내분비요법 중인 유방암 환자의 약물복용 교육프로그램 개발 및 효과: 확장된 건강신념 모델을 중심으로

다국어 초록 (Multilingual Abstract)

Breast cancer is increasing among Korean women, and about 70~80% of patients are hormone receptor-positive, requiring endocrine therapy. However, adherence remains low. This study was developed based on the extended Health Belief Model to improve medication adherence among breast cancer patients undergoing adjuvant endocrine therapy. This intervention program was designed to enhance patients’ knowledge of adjuvant endocrine therapy, beliefs about medication adherence, self-efficacy for medication adherence, and medication adherence. This study was conducted in education rooms of a general hospital in Busan City. A nonequivalent control group pre-post design was employed to examine the effects of the education program. Data were collected from July 21 to August 29, 2025. The experimental group consisted of 25 patients from Hospital A, and the control group consisted of 30 patients from Hospital B. Data were analyzed using the SPSS/WIN 27.0 program. For preliminary homogeneity testing, independent t-test, χ²-tests, or Fisher’s exact tests were applied where appropriate. To examine the study hypotheses, the Shapiro-Wilk test was first used to check the normality of pretest and posttest differences between the experimental and control groups, and independent t-tests were subsequently performed. The experimental group participated in a total of six sessions consisting of face-to-face education, practice activities, while the control group was provided with educational materials about adjuvant endocrine therapy. To evaluate the effects of the medication adherence education program for breast cancer patients undergoing adjuvant endocrine therapy based on the extended Health Belief Model, questionnaire surveys were administered to measure knowledge of adjuvant endocrine therapy, beliefs about medication adherence, self-efficacy for medication adherence, and medication adherence. The findings indicated that there were significant differences in knowledge of adjuvant endocrine therapy(t=8.00, p<.001), susceptibility of medication adherence(t=5.19, p<.001), benefit of medication adherence(t=0.10, p<.001), barrier of medication adherence(t=-6.90, p<.001), self-efficacy for medication adherence(t=9.45, p<.001), and medication adherence(t=4.17, p<.001) in the experimental group after the intervention program, as compared to the control group. Therefore, the medication adherence education program for breast cancer patients undergoing adjuvant endocrine therapy, developed in this study based on the extended Health Belief Model, was shown to be effective in enhancing patients’ knowledge of adjuvant endocrine therapy, susceptibility of medication adherence, benefit of medication adherence, barrier of medication adherence, self-efficacy for medication adherence, and medication adherence. Future studies are recommended to include long-term follow-up, larger and more diverse populations, and the application of digital or multi-institutional interventions to further validate the effectiveness of the program.

목차 (Table of Contents)

• I. 서론 1
• 1. 연구의 필요성 1
• 2. 연구 목적 4
• 3. 연구 가설 5
• 4. 용어의 정의 6
• Ⅱ. 문헌고찰 12
• 1. 유방암 환자의 내분비요법 12
• 2. 내분비요법 중인 유방암 환자의 약물복용 이행 영향요인 15
• 3. 약물복용 이행을 위한 교육프로그램 19
• Ⅲ. 개념적 기틀 24
• Ⅳ. 연구 방법 29
• 1. 연구 설계 29
• 2. 연구 대상 30
• 3. 연구 도구 32
• 4. 연구 진행절차 35
• 5. 윤리적 고려 56
• 6. 자료분석 방법 57
• Ⅴ. 연구 결과 58
• 1. 실험군과 대조군의 사전 동질성 검정 58
• 2. 연구 가설 검정 64
• VI. 논의 69
• 1. 내분비요법 중인 유방암 환자의 약물복용 교육프로그램의 개발 70
• 2. 내분비요법 중인 유방암 환자의 약물복용 교육프로그램의 효과 72
• VII. 결론 및 제언 78
• Reference 80
• Appendix 91
• Appendix 1. 약물복용 교육프로그램 선행연구 91
• Appendix 2. 건강신념모델 기반 약물복용 교육프로그램 선행연구 94
• Appendix 3. 환자 및 간호사와의 면담 99
• Appendix 4. 프로그램 내용 타당도 102
• Appendix 5. 설명문 및 동의서 104
• Appendix 6. 설문지 110
• Appendix 7. 회기별 프로그램 계획안 118
• Appendix 8. 교육 자료 124
• Appendix 9. 프로그램 진행사진 134
• Appendix 10. IRB 심사통지서 135
• Appendix 11. 도구 사용 승인 136