RESUMO
The failure of patients to comply with treatment regimens recommended by their physicians is a significant clinical problem. Researches on the assessment of compliance have, however, been precluded by methodological difficulties such as lack of adequate measures. The purpose of this study was to develop a self-administered questionnaire to evaluate drug compliance. First, questionnaire containing a 52-items complied by two doctors, a pharmacist and a nurse, was tested on 81 outpatients, all volunteers, attending the departments of psychosomatic medicine and internal medicine. Four items were temporarily removed for later analysis because they directly inquired about drug compliance (drug compliance items). The other 48 items were analyzed and three factors consisting of 26 items were further studied: expectation on taking medicine, rejection to taking medicine and seeking knowledge of drugs. Chronback's alpha coefficients representing internal consistency of the three factors were sufficiently high (ranging from .75 to .84). Furthermore, we preformed a simplified pill count to validate the 4 drug compliance items. There was a weak to moderate correlation between the result of pill count and each of 4 drug compliance items. A new self-administered questionnaire of 30 items was thus developed and named the Drug Compliance Scale.
Assuntos
Esquema de Medicação , Cooperação do Paciente , Inquéritos e Questionários/normas , Análise Fatorial , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , AutoadministraçãoRESUMO
The purpose of this study was to investigate psychological factors affecting drug compliance in the department of psychosomatic medicine. Seventy-four outpatients were asked to answer a battery of self-administered questionnaire including the Drug Compliance Scale (DCS) that we had recently developed and other questionnaire evaluating psychological and vegetative symptoms, self-efficacy and attributional styles on the promotion of health and personality closely related to interpersonal relationships. Results of path analysis indicated that attributional styles and self-efficacy mainly affected three factors of DCS such as expectation on taking medicine, rejection to taking medicine and seeking knowledge of drugs, through which they influenced drug compliance, and also indicated that personality and self-efficacy mainly affected the stability of mood state, suggesting a further influence on drug compliance.
Assuntos
Esquema de Medicação , Cooperação do Paciente/psicologia , Personalidade , Transtornos Psicofisiológicos/psicologia , Autoeficácia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Unidade Hospitalar de Psiquiatria , Transtornos Psicofisiológicos/tratamento farmacológico , Medicina Psicossomática , Autoadministração , Inquéritos e QuestionáriosRESUMO
Recently, the authors have shown that marked necrosis and fibrosis of myocardium were observed in rats given alkaline ionized water (AKW). To clarify the cause of myocardial lesions, the activities of myosin ATPase, actomyosin ATPase and creatine kinase (CK) in myocardium of rats given AKW at 15 weeks-old were compared with those in myocardium of rats given tap water (TPW). Furthermore, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) of myocardiac myosin and isoelectric focusing (IEF) of myocardiac CK were performed which revealed a distinct difference between AKW and TPW groups. The activities of myosin ATPase and actomyosin ATPase in the AKW group were higher than those in the TPW group, and these elevated activities were caused by the degradation of myosin in the AKW group judging from the SDS-PAGE pattern of myosin. On the other hand, the activity of CK in the AKW group was lower than that in the TPW group, and the IEF pattern of CK showed leakage of myocardiac CK. These results indicate that increases in actomyosin ATPase activity and myosin ATPase activity, plus the decrease in CK activity caused the disorder of coupled reaction in male rats given AKW at 15 weeks-old. It is concluded that this disorder of coupled reaction may cause marked myocardiac necrosis and fibrosis in rats given AKW.
Assuntos
Creatina Quinase/metabolismo , Eletrólitos/toxicidade , Miocárdio/metabolismo , Miosinas/metabolismo , Abastecimento de Água , Animais , Creatina Quinase/isolamento & purificação , Suplementos Nutricionais , Eletrólitos/administração & dosagem , Feminino , Coração/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Isoenzimas , Masculino , Miocárdio/patologia , Necrose , Ratos , Ratos Sprague-Dawley , Caracteres SexuaisRESUMO
Bovine colostrum has growth factor activity for stimulating DNA synthesis in calf kidney epithelial cells (CKT-1), Madincanine kidney epithelial cells (MDCK) and rat L6 myoblasts (L6), of which the DNA stimulation level and the activity change with the time elapsed after the birth of a calf varied with their respective cells. The growth factor activity of colostrum for CKT-1 was stable regardless of the collection time of colostrum, and it was purified about 3,650-fold in an overall yield of 1.2% from colostrum obtained 30 min after the birth of a calf. The purified growth factor had a molecular weight (MW) of 5,000 and an isoelectric point of pH 9.7, and the amino acid composition was: Asx5, Thr2, Ser4, Glx14, Pro2, Gly4, Ala4, Val2, Ile, Leu2, Tyr, Phe, Lys, His and Arg. The stimulated DNA synthesis in CKT-1 and L6 by the addition of purified growth factor at a final concentration of 16ng/ml was as the same extent as calf serum at a final concentration of 1.52 mg/ml, and the relative activity for CKT-1 was even greater than that for L6.