Factors Influencing 1-Year Medication Adherence of Korean Ischemic Stroke Survivors.

BACKGROUND: Medication adherence is important for secondary stroke prevention. However, suboptimal adherence to medication among patients after stroke or transient ischemic attack is reportedly 30.9%. We assessed medication adherence of Korean stroke survivors within 1 year of acute ischemic stroke and identified factors that influence adherence. METHODS: We consecutively enrolled ischemic stroke survivors who visited the Department of Neurology of a university hospital from March 9 to June 15, 2016. Data were collected by face-to-face interviews using a structured questionnaire which assessed general characteristics, clinical characteristics, medication beliefs, social support, and depression. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale. Multiple logistic regression was used to identify factors independently associated with medication adherence. RESULTS: Of the total 250 participants, 183 (73%) were in the optimal adherence group. Age (p = 0.035), smoking (p = 0.020), number of prescribed medicines (p = 0.037), frequency of daily doses (p = 0.040), and beliefs about medication (p < 0.001) were associated with medication adherence. Optimal medication adherence was associated with being a non-smoker (OR, 3.19; 95% CI, 1.29-7.87; p = 0.012), more prescribed medicines (OR, 1.27; 95% CI, 1.05-1.54; p = 0.014), less frequency of daily doses (OR, 0.37; 95% CI, 0.18-0.79; p = 0.010), and stronger beliefs about medication (OR, 1.09; 95% CI, 1.03-1.15; p = 0.004). CONCLUSION: To improve medication adherence of stroke survivors, post-stroke care should focus on bolstering patients' belief in the necessity of medication and encouraging lifestyle modifications, such as quitting smoking, as well as prescribing medicine with simple regimens.

The Validity and Reliability of the Korean Version of the Stigma Scale for Chronic Illness 8-Items (SSCI-8) in Patients with Neurological Disorders.

PURPOSE: The aim of this study was to develop a Korean version of the Stigma Scale for Chronic Illness 8-items (SSCI-8) and then assess its reliability and construct validity among patients with neurological conditions. METHOD: Patients diagnosed with stroke, Parkinson's disease, epilepsy, multiple sclerosis, myasthenia gravis, and amyotrophic lateral sclerosis were recruited. Reliability was assessed for internal consistency with Cronbach's alpha coefficient. Exploratory factor analysis (EFA) was used to extract potential factors of Korean SSCI-8. Convergent validity was assessed by correlating scores on the Korean SSCI-8 with scores for depression using the Beck Depression Inventory, anxiety using Spielberger's State-Trait Anxiety Inventory, and functional ability using the Korean modified Barthel Index (K-MBI), respectively. RESULTS: Of the total 202 patients enrolled in this study, 119 (58.9 %) were recruited with stroke, 33 (16.3 %) with Parkinson's disease, and 29 (14.4 %) with epilepsy. The Korean SSCI-8 had a high internal consistency (Cronbach's alpha = 0.90). The Korean SSCI-8 retrieved one factor from eight items by the EFA, and all factor loading scores were above 0.70 (0.71-0.84). The Korean SSCI-8 was correlated positively with depression (r = 0.74, p < 0.001) and anxiety (r = 0.61, p < 0.001), and negatively with the K-MBI (r = -0.48, p < 0.001). CONCLUSION: This study shows that the Korean SSCI-8 is a unidimensional model, even though it includes items of both enacted and internalized stigma. It is both reliable and valid for assessing stigma among Korean patients with neurological disease.

Low Body Mass Index for Early Screening of Adolescent Idiopathic Scoliosis: A Comparison Based on Standardized Body Mass Index Classifications.

PURPOSE: Scoliosis is a common musculoskeletal problem in adolescents. This study aimed to identify the prevalence of adolescent idiopathic scoliosis (AIS) and its associated factors among Korean adolescents. The prevalence of thin individuals among students with AIS was compared based on body mass index (BMI) classifications. METHODS: This study was a secondary data analysis and used the 2016 Korean National Health Examination for School Students data. Data from 16,412 students were analyzed using descriptive statistics, Chi-square tests, and logistic regression analysis. RESULTS: The prevalence of AIS was higher in women (3.8%) than in men (1.6%), and a higher school year was a risk factor for AIS in both sexes. In woman adolescents, scoliosis was associated with thinness; however, the risk of AIS was inversely associated with overweight/obesity in both sexes. The prevalence of thin woman students with scoliosis differed based on the criteria used: 3.3% by the World Health Organization criteria and 14.3% by the International Obesity Task Force criteria. CONCLUSION: The prevalence of thin students with scoliosis could increase by up to four times depending on the BMI criteria. For early screening of thin people at risk of AIS among female students, the criterion of International Obesity Task Force should be used as it is more permissive of thinness. This is also because of the underestimation of AIS prevalence when using the BMI Z score of the World Health Organization cutoff.

Development and psychometric evaluation of the Korean version of the cultural competence scale for clinical nurses.

PURPOSE: To develop and psychometrically test the Korean version of the Cultural Competence Scale for Nurses (K-CCSN). METHODS: A multi-phase questionnaire development method was used to develop the scale from November 2012 to April 2013. The item pool was generated based on literature review, existing scales and in-depth interviews. The content validity was evaluated twice by an expert panel. The scale validation was conducted with a convenience sample of 456 general hospital nurses recruited from five general hospitals and a nursing college in the Seoul Metropolitan Area of South Korea. The construct-related and criterion-related validity and internal consistency reliability of the scale were tested. RESULTS: The 33-item K-CCSN comprised four subscales-cultural awareness, cultural knowledge, cultural sensitivity and cultural skills-explaining 53.96% of the total variance. The criterion-related validity was supported by a known-group comparison. The reliability analysis showed an acceptable-to-high Cronbach's alpha in total and for subscales ranging from .879 to .932. CONCLUSION: This preliminary evaluation of psychometric scale properties demonstrated acceptable validity and reliability. The K-CCSN is able to provide scientific and empirical data regarding the cultural competence of clinical nurses. However, further studies are needed to test the applicability of the scale in different settings and contexts.