evaluate an integrated management program to enhance self-efficacy, compliance with sick-role behaviors, symptom management, and biomarker indication in hemodialysis patients. Methods: The integrated management program was developed through a systematic review of literature, analysis of relevant online data, and expert validation. It comprised 480 min of video-based education delivered eight times over four weeks, supplemented by weekly phone consultations and text message support from a nurse. To evaluate the program's effectiveness, it was administered to 44 patients with hemodialysis in a single group in a pre-post test experimental study. Changes in self-efficacy, sick-role behavior compliance, dialysis symptom index, and biomarkers were assessed. Results: The program yielded statistically significant improvements in self-efficacy (t=-7.13, p<.001), sick-role behavioral compliance (t=-7.35, p<.001), dialysis symptom index (t=4.32, p<.001), and blood urea nitrogen levels (t=2.55, p=.014) among the participants. Conclusion: The integrated management program is an effective intervention for improving hemodialysis patients' self-efficacy, compliance with sick-role behaviors, and experience of symptoms. Additionally, it is considered an intervention with high clinical applicability and efficiency through video reproducibility.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.10
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• pp.6495-6503
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• 2015

The purpose of the study was to evaluate patients' compliance with the hemodialysis and to investigate relationships between compliance, physiological parameters, and health-related quality of life. Data were collected from 220 patients at 27 local hemodialysis clinics. Compliance was measured with Sick-role Behavioral Compliance including interdialytic weight gain, serum potassium, and phosphorus. Health-related quality of life was assessed using Medical Outcomes Study Short Form-12. Data were analyzed using descriptive statistics, t-tests, ANOVA, and Pearson correlation. Total compliance scored 2.92 out of 4 points on average. Among fifteen items, 'I keep on my dialysis schedule(time and date)' was the highest score. There were differences in the scores for compliance according to age, marital status, and dialysis period. Statistically significant correlations were found between four compliance items(medication, infection control, sleep, eating vegetable and fruit) and health-related quality of life. The results of the study indicate that a patient-centered approach would be helpful to improve quality of life in patients with hemodialysis. Healthcare providers need to understand the patients' perspectives by identifying what is important to patients and taking patient values and priorities into account.

• Journal of Korean Academy of Nursing
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• v.10 no.2
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• pp.73-85
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• 1980

The purpose of this study was to investigate the compliance behavior of hypertensive patients in light of their health belief model that explains an individual's compliance with health maintenance or getting well. Although there are many effective regimens and treatments for hypertension nowadays. the most important point to be taken to consideration in their behavioral aspect is their compliance with regard to the control of body weight. eating habits as to salt and cholesterol intake. stresses. activity patterns and smoking as related to their life style. The important reasons for the failure in the control of hypertensive patients are the complexity of regimens to be complied to. irregular medication and the life long restrictions in their own life style. The compliance of patients to medical regimens and rocommendations or failure to do so is an essential factor. Accordingly. the degree of the patient's compliance is an important determinant as to the success or failure of hypertension control. The subjects for this study were 187 hypertensive patients selected from admitted and out patients of the medical department at seven University Hospitals in Seoul. Data was collected from Dec. 1, 1979 to Feb. 15, 1980 using the questionaire method and was analysed by the use of means. standard deviations, coefficient of correlations, analysis of variance and multiple regression analysis. The results obtained are as follows A. Of the seven independent variables in light of health belief model. benefit. barrier and severity are closely related to patient's compliance behavior. Therefore these variables could be used as determinants to predict and modify the hypertensive behavior. 1. Benefit is the most important and significant of the variables for explaining the dependent variables. It accounts for the highest variance of patient's compliance. (23.62%) 2. Then taking the former together with barrier. the variance of compliance showed on increase. (26.59%) 3. And with the addition of severity to the first two. the variance of compliance was also increased. (28.l2 %) B. Except for susceptibility all the independent variables such as severity. benefit, knowledge. motivation and barrier are correlated to dependent variable compliance. C. Sex. marital status and religion appeared to have significant influence on the dependent variables. Therefore one could conclude that the more the patients are aware that hypertension is a threat to health. the more they understand the benefit of taking actions to prevent such a threat. and the less they perceive any barrier when taking action. the more compliant they become in following medical regimens and recommendations. Age. marital status and religion played a significant influence to their compliance. Accordingly. the selected structural variables and demographic variables which have influenced sick role behavior of the hypertensive patient must be integrated to teaching and counselling programs for better hypertension control.

• Korean Journal of Health Education and Promotion
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• v.14 no.2
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• pp.59-68
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• 1997

당뇨병은 고혈당을 조절 안할 경우에는 돌이킬 수 없는 신체적 합병증은 물론 정신적 손상까지 받지만, 고혈당은 노력만 하면 조절이 가능하며, 정상에 가까울 정도로 조절되면 정상인과 같은 삶을 영위할 수 있다. 그러나 보건의료 전문가의 인슐린 주사 요법, 식사 및 운동요법 등의 일방적인 처방만으로 성공적인 당조절을 기대하기에는 어려움이 있다. 그래서 당뇨병 환자에게 당뇨병이라는 것이 무엇이며, 어떻게 이 병을 스스로 조절할 수 있게 만드느냐가 더욱 중요한 것이다. 따라서 우리나라에서도 당뇨병에 대한 관심이 높아짐에 따라 각 지역과 의료기관마다 다양한 당뇨병 교육 프로그램이 실시되고 있다. 특히 소아 당뇨병 환자는 이러한 전통적인 당뇨병에 관한 교육을 통해서 당뇨병에 관한 지식은 많이 가지고 있지만, 당뇨병 자가 조절을 위한 환자 역할 행위(sick-role behavior)를 변화시키는데는 그다지 성공절이라 할 수 없다. Bandura(1977)는 자기 효능은 ‘할 수 있다는 자신감’으로 수행 성취, 대리 경험, 언어적 설득, 정서적 각성에 관한 정보에 의해 결정된다고 하였다. 따라서 이러한 정보들은 자기 효능을 증진시키기 위한 중재의 방향을 제시해 준다. 오늘날 이러한 정보를 활용한 중재 프로그램 중에서 가정과 학교를 떠나 자연 환경 속에서의 집단 활동을 통하여 사회 학습 경험을 하는 캠프 프로그램에 대한 관심이 높아지고 있다. 캠프에 참여한 당뇨병 아이들은 캠프 활동속에서 다른 동료 아이들이 자신이 갖고 있는 문제들을 성공적으로 해결해 나가는 것을 관찰하여 대리 경험하게 될 때 희망을 가지게 되며, 당뇨병을 가진 다른 동료들과 공통의 경험을 공유할 수 있는 기회를 갖게 되어 그들은 자신이 더 이상 혼자가 아니며 남과 ‘다르지’도 않다는 것을 깨닫게 되어 점차 자신감을 가지고 살아갈 수 있게 된다. 본 연구는 캠프 프로그램이 소아 당뇨병의 자기 효능을 증진시키고, 당뇨병 환자 역할 행위 이행 정도를 높여주는지를 규명해 봄으로써, 소아 당뇨병 환자를 위한 효과적인 간호 중재 방안을 제시하고자 비동등성 대조군 전후 실험 설계의 유사 실험 연구를 시도하였다. 1996년 8월 10일 부터 12월 12일까지 종합병원에서 추후 관리하고 있는 소아 당뇨병 환자중 선정 기준에 맞는 환자 41명을 연구대상으로 하였으며, 그 중 19명은 실험군으로 Bandura의 자기 효능 증진을 위한 정보원을 활용한 캠프 프로그램을 5박 6일간에 걸쳐 실시하였고, 다음 22명은 대조군으로 캠프 프로그램을 실시하지 않았다. 자료수집은 자기 효능 척도와 환자 행위 역할 이행 척도를 캠프 프로그램을 실시하기 전에 사전 조사를 하고 중재 후 4주째 사후 조사를 하였다. 수집된 자료는 SPSS/PC+로 Chi-square test, t-test, ANCOVA, Pearson correlation을 이용하여 분석하였으며, 그 결과는 다음과 같다. 캠프 프로그램은 소아 당뇨병 환자의 자기 효능을 증진시키고 환자 역할 행위 이행을 높여주는데 효과적 이었다. 소아 당뇨병 환자의 자기 효능은 환자 역할 행위 이행과 순 상관 관계가 있어, 자기 효능이 증진될수록 환자 역할 행위 이행 정도가 높아졌다.

• Health Policy and Management
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• v.12 no.2
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• pp.23-42
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• 2002

The purpose of this study was to analyze the results of 133 studies related to patient compliance published between 1980 and 2001 and to assess the effectiveness of intervention on compliance by using meta-analysis. We collected the existing literatures by using web and manual search 'patient compliance', 'sick role behavior', 'major clinical disease', and 'intervention' as key words and by reviewing content of journals related to medicine, nursing and public health. The compliance interventions were classified by theoretical focus into educational, behavioral, and affective categories within which specific intervention strategies were further distinguished. The compliance indicators broadly represent five classes of compliance-related assessments: (1) health outcomes (eg, blood pressure and hospitalization), (2) direct indicators (eg, urine and blood tracers and weight change), (3) indirect indicators (eg, pill count and refill records), (4) subjective report (eg, patients' or others' reports), (5) utilization (appointment making and keeping, use of preventive services). Quantitative meta-analysis was performed by MetaKorea program which was developed for meta-analysis in Korea. Among the 133 articles, 10 studies were selected through the qualitative meta-analysis process, and then only 6 studies were selected for the quantitative meta-analysis finally. The interventions produced significant effects for all the compliance indicators with the magnitude of common effect size (4.1192) than the non-intervention group in a random effect model. The largest effects were each study for patient of hypertension using health outcome such as blood pressure (0.4679) and diabetes mellitus using direct indicator such as glucose level in blood and urine (0.7753). These results suggest that strategic interventions showed clear advantage for improvement of patient compliance compared with non-intervention group.