Factors influencing career preparation behavior of nursing students: A systemic review and meta-analysis / 한국간호교육학회지

Purpose@#The purpose of this study was to systematically review and conduct meta-analysis on factors affecting career preparation behavior of Korean nursing students. @*Methods@#Related articles published in Korean and English were collected based on search terms and converted into a numerical database. Data extraction, quality assessment and analysis including a systematic review and meta-analysis were completed. @*Results@#The review included 27 studies. There were 25 factors influencing career preparation behavior of Korean nursing students. Factors were categorized into four sub-factors: personal, contextual, cognitive-emotional, and goal-related. In the meta-analysis of 27 articles the total effect size (ESr) was .34. The effect sizes of the four sub-factors were .37 for individual factors, .25 for situation factors, .34 for cognitive and emotional factors, and .41 for target factors. The main factors were .53 for career-related efficacy, .43 for self-leadership, and .43 for career decision level. @*Conclusion@#Nursing students with high career-related efficacy and self-leadership are more likely to demonstrate career preparation behavior. Based on these results, educational institutions for nursing students must improve students’ self-leadership and career effectiveness through education so that they can set career goals.

The Experience of Male Nurses Working in Intensive Care Units / 임상간호연구

Purpose@#The purpose of this study was to understand and describe the meaning of the experience of male nurses working in Intensive Care Units (ICU). @*Methods@#Data were collected through in-depth interviews with 8 male nurses. Data were collected from november 2019 to february 2020 and were analyzed using Colaizzi's method, a phenomenological approach. @*Results@#8 theme clusters, and 28 themes were identified. The 8 clusters were as follows; the feeling of burden in a busy and sensitive situation, the daily life facing life and death, female colleagues and patients who are still difficult to treat, a reliable and grateful male colleague, being proud of this role that a man can do, various experiences that improve me, constant effort to be recognized as a team member, and wavering and weighing in the career. @*Conclusion@#These results could help to expand understanding the role of male nurses working in the ICU and in other areas. In addition, the results provide basic data needed to improve mutual respect and relationships between male and female nurses. It is necessary to offer mentoring programs for male nurses to adapt to nursing field.

The Experience of Male Nurses Working in Intensive Care Units / 임상간호연구

Purpose@#The purpose of this study was to understand and describe the meaning of the experience of male nurses working in Intensive Care Units (ICU). @*Methods@#Data were collected through in-depth interviews with 8 male nurses. Data were collected from november 2019 to february 2020 and were analyzed using Colaizzi's method, a phenomenological approach. @*Results@#8 theme clusters, and 28 themes were identified. The 8 clusters were as follows; the feeling of burden in a busy and sensitive situation, the daily life facing life and death, female colleagues and patients who are still difficult to treat, a reliable and grateful male colleague, being proud of this role that a man can do, various experiences that improve me, constant effort to be recognized as a team member, and wavering and weighing in the career. @*Conclusion@#These results could help to expand understanding the role of male nurses working in the ICU and in other areas. In addition, the results provide basic data needed to improve mutual respect and relationships between male and female nurses. It is necessary to offer mentoring programs for male nurses to adapt to nursing field.

Effect of Professional Quality of Life on the Professional Self-Concept of Intensive Care Unit Nurses in Tertiary Hospital / 중환자간호학회지

PURPOSE: The purpose of this study was to identify factors influencing the professional self-concept of nurses working in intensive care units (ICUs).METHODS: Data were collected from July 1 to August 15, 2014. The subjects were 206 ICU nurses working in four university hospitals in B and U cities, Korea. Their professional self-concept was measured using Arthur's Scale revised by Yoon (2012), and professional quality of life (QOL) was measured using Pro QOL Korean Ver. 5 developed by Stamm (2010). Data were analyzed with SPSS Ver. 18, using a t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis.RESULTS: Professional self-concept was significantly correlated with compassion satisfaction (r=.61, p<.001), and burn out (r=−.57, p<.001). The factors influencing professional self-concept were compassion satisfaction (β=.46, p<.001), burn out (β=−.27, p<.001), and education level (β=.14, p=.014). The explanatory power of this model was 46.5%.CONCLUSION: The results suggest that the influencing factors found in this study should be considered when planning nursing intervention programs for improving the professional self-concept of ICU nurses.

Optimism and Post-traumatic Stress Disorder in Breast Cancer Patients

PURPOSE: This study was to describe the relationship between optimism and post-traumatic stress disorder (PTSD) in breast cancer patients. METHODS: The data were collected by self-administered questionnaires from March 5 to April 24, 2012. The participants included 204 breast cancer patients at K university hospital in D city. The utilized measurements were Life Orientation Test-revised (LOT-R) and Impact of Event Scale (IES). RESULTS: The mean scores of optimism and PTSD were 21.61+/-3.54 and 30.18+/-10.43, respectively. There were significant differences in the score of optimism by monthly income, engaging in a hobby, perceived level of stress management, need to manage stress, and people thought to be helpful in stress management. There were significant differences in the score of PTSD by engaging in a hobby, recurrence of cancer, the number of hospitalization, perceived level of stress management, need to manage stress, and people thought to be helpful in stress management. There was a negative correlation between optimism and PTSD. CONCLUSION: To relieve post-traumatic stress in breast cancer patients, nurses should provide ongoing psychological stress assessment from the beginning of the diagnostic stage and offer proper nursing intervention to improve optimism in dealing with their stress.

Needs of Hospice Care in Families of the Hospitalized Terminal Patients with Cancer / 종양간호학회지

PURPOSE: The purpose of this study was to identify the needs of hospice care in families of the hospitalized patients with terminal cancer. METHOD: The data were collected from April to July, 2008. The participants were 100 family caregivers of hospitalized terminal patients with cancer recruited from two general hospitals in 2 cities in Korea. Needs of hospice care were measured using the 'Needs Assessment Instrument for Hospice Care in Families of the Patients with Cancer'. RESULTS: The mean of needs score was 76.6, which meant degree of the needs was very high. Among the categories of the needs, the mean of category 'emotional care' was the highest. There were significant differences in the needs of hospice care according to sex and type of present therapy. CONCLUSION: Health care providers in hospital and hospice facilities must assess the needs of families as well as the patients in order to meet their specific needs. Additionally, they need to have deeper understanding of the need of emotional care and to apply emotional care to hopice patients and their families.

Relationship between Perceived Family Support and Quality of Life in Hospitalized Patients with Terminal Cancer / 종양간호학회지

PURPOSE: This study was to identify the relationship between perceived family support and quality of life in hospitalized patient with terminal cancer. METHOD: Study subjects were 104 patients with terminal cancer who were hospitalized and treated at K university hospital, in Busan. Perceived family support and quality of life were measured using the Kang's Revised Family Support Scale and Youn's Quality of Life scale for terminal patients. RESULTS: 1) The mean score of perceived family support was 4.23+/-0.61. The mean score of quality of life was 5.83+/-1.37. 2) The perceived family support was significantly different with primary care giver, food type, medical period after diagnosis. 3) The levels of quality of life was significantly different by number of children, effect of religion on the one' life, perceived state of disease and pain. 4) There was moderate positive correlation between perceived family support and quality of life. CONCLUSIONS: Increase in perceived family support was associated with increase in quality of life in hospitalized patients with terminal cancer. It is necessary that the development of nursing education program for family which help to support the patient with terminal cancer for increasing the quality of life of patient with terminal cancer.

Development of a Critical Thinking Disposition Scale for Nursing Students / 간호학회지

PURPOSE: The purpose of this study was to develop a critical thinking disposition scale for nursing students. METHOD: The developmental process was construction of a conceptual framework, development of preliminary items, verification of content validity, development of secondary items, verification of construct validity and extraction of final items. The conceptual framework and first preliminary 60 items were obtained through a review of relevant literature and the development of critical disposition scales by 10 researchers who had been studying critical thinking for one year. These items were reviewed by five specialists for content validity and finally 55 items were chosen. The data was collected from October 1 to 15, 2004 and was analyzed using factor analysis and Cronbach's alpha with the SPSS program. The subjects were composed of 560 Bachelor of Science nursing students from 8 nursing schools. RESULT: There were 35 final items which were sorted into 8 factors. The factors were identified as 'intellectual integrity(6 items)', 'creativity(4 items)', 'challenge(6 items)', 'open-mindedness(3 items)', 'prudence(4 items)', 'objectivity(4 items)', 'truth seeking(3 items)' and 'inquisitiveness(5 items)'. The cumulative percent of variance was 55.107%. The reliability of the scale, Cronbach's alpha was .892 and the factors' ranged from .562-.836. CONCLUSION: The result of this study could be used for measuring critical thinking dispositions of nursing students. However, for further validity and reliability, repeated research is necessary.

A Study on Self-care among the Lymphedema Patients / 성인간호학회지

PURPOSE: The purpose of this descriptive study was to gain basic data to develop a self-care protocol for the lymphedema patients. METHOD: The subjects of this study consisted of 115 patients with lymphedema from 8 hospitals and two community health and welfare centers in Busan and Seoul. The data was collected with questionnaire by self reporting of patients between March 2001 and December 2001. Data was analyzed by mean and percentage. RESULT: For self-care activities in daily life, compliance of 'use skin care preparations', 'use heat and cold', 'protect from local compression on affected limbs', 'protect from insect biting', 'use aids to protect affected limbs', 'take diuretics and take protein diet' did not reach to 50%. For self-care activities related to complex physical therapy, 28.7% of subjects complied with compression garment, 14.8% with manual lymph drainage, and 13.0% with exercise. 20.0% of subjects tried to treat with acupuncture and 13.9% with heat therapy. CONCLUSION: From this study, it is suggested that patients need to get a self-care education with correct information about self care activities and health care professionals need to develop more convenience self-care techniques of massage and exercise.

Development of Comprehensive Nursing Intervention for the Client with Lymphedema / 성인간호학회지

PURPOSE: The purpose of this study was the development of a comprehensive nursing intervention program for the client with acute lymph stasis and stage I lymphedema. METHOD: The Quasi-experimental design using a non-equivalent control group was used. The subjects were 22 stroke patients with lymph stasis in the control group and 23 patients in the experimental group. The complex physical therapy of Casley-Smith was carried out to the control group for 10 hours, and comprehensive nursing intervention for the experimental group was carried out for 60 minutes. The data for this study was gathered from Feb. 2002 until June 2002 and pertains knowledge about lymphedema, self-care for managing lymphedema, and circumferences of affected limbs. Data was analyzed by mean, standard deviation, x2-test, and t-test. RESULT: The changes in knowledge about lymphedema, self-care practices, and circumference of affected limbs after nursing intervention did not show significant differences between control group and experiment group. CONCLUSION: It can be concluded that comprehensive nursing intervention had more efficiency than complex physical therapy in the treatment of edema for stroke patients because of it's simplicity and time saving. Thereby, the comprehensive nursing intervention program developed in this study would be a useful therapy for the clients with lymph stasis and early stage lymphedema.

Relationship between Fatigue and Sleep Quality in Patients with Cancer / 성인간호학회지

PURPOSE: The purpose of this study was to identify the relationship of fatigue and quality of sleep in patients with cancer. METHOD: The data was collected from January to February 2001. Study objects were recruited K university hospital in Busan, Korea. Their fatigue was measured using the Revised Piper Fatigue Scale developed by Piper et. al(1998), and quality of sleep was measured using Quality of Sleep Questionare by Oh et. al(1998). RESULT: 1) The fatigue score was mean 114.80+/-34.88(range: 22-220). The sub dimension that showed behavior/severity score at 33.70+/-13.89, affective score at 24.23+/-3.33, sensory score at 27.74+/-12.51, and cognitive/mood score at 29.11+/-3.71. And sleep quality score was mean 37.32+/-8.18. 2) There was a significant difference in religion(F=4.157, P= .008), present therapy(F=2.536, P= .043), past therapy(F= 6.625, P= .000), major caregiver(F=3.133, P= .028), and change of weight(F=7.965, P= .006), according to general characteristics in the fatigue in patients with cancer. 3) There was a significant difference in present pain(t=-2.103, P= .037) and change of weight(F=5.484, P= .005), according to general characteristics in the sleep quality in patients with cancer. 4) There was a significant negative correlation between fatigue and quality of sleep(r=- .340, P= .000). CONCLUSION: Patients with cancer experience in fatigue. Increase in fatigue are associated with decreases in quality of sleep. Nurses must provide patients with nursing care about the occurrence of fatigue and interventions to deal with sleep disturbance.

Relationship Between Body Image and Self-esteem in Patients with Chronic Renal Failure / 기본간호학회지

PURPOSE: The purpose of study was to identify the relationship between body image and self-esteem in patients with chronic renal failure. METHOD: The subjects of study were 97 patients with chronic renal failure who were outpatients at K medical center, B hospital, H hospital in Busan. Data were collected from Nov. 15th to Dec. 17th, 1999. The instruments used for study were the Body Cathexis Scale and Rogenberg's Self-esteem Scale. Collected data were analyzed by frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, and Pearson's correlation coefficients. RESULT: 1. The mean score for body image was 137.46+/-22.21, the mean mark 2.92+/-0.47, and the mean score of self-esteem was 30.80+/-0.76, the mean mark 3.08+/-0.87. 2. There was a significant difference in the score for body image according to educational level (F=5.189, P=0.002) and type of residence (F=6.095, P=0.001). 3. There was a significant difference in the score for self-esteem according to age (F=3.615, P=0.009), educational level (F=4.772, P=0.004), marital status (F=3.498, P=0.019), and presence of children (F=2.511, P=0.014). 4. Body image in patients with chronic renal failure patients showed significant correlation with self-esteem (r=0.519, P=0.000). CONCLUSION: From this study, a relationship between body image and self-esteem in patients with chronic renal failure was identified. Therefore, nursing interventions are needed to promote body image and self esteem in patients with chronic renal patients.

Predictive Factors of Hope in Patients with Cancer / 성인간호학회지

It has been believed that cancer is an omnious factor threatening the future and life itself. Patients having the disease experience anxiety, fear, feeling of weakness, depression and feelings of uncertainty and hopelessness. Most cancer patients, however, have expectations of possible recovery and a better future, very different from the patients who feel hopeless. Therefore. hope allows people to respond effectively to the fatal disease they have and prevents them from detoriorating physically and spiritually, positively influencing their survival, response to treatment and sense of security. Studies previously performed showed that hope is positively correlated with social and family supports, self-esteem, spiritual well-being, responsive action, health promotion behavior and quality of life. Thus, the study attempted to provide basic information on nursing cancer patients by investigating their levels of hope and determining predictive factors which influence hope. For the study 200 cancer patients in two university hospitals located in Pusan were sampled as subjects. Data were collected for twenty nine days from Feburary 1, 1999 to March 1. Instrumets for the study included 10 items from the self-esteem scale by Rosenberg (1965), 39 hope measurements by Kim and Lee(1965), 16 of the social support scale by Tae(1986) and 16 of the general characteristics scale, all of which totaled 81 items. The data were analyzed using the SPSS program. General characteristics of the investigated based on numbers and percentage. Hope, self-esteem and social support were analyzed using means, minimum, maximum and standard deviation. Relations among the foregoing three factors were analyzed using Pearson' correlation coefficient. Levels of hope in cancer patients were determined using t-test, ANOVA and Scheffe test. Predictive factors influencing hope were investigated using multiple stepwise regression analysis. Results of the study are summarized as follows: 1. An average level of hope was 185.55+/-23.39 points(96 min. and 234 max.) 2.Levels of hope showed a significant difference among them according to sex (t=-3.69, P=.000), age(F=4.714, P=.000), job(F=3.247, P=.008), monthly income (F=6.113, P=.003), treatment charge (F=3.796, P=.011), supportive resources (F=10.554, P=.000), diagnosis(F=2.287, P=.029), perceived health status(F=22.184, P=.000), level of pain(F=3.334, P=.021), religion (F=4.911, P=.001) and religion's effect in life (F=11.706, P=.000), 3. For the subjects, self-esteem and social support were 38.32+/-7.21(13 min, and 50 max.) and 52.97+/-8.49points(28 min, 80 max.). Concerning social support, average levels of family support and medical support were found 35.95+/-6.05(18 min, and 40 max) and 27.02+/-4.99 points(20 min and 40 max). The hope the cancer patients showed significant correlations with self-esteem (r=.588, P=.000), family support(r=.224, p=.001) and medical support(r=.221, P=.002). 4.The five variables related to hope (self-esteem, religion's effect in life, perceived health status, social support and age) accounted for 54.2 percent of the hope level; especially, self-esteem was the highest at 34.6%. As shown in the above results, predictive factors which most influence hope in cancer patients were self-esteem and religion's effect of life. Therefore, nursing interventions to increase self-esteem should be developed. Regarding religion's effects, studies on spiritual aspects should be carried out in a way that contributes to promotion of hope.

A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire / 재활간호학회지

The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose. the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer. hypertension. diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30. 1998. The frequency and mean values were computed to find the characteristics of the study subjects. and chi-test. t-test. factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined. men and women occupied for 58.8 % and 41.2 %. respectively. The subjects were 41.3 years old in average and had the monthly average earning of 0.99 million won or below. which was the most out of the total subjects at 34.6 %. Among the total. 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6 %. followed by hypertension at 24.2%. diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%. didn't. Among those patients having the intent. 85.6% had the intent of paying for home nursing and 14.4%. didn't. The subjects expected that the nursing would be paid 9.143 won in average and 47.7 % of them preferred national authorities as the mam servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social. home environment. disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing. the group having the intent had more cases of male patients. the age of 39 or below. residence in cities. 5 family members or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization within the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing, 'inject into a blood vessel' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients' status and refer them to hospitals or community resources as available, if necessary' was the most with percentage point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail. 70.0% wanted to pay for a service stated as 'inject into a blood vessel' , highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of technical nursing, muscle injection(0.26, the 1st rank) was highest in the rate while among aspects of supportive nursing. a service referred to as 'teach exercises needed for making patients move their bodies normally' (0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their independent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

Relationship of Hopelessness and Spiritual-Need of Cancer Patients / 성인간호학회지

The purpose of this study was to identify the re lationship of hopelessness and spiritual-need of cancer patients. Subjects for this study were 272 cancer patients sampled from a madical center in Pusan. The data were collected from Feb. 1 to Mar. 10, 1998 using questionnaire method. Hopelessness measured hopelessness scale was the One(1986) modification of Beck(1974) and spiritual -need measured spiritual-need scale by Kim (1986) according to classification of Fish and Shelly. The questionnaire consisted of question regarding hopelessness scale(20 items 5 point) and spiritual-need scale (30 items 5 point scale). The reliability of this instrument was that the hopelessness scale was Cronbach's alpha=0.89 and the spiritual-need was Cronbach's alpha=0.93. The data were analyzed with the SFSS program using mean, standard deviation, frequency and percentage, t-test, ANOVA, Post hok test and Pearson's Correlation Coefficient. The results of this study were as follow : 1. The mean score of the total hopelessness was 2.79 in 1(lowest) -to-5(highest) scoring system. The analysis of the hopelessness according to general characteristics of the cancer patients showed duration of treatment(F=3.77), cognition prognosis(F=2.92) age(F=2.66), religional effect of life(2.48). 2. The mean score of the total spiritual-need was 3.47 in 1(lowest)-to-5 (highest) scoring system. age(F=5.517), sex(F= .919), religion(F=25.89), religional effect of life(F=18.54), diagnosis(F= 7.67), main care giver(F=4.09), cognition of disease(F=2,92), cognition of prognosis (F=331), inspiring source(F= 12.72), acceptioal attitude of present situation(F= 13.52). according to the categoiised paiL were showed to the need for meaning and purpose(9.40), to the need for love and relatedness(7.08), and to the need for being forgiven(6,93). 3. There was significant correlation between the degree of hopelessness and spiritual-need(gamma=.146, P<0.05).

A study on Compliance in Self-Medication of Pulmonary Tuberculosis patients / 성인간호학회지

This study was made to identify compliance in self-medication, and factors influencing the self-medication of pulmonary TB patients. Self-medication of pulmonary TB patients is a very important factor for the cure of the patients. In this study, variables were used from three theories of health behavior. These were the Health Belief Model, Health Locus of Control, Theory of Planned Behavior. These were included to examine their effect on self-medication. Data were collected during the period from July 1 to August 20, 1994 using a structured questionnaire. And they were analyzed by mean, standard deviation, ANOVA, Pearson Correlation Coefficient, and Multiple Regression analysis using the SAS program. The result were as follows : 1. The mean on the self-medication scores ranging from 6.0 to 12.0 was 10.93. The mean for the self-evaluation scores of the self-medication ranging from 50.0 to 100.0 was 86.51. 2. There were significant associations between the scores on self-medication and age(F=2.34, p=0.033), and method of treatment(F=4.65, P=0.018). And there were significant associations between the self-evaluation scores of self-medication and age (F=3.79, P=0.000), and presence of TB patients among family(F=4.92, P=0.000). 3. (a) The relationship between the scores on self-medication and perceived barrier in health belief revealed a significant correlation(r=-.2046, p=0.0082). (b) The relationship between the scores on self-medication and other-dependency in LOC revealed a significant correlation(r=0.2322, p=0.0018). (c) The relationship between the self-evaluation score of self-medication and other-dependency in LOC revealed a significant correlation(r=0.1946, p=0.0122). (d) The relationship between the attitude in self-medication of the subjects and the self-evaluation score of self-medication revealed a significant correlation(r=0.2102, p=0.0066). 4. (a) 14.8% of the score of compliance in self-medication of the subjects was explained by five variables : Behavioral Intention, Duration of Treatment, Age, Perceived Sensitivity and Perceived Sensitivity and Perceived Barrier. (b) 8.7% of the score of self-evaluation of self-medication was explained by three variables : Perceived Control, Perceived Sensitivity, and Age. In conclusion : This study provides insights and information which may be valuable for motivation and instruction to improve compliance in self-medication among pulmonary TB patients.