• Proceedings of the Korean Society of Applied Pharmacology
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• 1994.04a
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• pp.343-343
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• 1994

1. 목 적 : 혈액 중에 존재하는 약물은 대부분 혈장 단백질과 결합하며, 비단백 결합성 약물만이 생체막을 통과하여 여러 조직에 분포되고, target eel1에서 약리학적 작용을 나타내며, 대사, 배설 될 수 있다. 단백결합율이 높은 약물일수록 비결합성 약물의 양은 적어지며, 따라서 비결합성 약물의 증가는 약효의 상승을 의미하게 된다. 최근 만성 질환에 한약의 병용투여가 증가하고 있다. 본 실험에서는 단백결합율이 높은 감초의 주성분인 Glycyrrhizic acid(GA)와 고혈압 치료제로 많이 사용되는 칼슘 길항제를 병용 투여할 경우, 칼슘 길항제의 혈장 단백결합에 미치는 영향을 살펴 보았다. 2. 방 법 : Diltiazem hydrochloride, Verapamil hydrochloride, Nifedipine 와 GA를 model 약물로 하여 평형 투석법과 한외 여과법을 이용하여 fatty acid free human serum albumin(HSA), Low density lipoprotein( LDL ), of-Acid glycoprotein(AAG), plasma 각각에 대한 결합율을 HPLC로 분석하였으며 또한 Scatchard plot를 이용하여 binding parameter를 구하였다. 3. 결과 및 고찰 : GA는 Diltiazem의 HSA와 plasma의 결합율에 영향을 미쳤으며, Verapamil의 HSA, LDL, AAG, Plasma 결합율에, 그리고 Nifedipine의 HSA, LDL, Plasma의 단백 결합율에 영향을 주었으며, 각각 n과 Ka값에 변화를 주었다.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.227-231
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• 1978

Since January 1973 we have performed 47 arteriovenous shunts and 22 arteriovenous fistulas for 57 patients with acute or chronic renal failure. Of these 57 cases, 50 cases had chronic renal failure and the other 7 cases had acute renal failure. The most frequent complications after operations were thrombosis, bleeding and infection. Less frequently dislodgement of shunt and aneurysmal change of the fistula were found. After 47 arteriovenous shunts, 21 those complications [44%] were found. On the other hand after 22 arteriovenous fistulas, 5 complications were found. Now we are using the arteriovenous shunt only for the patients who need emergency short term hemodialysis and temporary dialysis until arteriovenous fistula could be used.

• Journal of Korean Academy of Nursing
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• v.46 no.4
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• pp.598-609
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• 2016

Purpose: The purpose of this study was to examine effects of a dietary program based on self-efficacy theory on dietary adherence, physical status and quality of life (QoL) in hemodialysis patients. Methods: A non-equivalent control group pre-post test design was used. The intervention group received the dietary program for 8 weeks from August 4 to September 26, 2014. The control group received only usual care. Results: ANCOVA showed that dietary adherence (F=64.75, p <.001) was significantly different between the two groups. Serum albumin (F=12.13, p =.001), interdialytic weight gain (F=56.97, p <.001), calories (F=15.80, p <.001) as physical status indices were significantly different, but serum potassium (F=2.69, p =.106) and serum phosphorus (F=1.08, p =.303) showed no significant difference between the two groups. In terms of health-related QoL, the physical component scale (F=10.05, p =.002) and the mental component scale (F=16.66, p <.001) were significantly different between the two groups. In addition, in terms of diet related QoL, diet level (F=35.33, p <.001) and satisfaction level (F=15.57, p <.001) were significantly different between the two groups, but dietary impact level (F=1.23, p =.271) was not significantly different. Conclusion: Findings show that the dietary program based on self-efficacy theory is an effective nursing intervention program to improve adherence to diet, and to maintain physical status and QoL for hemodialysis patients.

• Journal of Nutrition and Health
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• v.36 no.4
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• pp.397-404
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• 2003

The present study was designed to compare the nutritional status of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. Subjects were 58 HD patients (male/female = 29/29) and 33 CAPD patients (male/female = 23/10) undergoing dialysis treatment in Artificial Kidney Unit of Chonbuk National University Hospital. For nutritional assessment, %IBW (ideal body weight), %TSF (tricep skin fold), %MAC (mid arm circumference), %MAMC (mid arm muscle circumference), serum albumin, serum transferrin, TLC (total lymphocyte count), SGA (subjective global assessment) and estimated energy and protein intakes by 1-month food frequency method were used. Between HD and CAPD group, mean age (50 $\pm$ 12 vs. 52 $\pm$ 12 yr), dialysis durations (37 $\pm$ 36 vs. 30 $\pm$ 26 mon), dietary energy intakes (28.3 $\pm$ 9.0 vs. 28.8 $\pm$ 8.6 kcal/kg/day), dietary protein intakes (1.1 $\pm$ 0.4 vs. 1.2 $\pm$ 0.3 g/kg/day) and incidence of co-morbid conditions (69.0% vs. 69.7%) were not significantly different. Data by using SGA showed a higher incidence of malnutrition in CAPD patients (45.6%) than in HD patients (36.2%). %IBW (p < 0.001), %TSF (p < 0.001) and %MAC (p < 0.001) were higher in CAPD patients than were in HD patients. But serum albumin (p < 0.001) and transferrin (p < 0.001) were significantly lower in CAPD patients than were in HD patients. A higher incidence of malnutrition was shown in CAPD Patients than in HD Patients due to different dialysis type. A significant finding was that CAPD showed protein deficient malnutrition and HD did calorie deficient malnutrition. It suggests that an adequate dietary intake considering dialysis type prevents a prevalence of malnutrition.

• Journal of Korean Academy of Nursing
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• v.47 no.1
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• pp.14-24
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• 2017

Purpose: The purpose of this study was to construct and test a hypothetical model of self-management in patients with hemodialysis based on the Self-Regulation Model and resource-coping perspective. Methods: Data were collected from 215 adults receiving hemodialysis in 17 local clinics and one tertiary hospital in 2016. The Hemodialysis Self-management Instrument, the Revised Illness Perception Questionnaire, Herth Hope Index and Multidimensional Scale of Perceived Social Support were used. The exogenous variable was social context; the endogenous variables were cognitive illness representation, hope, self-management behavior, and illness outcome. For data analysis, descriptive statistics, Pearson correlation analysis, factor analysis, and structural equation modeling were performed. Results: The hypothetical model with six paths showed a good fitness to the empirical data: GFI=.96, AGFI=.90, CFI=.95, RMSEA=.08, SRMR=.04. The factors that had an influence on self-management behavior were social context (${\beta}=.84$), hope and cognitive illness representation (${\beta}=.37$ and ${\beta}=.27$) explaining 92.4% of the variance. Self-management behavior mediated the relationship between psychosocial coping resources and illness outcome. Conclusion: This research specifies a more complete spectrum of the self-management process. It is important to recognize the array of clinical resources available to support patients' self-management. Healthcare providers can facilitate self-management through collaborative care and understanding the ideas and emotions that each patient has about the illness, and ultimately improve the health outcomes. This framework can be used to guide self-management intervention development and assure effective clinical assessment.

• Korean Journal of Adult Nursing
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• v.26 no.6
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• pp.693-702
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• 2014

Purpose: The purpose of this study was to examine the relationships between treatment belief, personal control, depressive mood, and health-related quality of life in patients with hemodialysis based on self-regulation theory. Methods: Data were collected from 220 patients at 27 local hemodialysis clinics in Seoul during 2013 and 2014. The Revised Illness Perception Questionnaire, the Hospital Anxiety and Depression Scale, and Medical Outcomes Study Short Form-12 were used to measure outcome variables. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and multiple regression using the 'enter' method. Results: Treatment belief and personal control scored 3.58 and 3.54 out of 5 points respectively, on average. Treatment belief and personal control of kidney disease were negatively correlated with depressive mood and positively correlated with health-related quality of life. According to the regression analysis, treatment belief, monthly income, and personal control were discovered to account for 21.8% of the variance in depressive mood, where as depressive mood, monthly income, treatment belief, and age were found out to account for 40.6% of the variance in health-related quality of life. Conclusion: Our study demonstrated significant positive relationships between treatment belief and illness outcome in hemodialysis patients. Interventions aimed to provide the necessary information and trust to maximize the effectiveness of treatment need be developed to improve patients outcomes.

• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.718-727
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• 2015

Purpose: The purpose of this study was to identify the levels of physical activity and its relationships with depression, health-related quality of life (QoL), sleep disturbance, and physiological indicators in hemodialysis patients. Methods: The participants in this study were 139 patients undergoing hemodialysis in the hospitals in Busan and Yangsan-si. Data were collected using hematologic tests and questionnaires that contained items about individual characteristics, International Physical Activity Questionnaires (IPAQ), Center For Epidemiological Studies Depression Scale (CES-D), a 12-item Short-Form Health Survey (SF-12), and Pittsburgh Sleep Quality Index (PSQI). Data were analyzed using descriptive statistics, one way ANOVA, and correlation. Results: Mean age of the participants was $59.91{\pm}12.63$ and mean physical activity levels were $1,660.35{\pm}1,654.17$. Patients who performed higher physical activities during their daily activities reported lower levels of depression (F=4.16, p=.018) and higher levels of QOL (PCS: F=5.00, p=.008, MCS: F=8.66, p<.001) than those of the others who did not perform physical activities. Conclusion: This study showed that the levels of physical activity among hemodialysis patients was significantly associated with their depression and QOL. Developing strategies for enhancing physical activity is warranted to improve depression and QOL among hemodialysis patients.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.706-716
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• 2000

The purpose of this study was to provide fundamental data for nursing intervention by assessing self-esteem and quality of life(QL) in patients on hemodialysis and peritoneal dialysis. The subjects of this study were 60 patients on hemodialysis at H university medical center in Seoul and 56 patients on peritoneal dialysis at B company. The analysis was done by using t-test, ANOVA, Scheffe and Stepwise multiple regression. The results were as follows: 1. The average self-esteem score was significantly higher in patients on hemodialysis (27.98) than in patients on peritoneal dialysis (25.64). And there were no statistically significant differences between patients on hemodialysis(128.45) and patients on peritoneal dialysis(122.83) in the scores on QL. Among four factors of QL, hemodiaysis patients showed higher score than peritoneal dialysis patients in all factors. But, only family had statiscally significant differences. Also family showed the highest score in both groups, but psychomental showed the lowest score. 2. In patients on hemodialysis, self-esteem was significantly different by occupation(t=3.122, p=.003) and in patients on peritoneal dialysis by age(F=4.450, p=.007), education level(F=7.458, p=.001) and occupation (t=2.491, p=.017). Also in patients on hemodialysis, QL was significantly different by occupation(t=2.223, p=.033) and in patients on peritoneal dialysis by education level(F=4.007, p=.024), and occupation (t=2.806, p=.007). 3. Self-esteem accounted for 36.3% of variance in QL and monthly income accounted for an additional 6.1% of QL in hemodialysis patients by means of stepwise multiple regression analysis. In peritoneal patients, self-esteem accounted for 65.1% and monthly income accounted for an additional 2.7% in QL.

• Journal of Korean Biological Nursing Science
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• v.25 no.3
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• pp.143-159
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• 2023

Purpose: The purpose of this study was to provide evidence for future research by analyzing the contents, delivery methods, and educational effects of educational programs for hemodialysis patients. Methods: A literature review was conducted in the following order: problem identification, literature search and data collection, data evaluation, data analysis, and data presentation. In total, 936 documents were retrieved from the search, and 24 documents were finally included in this study. Results: The contents of the educational programs were comprehensive hemodialysis-related knowledge education in seven studies, exercise-related education in 10 studies, diet-related education in four studies, drug-related education in one study, and complex education in two studies. The delivery methods were pamphlets in six studies, audio-visual materials in four studies, direct guidance by researchers in six studies, and multiple methods in seven studies. The effects of the educational program were divided into physical indicators, emotional indicators, and knowledge and performance related to hemodialysis. Sixteen out of 20 articles using physical indicators showed significant outcomes, and 10 out of 12 articles using emotional indicators derived positive results. Hemodialysis-related knowledge and performance were measured in eight and 10 studies, respectively, and meaningful results were found in six studies for knowledge and seven studies for performance. Conclusion: Future research will require the development of a systematic and standardized educational program with comprehensive content that can be provided to all hemodialysis patients, as well as a highly accessible education delivery method to enhance the effectiveness of education.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.135-145
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• 2023

Purpose: This was a descriptive study investigating the effect of symptom experience and self-care agency on quality of life among patients with stage 5 chronic kidney disease undergoing regular hemodialysis. Methods: The participants were recruited from one general hospital and two private hospitals located in J city. 154 participated and completed structured questionnaires from June 30 to July 18, 2022. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient, and hierarchical multiple regression. Results: The mean symptom experience score was 0.91±0.67 (out of 5), self-care agency was 4.19±0.71 (out of 6), and quality of life was 3.02±0.49 (out of 5). A negative correlation was found between quality of life and physical symptom experience (r=-.39, p<.001) and emotional symptom experience (r=-.39, p<.001). A positive correlation was found between quality of life and self-care agency (r=.66, p<.001). The regression analysis showed self-care agency (β=.48, p<.001), emotional symptom experience (β=-.27, p=.001), and monthly family income (β=.19, p=.002) significantly influenced quality of life, and explained 54.0% of the quality of life. Conclusion: These results suggest to improve the quality of life among patients on hemodialysis, it is necessary to assess and intervene with emotional symptom experiences and develop effective programs with specific strategies to enhance self-care agency.