• Journal of Korean Biological Nursing Science
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• 제15권1호
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• pp.15-23
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• 2013

Purpose: The purpose of this study was to identify the relationship among the attitudes on exercise, physical activity and quality of life (QOL) in hemodialysis patients. Methods: A total of 42 patients in a hemodialysis unit participated in this study. Physical activity level was measured directly by 6 minute walking test and grip strength test. Structured questionnaires were also used for measuring their attitudes on exercise, physical activity and QOL. Participants' medical records were reviewed for obtaining their biochemical and clinical information. Statistical analysis was performed using Pearson correlation, and multiple liner regression. Results: A significant positive correlation between participants' attitudes and physical activity level measured by International Physical Activity Questionnaire (IPAQ) was found. And the physical activity level measured by Korea Activity Scale/Index (KASI) was significantly related to QOL. Conclusion: This study shows that QOL of the hemodialysis patients was significantly associated with their physical activity level.

• Journal of Korean Biological Nursing Science
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• 제11권1호
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• pp.59-67
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• 2009

Purpose: The purpose of this study was to compare characteristics of two groups (pruritus and non pruritus group), in hemodialysis patients. Method: The degree of ichting in 130 patients treated at the D Medical Center Hemodialysis Unit was examined by itching severity & sites tool, itching observation tool and itching NRS tool. The data were collected from October 1 to 12, 2007 and analyzed by student t-test and Mann-Whitney test. Result: Sixty three patients (48.3%) of hemodialysis patients had pruritus. The severity and number rating scale score of pruritus in one day before hemodialysis was higher than during and after hemodialysis. The frequency of dialysis and usage of anti-histamine drug were significantly lower in nonpruritis group than in pruritus group (F=5.209, p=.022, F=6.549, p=.010). The other general characteristics, hemodialysis-related characteristics and laboratory data were not significantly different between the two groups. The depression score was significantly higher in pruritus than in nonpruritus group (t=-2.505, p=.017). But there were no significant differences in hostility and anxiety between the two groups. Conclusion: Residual renal function and depression were associated with pruritus in hemodialysis patients. Efforts for preservation of residual renal function and emotional support may decreased severity and frequency of pruritus in hemodialysis patients.

• Perspectives in Nursing Science
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• 제12권1호
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• pp.60-70
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• 2015

Purpose: The purpose of this study was to identify the factors influencing medication adherence in hemodialysis patients among primary medical care and secondary medical care. Methods: A cross-sectional survey design was utilized. Data were collected using questionnaires from 280 hemodialysis patients who had taken prescribed medication regularly as a result of chronic renal failure at primary and secondary medical care in Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: There were statistically significant differences in medication adherence according to living area (p=.002), health condition (p<.001), amount of medication (p=.004), inconvenience for taking medication (p<.001), and depression level (p=.001). The mean of medication adherence was 3.72 points. Medication adherence was explained by perceived barrier related to medication taking (${\beta}=.338$), attitude (${\beta}=.250$), and depression (${\beta}=.132$). Conclusion: This study strongly recommended that nursing intervention program to improve medication adherence should be developed and a match control study in improvement of medication adherence for hemodialysis patients needs to be done.

• Journal of Korean Biological Nursing Science
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• 제3권1호
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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.

• 기본간호학회지
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• 제3권1호
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• pp.68-80
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• 1996

Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietrary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group. 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, $B_1,\;B_2$, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both calorie and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfold thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit in the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of TSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferrin concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferrin concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients are needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.

• 가정∙방문간호학회지
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• 제12권2호
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• pp.87-101
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• 2005

Purpose: The purpose this study was to investigate the relationship between self-care performance and influential factors in hemodialysis patients. Method: The subjects of this study were 102 hemodialysis outpatients who had been visiting C University Hospital in Seoul. The data were collected through the scale of self care, self efficacy family support, daily living activity and hope from the 1st to 31st of December 2004. The collected data were analysed using SPSS PC Win 10.0. Result: The average score of self-care performance of subjects was $3.2\pm0.4$ points(4points scale) and significantly different among groups according to age and duration of dialysis. Self care performance of subjects was in a significant positive correlation with family support and hope. Factors affecting self care performance of subjects were family support, duration of hemodialysis, age and daily living function, and the explanatory power of these factors was 31.4%. Conclusion: These findings indicate that is necessary to enhance family support, to develope and apply self-care education programs in consideration of duration of dialysis and age, to have hope-giving communication with patients and their families, and to provide nursing interventions for maintaining patients' daily living function in order to improve the self care performance of hemodialysis patients

• 대한간호학회지
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• 제46권4호
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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.

• 대한간호학회지
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• 제47권1호
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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.

• 성인간호학회지
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• 제26권6호
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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.

• 성인간호학회지
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• 제27권6호
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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.