• Journal of muscle and joint health
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• v.30 no.3
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• pp.157-167
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• 2023

Purpose: The purpose of this study was to measure the relationship among activities of daily living, ego integrity, social support and the compliance of patient-role behavior in elderly patients receiving hemodialysis, including the effect of these variables on the compliance of patient-role behavior. Methods: A descriptive survey was conducted with 150 elderly patients over 65 years of age who were also receiving hemodialysis. Data was collected from September 28 to November 13, 2021 and analyzed using t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analysis with SPSS/WIN 26.0. Results: The results show that patient compliance had significant correlations with ego integrity (r=.63, p<.001) and social support (r=.28, p=.001). The other factors influencing patient compliance were the sub-domains of ego integrity, such as the acceptance of the past and the presence (β=.46, p<.001) and attitudes toward life (β=.26 p<.001), with an explanatory power of approximately 35.0% (F=17.21, p<.001). Conclusion: This study confirms that the ego integrity of elderly patients receiving hemodialysis has an effect on the compliance of patient role behavior. Nursing intervention programs that improve the ego integrity of elderly hemodialysis patients could help improve the compliance of patient-role behavior, which is an important factor in the disease management process.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.92-101
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• 2000

Purpose : We analyzed the demogaphic data md clinical course of Korean children with chronic renal failure (CRF) observed between 1990 and 1999. Patients and Methods : Questionnaires were mailed to all children's hospitals ail through the country. We asked for primary renal disease age and serum creatinine levels at first presentation with CRF and end-stage renal disease (ESRD), and modes of renal replacement therapy (RRT). Results : 401 children (254 boys, 147 girls) with CRF, defined as a permanent increase of serum creatinine above 1.2 mg/dl for at least 3 months or until death, were identified. This represents an incidence of 3.68 per million child population per year. Of these patients, 22$\%$ on younger than 5 years, 28$\%$ 5 to 10 years and 50$\%$ 10 to 15 year. Eight five $\%$ of the patients could be classified with a primary renal disease. The most frequent cause is glomerulonephritis (36$\%$), followed by chronic pyelonephritis (21$\%$), renal hrpo/dylplasia (9$\%$), and hereditary nephropathies (7$\%$). Reflux nephropathy (16$\%$) was the most common single cause of CRF. ESRD was reached in 70$\%$ of all patient. 99.3$\%$ of these started RRT. Hemodialysis (HD, 42$\%$), peritoneal dialysis (PD, 35$\%$) and transplantation (TP, 23$\%$) were performed as the initial mode of RRT. A total of 161 TPs were performed (159 first grafts, 2 second grafts). A total of 32 patients died. The main causes of death were dialysis related complication in HD patients and infections in PD patients. Survival rate on any form of RRT was 88.7$\%$ during the mean follow-up period of 37 months. Conclusion Major efforts should be directed toward earlier diagnosis and treatment of reflux nephropathy to prevent occurrence of Of. Dialysis and TP have now become well accepted forms of treatment in Korean children with ESRD.

• Journal of Korean Academy of Nursing
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• v.30 no.4
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• pp.1066-1077
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• 2000

The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by x$^2$ and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.20 no.1
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• pp.29-35
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• 2020

Joubert syndrome (JS) is a rare genetic disorder that is characterized by ataxia, hypotonia, developmental delay, respiratory abnormalities such as apnea-hyperpnea, and abnormal eye movements. The pathognomonic diagnostic finding is the "molar tooth sign" (MTS) on brain magnetic resonance imaging (MRI), described as cerebellar vermis hypoplasia or dysplasia, thick and horizontally oriented superior cerebellar peduncles, and an abnormally deep interpeduncular fossa. JS is characterized by genetic heterogeneity: pathogenic variants in over 30 genes have been identified to date. The CEP290 protein, which is on chromosome 12q21.3, is most frequently mutated in patients with JS, especially with renal involvement. Here, we report a case of JS in a 14-year-old male patient with end-stage renal disease. To the best of our knowledge, this is the first Korean report of a patient with JS due to CEP290 mutation (c.6012-12T> A) whose diagnosis was confirmed after repetitive MRI. We suggest consultation with an experienced neuro-radiologist and follow-up MRI studies to detect a "hidden" MTS if clinical findings suggest a diagnosis of JS. Furthermore, even in the absence of an MTS, whole exome sequencing should be considered.

• Journal of Korean Biological Nursing Science
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• v.6 no.1
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• pp.53-64
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• 2004

Introduction : Chronic hemodialysis patients have been psychological problems because of being compelled to follow a dialysis schedule for a long period of time. Specifically, depression and anxiety are so frequently observed that psychological management is required for most hemodialysis patients. Fragrance has been known to have beneficial psychological and physiological effects on human. This study was designed to investigate the psychological effect of aromatherapy on chronic hemodialysis patients. Methods : 40 subjects of this study selected from Je Young-Sung Internal Medicine Clinic in Busan. The experimental group were random assigned to 20 subjects who had visited on Monday, & Wendesday & Friday and received aromatherapy every day for 2 weeks. the control group were random assigned to 20 subjects who had visited on Tuesday & Thursday & Saturday and did not receive any intervention. Experiment had been conducted from July. 7th July 21, 2003 and anxiety by Spilberger's state anxiety scale and depression by Zung's Scale were measured in the course of aromatherapy for both experimental group and control group. A control period consisting of natural hospital smells was established before each test session, and then aromatic test conditions were systematically evaluated for odorless conditions as well as aromatic conditions containing 100% lavender necklace for 2 weeks. Data were analyzed by, frequency, percentage, mean, S.D. $x^2$- test, t-test. Results:1) Anxiety scores were not significantly decreased in the experimental group($54.57{\pm}13.20$) after treatment compared to the control group($49.45{\pm}12.41$)(t=1.225, p=.228). 2) Depression scores were significantly decreased in the experimental group($43.95{\pm}5.63$) after treatment compared to the control group($49.65{\pm}9.84$)(t=-2.367, p=.023). Conclusions : These findings indicate that the aromatherapy may decreased depression. It is suggested that the aromatherapy could be an effective nursing intervention to reduce to depression by chronic hemodialysis patients.

• Anxiety and mood
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• v.2 no.2
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• pp.128-135
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• 2006

Objective : In this study, we investigated the prevalence of depression and its impact on the healthrelated Quality of life (HRQoL) of the patients with End-Stage Renal Disease (ESRD) on Hemodialysis. Method : The Quality of life (QOL) of patients was evaluated by HRQoL Questionnaire, "Medical Outcome Survey 36-Item Short Form Health Survey Korean Version (SF-36-K)". The patients on Hemodialysis in ESRD, were chosen from the hemodialytic room at Wonkwang University and Jeongeup-Asan Hospital. The number of patients was 95 (64 from Wonkwang University Hospital and 31 from Jeongeup-Asan Hospital) and all of them were above 19 years old. We performed various investigations to find a statistical correlations between HRQoL and physical & psychosocial factors such as the demographic characteristics, clinical characteristics (hemoglobin level and albumin level etc), and the score of Beck's depressive inventory (BDI). Results : The HRQoL value of patients on hemodialysis in ESRD is far poorer than the HRQoL reference value of Koreans and Americans, who are in normal healthly. The prevalence of depressive symptoms by BDI of the ESRD patients on hemodialysis is 68.6%, and age and depression have negative correlations with HRQoL of the patients. However, education level, serum albumin level, and social support have positive correlations with HRQoL. The patient group with depression has significantly poorer HRQoL than the group without depression. Conclusion : The HRQoL of ESRD patients on hemodialysis is not good in both physical and mental aspects. The prevalence of depression is very high and depression has negative impact of HRQoL of patients. Based on our study, it is essential to accompany with therapeutic Strategy to improve the HRQoL of ESRD patients on hemodialysis.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.444-453
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• 1997

The purpose of this study was to construct a grounded theory as the basis for nursing intervention by describing and analysing the holistic lived experiences of clients receiving long-term hemodialysis. The subjects of this study were fifteen persons receiving regular hemodialysis regimen at artificial kindey treatment centers in two different university hospitals, and who were able to participate in conversation and were available for long and dup interviews. Eight of the subjects were male and seven were female and their ages ranged from 30's to 60's. The length of the hemodialysis experience ranged from two months to six years. The collection and analysis of data were done in accordance with the grounded theory methodology of Strauss & Corbin. The method to collect the data mainly depended. on long and deep interviews, participant observation and focused group interviews and the equipment used to collect data were a portable tape recorder and field notes. The study is summarized as follows : 1. The meaning of holistic lived experiences of clients receiving long -term hemodialysis was found to be uncertainty. which was identified as the core category. 2. The main categories following the core category were found to be shock, ambiguity, social support and quality of life. 3. Through the main category the type of behavior newly formed by clients receiving long-term hemodialysis was found to be as follows. That is to say, in the circumstances of shock caused by the identified fact and the ambiguity of hemodilysis they formed a quality of life based on social support, which was found to be a kind of chaotic phenomenon. 4. The lived experiences of clients receiving long-tern hemodialysis was found to include nine categories : emotional shock, feelings of isolation, burden, unclearness, dependency, help from others, coping strategies, maintenance of self-esteem and transitional life. 5. The intervening factors influencing each category are as follows : 1) The factors influencing 'emetional shock' were found to be set age, the level of knowledge received in advance, locus of control, the period of struggle against the disease before hemodialysis and whether any serious illness existed. 2) The factors influencing 'feelings of isolation' were found to be religion and the length of the hemodialysis experience. 3) The factors influencing 'burden' were found to be sex, economic situation, employment status and the length of the hemodialysis experience. 4) The factors influencing 'unclearness' were found to be sex, age, religion. economic situation, the length of the hemodiaysis experience, whether they had had a transfusion and whether there were any complications. 5) The factors influencing 'help from others' were found to be religion. economic situation, past experiences and whether family members lived together. 6) The factors influencing 'coping strategies' were foung to be age, level of education, experiences of illness and locus of control. 7) The factors influeruing 'maintenance of self-esteem' were found to be the length of the hemodialysis experience and self-actualization. 8) The factors influencing 'transitional life' were found to be age, religion, economic situation, employment status. locus of control. past experiences and whether there was a plan for a kidney transplant.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.413-424
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• 2000

The purpose of this study was to analyze the effect of anticipated variables on hemodialysis that was impact patients' quality of life. The subjects of the study were 104 patients who were over 18 years old. They were enrolled at Kidney dialysis unit in General Hospital located in T and M city, Republic Korea. And the duration of treatment was more than 6 months. They all met the research criteria and agreed to participate in the research. The research instrument have 25 questionnaire which were originally Ferrans' (1985) instrument to measure the quality of life for hemodialysis patients and later changed by Lee, Suk-Ja into the 35 items after eliminating repeated contents, the Cronbach's $\alpha$in this study was .87. The stress instrument was measured by 36 items which were modified and supplemented the instrument developed by Kim, Yong-Kyong(15) for hemodialysis patients, and the Cronbach's $\alpha$was .9333. Depression instrument was 20 questions modified BDI(Beck Depression Inventory) to meet hemodialysis patients' conditions, and Cronbach's $\alpha$ was .92. June 25, 1999 and the data was analyzed by SPSS/PC, and the statistical techniques were ANOVA(variables analysis), Scheffe test, Multiple Regression. The findings of this study were as follows: 1. The effect of general characteristics on hemodialysis patients' quality of life, the characteristics showing a statistically, significant difference were the existence of an occupation(t=6.7353, P= .0109), marital status (F=4.3550, P= .0290), economic status (F=4.6475, P= .0118) and presence of care support (F=2..4738, P= .0494). 2. The effect of general characteristics on the patient's stress, the characteristics showing a significant difference were gender (t= 4.1143, p= .0451), education level (F= 4.3550, p= .008), the existence of an occupation (t=8.7498, p= .0038), and presence of care support(F=3.1715, p= .0169). 3. The effects of general characteristics on depression, the characteristics were education level (F=3.7517, P= .0069), the existence of religion(t=9.4843, p= .0027), an occupation (t=15.3745, p= .0002), marital status (F=3.3400, P= .0223) and presence of care support (F=3.7605, p= .0069). 4. The Multiple Regression is used to identify the effect of anticipated variables on the patient's quality of life. The variables were depression (T=-9.656, P=.000), marital status (T=-2.287, P=.0243) and the regression expression was Y=117.62053 - 1.13618Χ$_1$ + 2.66213Χ$_2$(Χ$_1$: Depression, Χ$_2$ : Marriage), The explanation of the total regression expression appeared to be 52.578%.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.2 no.1
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• pp.37-43
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• 1995

This study was conducted to compare the severity of cannulation pain in hemodialysis patients after topical application of EMLA cream and local injection of lidocaine and evaluated side effects and problems accompanied by the former. Twenty patients, who were on hemodialysis from September 1 to October 15, 1994 at the Kangnam St. Mary's Hospital, Catholic University Medical College, were divided into two groups of ten. To conduct a cross over study, two groups were placed on four repeated methods with lidocaine followed by four repeated methods with EMLA cream and vice versa, respectively, while the severity of cannulation pain was being measured according to a Visual Analogue Scale with each methods. The results are follows : 1) The scale of pain was recorded as $4.56{\pm}1.38$ and $2.05{\pm}1.36$ points for methods with lidocaine and EMLA cream, respectively, indicating the less severe pain with EMLA cream. 2) Local side effects such as itching(4 cases, 5.0%)and pallor (5 cases, 6.3%)were observed with methods with EMLA cream but disappeared before the completion of hemodialysis. 3) Problems associated with local lidocaine were pain at the injection of anesthetic (27cases, 16.9%)and fear for needle insertion(6 cases, 3.8%). The most frequent problems with EMLA cream application were an inconvenience in use (11 cases, 6.9%)and tedious long pretreatment time(11 cases, 6.9%), those associated with inconvenience in cream applying procedures. 4) Twelve out of twenty patients(60.0%) responded with yes to a continued use of EMLA cream in spite of problems with cream application and economical difficulties in purchasing. These results indicate that 5% EMLA cream used as a local anesthetic in hemodialysis significantly reduces cannulation pain and lacks side effects, thus serving as a suitable method for the alleviation of cannulation pain and inconvenience in hemodialysis and the relief of psychological stress of nurses.

• Journal of Korean Academy of Nursing
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• v.23 no.3
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• pp.431-452
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• 1993

This study was done to determine the effect of music therapy on stress and quality of life in patients undergoing hemodialysis. The research design was a nonequivalent control group pre -post test design. The subjects consisted of 21 patients who received hemodialysis in two hospitals located in Kwang Ju. The fourteen receiving treatment in one hospital were assigned to the experimental group and the seven in the other hospital to the control group. Data were gathered from December 14, 1992 to January 16, 1993 through questionnaires and physiological measurement. Data were analyzed by the SAS package using frequency, t-test, paired t-test and Pearson Prod uct - Moment Correlation Coefficient. The results of this study are summarized as follows ; 1. There were no significant differences between the two groups on stress scores and quality of life scores before the treatment. 2. The mean score on the psychological stress scale for the patients undergoing hemodialysis was 2.48 out of a maximum mean score of four, the items with high stress scores were “feeling of weakness and annoyed by everything”, “limitation of food”, “limitation of fluid”, “change in skin color” in that order. The psychological category showed the highest stress score followed by developmental, scoioeconomic and physiological stress categories in that order. 3. In the experimental group, post - test diastolic blood pressure decerased significantly(t=3.24, p=0.0064), but in the control group pre and post - test diastolic blood pressure were not different. 4. There was no difference between the two groups on the pre and post -test psychological stress scores or the depression scores. 5. The mean score of quality of life for patients undergoing hemodialysis was 2.75 out of a maxi-mum mean score of five. The category of ‘emtional state’ showed the highest score followed by ‘self - esteem’, ‘physical state and function’, ‘economic life’, ‘relationship with neighbors’ and ‘family relationship’ categories in that order. There was no significant difference in the pre and post - test quality of life scores between the two groups. 6. Hypothesis 1 that patients undergoing hemodialysis who received music therapy would have less stress than patients undergoing hemodialysis who did not receive music therapy is divided into two sub - hypotheses. 1) The first sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less physiological stress than patients undergoing hemodialysis who did not receive music therapy was partly supported. Among three physiological stress indices (pulse, systolic blood pressure, diastolic blood pressure), only diastolic blood pressure decreased significantly after the treatment in the experimental group. 2) The second sub-hypothesis that patients undergoing hemodialysis who received music therapy would have less psychological stress than patients undergoing hemodialysis who did not receive music therapy was not supported. Psychological stress score and depression score were not significantly different before and after the treatment. 7. Hypothesis 2 that patients undergoing hemodialysis who received music therapy would have a higher quality of life score than patients undergoing. hemodialysis who did not received music therapy was not supported. There were no significant changes in the quality of life scores before and after the treatment.