노인 만성질환자의 인지기능과 자기 효능감이 약물복용 이행도에 미치는 영향

류경희; 손연정

서지반출

국문초록

최근 노인인구의 급속한 증가에 따라 국내 만성질환 유병률도 함께 증가하고 있는데, 65세 이상 노인인구의 약 90.9% 이상이 한 가지 이상의 만성질환을 앓고 있으며(Ministry for Health, Welfare and Family A airs, 2009), 노인 만성질환자 대부분이 신체적 기능 저하로 인한 심리적 위축과 사회로부터의 소외를 경험하기 쉬워, 올바른 건강증진 행위를 하는 데 있어 상당한 어려움을 겪는 것으로 알려져 있다(Kim et al., 2008; Williams, 2002). 만성질환 관리의 궁극적 목표는 질병의 완치보다는 증상 완화와 질병 악화를 지연시켜 합병증 을 예방하는 데 있으며(Gellad, Gernard, & Marcum, 2011), 이를 위해 식습관, 흡연, 음주, 운동 등의 생활습관 개선을 포함한 비약물요법 과 약물요법의 지속적인 이행이 요구된다(Brownie, 2006). 만성질환자 증상관리에 있어서 약물요법은 장기간에 걸친 올바 른 복용 이행이 특히 강조되는데(Lee, 2002), 국내 노인 만성질환자 의 경우, 2-3가지 약을 복용하는 환자가 52-75%에 이르고(Han, 2007; Lee & Park, 2002), 이 중 의사의 처방대로 약을 잘 복용한 경우는 약 47-78%로 보고되고 있다(Kim et al., 2008; Park 2008). 약을 제대로 복 용하지 않을 경우, 치료효과가 급격히 떨어져 재입원과 질병악화로 인한 삶의 질 저하는 물론, 사망과 같은 부정적 건강결과를 초래할 뿐 아니라 국가적으로는 의료비 상승을 야기시키는 원인이 되므로 (Wertheimer, Chaney, & Santella, 2003) 고령화 사회에 접어든 사회현 실을 고려할 때, 취약계층인 노인 환자의 올바른 물복용 이행을 향상시키는 방안을 모색하는 노력이 필요하다.

영문초록

Purpose: This study was aimed to describe the level of medication adherence and to identify the impact of cognitive function and self-efficacy on medication adherence of elderly patients with chronic disease. Methods: The descriptive study included 303 patients over 65 years with chronic diseases from two medical centers in Cheonan city. Data were collected from July to November 2011. A questionnaire including questions on the Korean version of mini-mental state examination (MMSE-K), self-efficacy and medication adherence were completed by the subjects. Data were analyzed using the SPSS/WIN 20.0 program. Results: The mean score of medication adherence was 1.4±1.6. In univariate analysis, exercise (t=2.85, p=.005), type of disease (F=3.91, p=.001) and self-efficacy (r=-.57, p<.001) were the significant factors related to medication adherence. Linear regression analysis demonstrated that self-efficacy (β=-.57, p<.001) was a significantly associated factor with medication adherence. Self-efficacy explained about 33% of the total variance of the medication adherence in elderly patients. Conclusion: The results suggest that self-efficacy to medication can be a facilitator to medication adherence in elderly patients. However, these results indicate that there remains much work to be done in identifying other predictors of medication adherence of elderly patients with chronic diseases.

키워드

Aged Chronic disease Cognition Self-efficacy Medication adherence 노인 만성질환 인지기능 자기효능감 약물복용이행도

참고문헌 (30건)

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