• Korean Journal of Adult Nursing
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• v.28 no.4
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• pp.436-446
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• 2016

Purpose: The purpose of this study was to identify the effect of auricular acupressure on pruritus and fatigue in hemodialysis patients. Methods: The study design was a randomized control group pre-post test. Initially, forty-four patients were randomly assigned to one of two groups. There was a loss of three participants assigned to the treatment group. The period of data collection was from December 2014 to March 2015. Both groups completed a pre-test. The treatment group received auricular acupressure once a week for ten weeks. Data were collected from the treatment group at two time periods: five weeks and ten weeks following initiation of the treatment protocol. Data were collected from the control group at week 5 and week 10. Data analysis was performed using IBM SPSS Statistics 21.0 program, specifically with the independent t-test and the Repeated Measures of ANOVA. Results: Auricular acupressure was effective in reducing pruritus (F=13.93, p<.001) and fatigue (F=18.33, p<.001). Conclusion: Auricular acupressure is a non-invasive simple method that can be used for the relief of symptoms reported by hemodialysis patients. This treatment modality could be used in several clinical areas.

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.91-99
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• 2017

Purpose: The purpose of this study was to determine the time and content of dietary education by analyzing the physiological indicators of hemodialysis patients during their first year and to present baseline data related to dietary education for patients on hemodialysis. Methods: For this retrospective study physiological indicators for 73 patients on hemodialysis were analyzed. Data included levels of potassium, phosphorus, albumin and the IDWG rate, and Kt/V during the first year after starting hemodialysis. Repeated-measure ANOVA was used for statistical analysis. Results: Serum levels of phosphorus (p<.006), albumin (p<.001) and the IDWG rate (p<.001) increased significantly in the 7 months from the start of hemodialysis. Conclusion: The results indicate that the period in which diet related educational intervention is necessary is before physiological changes, that is, after 6 months of dialysis. The contents for effective education should include phosphorus-limited and weight control dietary restrictions at 6 months.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.2
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• pp.149-158
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• 2010

Purpose: This study was done to gain understanding of what career and related experience mean to individuals undergoing hemodialysis. Methods: Ten male patients receiving hemodialysis participated in the study. Data collection took place between November 18, 2008 and February 10, 2010, via unstructured interviews. Data collection and analysis were conducted simultaneously, and Colaizzi's phenomenological method (1978) was used for the analysis. Results: The significance the participants found in their "dual" life as worker and dialysis patients was classified into five categories: 'Recognition of self-existence value', 'My health comes before my work', 'Being afraid of stigma', 'Limitation of restricted work', and 'Difficulty with time management.' Conclusion: It was found that the dialysis patients showed ambivalent feelings towards their careers, hoping they will be able to continue to work yet fearing that the continued work might break balance the between their livelihood and healing. Therefore, it is recommended that hours for hemodialysis be more flexible to ensure that patients can keep their jobs and better manage their time while undergoing treatment.

• Journal of Korean Academy of Nursing Administration
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• v.22 no.2
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• pp.189-198
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• 2016

Purpose: The aim of this study was to investigate the relationships between the hemodialysis unit nurses' experience of verbal abuse, job stress, burnout, and turnover intention, and to identify the explained variances for turnover intention. Methods: The research design was a descriptive survey using a probability sampling. The data were measured using self-report questionnaires from 231 hemodialysis unit nurses in seven cities in Korea and were analyzed with SPSS 20.0. Results: The mean scores were $2.45{\pm}0.62$ (out of 5) for experience of verbal abuse, $2.40{\pm}0.26$ (out of 4) for job stress, $2.31{\pm}0.48$ (out of 4) for burnout, and $3.16{\pm}0.05$ (out of 5) for turnover intention. There were significant correlations among the experience of verbal abuse, job stress, burnout, and turnover intention within the hemodialysis unit nurses. Factors influencing turnover intention were 'burnout' (${\beta}=.42$, p<.001) and 'job stress' (${\beta}=.17$, p=.015)which explained 42% of the variance (F=15.98, p<.001). Conclusion: Results suggest that in order to reduce nurses' turnover intention, nurse managers should explore strategies to reduce nurses' burnout and job stress in nurses in hemodialysis units.

• Journal of Korean Academy of Nursing Administration
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• v.22 no.2
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• pp.178-188
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• 2016

Purpose: This study was performed to investigate the effect of work environment on nursing performance and the effect of job satisfaction and empowerment on nurses performance in hemodialysis units. Methods: Participants in this study were 206 nurses from 22 hemodialysis units in local clinics, general and university hospitals in two metropolitan areas. The work environment, nursing performance, job satisfaction and empowerment of the participants were measured using four self-report questionnaires. Data were analyzed using SPSS/WIN 18.0. Results: Nursing performance correlated significantly with work environment, job satisfaction, and empowerment in the participants. Predictability of work environment for nursing performance was 28%. Job satisfaction and empowerment showed complete mediating effects, but not moderating effects in the relationship of work environment and nursing performance in the participants. Conclusion: Findings indicate that work environment is an important variable affecting nursing performance in nurses in hemodialysis units and that job satisfaction and empowerment are mediating variables in the relationship of work environment and nursing performance in nurses in hemodialysis units. Improvements in the work environment are needed to induce the high job satisfaction and empowerment that can lead to improvement of nursing performance.

• Journal of Korean Academy of Nursing
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• v.35 no.7
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• pp.1353-1361
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• 2005

Purpose: This study was done to provide fundamental data for developing a depression prediction model by discovering main factors that affect depression in patients who do maintenance hemodialysis. Method: The subjects were 191 patients doing maintenance hemodialysis selected from outpatient dialysis clinics at 9 major general hospitals, The Instrument tools utilized in this study were adapted from depression, fatigue, sleep disturbance, stress, adaptation, symptoms, daily activities, and role limitation and thoroughly modified to verify reliability and validity. The collected data was analyzed with a SPSS-PC 11.0 Window Statistics Program for real numbers, percentage, average, standard deviation, and multiple regression. Results: The correlation factor for depression was (M=2.54) fatigue(M=3.12), sleep disturbance (M=2.82), stress(M=3.04), adaptation(M=2.53), daily activities(M=2.24), symptoms(M=2.37), and role limitation(M=2.24). The strongest factor that affected depression was explained by symptoms of the patients who performed hemodialysis. The analysis of the factors that affected depression revealed a $58.4\%$ prediction in symptoms, stress, role limitation, and adaptation. Conclusion: It has been confirmed that the regression equation model(Depression=7.351 + .266$^{\ast}$symptoms + .260$^{\ast}$stress -.l89$^{\ast}$adaptation + .057$^{\ast}$fatigue) of this research may serve as a prediction factor for depression in Hemodialysis Patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.235-246
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• 1996

The purpose of this study was to discover the experience of hemodialysis which clients confronted hemodialysis at the same time as CRF diagnosis and to understand the nature and meaning of their crisis experience. The research subjects were 6 clients receiving hemodialysis in Seoul from Jan. 1996 to Jul. 1996. Data were collected by informal indepth interview and participant observation. Content Analysis(by Seaman & Verhonick, 1982; Woods & Catanzaro, 1988) was applied to collect similar contents and common experience in order to derivate concepts and categories for better understanding of their hemodialysis experience. As a result, 6 categories derivated to indentify their hemodialysis experience of the CRF clients-confronted hemodialysis at the same time as CRF diagnosis-were as follows: 1) The category of shocking crisis composed the concepts of shock, amagement and suffocation. 2) The category of denial composed the concepts of disease refusal and hemodialysis refusal. They repeatedly visited hospitals or didn't visit hospital in order to refuse disease, then depended on folk remedy or shamanistic method. 3) The category of severe anxiety composed the concepts of abandoned feeling, shame, resentment, neurosis and anger. 4) The category of depression composed the concepts of grief, suffering of unfairness, tearing, desire to death. 5) The category of powerlessness composed the concept of hopelessness. 6) The category of resigned acceptance composed the concepts of resignation and acceptance. In this study, the CRF clients who confronted hemodialysis at the same time as CRF diagnosis experienced six stages in accepting hemodialysis but these stages were mingled simultaneously and went on.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.183-199
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• 1996

The Purpose of this study is to develop and test a nursing model which can be applied to prediction of the quality of life for the patient receiving hemodialysis. A hypothetical model was constructed on Johns & Meleis's empowerment model framework which has 3 contsructs(stress, resource, empowerment). 6 Factors(perceived stress, self-esteem as personal resource, perceived social support as social resource, perceived fertigue, perceived health status & self efficacy as empowerment) were selected to pre dict the quality of life of receiving hemodialysis patients. 4 Factors(self-esteem, perceived social support, perceived health status & self efficacy) had direct effects on the quality of life significantly. Self-esteem had indirect effect on the quality of life via perceived heath status significantly. Perceived social support had indirect effect on the quality of life via self-effcacy significantly. Perceived stress had no direct and indirect effect on the quality of life significantly. Revised model from hypothetical model showed better fit to the data by eliminating unsignificant path. From results of this study we suggest that to improve quality of life of hemodialysis patient nurses provide nursing interventions which improve self-esteem, perceived social support, self-efficacy & perceived health status.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.1
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• pp.42-59
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• 2000

This study was done to analyze and develop the concept of coping in patients receiving hemodialysis. The Hybrid Model of concept development was applied to develop a conceptual structure of coping in patients receiving hemodialysis, which included a field study carried out using an in-dept interview with 18 patients in the hemodialysis room of one general hospital in Seoul. Data-analysis was done in three phases as suggested by the Hybrid Model. Finally, by summarizing the results from each case, the attributes of coping, its dimensions, definition and structure were outlined. According to the results of the study, a conceptual structure of coping which centers around stressors, stress-appraisal, strategy of coping and new definitions of coping in patients receiving hemodialysis was suggested : The coping of patients receiving hemodialysis is a process that deals with physical, emotional, inter-personal, and role stress caused by hemodialysis due to renal failure. It has a series of phases which include a phase that appraises the stressful situation based on past experience of chronic disease management, one's remaining rears, the extent of family support, the extent of economic dependency, inter-personal support. education and uncertainty, and a phase of developing coping strategies that con be affected by social support and self esteem. As a result of coping, patients adapt or not to the life situation of receiving hemodialysis.

• The Journal of Korean Academic Society of Nursing Education
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• v.21 no.3
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• pp.340-349
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• 2015

Purpose: Patients on hemodialysis need to manage the stress of having a life-threatening condition. The purpose of this study was to identify factors associated with stress among patients on hemodialysis. Methods: The research had a cross-sectional, descriptive design using a questionnaire. The participants were 91 adult patients on hemodialysis from four dialysis centers in a large Korean city. Data were analyzed with the SAS 9.2 program using descriptive statistics, t-tests, ANOVA, and multiple regression. Results: There were statistically significant differences in stress by age, dialysis period, and change in employment status. In hemodialysis patients, stress was significantly positive correlated with fatigue and depression, but negatively correlated with self-esteem. Stepwise multiple regression analysis for stress revealed that the most powerful predictor was depression. Depression and fatigue explained 32.5% of the variance. Conclusion: The results indicate a need to manage the stress of these patients. The findings also suggest that consideration be given to characteristics of age, dialysis period, and employment status in developing strategies to reduce depression and fatigue and developing programs to manage the stress of patients on hemodialysis.