만성 C형 간염 환자를 위한 항바이러스제 복용이행 교육프로그램 개발 및 효과

Abstract

The Development and Evaluation of Antiviral Agents Medication Adherence Education Program for Chronic Hepatitis C Patients

The purpose of this study was to develop and verify the effectiveness of the goal-attainment-theory-based antiviral agents medication adherence education program for chronic hepatitis C patients. A nonequivalent control group pretest-posttest design was used in this study. Data were collected from December 2019, to March 2020, with a control group of 35 patients from General Hospital A and an experimental group of 28 patients from General Hospital B. The data analysis was performed using an SPSS/WIN 25.0 program, and either an independent t-test, χ2-test, or Fisher's exact test was used for preliminary testing regarding homogeneity. To test the hypotheses, the normality of the differences between the pretest and posttest data of the intervention and control groups was assessed using the Kolmogorov-Smirnov test and, subsequently, the Mann-Whitney U test, because the data were not normally distributed.

The results were as follows: 1) This study has showed that patients' knowledge of hepatitis C would improve more among patients in the experimental group than among patients in the control group after completion of the antiviral agents medication adherence education program(Z=-5.91, p<.001). 2) This study has showed that medication adherence self-efficacy would improve more for patients in the experimental group than for patients in the control group after completion of the antiviral agents medication adherence education program(Z=-5.02, p<.001). 3) This study has showed that medication adherence rate would improve more among patients in the experimental group than among patients in the control group after completion of the antiviral agents medication adherence education program(t=-3.88, p<.001). 4) This study has showed that medication misuse behavior would decrease more among patients in the experimental group than among patients in the control group after completion of the antiviral agents medication adherence education program(Z=-5.00, p<.001). 5) This study has showed that satisfaction with the healthcare provider would improve more for patients in the experimental group than for patients in the control group after completion of the antiviral agents medication adherence education program(Z=-6.61, p<.001).

This study has showed the effectiveness of the goal attainment theory based antiviral agents medication adherence education program for chronic hepatitis C patients with regard to patients' medication adherence in clinic by a gastroenterology nurse practitioner. Therefore, it is hoped that the medication adherence education program developed and applied in this study will be utilized as a nursing intervention for the healthcare of chronic hepatitis C patients and be further developed for the wider care of patients with viral hepatitis. Further studies are warranted to explore the role of behavioral modification mediating between chronic liver disease risk management and health-related quality of life in this population.

Key Words : Medication adherence, Hepatitis C, Antiviral agents, Nursing, Education