Adherence to health regimens and the factors associated with it and the effects of nurse-led case management intervention on frequent attenders

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Lecture Hall K101 (Aapistie 7). Remote access: https://oulu.zoom.us/j/67861507253?pwd=WU5aeHNSRk5BajZKQUhwNHpEcnREUT09

Topic of the dissertation

Adherence to health regimens and the factors associated with it and the effects of nurse-led case management intervention on frequent attenders

Doctoral candidate

Master of Health Sciences Sari Hirsikangas

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu

Subject of study

Nursing science

Opponent

Docent Jari Kylmä, Tampere University

Custos

Professor Helvi Kyngäs, University of Oulu

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Adherence to health regimens and the factors associated with it and the effects of nurse-led case management intervention on frequent attenders

The purpose of the study was to describe adherence to health regimens and the factors associated with it. In addition, the study evaluate the effects of nurse-led case management intervention on frequent attenders. The study is a quasi-experimental intervention study in which the participants were measured at the initial stage of the study (whole study group n = 462), one-year follow-up (intervention group n = 200 and control group n = 166) and 2 years follow-up (intervention group n = 161 and control group n = 153).

The study answered three research questions. The first research question described adherence to health regimens and the factors associated with it on frequent attenders. The second research question with an intervention and control group evaluated the effects of the intervention on frequent attenders’ adherence to health regimens, depression, somatization, and hypochondriasis. The third research question with an intervention and control group evaluated the effects of the intervention on the quality of life, sense of coherence, and daily activities. The data were collected using structured instruments and analyzed using descriptive statistics and methods.

Frequent attenders adhered well to health regimens. The variables that predict the best adherence to health regimens were feeling responsible for self-care, carrying out self-care, and receiving medical care. The intervention had a positive effect on customers’ somatization, depression symptoms, and adherence to health regimens. In the intervention group, hypochondriasis increased. Hypochondriacal beliefs were more common among those who had poor adherence to health regimens. These results indicated a correlation between the quality of life and amount of daily activities and between the sense of coherence and the quality of life among frequent attenders.

The findings can be utilized when designing better evidence-based service processes, and models for frequent attenders needs.
Last updated: 1.3.2023