• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.51-59
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• 2017

Purpose: The purpose of this study was to identify the retention effects of an individualized dietary education program for hemodialysis patients on diet knowledge, diet self-care compliance, and physiological indices, thus to find the most effective time period for re-education. Method: This study utilized one-group repeated pretest-posttest design. The participants were 52 hemodialysis patients in C hospital, Gyeonggi-Do. Data were collected at 4 and 12 weeks after the education from January through April 2016. Results: There was significant increases in diet knowledge even 12 weeks after the education (p= .007). Diet self-care compliance showed a significant increase at 4 weeks (p= .001), but a decrease at 12 weeks after the education. The level of blood natrium was significantly decreased between 4 and 12 weeks after the education (p= .006). The weight was significantly decreased at 12 weeks after the education. Conclusion: It has been identified that re-education for hemodialysis patients should be implemented between 4 and 12 weeks after education in order to maintain patients' diet self-care compliance, an ultimate aim of diet education. By helping them with their self-care compliance, the patients would maintain their physical and psychological function optimally, thus contributing to a better quality of life among hemodialysis patients.

• Journal of Korean Academy of Nursing
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• v.50 no.1
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• pp.52-65
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• 2020

Purpose: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients. Methods: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records. Results: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change. Conclusion: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.161-172
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• 2008

Purpose: This study was to classify patient severity score for hemodialysis patients. Method: The subject of this study was 1,575 patients. To study the severity of the patients, we used t-test and ANOVA. The congruity was measured by Kappa coefficient and the severity in each medical facility was analyzed by ANOVA. Result: The results showed that there was a significant difference according to the levels of medical center (F=171.187, p<.0001). Categorizing the severity of the patients in each medical facility, group II and III of the secondary medical institution had higher ratio than the primary medical institution. There was not a single patient coming under group IV in both of the primary or secondary medical institutions. However, the tertiary medical institutions had more subjects in group II and III than the primary and secondary medical institutions. The group IV with the highest severity had 11 patients(1.5%), demonstrating that the tertiary medical institution had higher severity patients than the primary or secondary medical institutions. Conclusion: The results of this study appropriately reflects the repayment system of medical expenses by the government. Also, it provides the fundamental information to develop nursing fee system taken into account of the systemic differences among the primary, secondary and tertiary medical institutions.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.285-297
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• 2013

Purpose: This study was conducted to investigate the differences in sleep disturbance, stress, self-efficacy and depression by fatigue level and to identify the factors influencing fatigue in hemodialysis patients. Methods: This study used a cross-sectional design and the subjects were 195 patients undergoing hemodialysis in a local unit. Data were collected using a structured questionnaire and medical records from June to August 2012. The data were analyzed using descriptive statistics, independent t-test, one way ANOVA, $Scheff{\grave{e}}$ test, and Pearson's correlation coefficients. Also a multiple regression analysis was used to assess the independent association between fatigue status and indices of sleep disturbance, stress, self-efficacy and depression. Results: A total of 99 (50.8%) subjects experienced a high level of fatigue and 96 (49.2%) experienced a low level of fatigue. There were significant differences in the levels of sleep disturbance, stress, self-efficacy and depression between the two groups. Fatigue was significantly correlated to sleep disturbance, stress, self-efficacy and depression. The most important factor related to fatigue was stress, followed by sleep disturbance. These factors explained about 37% of fatigue of the respondents. Conclusion: The results of this study showed that sleep disturbance and stress were significant predictors of fatigue in hemodialysis patients. Possible interventions for minimizing fatigue in patients undergoing long-term hemodialysis should be aimed to manage the known contributing factors.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.258-266
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• 2017

Purpose: The study aimed to examine quality of sleep in hemodialysis patients and explore physical, physiological, and psychological factors determining sleep quality. Methods: The survey was conducted among 165 patients on maintenance hemodialysis at a university hospital. Data were collected from July to October in 2015. The sleep quality and its related factors were assessed by standardized questionnaires, anthropometric measures, and lab tests after obtaining a written consent from the participant. Results: The mean age of the participants was 62.58 years old, and 67.9% of the participants experienced sleep disorders such as 'not falling asleep within 30 minutes' or 'frequently waking up at night'. Pain (t=-3.29, p=.007) and depression (t=-6.028, p<.001) were significantly different between the group with sleep disorder and the other without. The demographic factors (age, shared room, sleep during the day), physical factors (pain and symptom), and psychological factors (depression and trait and status anxiety) together explained 20.0% of variance in sleep quality. Conclusion: Sleep disorder was frequently experienced among the patients on maintenance hemodialysis. The effective nursing strategies should focus on sleep environment, pain and depression management. Further study is warranted to explore the effect of physiological factors related to the disease on sleep disorder in this population.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.2
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• pp.217-225
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• 2002

Purpose : This research is aimed at developing a substantive theory related to the experience of adjustmented hemodialysis patients by identifying and analyzing the nature, process, and types of adjustment experienced by them. For this purpose, this study takes a grounded theory approach. Method : Data were collected from April, 2002 through September, 2002 through in-depth interviews and close observations of eleven hemodialysis patients who have experienced adjustment. With their consent, the interviews were recorded by audio tapes and later transcribed. Observation memos were also prepared on the subjects' behavior during the interviews. Data collection continued until saturated. The data were analyzed into concepts, subcategories, and categories with the open coding process. The axial coding was done to identify the relationships of the concepts and categories. And the selective coding was done to develop a core category, which is the central phenomenon of the hemodialysis patients who experienced adjustment. Result : This process resulted in 88 concepts, which may be grouped into 24 subcategories and 6 core categories. The 6 categories, in fact, depict the process of changes the patients experience from the sense of crisis, self-control, new life meaning, support system, coping ability, and quality of life improvement. And its core is self-control, which encompasses the dynamic stages from recognition, change attempts, belief solidification, and empowerment. Conclusion : The results of the research offer the following implications. First, research on adjustment is a formative stage in nursing, it is imperative for nursing researchers to develop them, which may be more relevant to nursing. Second, it is important to develop nursing intervention techniques that may be most effective in adjustment of hemodialysis patients and at the same time for each stage of changes taking place in adjustmented hemodialysis patients.

• Journal of Korean Biological Nursing Science
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• v.3 no.1
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• pp.29-40
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• 2001

The purpose of this study was to investigate the effect of exercise training on work capacity, psychologic functions and quality of life in hemodialysis patients. Forteen hemodialysis patients, 3 males, 11 females, age ranged from $23{\sim}58$ years($42.3{\pm}0.4$) were selected and assessed using a modified Bruce protocol on a treadmill. The 3 months supervised exercise training consisted of 60 minites session thrice weekly on the treadmill, bicycle and arm ergometer at $40{\sim}60%$ of maximum $O_2$ consumption. The changes of maximum $O_2$ consumption, psychologic test and quality of life questionnaire in 14 patients before and after 3 months exercise training have been measured. The mean maximum $O_2$ consumption($VO_2$ max) of exercises increased by 23% after training(pre-and postexercise $26.3{\pm}4.6ml$/kg/min vs $29.8{\pm}4.9ml$/kg/min, p=0.013). There was significant reduction in anxiety score(p=0.004) and significant improvement in quality of life score(p=0.031) after training. The result of this study indicated that a structured exercise training for hemodialysis patients provides many benefits. These result suggest the exercise training can improve the work capacity, psychologic functions and quality of life outcomes in hemodialysis patients.

• Journal of Korean Public Health Nursing
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• v.26 no.1
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• pp.82-90
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• 2012

Purpose: This study was conducted in order to compare muscle strength and gait ability of hemodialysis patients with those of healthy adults. Methods: Data were collected through a questionnaire, by testing of muscle strength and gait ability of 40 hemodialysis patients and 40 healthy adults. $X^2$-test, t-test, and ANCOVA were used in performance of data analysis. Results: First, variables including of occupation ( $X^2$=22.40,p<.001), body weight (t=-3.72, p<.001), and BMI ( $X^2$=14.65, p<.001) differed significantly between patients in the hemodialysis group and subjects in the healthy adult group. Second, using ANCOVA analysis with correction for related variables, such as occupation, body weight, and BMI as covariates, numbers for lift/reach (F=8.15, p<.001) and sit-to-stand (F=5.47, p=.001), and both maximum safe speed (F=9.17, p<.001) and normal comfortable speed (F=8.89, p<.001) were significantly lower for patients in the hemodialysis, compared with subjects in the healthy adult group. Conclusion: According to the results, muscle strength and gait ability of patients in the hemodialysis group were lower than those of subjects inthe healthy adult group. These findings suggest the importance and necessity for an interventional exercise and rehabilitation program for hemodialysis patients.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.286-296
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• 2011

Purpose: This research was done to compare the pain relief effects of various nursing interventions, such as cold therapy, attention diversion and 10% Lidocaine spray during arteriovenous fistula needling for patients on hemodialysis, and also to identify and develop more effective nursing interventions for pain relief in these patients. Methods: This research was conducted from October 1, 2010 to January 31, 2011 with 8 hemodialysis patients, who were on regular dialysis (3 times a week) at K University Hospital in Seoul and had an arteriovenous fistula within the past 3 months. Each patient received the three nursing interventions (cold therapy, attention diversion and 10% Lidocaine spray therapy) prior to the arteriovenous fistula needling and applied in turn with the series being repeated 4 times. After each intervention, physiologic indexes, subjective and objective pain were measured at the time of needling. ANOVA was used with SPSS/WIN 12.0 to analyze pain scores and comparison of physiologic indexes (BP, pulse). Results: No significant differences were found for subjective pain (p=.574), objective pain (p=.562) and total pain (p=.506) among the 3 interventions. Systolic blood pressure (p=.689), diastolic blood pressure (p=.969) and pulse (p=.980) also showed no significant difference among the 3 interventions. Conclusion: These 3 interventions are all possible for pain relief during arteriovenous fistula needling for these patients. However, the only interventions that nurses can do independently are cold therapy and attention diversion so we recommend that these nursing interventions be used.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.26 no.1
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• pp.62-73
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• 2019

Purpose: The purpose of this study was to estimate the effects of a video low intensity exercise program provided during hemodialysis on fatigue, activity of daily living, positive psychological capital and blood pressure of patients being treated. Methods: A non-equivalent control group pre-post test design was used. Participants were 85 hemodialysis patients assigned to either the experimental group (n=41) or the control group (n=44). The experimental group exercised for about 25 minutes 3 times a week for 8 weeks. Data analyses involved descriptive statistics, $x^2$ test, t-test, multiple regression and repeated measure ANOVA using SPSS/WIN 23.0. Results: The exercise intervention significantly reduced post hemodialysis fatigue and significantly increased positive psychological capital. There was a significant interaction effect on time by group in blood pressure. Systolic blood pressure changes in the experimental group were stable but, changes in the control group tended to increase gradually. Conclusion: To reduce fatigue and increase positive psychological capital for hemodialysis patients, providing exercise during hemodialysis is recommended. Furthermore individualized exercise in terms of intensity, time, duration, etc should be developed and tested. Also, to reduce drastic blood pressure changes during hemodialysis, exercise should be provided.