Purpose: The purpose of this study was to determine the effects of music therpy on anxiety and depression in patients undergoing hemodialysis. Method: The study was designed using a nonequivalent control group pretest-posttest design. The subjects consisted of 36 patients (Experimental group: 18, Control group: 18) who received hemodialysis in three hospitals located in Seoul. The measures were a Music Preference Questionnaire (MPQ), anxiety measurement, and depression measurement. Data was collected from December 26, 2004 to April 2, 2005 through questionnaires. The collected data was analyzed by the SPSS 10.0 program. Result: The first hypothesis that patients undergoing hemodialysis who received music therapy would have less anxiety than patients undergoing hemodialysis who did not receive music therapy was supported(F=8.05, p=.008). The second hypothesis that patient undergoing hemodialysis who received music therapy would have less depression than patients undergoing hemodialysis who did not receive music therapy was supported(F=11.86, p=.002). Conclusion: The results of this study suggest that music therapy may be applied as a method of nursing intervention contributing to the improvement of quality life by reducing their anxiety and depression of patients undergoing hemodialysis.
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.
Purpose: The objectives of this study were to investigate the current status of the pain in and the dysfunction related to the musculoskeletal system experienced by patients with end-stage renal failure receiving hemodialysis. Methods: A questionnaire survey was given to 107 patients undergoing hemodialysis in M Hospital. The survey was conducted by using a brief pain inventory(BPI) to investigate the body parts in pain, degree of pain, difficulty in daily life, correlation with hemodialysis and the degree of satisfaction with their own health. Results: The investigation of the patients undergoing hemodialysis showed that 89(83.2%) of the 107 patients experienced pain in their musculoskeletal system. Their pain's incidence was highest in the knees(46.1%) and 68.5% of the patients reported that the most severe pain they had experienced within the past 24 hours was at a level between "moderate" and "severe." The limitation of daily life by pain is high most as 47.7% in the accomplishment of works. Conclusion: Most hemodialysis patients experience musculoskeletal related pain that affects their daily life. Hemodialysis patient management programs should include an assessment and management of such pain.
Purpose: The purpose of this study was to explore the meaning of the experience of adapting to the dietary treatment for hemodialysis patients. Methods: The data were collected through in-depth interviews of ten hemodialysis patients who have been dialyzed for longer than five months. Giorgi's phenomenological method was used for data analysis. Results: The findings included five constituents and 16 sub-constituents. The five constituents concerning diet therapy were: 'suffering', 'undergoing trial and error', 'understanding the need', 'finding alternatives', and 'realizing the meaning of dietary therapy.' Conclusion: The findings contribute to understanding the process of adapting to diet therapy. The results of this study may be utilized in assisting patients to understand the diet therapy process.
This study was a qualitative investigation into hemodialysis patients' dietary practices. The purpose of this study was to explore the obstacles and requirements to maintain a recommended diet therapy in hemodialysis patients. Five patients undergoing hemodialysis in the renal chamber of the general hospital were interviewed individually. The interviews were based on an interview guide and analyzed by Giorgi's method of analysis. As a result of this study, five elemental factors and 12 subelemental factors were derived. Derived elements were "difficulty in dietary guidelines", "recognizing necessity of diet therapy", "awareness of importance of diet", "difficulty practicing diet therapy", and "looking for ways to practice diet therapy". Patients not only felt difficulties in practicing dietary guidelines but also recognized the need and importance of diet therapy. Patients seemed to have difficulty practicing meal therapy and eating with their families or others. They were also stressed by the limited selection of dietary components and rapid dietary changes before and after dialysis. However, patients showed a willingness to implement dietary management to improve their quality of life and to practice dietary therapy. In order to improve the practice of dietary management in hemodialysis patients, nutritional education should be focused on long-term dietary habits through continuous education and monitoring, not just one-off education. Moreover, patients should be educated that adherence to dietary control may be less burdensome on their families.
Malnutrition is a common problem in patients undergoing maintenance hemodialysis(HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in chronic HD patients. We investigated the nutritional parameters of 50 Korean HD patients(mean age: 46.9 $\pm$ 10.3y, men : 23, women : 27) by measuring anthropometric and biochemical blood indices and assessing food intake using 24-h recall method. Also we administered two questionnaires, one for assessing nutritional knowledge about renal disease and dietary therapy, the other for measuring dietary habits related to dietary therapy. According to the distribution of BMI, 21.3% of HD patients were underweight. The hematological values of HD patients, such as plasma hemoglobin, hematocrit, and total lymphocyte count were below the normal range. The serum cholesterol levels were 133.2 $\pm$ 30.5mg/dl. HD patients took energy and protein only 77.5% and 83.1%, respectively, of their RDA. There were significantly positive correlations between nutritional knowledge and intake of nutrients, such as energy, fat, cholesterol, iron, potassium, vitamin B$_1$, vitamin B$_2$, and niacin. Also, there was a significantly positive correlation between nutritional knowledge and dietary habits(r = 0.317, p < 0.05). In conclusion, Korean HD patients showed mild malnutrition and suboptimal nutrition intake. It can be postulated that the dietary intake can be increased by nutrition education improving nutritional knowledge and correcting the dietary habits of HD patients.
Background: Maintenance of adequate vascular access for hemodialysis is important in patients with end-stage renal disease. Once arteriovenous fistula (AVF) occlusion occurs, the patient should be treated with rescue therapy. This study was performed to evaluate the results of a rescue therapy for AVF occlusion. Methods: From January 2008 to December 2012, 47 patients who underwent surgical rescue therapy for AVF occlusion after graft AVF formation, were enrolled in this study. The patients were divided into two groups, namely the graft repair group (group A, n=19) and the thrombectomy group (group B, n=28). Postoperative results of both groups were analyzed retrospectively. Results: There were no statistically significant differences in the clinical characteristics between the two groups. In terms of the duration of AVF patency after the first rescue therapy, group A showed a longer AVF patency duration than group B ($24.5{\pm}21.9$ months versus $17.7{\pm}13.6$ months), but there was no statistically significant difference (p=0.310). In terms of the annual frequency of AVF occlusion after the rescue therapy of group A was lower than that of group B (0.59 versus 0.71), but there was no statistically significant difference (p=0.540). The AVF patency rates at 1, 2, 3, and 5 years after the first rescue therapy in group A were 52.6%, 31.5%, 21.0%, and 15.7%, respectively, and those in group B, they were 32.1%, 25.0%, 17.8%, and 7.14%, respectively. There was no statistically significant difference (p=0.402). Conclusion: Graft repair revealed comparable results. Although there was no statistically significant difference, the patent duration and annual frequency of AVF occlusion of group A were better than those of group B. Therefore, graft repair is considered as a safe and useful procedure for maintaining graft AVF.
This study examined and identified the relationship between the level of hope and self-care agency in hemodialysis patients. The purpose of the study was to reveal that hope is an essential factor to enhance self-care agency and to prepare the basic materials to help nurse the patients. The subjects for this study consisted of 108 persons who undergoing hemodialysis from 2 hospital, 2 hemodialysis center in Pusan, Korea. The degree of hope was measured by the questionnaire that has been developed by Miller. The self-care agency was measured by the questionnaire that has been developed by Kearney B.Y & Fleisher B.J. The collected data were analyzed by descriptive statistics and t-test. one-way ANOVA and Pearson's Correlation Coefficient with SPSS WIN program. Results were obtained as follows: 1) The mean scores of hope were $131.77{\pm}25.77$(range 67-195). The rate of hope classified said that the lowest hope was 2.8% and low hope was 27.8%. 2) The mean scores of self-care agency were $143.78{\pm}23.63$(range 74-187). The degree of self-care agency classified said that the rate of self-care agency deficiency was 0.9% and low self-care agency was 12.0%. 3) The hope was significantly related to self-care agency. That is, the higher the hope score was, the higher the level of self-care agency score(r=0.668,p=0.001) was. In this result, there were hemodialysis patients who have very low hope score and self-care agency score. In this cases self-care agency can be increased by encouraging the patients to be more hopeful. Conclusively nurses should access the degree of hope and self-care agency of hemodialysis patients individually and apply the hope therapy in order that the patient have higher hope than before.
The purpose of this study was to identify the degree of learned helplessness and self-care agency in dialysis patients and the relationship between learned helplessness and self-care agency. The subjects were 168 dialysis patients who were undergoing hemodialysis and peritoneal dialysis from 1 university hospital, 1 hospital, 1 hemodialysis center in Seoul, 1 hospital in Incheon, Korea. The data were collected with two interview questionnaires which were Learned Helplessness Scale (LHS) and Self-as-Carer Inventory (SCI). The collected data were analyzed by descriptive statistics and t-test, One-way ANOVA and Pearson Correlation with SPSSWIN program. Results were obtained as follows : 1) The mean scores of learned were 45.93(range 20-80). The mean learned helplessness scores of peritoneal dialysis patient and hemodialysis (HD) patient were not different significantly. However by the aging process, the mean scores of learned helplessness has a tendency to get higher and who had a job were likely to low score of learned helplessness. 2) The mean scores of self-care agency were 142.48 (range 33-198). The mean self-care agency scores of peritoneal dialysis (PD) patient much higher than the score of it with hemodialysis. The score of self-care agency were significantly different between peritoneal dialysis patient and hemodialysis patient. The patients who have job were likely to be higher score of self-care agency than other groups. 3) There was significant relationship between the score of learned helplessness and self-care agency. In conclusion, there was an inverse relationship between learned helplessness and self-care agency in dialysis patients. Considering this, the high level of learned helplessness of dialysis patients should be intervened by nurse with a well developed edicational program or cognitive behavioral therapy.
For the assessment of changes in the bone architecture of the maxilla and mandible in renal osteodystrophy, 31 chronic renal failure patients who were undergoing hemodialysis therapy were selected. They were evaluated through clinical oral examination, radiographic and biochemical examination. The results were as follows: 1. In 17 cases (54.8%), there were evidences of bony change in jawbone. 2. The most common dental radiographic finding was decreased bone density (14 cases, 45.2%). 3. The second most common dental radiographic finding was total or partial loss of lamina alveolar dura (11 cases, 35.5%). 4. The third most common dental radiographic finding was total or partial loss of inferior canal wall (8 cases, 25.8%). 5 cases showed evidences of bony change only in jawbone, and 5 cases only in hand, and 12 cases in both. 6. Serum creatinine, urea nitrogen and alkaline phosphatase values in hemodialysis group were much higher than in control group. 7. There were statistically significant correlation between bone density and lamina dura, and inferior alveolar canal wall.
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