• 성인간호학회지
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• 제24권3호
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• pp.209-218
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• 2012

Purpose: This study is to identify how depression, hope and social support influence to suicidal ideation of renal dialysis patients and the relating factors according to their general characteristics. Methods: This descriptive correlative study was conducted through a organized and structured self-administrated questionnaire and 120 sampled renal dialysis patients. Collected data was analyzed by t-tests, ANOVA, Pearson's correlation coefficient and multiple regression analysis using SPSS/WIN 18.0. Results: Findings revealed that; 1) The degrees of suicidal ideation were significantly different among groups according to the marital status (F=3.37, p=.021), drinking (F=4.97, p=.008) and smoking history (F=4.77, p=.010), 2) Pearson's correlation coefficient revealed a significant association among the suicidal ideation, hope, depression and social support, 3) Multiple regression analysis showed depression (${\beta}$=.58, t=7.77, p<.001), social support (${\beta}$=-.21, t=-2.69, p=.008) and alcohol drinking (${\beta}$=.17, t=2.61, p=.010) were related to factors. They accounted 54% of the suicidal ideation of the subjects. Conclusion: Based on the findings of this study, health professionals should provide renal dialysis patients with proper management of suicidal ideation as well as its relating factors, hope, depression and social support. Especially, it needs to implement suicidal ideation management and self-help group program to renal dialysis patients.

• 임상간호연구
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• 제21권3호
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• pp.293-308
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• 2015

Purpose: This study aimed to develop nursing practice standards of hemodialysis care according to admission types. Methods: The standards were developed in four phases. Phase 1: The preliminary standards of hemodialysis care were developed based on literature review and evaluation of professional experts. Phase 2: Content validity was evaluated by 34 professional experts and the standards were modified and revised. Phase 3: Clinical validity was evaluated by 212 hemodialysis nurses. Expert group validated and verified the final outcome. Phase 4: Final standards of hemodialysis care according to admission types were developed. Results: The standard of hemodialysis care for out-patients included 5 standards, 9 contents, 43 nursing activities. The standard for in-patients included 6 standards, 10 contents, 50 nursing activities. The standards for critical patients included 4 standards, 10 contents, 43 nursing activities. There were differences in nursing activities according to admission type. Time required to meet the standards were different according to admission types. Conclusion: The findings of this research demonstrated that the time required for hemodialysis care and appropriate number of nurse would be different according to admission types. Different nursing workload according to admission type of hemodialysis patients need to be considered in allocating nursing manpower.

• 성인간호학회지
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• 제20권6호
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• pp.883-894
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• 2008

Purpose: This study was to examine the effects of aroma hand massage on pruritus, fatigue and stress of the patients undergoing hemodialysis. Methods: This study was a nonequivalent control group pretest-posttest design. Study sample was conveniently recruited from two hospitals(28 for experimental and 30 for control group). The experimental group went through aroma hand massage on hand without AVF for 5 min for 12 times mixed with Lavender, Chamomile and Geranium oils in the ratio of 4 : 4 : 2, which was diluted 3% with sweet almond crrier oil 100 ml. The collected data were analyzed using SPSS/WIN 12.0. Results: The 1st hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of pruritus than the control group' was accepted(t = -5.084, p = .001). The 2nd hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of fatigue than the control group' was accepted(t = -2.557, p = .015). The 3rd hypothesis, 'Experimental group who has received aroma hand massage will have lower rate of stress than the control group' was accepted(t = -5.537, p = .001). Conclusion: The aroma hand massage has shown to be an effective nursing intervention to reduce the pruritus, fatigue and stress among patients undergoing hemodialysis. Therefore, the massage is needed to continuously be applied to hemodialysis patients to improve their quality of life.

• 성인간호학회지
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• 제17권3호
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• pp.435-443
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• 2005

Purpose: This study investigated the degree of fatigue of hemodialysis patients, and finds the relationship between fatigue and self-efficacy, family support, and sleep factor. Also, this study was purposed to provide fundamental data to help set up a nursing plan and intervention for recovery and mitigation of hemodialysis patient's fatigue. Method: The subjects in this study were patients treated as hemodialysis patients in Kwangjoo City. Data, subjects are 143 patients. Fatigue was measured using Lee's scale(1991), Self-efficacy using Kim's scale(1995), and Family support using Kim's scale(1993). For the analysis of collected data, Cronbach alpha, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, Stepwise multiple regression were used for statistical analysis by SPSSwin(version 11.0) program. Result: Fatigue degree of hemodialysis patients averaged 4.22. Among 143 hemodialysis patients, 70.63% patients answered that they had felt fatigue as noted in this study. The weariest time was after hemodialysis for 21.0% patients. There was significant difference according to the diagnosis period. The patients who were diagnosed over one year had felt more fatigue than ones who were diagnosed within one year. Fatigue was significantly associated with self-efficacy, family support, and sleep factor. Self-efficacy could explain 14.6% of fatigue. Conclusion: The fatigue degree relates with all, self-efficacy, family support, and sleep factor. Especially, it is affected by self-efficacy among them. Thus, the program should be developed to mitigate fatigue as the self-efficacy of hemodialysis is enhanced.

• 성인간호학회지
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• 제27권5호
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• pp.493-504
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• 2015

Purpose: This study was a qualitative study to explore and understand the adaptation experiences of hemodialysis among women with End-Stage Renal Disease (ESRD) and to develop a substantive theory using the grounded theory method. Methods: Participants were 15 female patients who underwent hemodialysis for ESRD treatment from three general hospitals. The data were collected through in-depth individual interviews. Results: The adaptation experience of participants was emerged as a process of taking care and enduring. There were four adaptation stages as a negative, despair, receptive, and maintenance period in reference to hemodialysis. The causal conditions were a vague expectations of recovery and refusal to undergo hemodialysis. The core phenomenon was that of confinement to dialysis machine. The contextual conditions for this phenomenon were the loss of femininity. They used action/interaction strategies such as transition their life with a focus on hemodialysis, seeking information, and learning how to take care of their body. Through this process, they had a strong will to live or had sustained their life. Conclusion: These results indicate that there is a need for nurses to understand the different steps of adaptation experiences of the given patient population. It is necessary for nurses to support them to lead their life as much normal as possible and improve the adaptation experience of ESRD.

• 대한간호학회지
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• 제29권6호
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• pp.1284-1293
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• 1999

This study was designed to investigate the effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. Twenty one subjects of this study were selected from St. Paul's Hosipital in Seoul. All the subjects were received the mineral oil massage at the arm without fistular three timesper week for 4 weeks. After 2 weeks period of wash-out, the subjects were received the aromatherapy of lavender and tea tree essence oil in the same way. This study was carried out from March 20 to June 13, 1998. Pruritus score, skin pH and stratum corneum hydration were measured before and after each treatment. But, biochemical parameters were measured before the treatment of the mineral oil massage, after the treatment of the mineral oil massage and the aromatherapy. Data of this study were analyzed by paired t-test, repeated measures ANOVA, Bonferroni multiple comparisons and Pearson correlation coefficient. The results were as follows ; 1. Pruritus score was significantly decreased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the priritus score between the two treatments. 2. Stratum corneum hydration was significantly increased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the stratum corneum hydration between the two treatments. 3. Skin pH was significantly increased after the treatment of the mineral oil massage, while no significant change after the aromatherapy. Therefore, there was no significant difference in the skin pH between the two treatments.4. After the aromatherapy, the serum calcium was significantly increased. Whereas the serum parathyroid hormone intact was significantly decreased compared with the treatment of the mineral oil massage. But the level of the serum Ca and PTH-intact were within the normal range. 5. Stratum corneum hydration was decreased corresponding to the duration of hemodialysis, while pruritus score and skin pH showed no change corresponding to the duration of hemodialysis and the age of the subjects. The correlation of pruritus score on skin pH, stratum corneum hydration and biochemical parameters was not significant. In conclusion, this findings indicate that aromatherapy may be effective in decreasing skin xerosis and pruritus score in uremic pruritus patients undergoing maintenance hemodialysis.

• 대한간호학회지
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• 제30권3호
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• pp.791-798
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• 2000

The hemodialysis patients with chronic renal disease have experienced negative emotions, especially depression among with physical, social, and psychological changes. Based upon a stress-coping theory, group imago psychotherapy which can induce effective coping through self awareness and positive emotional responses is implemented to the hemodialysis patients. The effects of the imago psychotherapy in regards to comfort and depression are studied here. Group imago psychotherapy was performed on forty-three subjects(twenty subjects in the experimental group and twenty-three subjects in the control group). The results of the study were as follows. After being given group imago psychotherapy, the comfort scores of the experimental group were significantly higher than those of the control group (F=15.33, p= .003). Moreover, after being given treatment, the depression scores of the experimental group were significantly lower than those of the control group (F=9.14. p=.0044). Specifically, the scores on comfort in the experimental group under emotion-focused coping style were significantly higher than those of the control group (F=18.59, p= .0002). The mean difference on comfort scores in the experimental group under problem - focused coping style was higher than that of the control group. But their scores were not significant (F=0.19, p= .6729). The scores on depression in the experimental group under emotion-focused coping style were significantly lower than those of the control group (F=14.62, p= .0006). The mean difference on depression scores in the experimental group under problem - focused coping style was much lower than that of the control group. But their scores were not significant (F=0.31, p=.5947). There was a significant positive correlation between comfort and depression variables. After group imago psychotherapy the hemodialysis patients recognized positive changes in emotional reponses, self awareness, self control, ease of mind, and felt overall more relaxed. Imago psychotherapy is a nursing intervention which as this study has shown can improve to comfort. The results of this study can be applied to general nursing practices. In the view of holistic nursing, the development of the nursing practice combined with imago psychotherapy will contribute to the enlargement of the nursing field with conventional nursing practices.

• Perspectives in Nursing Science
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• 제12권1호
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• pp.60-70
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• 2015

Purpose: The purpose of this study was to identify the factors influencing medication adherence in hemodialysis patients among primary medical care and secondary medical care. Methods: A cross-sectional survey design was utilized. Data were collected using questionnaires from 280 hemodialysis patients who had taken prescribed medication regularly as a result of chronic renal failure at primary and secondary medical care in Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: There were statistically significant differences in medication adherence according to living area (p=.002), health condition (p<.001), amount of medication (p=.004), inconvenience for taking medication (p<.001), and depression level (p=.001). The mean of medication adherence was 3.72 points. Medication adherence was explained by perceived barrier related to medication taking (${\beta}=.338$), attitude (${\beta}=.250$), and depression (${\beta}=.132$). Conclusion: This study strongly recommended that nursing intervention program to improve medication adherence should be developed and a match control study in improvement of medication adherence for hemodialysis patients needs to be done.

• 임상간호연구
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• 제21권1호
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• pp.21-30
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• 2015

Purpose: The study was conducted to identify the effects of holistic breathing using biofeedback on fatigue, depression, and sleep disorders of hemodialysis patients. Methods: A quasi-experimental study was conducted with a nonequivalent control group non-synchronized design and pre-post tests. Data were collected from August 20, 2012 to April 6, 2013. Twenty-five patients were assigned to an experimental group and twenty-five patients were assigned to a control group. Holistic breathing using biofeedback was applied during hemodialysis in a hospital with a frequency of twice a week for five weeks. Patients practiced 10 minutes of the holistic breathing twice daily for while at home. Chi-square and t-test were utilized for analyzing the data using SPSS 18.0. Results: Hemodialysis patients who practiced the holistic breathing using biofeedback experienced significantly lower levels of fatigue (t=2.612, p=.012), depression (t=3.390, p=.001), and sleep disorders (t=2.016, p=.049) when compared to the control group. Conclusion: The results indicate that the holistic breathing using biofeedback is an effective nursing intervention for patients receiving hemodialysis for the management of fatigue, depression, and sleep disorders.

• 임상간호연구
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• 제20권1호
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• pp.134-145
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• 2014

Purpose: The purpose of this study was to develop and apply a video dietary instruction program for hemodialysis patients to understand dietary compliance as well as the effect on the physiological indicator. Methods: This is a quasi-experimental study of a nonequivalent control group pre-post test design. Data were collected from August 6, 2012 to January 10, 2013. Twenty patients were assigned to an experimental group and twenty-one patients were assigned to a control group. A video dietary instruction program was developed and applied only to the experimental group once a week for a total of 8 weeks. Dietary compliance and physiological indicators were subsequently measured. Results: Dietary compliance was improved in both groups over time. There was no significant change in the physiological indicator value in both groups, indicating that there was no correlation between the treatment type and time. Conclusion: The video dietary instruction program could not make a statistically significant change on the physiological indicator value of the experimental group; however, this change was maintained within the allowable limits. Therefore, the video dietary instruction program can be utilized continuously as a standardized nursing intervention program in order to maintain the dietary compliance of hemodialysis patients.