Purpose: The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory. Methods: Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0. Results: The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients. Conclusion: It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.
Kim, Tae-Hyung;So, Yong-Seon;Kweon, Ki-Hyeon;Han, Sang-Woong;Kim, Seok-Hwan;Kim, Jong-Soon;Han, Seung-Soo
The Korean Journal of Nuclear Medicine
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v.30
no.1
/
pp.130-138
/
1996
Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.
Purpose: We have examined the utility of $^{99m}Tc$-MAG3 perfusion indices for assessing renal graft function in early post-transplantation period. Materials and Methods: Our study included 80 renal transplant recipients (48 men and 32 women, mean age: 40.3 years). Diagnosis was based on biopsy, laboratory data and clinical course. Renal scintigraphy (RS) was obtained using 100 MBq of $^{99m}Tc$-MAG3 from 11 days to 23 days of kidney transplantation. We measured 5 indices in whole-kidney (WK) and cortical (C) renograms; Hilson's perfusion index (PI), transplant perfusion index (TP) and transplant function index (TF) as perfusion parameter, and the time to peak activity (Tmax) and the ratio of renal counts at 20 min to that at 3 min (K20/3) as functional parameter. Results: The diagnoses at the day of RS were normal graft (NG) in 44, acute rejection (AR) in 14, acute tubular necrosis (ATN) in 10, and Cyclosporine A nephrotoxicity (CsA) in 12. TP and TF were significantly decreased in AR, ATN and CsA, compared to those in NG. K20/3 of AR and ATN wore significantly greater than that of NG. WK-Tmax of AR was significantly longer than that of NG. K20/3 of AR and C-K20/3 of ATN were significantly prolonged relative to those of CsA. There were no statistically significant perfusion indices among complication groups. Conclusion: TP and TF reflecting microperfusion and initial tubular extraction are reliable in assessing graft function. However, it is required to correlate perfusion indices with functional indices and clinical course in differentiating from one another among complication groups.
Purpose: The purpose of this study was to investigate the distribution of the diameter of four strand autologous hamstring tendon and to identify the factors related to the diameter. Materials and Methods: Between December 2004 and July 2006, 66 patients underwent anterior cruciate ligament reconstruction using autologous hamstring tendon. Sixty one patients were male and the other 5 patients were female. Both semitendinosus and gracilis tendon were harvested in every case. Harvested two tendons were folded once together to create a four strand double loop graft and were passed through cylindrical sizer to measure their diameter. Parameters such as sex, age, height and weight were analyzed for their correlation with the diameter of the graft. Results: The diameter of the graft ranged from 6 mm to 10 mm. The graft with the diameter of 8 mm was most common and the average diameter of all the grafts was $7.85{\pm}0.92mm$. Seven patients (10.6%) had a graft with the diameter of 6 mm, which is considered too thin to be ideal one. No statistically significant correlation was found between age of the patient and the diameter of the graft. However, the diameter of the graft was significantly correlated with sex, height and weight of the patient. Female patients had a significant tendency to have thinner hamstring tendons. Both small height and light weight of the patients were correlated with thinner hamstring tendons significantly. Conclusion: Sex, height and weight of the patients were the factors that had a statistically significant correlation with the diameter of the graft. Being aware of the risk factors related with harvesting exceedingly thin hamstring tendon prior to anterior cruciate ligament reconstruction, one can utilize wide range of options in selecting an optimal graft.
Cho, Han Kyung;Jeong, Jae Sim;Moon, Seongmi;Kim, Mi-Na
Journal of Korean Biological Nursing Science
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v.18
no.2
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pp.118-125
/
2016
Purpose: The present study examines the current influenza immunization rate among kidney transplant patients in an effort to identify the factors influencing their decisions pertaining to the immunization. Methods :Participants in the study included 150 adults over the age of 64 years who visited a General Surgery Department in Korea on April 2015, who had had a kidney transplant at least two years prior to the visit. We compared the characteristics of transplant patients who were immunized against those of the patients who had not been immunized. Results: The average age of the participants was $48.5{\pm}9.6years$, consisting of 87 males (58.0%) and 63 females (42.0%). The average post-surgery period was $91.0{\pm}59.0months$. Between September and December 2014, the immunization rate among these participants was 61.3%. Factors which influenced the participant's decision to get immunized in 2014 and drove up the immunization rate were: previous immunization in 2013 (OR=24.57, CI= 8.79-68.70, p<.001), marital status (OR=3.33, CI 1.05-10.56, p=.041), and awareness (OR=1.58, CI=0.99-2.52, p=.056). Conslusion: The current study found that the previous year's immunization record, marital status, and awareness increased the rate of immunization among the participants.
The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Program to prevent of obesity and cardiovascular diseases for the kidney transplant recipients. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study ws carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids therapy and did not take any physical exercise regularly. The subjects received the self efficacy promotion and exercise program for 12 weeks which contained self efficacy promotion education and exercise program. The weight, body fat rate, exercise time and cardiopulmonary function were evaluated before the experiment and after the experiment. The results were as follows: 1. After the experiment, the weight was significantly decreased than that of before the experiment(p=.0001). 2. After the experiment, the body fat rate was significantly decreased than that of before the experiment(p=.0010). 3. After the experiment, the exercise time was significantly increased than that of before the experiment(p=.0002). 4. After the experiment, the absolute VO2 was significantly increased than that of before the experiment(p=.0008). 5. After the experiment, the relative VO2 was significantly increased than that of before the experiment(p=.0002). This study showed that the self efficacy promotion and exercise program was effective. So it would be expected that this self efficacy promotion and exercise program could be applied as an effective independent nursing intervention widely in prevention of obesity and cardiovascular diseases for kidney transplant recipients.
The purpose of this study was to explore the change of muscle strength, muscle endurance, flexibility and activities of daily living to develop a rehabilitational program. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study was carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids and did not take any physical exercise regularly. The muscle strength, muscle endurance, flexibility and activities of daily living were evaluated at 1st week and after 12 weeks. The data were analyzed with numbers, percentiles, mean, standard deviation and t-test. The results were as follows: 1. After 12 weeks, the grip strength was significantly decreased than 1st week (p=.0002). 2. After 12 weeks, the back lift strength was significantly decreased than 1st week (p=.0002). 3. After 12 weeks, the muscle endurance was increased than 1st week, but it was not significant(p=.5487). 4. After 12 weeks, the flexibility was significantly decreased than 1st week (p=.0002). 5. After 12 weeks, the activities of daily living was significantly decreased than 1st week (p=.0006). Like the above result, the kidney transplant receipients' muscle strength, flexibility and activities of daily living were reduced. In order to solve this problem, the writer has found that program development to prevent the defects should be extremely required. Since now on the number of patients should expand. After the kidney transplantation, the periods of 4, 8, 12 and 16 weeks are extended. The writer proposes to examine the different phase of change in each periods.
The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Training Program to decrease anxiety and depression and to increase the quality of life for kidney transplant recipients. The subjects were selected randomly among the patients who underwent renal transplant at three major transplantation hospitals in Seoul, Korea. The observed subjects in this study consisted of 56 patients who had renal transplantations between one to twelve months prior to this study. The patients did not take any regular physical exercise. This study was carried out between November, 1999 and March, 2000. The study groups were divided into 3 groups; exercise training group (n=16), self efficacy group (n=18) and control group (n=22). The exercise training group received self efficacy promotion and exercise training program for 12 weeks. The self efficacy group received self efficacy promotion education, but no exercise training was given. The control group was not offered any education. The anxiety, depression and quality of life were evaluated 3 times, before the experiment, after 8 weeks and after 12 weeks. The data were analyzed with mean, standard deviation, Chi-square test, ANOVA and $Scheff\acute{e}$ test. The results were as follows: 1. After the experiment, anxiety and depression scores of the exercise training group and self efficacy group were more significantly decreased than those of the control group (p=.05). 2. After the experiment, the quality of life score of the exercise training group and self efficacy group were more significantly increased than those of the control group (p=.05). This study showed that the Self Efficacy and Exercise Training Programs were effective. Therefore, it is expected that the Self Efficacy Promotion and Exercise Training Program could be widely applied as an effective independent nursing intervention to decrease anxiety and depression and to increase quality of life for kidney transplant recipients.
The purpose of this study was to explore the educational needs of kidney transplant patients and educational importance perceived by their nurses to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to July 30, 1999 with interviews using a structured questionnaire. The subjects for this study were 173, of whom 107 were patients who had had a kidney transplant and had visited the out-patient department and 66 were transplant ward nurses who were taking care of the kidney transplant patients at six general hospitals located in Seoul. The questionnaire used for this study was developed by the investigator through a literature review and collected and modified by 11 professional personnel and 3 kidney transplant patients. The data were analyzed using the SAS program for numbers, percentiles, mean, standard deviation, t-test, ANOVA, and $Scheff{\acute{e}}$ test. The results were as follows; 1) In the patient group, the total mean score for educational needs was 154.61 and the item mean score was 3.96. In the nurses group, the total mean score for perceived educational importance was 166.26 and the item mean score was 4.26. In the nurses group, perceived educational needs were scored higher than by the patient group. With regard to domains, both patient and nurses group had the highest educational needs and perceived educational importance in the domain of physical condition and the top five items in the educational needs and perceived educational importance were also in the domain of physical condition. 2) In the patient group, women and the divorce/bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than 4 weeks from their kidney transplant time had higher educational needs in the domains of physical condition and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the nurses group, those who were married had higher perceived educational importance in the domain of physical condition.
The purpose of this study was to explore the educational needs of patients with, kidney transplants and their family members to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to April 20, 1999 with interviews using a structured questionnaire. There were 184 subjects in this study. of them, 107 were patients who had kidney transplants and had visited at the out-patient department of three general hospitals located in Seoul and 77 were family members. The questionnaire used for this study was developed by the investigator through a literature review and from data collected from 11 professional personnel and three kidney transplant patients and their families. The data were analyzed using the SAS program with t-test, ANOVA, Scheff test, Pearson correlation coefficient. The results are as follows; 1) In the patient group, total mean score for educational needs was 154.61 and the item mean score was 3.96. For the family group, total mean score for educational needs was 168.84 and the item mean score was 4.15. So in the family group, educational needs were scored higher than by the patient group. With regard to domains, both patient and family groups had as the highest educational needs, the domain of physical health and the top ten items in the educational needs were also in the domain of physical health. 2) In the patient group, women and the divorce/ bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than four weeks from their kidney transplant had higher educational needs in the domain of physical health and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the family group, those who were Catholics and had high school education had higher educational needs in the domain of nutritional management. 3) In the patient group, academic background was positively correlated(r=.208, p=.031) to educational needs.
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