Analysis on Pediatric Sick Role and Doctor-patient Relationship Based on Parsons’ Theory of "Sick Role" / 中国医学伦理学

With the development of medicine technology and the increasing of people’s demand for quality of life, the complexity of doctor-patient relationships is also increasing. Pediatrics is one of the departments with the most concentrated and complex doctor-patient conflicts, therefore, it is necessary to analyze the sick roles and doctor-patient relationships in pediatrics. This paper explained the connotation of the sick role and the doctor-patient social interaction pattern based on Parsons’ theory of "sick role", and analyzed the particularity of the pediatric sick roles in China according to China’s national conditions. Meanwhile, combining the group characteristics and social background of pediatric sick role, this paper elaborated the sociological crux of pediatric doctor-patient relationship in China, and conducted a critical analysis on Parsons’ theory of "sick role".

Factors Influencing Sick Role Behavior Compliance in Patients on Hemodialysis / 기본간호학회지

PURPOSE: This study was a descriptive survey research to identify the factors that influence sick role behavior compliance in patients on hemodialysis. METHODS: Structured surveys were used to collect data from 170 patients who are on hemodialysis three times a week through outpatient care at a university hospital located in G City using tools measuring resilience, family support, and sick role behavior compliance. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and Stepwise multiple linear regression. RESULTS: The results showed that factors that influenced sick role behavior compliance in the subjects were in the order of family support (β=.27, p < .001), age (β=.27, p < .001), and resilience (β=.23, p=.003). Resilience, family support, and sick role behavior compliance were positively correlated. Factors influencing hemodialysis patients' sick role behavior compliance included family support, age, and resilience. These variables explained 30.2% of the variance in sick role behavior compliance. CONCLUSION: Based on these results, care intervention and the development of a training program that involves family in the treatment plan and process to support and encourage patients are needed to increase the sick role behavior compliance in patients on hemodialysis.

Family Characteristics, Family Support, Family Function and Compliance of Patient Role Behavior in Long-term Hemodialysis Patients / 재활간호학회지

PURPOSE: The purpose of this study was to examine the role of family to the compliance of patient role behavior in long-term hemodialysis patients. METHODS: In this descriptive correlational design, 103 participants recruited from 3 hemodialysis clinics at D city. They completed the self-reported questionnaire including family characteristics, family support, family function, and compliance of patient role behavior. All participants have family and are undergoing regular hemodialysis more than 1 year. RESULTS: Among patient's characteristics, compliance of patient role behavior was significantly different by standard of living, burden of treatment, marital status, experience of hospitalization, perceived health status, kidney transplantation plan, and depression. Experience of hospitalization, perceived health status and family support explained 31.9% of the variance in the compliance of patient role behavior (R2=.319, F=5.34, p=.001). CONCLUSION: Family support is important for compliance of patient role behavior in the long-term hemodialysis patients. Therefore it is recommended that the family must be included to improve compliance of patient role behaviors.

Diseño, validez facial y de contenido del instrumento carga de la enfermedad crónica para el paciente - GPCP-UN / Design, facial and content validation of the instrument “ Burden of chronic illness for the patient - gcpc-UN

Objetivo: Diseñar y realizar validación facial y de contenido del instrumento Carga de la Enfermedad Crónica para el Paciente . Método: Estudio descriptivo desarrollado entre los años 2012 - 2015, en las siguientes fases: 1) Revisión de la literatura. 2) Recuento y evaluación y de síntomas, quejas y preocupaciones expresadas por 1850 pacientes con seguimiento de un año. 3) Construcción del instrumento 4) Prueba de comprensibilidad y ajuste semántico 5) Pruebas de validez facial y de contenido con expertos. Resultados. El instrumento Carga de la Enfermedad Crónica para el Paciente - GCPC-UN consta de 49 ítems. Cada situación que se asocia con la enfermedad es medida en términos de la frecuencia, la intensidad y el nivel en que es considerada amenazante o peligrosa. Conclusiones. El Instrumento permite valorar integralmente el impacto que la situación de enfermedad crónica genera a la persona con la enfermedad. Los resultados de sus pruebas de comprensibilidad, validez facial y contenido, avalan su aplicación en el contexto colombiano y son base para nuevas investigaciones en el campo

Objective: To design and perform facial and content validation of the instrument Burden of Chronic Illness for the Patient - GCPC UN. Method: Descriptive study developed between the years 2012 - 2015, in the following phases: 1) Review of the literature. 2) Count and evaluation of symptoms, complaints and concerns expressed by 1850 patients with a follow up of one year. 3) Construction of the instrument 4) Proof of comprehensibility and semantic adjustment 5) facial and content validation with experts. Results: The instrument “Burden of Chronic Illness for the Patient - GCPC- UN” consists of 49 items divided into three dimensions: the psychological and spiritual suffering, with 15 items; the discomfort and physical distress, with 19 items; and the altered cultural and family patterns with 15 items; 1 final question that gives options for other problems was included. Each situation associated with the disease is measured in terms of frequency, intensity and the level in which it is considered threatening or dangerous. Conclusions: The Instrument “Burden of Chronic Illness for the Patient - GCPC UN” can fully assess the impact of chronic Illness for the person with a chronic disease. The results of the tests of comprehensibility, as well as the facial and content validity tests support the instrument “Burden of Chronic Illness for the Patient - GCPC UN” for its application in the Colombian context and are the basis for further research in the field

Alcoholic patients' response to their disease: perspective of patients and family / Resposta da pessoa doente alcoólatra frente à sua doença: perspectivas de pacientes e familiares / Respuesta del enfermo alcohólico ante su enfermedad: Perspectivas de pacientes y familiares

Objective: to know the perspective of alcoholic patients and their families about the behavioral characteristics of the disease, identifying the issues to modify the addictive behavior and seek rehabilitation. Method: ethnographic research using interpretative anthropology, via participant observation and a detailed interview with alcoholic patients and their families, members of Alcoholics Anonymous (AA) and Alanon in Spain. Results: development of disease behavior in alcoholism is complex due to the issues of interpreting the consumption model as a disease sign. Patients often remain long periods in the pre-contemplation stage, delaying the search for assistance, which often arrives without them accepting the role of patient. This constrains the recovery and is related to the social thought on alcoholism and self-stigma on alcoholics and their families, leading them to deny the disease, condition of the patient, and help. The efforts of self-help groups and the involvement of health professionals is essential for recovery. Conclusion: understanding how disease behavior develops, and the change process of addictive behavior, it may be useful for patients, families and health professionals, enabling them to act in a specific way at each stage.

Objetivos: conhecer as perspectivas de pessoas doentes alcoólatras e familiares sobre as características do comportamento da doença, identificando as dificuldades para modificar o comportamento aditivo e motivar a recuperação. Método: pesquisa etnográfica baseada na antropologia interpretativa, mediante observação participante e entrevista em profundidade com as pessoas doentes alcoólatras e seus familiares, membros dos Alcoólicos Anónimos e Al-anon, na Espanha. Resultados: o desenvolvimento do comportamento da doença no alcoolismo é complexo, dadas as dificuldades para interpretar o modelo de consumo como sinal de doença. Usualmente, as pessoas doentes permanecem por longos períodos de tempo na etapa de pré-contemplação, atrasando a demanda de assistência, a qual costuma chegar sem a aceitação da doença pela própria pessoa doente. Isso dificulta a recuperação e relaciona-se à consideração social do alcoolismo e à auto estigma em alcoólatras e familiares, levando-os a negar a doença, a condição de doente e a ajuda. O trabalho dos grupos de ajuda mútua e a implicação dos profissionais da saúde são fundamentais para sua recuperação. Conclusão: conhecer o desenvolvimento do comportamento da doença e o processo de mudança do comportamento aditivo pode ser útil para as pessoas doentes, familiares, e profissionais da saúde, permitindo-lhes atuar de forma específica em cada etapa.

Objetivos: conocer las perspectivas de enfermos alcohólicos y de familiares sobre las características de la conducta de la enfermedad, identificando las dificultades para modificar la conducta adictiva y emprender la recuperación. Método: investigación etnográfica desde la antropología interpretativa, mediante observación participante y entrevista en profundidad con enfermos alcohólicos y sus familiares, miembros de Alcohólicos Anónimos y Al-anon en España. Resultados: el desarrollo de la conducta de enfermedad en el alcoholismo es complejo dadas las dificultades para interpretar el modelo de consumo como señal de enfermedad. Los enfermos suelen mantenerse largos periodos de tiempo en la etapa de precontemplación retrasando la demanda de asistencia, a la que suelen llegar sin aceptar el rol de enfermo. Esto dificulta la recuperación y se relaciona con la consideración social del alcoholismo y el autoestigma en alcohólicos y familiares, llevándoles a negar la enfermedad, la consideración de enfermo y la ayuda. La labor de los grupos de ayuda mutua y la implicación de los profesionales sanitarios resulta fundamental para su recuperación. Conclusión: conocer el desarrollo de la conducta de enfermedad y el proceso de cambio de la conducta adictiva, puede ser de utilidad para enfermos, familiares, y profesionales sanitarios, permitiéndoles actuar de forma específica en cada etapa.

The Effect of a Discharge Education Program for Readmitted Chemotherapy Patients on Compliance with Sick Role Behavior and Educational Satisfaction

PURPOSE: This study was designed to evaluate the effects of a discharge education program for hospitalized readmitted patients with chemotherapy-in terms of sick role behavior and educational satisfaction. METHODS: The data were collected with a nonequivalent control group non-synchronized design and were analyzed with a nonequivalent control group pre-posttest design. The subjects included 49 patients with cancer, 25 in the experimental group, and 24 in the control group. Data were analyzed with spss win 21, chi2-tests, paired t-tests, and independent t-tests. RESULTS: The experimental group was educated according to their needs at discharge, and they showed higher compliance with sick role behavior. CONCLUSION: To improve compliance with sick role behavior, readmitted hematologic neoplasms chemotherapy patients should receive discharge education according to their needs at the clinic by using an educational manual.

Evolving Concept Of Abnormal Illness Behavior & Clinical Implications

Objectives: The concept of “Abnormal illness behavior (AIB)” has been evolved to a greater extent in the last century. Henry Sigerist introduced the concept of “illness behavior” in 1929. Mechanic & Volkart defined and further conceptualized the impression on illness behavior. Talcott Parson had given the concept of “Sick role,” and Issy Pilosky had familiarized the notion of “abnormal illness behavior.” The main objective of this article is to review the conceptual evolution on “abnormal illness behavior” and to analyze its current clinical implications. Methods: Extensive search of literature was performed regarding abnormal illness behavior, illness behavior and sick role in online web searching sites like – Google Scholar, PubMed and individual journal sites as well as google books. The literature was critically reviewed with personal inputs from authors. Results: Abnormal illness behavior ranges from denial of illness in one extreme to conscious amplification of symptoms on the other. Abnormal illness behavior is noticed in various clinical conditions like stress-related disorder, stress-related disorders, factitious disorder and malingering. Conclusions: Identifying abnormal illness behavior can prevent unnecessary and excessive utilization of medical aids for the same.

Experiências do adoecimento de pessoas com anemia falciforme e estratégias de autocuidado / Experiences of illness among individuals with sickle cell anemia and self-care strategies

ObjetivoConhecer as experiências do adoecimento de pessoas com anemia falciforme e suas estratégias para o autocuidado.MétodosPesquisa qualitativa realizada com 17 pessoas com anemia falciforme. A coleta e a análise dos dados ocorreram simultaneamente, realizando-se a codificação aberta e sua categorização, segundo os passos da Teoria Fundamentada nos Dados. Tal procedimento deu origem a categorias relativas à experiência do adoecimento de pessoas com anemia falciforme e autocuidado.ResultadosAs experiências com o adoecimento crônico possibilitaram a construção de estratégias para conhecer melhor a doença, determinaram mudanças na vida cotidiana, e afetaram o modo como cada pessoa observa e vivencia o tempo e como as habilidades específicas para o autocuidado foram desenvolvidas a partir dos aprendizados e deslizes cometidos.ConclusãoConstatou-se que as pessoas com anemia falciforme apresentaram vários elementos favoráveis em busca de adaptação ao adoecimento na fase adulta.

ObjectiveTo determine the experience of sick individuals with sickle cell anemia and their self-care strategies.MethodsThis was a qualitative study of 17 individuals with sickle cell anemia. Data collection and analysis occurred simultaneously by open codification and categorization, according to steps in the theory based on data. This procedure led to the development of categories related to the experience of individuals who have sickle cell anemia and their self-care.ResultsExperiences of patients who became chronically ill enabled the construction of strategies to better determine the disease, changes in daily life, and the manner in which it affects how patients observe and experience time. Also identified were specific skills for self-care that were developed from lessons learned and mistakes made.ConclusionWe found that individuals with sickle cell anemia had several favorable approaches for adapting to having become sick during adulthood.

Necessidades espirituais da pessoa doente hospitalizada: revisão integrativa / Necesidades espirituales de la persona enferma hospitalizada: revisión integrativa / The Spiritual Needs of Ailing Hospitalized Patients: An Integrative Review

A espiritualidade é intrínseca ao ser humano e manifesta-se também associada à doença, à perda ou quando o ser humano é confrontado com o sofrimento ou a morte. Como a expressão das necessidades espirituais não se processa de igual forma na pessoa saudável ou doente, a sua atenção requer uma intervenção rigorosa e profissional. Objetivos: identificar necessidades espirituais da pessoa hospitalizada e conceitos de espiritualidade. Método: revisão integrativa de dez estudos quantitativos e qualitativos sobre necessidades espirituais, publicados no período de 2004 a 2011 nas bases de dados (EBSCO, MEDLINE, SAGE e B-ON), orientada pelas questões: quais as necessidades espirituais da pessoa hospitalizada e os conceitos de espiritualidade utilizados nos estudos selecionados? Resultados: da análise dos artigos emergiram as seguintes necessidades espirituais: procura de sentido na doença e sofrimento; estar em relação com os outros e com o Ser Superior, o que indica presença evidente de valores, crenças espirituais, fé, esperança e necessidades religiosas, associadas aos conceitos: sentido de vida, relacionamentos, transcendência e práticas religiosas. Conclusões: os doentes podem expressar as suas necessidades espirituais por meio das formas mais sutis. Os enfermeiros devem avaliar as necessidades espirituais de "mente aberta" e serem capazes de proporcionar a assistência mais adequada.

La espiritualidad es intrínseca al ser humano y se manifiesta también asociada a la enfermedad, la pérdida o cuando el ser humano se enfrenta con el sufrimiento o la muerte. Como la expresión de las necesidades espirituales no se procesa de igual forma en la persona sana o enferma, su atención requiere una intervención rigurosa y profesional. Objetivos: identificar necesidades espirituales de la persona hospitalizada y conceptos de espiritualidad. Método: revisión integrativa de diez estudios cuantitativos y cualitativos sobre necesidades espirituales, publicados en el período del 2004 al 2011 en las bases de datos (EBSCO, MEDLINE, SAGE y B-ON), orientada por las interrogantes: ¿Cuáles son las necesidades espirituales de la persona hospitalizada y los conceptos de espiritualidad utilizados en los estudios seleccionados? Resultados: del análisis de los artículos emergieron las siguientes necesidades espirituales: busca de sentido en la enfermedad y sufrimiento; estar en relación con los otros y con el Ser Superior, lo que señala presencia evidente de valores, creencias espirituales, fe, esperanza y necesidades religiosas, asociadas a los conceptos: sentido de vida, relaciones, transcendencia y prácticas religiosas. Conclusiones: los enfermos pueden expresar sus necesidades espirituales por medio de las formas más sutiles. Los enfermeros deben evaluar las necesidades espirituales de "mente abierta" y ser capaces de proporcionar la asistencia más adecuada.

Spirituality is intrinsic to human beings and is also manifest in association with illness, loss or when man is faced with suffering or death. Because those who are ill do not process the expression of spiritual needs the same way as healthy persons, their care requires thorough and professional intervention. Objectives: This study is designed to identify the spiritual needs of hospitalized patients and concepts of spirituality. Methodology: It involves an integrative review of ten quantitative studies on spiritual needs published from 2004 to 2011 in databases (EBSCO, MEDLINE, SAGE and B -ON). The guiding question was: What are the spiritual needs of a hospitalized person and the concepts of spirituality used in the selected studies? Results: An analysis of the articles revealed several spiritual needs; namely, the search for meaning in illness and suffering, and being in relationship with others and with God, signaling the obvious presence of values, spiritual beliefs, faith, hope and religious needs associated with the concepts of the meaning of life, relationships, transcendence and religious practices. Conclusions: Patients are able to express their spiritual needs through the most subtle of ways. Nurses must assess spiritual needs with an "open mind" and be able to provide the appropriate assistance.

Busca de tratamento por portadores de tuberculose pulmonar: estudo qualitativo baseado no modelo“comportamento de enfermo” / The search for treatment by pulmonary tuberculosis patients: a qualitative study based on the “illness behavior” model

Objetivo: Avaliar como portadores de tuberculose pulmonar em tratamento narram suas experiências de doença,verificando-se, no seu discurso, as diferentes fases do“Comportamento de Enfermo”, interpretadas na perspectiva da análise de conteúdo proposta por Bardin. Material e Métodos: Estudo qualitativo fundamentado na técnica da análise discursiva a partir de entrevistas com 16 pacientes com tuberculose pulmonar em tratamento ambulatorial no Hospital de Doenças Infecto-Contagiosas Clementino Fraga em João Pessoa, Paraíba. O referencial teórico foi o enfoque“Comportamento de Enfermo” proposto por Mechanic.Resultados: Observou-se busca tardia de atenção médica,procura inicial de hospitais gerais, com atraso no diagnóstico e limitação para o trabalho como fator determinante da aceitação do papel de doente e da necessidade de assistência médica. Ao receber o diagnóstico, observou-se temor de contágio de familiares e estigma em relação ao diagnóstico. As causas para a tuberculose foram atribuída são estilo de vida, condições climáticas, trabalho e problemas emocionais. Na fase de comportamento dependente, os pacientes referiram transferência do controle ao médico.Conclusão: Foram observadas diversas fases do“Comportamento de Enfermo”, desde a negação dos sintomas até o ajustamento a esse papel. Após essa conformação, os pacientes manifestaram necessidade da legitimação de sua doença através do diagnóstico médico. Estes dados apontam para a necessidade de se ir além do quadro clínico para maior efetividade de tratamento.

Objective: To evaluate how pulmonary tuberculosis patients report their illness experiences as well as to verify thedifferent phases of “illness behavior” in the perspective of content analysis as proposed by Bardin. Material andMethods: This was a qualitative study using the discourse analysis of interviews with 16 pulmonary tuberculosis patients undergoing Directly Observed Treatment Short course(DOTS) at the Clementino Fraga Hospital of Infectious Diseases in João Pessoa, Paraiba, Brazil. This study wasbased on the theory of “illness behavior” proposed byMechanic. Results: It was observed a late seeking formedical attention, initial demand for general hospitals, with adelay in diagnosis, and limitation to work as a determinantfactor for the acceptance of the sick role and of the need formedical assistance. Upon receiving the diagnosis, there wasfear of contagion to family and stigma regarding the diagnosis.The causes for tuberculosis were attributed to lifestyle,weather, work and emotional problems. As to the dependentbehavior phase, patients reported transferring the control tothe doctor. Conclusion: Diverse phases of the “illnessbehavior” were observed, since denial of symptoms untiladjustment to this sick role. As such, patients reported theneed for legitimizing their illness through the medical diagnosis.This study indicates the need for healthcare professionals to go beyond the clinical framework in order to reach a more effective treatment.

The Association of Compliance with Sick Role Behavior with Satisfaction of Basic Psychological Needs Among Hemodialysis Patients

BACKGROUND: This study aimed to identify the association of compliance with sick role behavior with satisfaction of basic psychological needs, and to assess the influence of compliance with sick role behavior among hemodialysis patients. METHODS: Participants included 109 patients from outpatient dialysis clinics at 6 major general hospitals located in urban areas in Korea. Data for compliance with sick role behavior and basic psychological needs were collected through a self-reported questionnaire and was analyzed with independent t-test, one-way analysis of variance, Pearson' correlation analysis, and multiple stepwise linear regression analysis. RESULTS: This study showed positive correlations between compliance with sick role behavior and satisfaction of basic psychological needs (r=0.59, P<0.001). The variables predicting compliance with sick role behavior were relatedness (beta=0.28), autonomy (beta=0.29), competency (beta=0.30), and age (beta=0.24). These variables accounted for 38.2% of the variance of compliance with sick role behavior in hemodialysis patients. CONCLUSIONS: Our results indicated that it is necessary to improve compliance with sick role behaviorin order to increase satisfaction of basic psychological needs in hemodialysis patients.

Delay of medical care for symptomatic breast cancer: a literature review: [review] / El retraso en la atención médica del cáncer de mama: una revisión de la literatura: [revisión]

The purpose of this paper is to organize and summarize existing information on delayed medical attention for women with breast cancer and identify research needs in this area. This review is organized in six parts: origins and permanence of the message "do not delay" medical attention for potential cancer symptoms; definition and classification of breast cancer delay; impact of delay on breast cancer prognosis; factors related to breast cancer delay and the ways these have been studied; the study of breast cancer delay in Mexico; and directions for future research in developing countries, with a special focus on Mexico. We point out the need of a more integral study of delay that takes into account socio-structural and health services factors, in order to find modifiable factors towards which political actions should be directed to improve breast cancer medical attention in underdeveloped countries.

El objetivo de esta revisión es integrar información disponible con respecto al retraso en la atención médica del cáncer de mama e identificar necesidades de investigación en este tema. La revisión consta de seis apartados: origen del mensaje "no retrasar" ante la aparición de síntomas de cáncer; definición y clasificación del retraso en la atención del cáncer de mama; impacto del retraso sobre el pronóstico de la enfermedad; factores asociados con el retraso; la investigación del retraso en la atención del cáncer de mama en México; y necesidades de investigación en este tema. Se señala la necesidad de estudiar el retraso en la atención del cáncer de mama de forma más integral, tomando en cuenta características socio-estructurales y de servicios de salud, para identificar factores modificables hacia los cuales dirigir esfuerzos para mejorar la atención de esta enfermedad en países en vías de desarrollo.

The Effect of Supportive Nursing Care on the Knowledge Level and Compliance of Sick-Role Behavior in Patients with Coronary Artery Disease after Coronary Angiography / 성인간호학회지

PURPOSE: The purpose of this study was to determine the effect of supportive nursing care on the level of knowledge and compliance with sick-role behavior in patients with coronary artery disease after coronary angiography(CAG). METHODS: A quasi-experimental research was performed with 81 subjects with coronary artery disease who were admitted for CAG to a cardiovascular department. Among the selected subjects, 40 of them were assigned to experimental group and the rest of them were assigned to control group by convenience. Supportive nursing care was implemented twice by a researcher. RESULTS: 1. The mean score of knowledge related to coronary artery disease was higher in the group who received supportive nursing care than that of the control group(t=2.259, p=.027). 2. The mean score of compliance of sick role behavior was higher in the group who received supportive nursing care than that of the control group(t=4.580, p=.001). CONCLUSION: The supportive nursing care after CAG was effective in increasing the knowledge level and compliance of sick-role behavior in patients with coronary artery disease. Further studies would be recommended to identify long-term effectiveness of supportive care on patients' outcomes.

A survey on Patients' Compliance with Follow-up Coronary Angiogram after Coronary Intervention / 성인간호학회지

Coronary intervention is now a well established method for the treatment of coronary artery disease. Coronary restenosis is one of the major limitations after coronary intervention. So medical teams advise the patients to get the follow-up coronary angiogram in 6 months after coronary intervention to know if the coronary artery stenosis recurs or not. This study was done in order to know how many patients complied with the advice, and to identify the relative factors to the compliance with getting the follow-up coronary angiogram. The subjects were 101 patients (male: 58 female: 22, mean age: 61+/-15), who received coronary interventions from Jan. 1st to Mar. 31st 1997, and their data were collected from them by questionnaires one year after intervention. The questionnaires consisted of family support scale, self efficacy scale and compliance with sick role behavior scale. The result may be summarized as follows. 1. The number of patients who complied with getting the follow-up coronary angiogram were 37 people(36.6%) and did not comply with it were 64 people(63.4%). All scores of family support(t=5.56, p.05). 2. The major motivations for getting follow-up coronary angiogram were recurrence of subjective symptom(40.5%), the advice of medical team(32.4%), and fear of recurrence (27.1%). The restenosis rate in patients who got the follow-up coronary angiogram was 37.8%. 3.The restenosis rate was higher in the patients who had subjective symptoms than in those who did not have any subjective symptom. So subjective symptom and restenosis rate showed a high positive correlation(r=39.9, p<.001). However, 27.2% of the patients who did not have any subjective symptom showed coronary restenosis. 4. The reasons why they did not get the follow-up coronary angiogram were economic burden(37.5%), improved symptom(34.4%), busy life schedule(10.9%), fear of invasive procedure(9.4%), negative reaction of family member(3.1%), no helper for patient(3.1%) and worry about medical team's mistake (1.6%). The relative fators on compliance with getting the follow-up coronary angiogram after coronary intervention were family support, self-efficacy and Compliance with sick role behavior. And the most important reason why the patients did not get the follow-up coronary angiogram after coronary intervention was an economic burden.

How Long the Effect of Social Support Would Be Continued for the Patients with Hypertension? / 성인간호학회지

The purpose of this study was to identify the effect of social support revealed in the time duration of sick role behavior compliance on the patients with hypertension using Quasi- experimental research design. Data collection was made through the interview survey technique from the hypertensive patients who received social support intervention (experimental group, n=41) and from those who were not exposed to the intervention(control group, n= 34). The subjects were registered in the cardiovascular outpatient clinic at the Chonnam National University Hospital from June 3, 1996 to November 30, 1997. X2-test or t- test, Repeated measures ANOVA were utilized in the data analysis. The results were as follows: 1. The effect of social support intervention on sick role behavior compliance was significant in 1 month(F=69.17, p=.000), 6 months (F=11.51, p=.001), and 12 months(F=.07, p=.789) and between two groups(1 month; F=153.70, p=.000, 6 months; F=13.94, p=.000, 12 months; F=6.72, p= .011). 2. The effect of social support intervention on blood pressure was not significant through all the periods of time (F=1.21, p=.274) between the two groups(F=.12, p=.732). In conclusion, it was showed that social support had an effect on sick role behavior compliance and the effect of social support continued for twelve months(F= 10.03, p=.002) However, the score of compliance tends to decrease after 6 months of intervention. Therefore, this study indicated that social support re-intervention would be needed between six and twelve months.

The Effect of Social Support on Compliance with Sick Role Behavior in Hypertensive Clients and Duration of the Effect for up to 6 months / 간호학회지

This study was done using a Quasi-experimental research design to determine the effects of social support on compliance with sick role behavior in hypertensive patients and to know if the effect of the social support on compliance lasted for at least 6 months. The subjects consisted of 81 hypertensive patients who were registered in the Cardio-Vascular OPD at Chonnam National University Hospital. They were divided by random sampling into 42 people for the experimental group and 39 for the control group. Data were gathered from June 3, 1996 to June 10, 1997 through individual interviews using a structured questionnaire. The results of the study were summarized as follows : 1. Compliance with sick role behaviors in hypertensive clients was significantly increased in the experimental group who received social support from the nurse as compared to the control group who did not receive social support(t=15.99, p.05). Finally, social support was effective on compliance with sick role behaviors and stopping smoking in the hypertensive clients, and the effect of social support on compliance lasted for 6 months.

Sick-role Behavioral Compliance and Influencing Factors in Patients with Diabetes / 성인간호학회지

The purpose of this study was to identify the relationships between self-efficacy, self-esteem, health locus of control and sick-role behavioral compliance in diabetic patients and to identify the influencing factors for sick-role behavioral compliance. The subjects for study were 244 NIDDM patients from 2 hospitals, who were visiting the outpatient clinic in Taegu. Data were collected from Sep. 18.th to Oct. 5th 1996. In data analysis, SPSS/PC+ programs were utilized for descriptives, as well as Pearson correlation coefficient, t-test, ANOVA and stepwise multiple regression. The results were as follows : 1. The average score for the sick-role behavioral compliance was 50.38, for the self-efficacy was 1337.17, for the self-esteem was 27.81, for the internal health locus of control was 28.79, for the chance health locus of control was 20.55, for the powerful others health locus of control was 28.70. 2. The relationships between self-efficacy, self-esteem, health locus of control and sick-role behavioral compliance were significant. Sick-role behavioral compliance were significantly related to self-efficacy(r=0.36, 0.000), to self-esteem (r=0.19, p=0.001), to internal health locus of control(r=0.28, p=0.000), to powerful others health locus of control (r=0.28, p=0.000). 3. In the relationship between general characteristics and sick-role behavioral compliance there were significant differences in a job (t=-2.01, p=0.045), experience of diabetic education(t=2.32, p=0.022). 4. Stepwise multiple regression analysis was performed to identify the influencing factors for sick-role behavioral compliance. Self-efficacy, self-esteem, internal health locus of control, having or not having a job and experience of diabetic education accounted for 24% of the variance in sick-role behavioral compliance. The self-efficacy was the most predictive factor (R2=13%) followed by internal health locus of control, job, self-esteem and experience of diabetic education. The results suggest that self-efficacy is an important variable in the compliance of diabetic patients. For improvement in sick-role behavioral compliance nursing intervention needs to be directed at promoting self-efficacy.