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

• Korean Journal of Psychosomatic Medicine
• /
• v.11 no.2
• /
• pp.170-181
• /
• 2003

Objectives: The purpose of this study was to evaluate the quality of life in hemodialysis patients and compare it with those of depression or anxiety patients. Methods: Quality of life in hemodialysis patients(n=33) and depression or anxiety patients(n=34) was evaluated. we performed Korean Version of WHO Quality of Life Scale Abbreviated Version(WHOQOL-BREF), Beck Depression Inventory(BDI), State-Trait Anxiety inventory(STAI) to both hemodialysis patients and depression or anxiety patients. Results: The WHOQOL mean scores showed no differences between hemodialysis patients and depression or anxiety patients. Among WHOQOL domains, psychological domain score of WHOQOL was significantly higher in hemodialysis patients than in depression or anxiety patients. Anxiety score of hemodialysis patients was significantly lower than that of depression or anxiety patients, while depression score showed no difference. Conclusion: These results show that psychological domain score of WHOQOL was higher and anxiety score was lower in hemodialysis patients than in depression or anxiety patients. However, there were no significant differences in total QOL and depression between hemodialysis patients and depression or anxiety patients, and the prevalences of depression and anxiety were higher in hemodialysis patients than those of general population. This suggest that hemodialysis patients need more specialized help for psychiatric problems.

• Journal of Korean Academy of Nursing
• /
• v.30 no.4
• /
• pp.1066-1077
• /
• 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 Korean Clinical Nursing Research
• /
• v.23 no.3
• /
• pp.388-397
• /
• 2017

Purpose: The purpose of this study was to explore the effects of the lower limb muscle strength exercise program during hemodialysis on the leg strength and falls efficacy (fall-related self-efficacy) of hemodialysis patients. Methods: The study was designed to be a quasi-experimental, nonequivalent control group pre and post test design. A total of 42 patients participated in the study. We applied lower limb muscle strength exercise program to the experimental group in every hemodialysis three times a week for 8 weeks. Data were analyzed using ${\chi}^2$ test, fisher's exact test, t-test and repeated measures ANOVA. Results: The mean age was 58 years old (t=-1.54, p=.132), the mean hemodialysis period was 67 months (t=1.949, p=.058) and there was no significant difference of dependent variable (t=1.17, p=.251)(t=-.89, p=.381) between the two groups before the experiment. After the experiment, leg strength was significantly improved in the experimental group compared to that of the control group (F=6.63, p=.004). However, falls efficacy was not significantly different between the experimental group and the control group (F=2.33, p=.104). Conclusion: The study results indicated that the lower limb muscle strength exercise program during hemodialysis may improve leg strength and potentially to prevent falls for hemodialysis patients. Further studies are warranted in which larger number of participants and longer duration of intervention are recommended.

• Korean Journal of Adult Nursing
• /
• v.13 no.3
• /
• pp.451-462
• /
• 2001

This study was conducted to examine and compare the characteristics in the cognitive functions of peritoneal dialysis, hemodialysis and normal kidney function groups as basic data for effectively educating dialysis patients. The data were collected from May 10 to October 30. 2000, collected from each of 20 patients with peritoneal dialysis, hemodialysis and normal Kidney function and who registered for the dialysis room at a general hospital affiliated to a university in Seoul and sampled by age and educational level through personal interviews with the researchers of this study. As a measuring tool, MMSE developed by Folstein et al.(1975) to measure cognitive function disorder was used, slightly revised for hemodialysis patients. Collected data were processed into frequency, percentage, mean, and standard deviation by the use of SAS. The results of this study are as follows : 1. With a maximum of 30 points for cognitive function, the mean of the peritoneal dialysis patients was $27.06{\pm}2.06$, while that of the hemodialysis patients was $27.25{\pm}2.76$; that of the normal Kidney function patients was $27.85{\pm}2.00$, indicating no significant difference among those three groups. 2. As for the subjects who scored 23 points, the turning point of confirming the cognitive disorder, the percentage was 5% in the case of the peritoneal dialysis, 10% in the case of the hemodialysis and 5% in the case of the normal Kidney function group. 3. Differences between the peritoneal dialysis and hemodialysis patients by gender, occupation, spouse, diabetes, hypertension, the period of dialysis, number of hospitalizations, and the use of erythropoietin were not significant in the scoring of cognitive function. 4. There was no significant correlation between the level of Hb, Hct, albumin, aluminium, PTH, BUN, Cr, dialysis adequacy and the cognitive function. Considering such results, it is clear that there is no significant difference in the cognitive functions of the sampled subjects. Therefore, the nurse in the dialysis room should continually carry out assessment and intervention against elements degrading the effect of patients' education to improve self- care.

• The Journal of the Korea Contents Association
• /
• v.17 no.8
• /
• pp.631-643
• /
• 2017

The purpose of this study is to examine factors affecting the life satisfaction of patients with hemodialysis in order to improve the quality of life for patients with hemodialysis. The subjects of this study are 168 patients who have undergone hemodialysis treatment in the hemodialysis rooms in D-city and C-providence. The data are collected between August 20th to September 5th, 2015. By using SAS 9.3 statistics program for data analysis, frequency, ${\chi}^2$-test, variance analysis and multiple regression analysis are conducted. Based on the analysis, it is found that family support(t=5.33, p<.001) and self-efficacy(t=3.52, p<.001) are statistically significant to the quality of life for male patients. Family support(t=2.58, p<.012) and adherence to self-care(t=4.08, p<.001) are statistically significant to the quality of life for female patients. With the study results, it suggests that nurses can help improve the affective and psychological stability of patients with hemodialysis by recognizing the factors affecting the life satisfaction of patients with hemodialysis by gender, developing and utilizing a nursing intervention.

• The Transactions of the Korean Institute of Electrical Engineers D
• /
• v.51 no.11
• /
• pp.521-527
• /
• 2002

The Hemodialysis system is the device for the patients who have suffered from end stage renal failure as the kidney which removes the waste products in a human body. The existing hemodialysis is based on a 8-bit micro-controller and it is not a touch-screen type but a manual type. This paper is focused on hemodialysis system based on high control and expension embedded system. The whole system consists of main control unit and sub control unit(dialysis control unit, blood control unit, monitoring control unit, networking unit). The dialysis control unit, blood control unit, monitoring control unit are processed by 3 microcontrollers and network unit is for monitoring a renal failure patient's condition. For the evaluation of the system performance, the saline was pured into blood unit and then water removal rate, conductivity and temperature of hemodialysis liquid were measured 10 times in an each state suing the UF pump in the fluid unit varing the quantity of saline to 1000cc, 2000cc, 3000cc and 4000cc. As a result, the rates of water removal are 98.6% in condition of 000cc saline, 96.9% in 2000cc, 98.9% in 3000cc and 98.3% in 4000cc. The conductivities of hemodialysis liquid are 99.6% in the first to third condition and 99.7% in the forth condition. The temperatures of hemodialysis liquid are 99.8% in the first to third condition and 99.6% in th forth condition.

• Journal of muscle and joint health
• /
• v.22 no.3
• /
• pp.160-166
• /
• 2015

Purpose: The purpose of this study is to examine the effect of leg crossing on reducing orthostatic hypotension and orthostatic hypotension symptoms in hemodialysis patients. Methods: A one-group pretest-posttest design was used. A total of 40 post-hemodialysis adult patients were enrolled, excluding the case of intradialysis hypotension, unbalance of standing with leg crossing, adding antihypertensive medications. Blood pressure (BP) and heart rate (HR) were measured in supine and standing positions. After a week, BP and HR were measured in supine and standing with leg crossing position. Orthostatic hypotension symptoms were also measured by self-reported structured questionnaire in standing without leg crossing and with leg crossing position. Results: We found out that systolic blood pressure, diastolic blood pressure, and mean arterial pressure increased significantly in standing with crossing leg position applied (p=.006, p=.001, p=.006). However, presences of orthostatic hypotension symptoms were not significantly decreased in standing with leg crossing position (p=.500, p=.318, p=.306, p=.241, p=.356, p=.500, p=.241, p=.308). Conclusion: This study shows that leg crossing is effective for reducing orthostatic hypotension without additional cost or instruments. Leg crossing as one of the preventive interventions to reduce orthostatic hypotension is easier and simpler to be implemented in hemodialysis patients.

• Korean Journal of Adult Nursing
• /
• v.12 no.4
• /
• pp.706-716
• /
• 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 Public Health Nursing
• /
• v.26 no.1
• /
• pp.82-90
• /
• 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.