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Psychometric Evaluation of Hill-Bone Medication Adherence Subscale
송영신,Hae-Ra Han,Hee-Jung Song,Soohyun Nam,Tam Nguyen,Miyong T. Kim 한국간호과학회 2011 Asian Nursing Research Vol.5 No.3
Purpose: Medication adherence is an essential part of the management and control of high blood pressure (HBP). Although the Hill-Bone Medication Adherence (HBMA) scale is one of the most frequently used instruments for measuring HBP medication adherence, the psychometric properties of the scale have never been tested among Korean Americans, a population that experiences a disproportionately high prevalence of HBP. Therefore, the objective of this study is to validate a Korean version of the HBMA subscale (HBMA-K). Method: We used two, independent samples of Korean Americans (KAs) (combined n ¼ 525) who participated in community-based intervention trials for HBP control. To develop the HBMA-K, the original scale was translated into Korean and then back translated into English. Reliability was assessed by calculating the Cronbach’s alpha. Exploratory factor analysis (EFA) was done to assess construct validity. We also calculated the Pearson’s correlation coefficients between the scale and theoretically driven variables such as blood pressure, knowledge, and HBP belief to test concurrent validity. Results: The EFA revealed a one-factor solution with eight items, explaining 35.4% of the variance. Cronbach’s alpha was .80. The 8-item HBMA-K scale was significantly associated with systolic blood pressure (BP) (r ¼ .18, p < .01), diastolic BP (r ¼ .24, p < .01), HBP knowledge (r ¼ .13, p < .01), and HBP belief score (r ¼ .18, p < .05). Conclusions: The 8-item HBMA-K scale is a valid and reliable instrument for measuring medication adherence among KAs with HBP. It can be easily administered at community and clinical settings to screen hypertensive patients with low medication adherence.
Patients' perspectives on taking insulin in diabetes - Perspectives of convergence
송영신,안은경 한국디지털정책학회 2016 디지털융복합연구 Vol.14 No.12
The purpose of this study was to explore the cultural perspectives and experiences relating to insulin therapy among the diabetes. The authors conducted four semi-structured focus groups and individual interviews with 19 adults with type 1 and 2 diabetes, focusing on the personal experiences and thoughts regarding insulin therapy. Patients’ perspectives and experiences relating to taking insulin formed three categories of themes: preoccupations about insulin, barriers to taking insulin, and benefits to taking insulin. The theme for preoccupations about insulin was “vague fear,” while the theme of barriers to taking insulin were “worrisome insulin-related issues”, “ambivalent feelings (trust/mistrust) about healthcare providers,” “dependent life,” “feeling about supporters(family, friends, and religion),” “inconvenience,” “regret about the past,” and “embarrassment.” The theme of benefits to taking insulin were “recognition” and “physical recovery and confidence in regulating blood glucose”. Based on this study, patients’ feelings about their insulin should be respected by healthcare providers.
송영신,구보경,김상완,이가희,신기철,문민경 대한당뇨병학회 2018 Diabetes and Metabolism Journal Vol.42 No.1
Background: In Korea, the costs associated with self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes mellitus (T2DM) under insulin treatment have been reimbursed since November 2015. We investigated whether this new reimbursement program for SMBG has improved the glycemic control in the beneficiaries of this policy. Methods: Among all adult T2DM patients with ≥3 months of reimbursement (n=854), subjects without any changes in anti-hyperglycemic agents during the study period were selected. The improvement of glycosylated hemoglobin (HbA1c) was defined as an absolute reduction in HbA1c ≥0.6% or an HbA1c level at follow-up <7%. Results: HbA1c levels significantly decreased from 8.5%±1.3% to 8.2%±1.2% during the follow-up (P<0.001) in all the study subjects (n=409). Among them, 35.5% (n=145) showed a significant improvement in HbA1c. Subjects covered under the Medical Aid system showed a higher prevalence of improvement in HbA1c than those with medical insurance (52.2% vs. 33.3%, respectively, P=0.012). In the improvement group, the baseline HbA1c (P<0.001), fasting C-peptide (P=0.016), and daily dose of insulin/body weight (P=0.024) showed significant negative correlations with the degree of HbA1c change. Multivariate analysis showed that subjects in the Medical Aid system were about 2.5-fold more likely to improve in HbA1c compared to those with medical insurance (odds ratio, 2.459; 95% confidence interval, 1.138 to 5.314; P=0.022). Conclusion: The reimbursement for SMBG resulted in a significant improvement in HbA1c in T2DM subjects using insulin, which was more prominent in subjects with poor glucose control at baseline or covered under the Medical Aid system.