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현재편향과 약물에 대한 신념이만성질환자의 복약불이행에 미치는 영향
이소아,현명호 한국건강심리학회 2021 한국심리학회지 건강 Vol.26 No.1
In this study, we examined the effect of present bias(time preference) and belief about medicines on the medication non-adherence(intentional/unintentional) of patients with chronic disease in Korea. Over the course of this study, 158 patients with chronic diseases (hypertension/diabetes/hyperlipidemia) completed Delayed Discounting Tasks(DDT), Belief about Medicines Questionnaire-Specific(BMQ-Specific), and a revised Korean version of Adherence to Refills and Medication Scale(ARMS-K). As a result, it was found that present bias held a significantly positive effect on patients’ medication non-adherence, and results showed that the more present-biased the patients were, the higher both the intentional and unintentional non-adherences appeared. Additionally, results showed that belief about medicines held a significantly negative effect on medication non-adherence, with the stronger the belief about medicines, the lower the non-adherence, not merely unintentionally, but also intentionally. Finally, there were no interaction effects of belief about medicines on the relationship between present bias and medication non-adherence. Further analysis revealed, however, that concern about medicines, a subtype of belief about medicines, had an interaction effect on the relationship between present bias and medication non-adherence. Specifically, these results were shown in intentional non-adherence, but not in unintentional non-adherence. This study examined not only the belief patients hold for medicines, which has already been dealt with in pre-existing literature, but also suggests a new possibility where present bias may be a factor that may lead to the failure of medicine in-take for patients with chronic diseases. This study concludes with a final summary of these findings, a discussion of the implications and limitations of the study, and further suggestions for future studies. 본 연구에서는 국내 만성질환자의 현재편향(시간선호)과 약물에 대한 신념이 복약불이행(의도적/비의도적) 수준에 미치는 영향을 살펴보았다. 이에 따라 만성질환자(고혈압/당뇨/고지혈증) 158명을 대상으로 지연할인과제(DDT), 약물에 대한 신념 질문지(BMQ-Specific), 수정된 한국어판 자가보고 복약이행도 척도(ARMS-K)를 실시했다. 그 결과 현재편향은 만성질환자의 복약불이행에 정적 영향을 미치는 것으로 나타났다. 현재지향적일수록 의도적 불이행과 비의도적 불이행 모두 높아졌다. 약물에 대한 신념은 만성질환자의 복약불이행에 부적 영향을 미치는 것으로 밝혀졌다. 약물에 대한 필요성을 염려보다 크게 지각할수록 의도적 불이행은 낮아졌으나, 비의도적 불이행에는 영향을 미치지 않았다. 마지막으로 현재편향과 복약불이행간의 관계에서 약물에 대한 신념의 상호작용효과는 유의하지 않았다. 추가적인 분석을 실시한 결과 약물에 대한 신념의 하위유형인 염려는 상호작용효과가 있었으며, 이러한 결과는 의도적 불이행에서 나타났지만 비의도적 불이행에서는 나타나지 않았다. 본 연구는 국내 만성질환자의 복약불이행에 영향을 미치는 요인으로써 기존에 연구되어 왔던 약물에 대한 신념을 검증함과 동시에, 현재편향의 영향력을 검토했다는 의의가 있다. 이를 바탕으로 본 연구의 시사점과 한계, 후속연구를 제언하였다.
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한국어판 약물에 대한 신념도구의 타당도와 신뢰도: 항호르몬제를 복용하는 유방암 환자를 대상으로
김영란 ( Younglan Kim ),민열하 ( Yul Ha Min ) 한국보건정보통계학회 2017 보건정보통계학회지 Vol.42 No.2
Objectives: The purpose of this study was to assess the validity and reliability of the Korean version of the Beliefs about Medicines Questionnaire-Spe cific (BMQ-specific). Methods: Forward-backward translation of the BMQ-specific from English to Korean was conducted. Data were collected from 210 breast cancer patients on hormone therapy treated at a hospital in Seoul using the questionnaires. Data were analyzed by item analysis for validity, which included factor analysis of Principal Component Analysis and correlation with the Morisky Medication Adherence Scale (MMAS), and for internal consis tency reliability. Results: The overall score for the BMQ-specific, necessity beliefs and concern beliefs were 24.50±6.47, 13.83±4.17, and 10.68±4.10, respectively. The item-total correlation coefficients of all the items were >0.20 and ranged from 0.26 to 0.59. A factor analysis was conducted, and 10 items that had a factor loading of more than 0.40 were extracted. The explained variance from two factors was 61.2% of the total variance. The criterion-related validity was supported by the MMAS. The total Cronbach`s alpha was 0.80. Conclusions: The findings show that the Korean version of the BMQ-specific was reliable and valid in measuring the patients` beliefs about medication in Korean breast cancer patients on hormone therapy. The K-BMQ-specific enables healthcare providers to effectively measure the necessity beliefs and concern beliefs of patients regarding medication so they can pro vide appropriate and adequate management and strategies for medication adherence.
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