• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.16 no.10
• /
• pp.6483-6494
• /
• 2015

This study was conducted to investigate the prevalence, severity or impact of symptoms in hemodialysis patients and its relationship with self efficacy and family support to identify factors influencing their symptoms. A cross-sectional design was used and the subjects were 243 patients undergoing hemodialysis at local units. The patients were Dialysis Symptom Index (DSI), a questionnaire about the presence and severity of symptoms. The data were analyzed by descriptive statistics, independent t-test, Pearson coefficient correlation and multiple regression. There were significant differences in the total score of symptoms according to age and duration of hemodialysis. Symptoms score had significant negative correlations with family support (r=-.35, p<.001) and self-efficacy (r=-.16, p=.006). Family support explained 16.0% of the variance in symptoms score. Hemodialysis patients experience many distressing symptoms, which have negative effects on quality of their life. Promoting family support can help to reduce and control distressing symptoms in hemodialysis patients.

• Korean Journal of Health Education and Promotion
• /
• v.16 no.1
• /
• pp.149-166
• /
• 1999

Self-care and the performance of their own role might be important for the prevention of complications and improvement of quality of life in hemodialysis patients with chronic renal failure(CRF). To improve well-being and quality of life for the patients, the author estimated the level of self-care and associating factors through a questionnaire. The information was composed of the knowledge for hemodialysis and renal disease, the level of self-care, health belief, supports from the family, disease-related stresses, personal characteristics, medical history, relationships with medical personnel, etc. The data was gathered from 126 hemodialysis patients who were undergoing hemodialysis in one university hospital and five hospitals in Kyungsangnam-Do area from December 1997 to January 1998, and was analyzed by PC SAS program(version 6.12) with the level of significance($\alpha$=0.05). The mean age of subjects was 47.0$\pm$13.5years with no significant difference in gender distribution. The mean duration of hemodialysis was 39.0 months, and their frequencies of hemodialysis were more than three times per week(77.0%). Only 21.4% had the specific education on hemodialysis and CRF. In the level which was expressed as the score out of 100, the mean of knowledge was 90.7$\pm$9.1 and the mean of self-care was 73.9$\pm$12.7, that means, they only partially carried their knowledge into practice. They showed a significant correlation between knowledge and health belief($\gamma$=0.282); self-care and health belief($\gamma$=0.357), family supports and knowledge($\gamma$=0.221), self-care($\gamma$=0.402), health belief($\gamma$=0.431); and health belief and stress($\gamma$=-0.361). Age, religion, marrital status, education, and relationships with medical personnel showed positive correlations, and smoking showed negative correlation with self-care. In the multiple regression with the level of self-care as dependent variable, and each of the characeristics as independent variables, supports from the family($\beta$=6.615=0.158), the experience of disease specific education($\beta$=4.959), relationships with medical personnel($\beta$=6.615), current smoking($\beta$=-6.986), and current drinking ($\beta$=-7.095) were detected as significant factors. The value of R-square was 34%. In summary, to promote the level self-care and to improve the well beings and Quality of life for the hemodialysis patients, it would be emphasized that they terminate smoking and drinking, and it would be recommended that the education programs and supports from the family be strengthened. And, because there was a considerable difference between the level of knowledge and self-care, it would also be emphasized to propose the education programs which focused on execution. In addition to that, there is a need to improve relationships between the patients and medical personnel through positive changes in the attitudes of the medical personnel.

• Journal of the Korea Convergence Society
• /
• v.10 no.6
• /
• pp.381-391
• /
• 2019

The purpose of this study was to identify factors associated with self-care performance in hemodialysis patients based on the unpleasant symptom theory. Data were collected from 237 patients at five hemodialysis clinics in Seoul from March to April 2018. The results were evaluated by the SPSS/WIN 21.0 program. As a result, Self-care performance was positively correlated with hope, family support and medical support, but negatively correlated with emotional symptom experience and physical symptom experience. In multiple step regression analysis, family support, emotional symptom, and hope were independently associated with self-care performance, and the regression model explained 33.2% of the variances predicting self-care performance. The independent factors associated with self-care performance were family support, emotional symptom, and hope. Therefore, self-care performance may be improved by applying the hope program for the patient and the family.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.25 no.1
• /
• pp.22-32
• /
• 2018

Purpose: The study was done to examine hemodialysis unit nurses' knowledge on blood-borne infections, compliance and barriers to control and predictors of compliance. Methods: A descriptive correlational study was conducted with 122 nurses from hemodialysis units. Data were collected using a structured questionnaire. The data collection period was May to September, 2017. Data were analysed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple linear regression. Results: The mean score for knowledge on blood-borne infections was $15.41{\pm}2.01$ out of 19 and the compliance with blood-borne infection control was $4.08{\pm}0.49$ out of 5. Barriers to the performance of blood-borne infections control were lack of time and personal protective devices. Knowledge on blood-borne infection did not correlate with compliance on blood-borne infection control (r=.13, p=.171). Predictors of compliance on blood-borne infections control were 1) infection control education on injuries caused by injection needles (${\beta}=.23$, p=.010), 2) infection control room (${\beta}=.24$, p=.006) and 3) blood exposure experience over the past week (${\beta}=-.24$, p=.005) and explained 22.2% of the variance (F=10.81, p<.001). Conclusion: Findings suggest that to improve the performance of blood-borne infectious disease management, customized education for nurses on blood-borne infection and systematic support related to the infection control room should be given priority.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.7 no.2
• /
• pp.150-155
• /
• 2009

Purpose: Extracorporeal elimination of drugs is a critical part of managing poisonings, although the indications and optimal method remain a matter of debate. The aim of this study is to report our clinical experiences with continuous renal replacement therapy (CRRT), as performed by emergency room physicians, as method of extracorporeal drug elimination in patients with poisoning. Methods: This study was a retrospective study of the consecutive patients who underwent CRRT, as performed by an emergency room physician, for acute poisoning. The patient characteristics, the kinds of drugs and the method of extracorporeal elimination were analyzed by reviewing the patients' charts. Results: During eleven months, 26 patients with acute poisoning underwent extracorporeal elimination (2 patients; intermittent hemodialysis, 24 patients; CRRT). The mean time from the decision to performing extracorporeal elimination was $206.0{\pm}36.8$ minutes for intermittent hemodialysis, $62.9{\pm}8.5$ minutes for continuous venoveno-hemodiafiltration (CVVHDF) and $56.6{\pm}6.8$ minutes for charcoal hemoperfusion. For the patients with CRRT, CVVHDF was conducted in 10 patients (3 patients; valproic acid, 2 patients; Lithium, 1 patient; salicylates, 1 patient; methanol) and charcoal hemoperfusion by using CRRT was done in 14 patients (13 patients; paraquat, 1 patient; dapsone). For the 12 patients who required hemodialysis due to severe poisoning, 7 patients underwent CRRT because of their unstable vital signs. Conclusion: CRRT was an effective method of extracorporeal drug elimination in patients with acute poisoning, and especially for the cases with unstable vital sign and for those patients who required an early start of extracorporeal elimination according to the characteristics of the drug. (ED note: the writing of the abstract was not clear. Check it carefully.)

• Journal of Digital Convergence
• /
• v.10 no.5
• /
• pp.301-305
• /
• 2012

This study was performed to examine the relationship between fatigue and fatigue-regulation behavior in Hemodialysis(HD) patients. Methods: The subjects for this study were 107 patients on HD who were registered in a hospital in Seoul. The data were collected from August 2 to August 14, 2010. The collected data were analyzed by the SPSS WIN 12.0 program. Results: The mean score of fatigue was 77.1 which means their experience of high level fatigue. Frequency of the fatigue-regulation behavior and the mean of efficiency of the fatigue-regulation behavior was 8.8 and 22.8. Positive correlation was found between fatigue and fatigue-regulation behavior (r=.45, p=.000). Conclusion: It is considered that the study emphasizes for the healthcare providers to recognize fatigue as the important nursing issue for HD patients. And it is necessary to develop an evidence-based nursing intervention program for regulating fatigue in HD patients.

• Journal of Chest Surgery
• /
• v.29 no.8
• /
• pp.883-888
• /
• 1996

Expanded polytertrafluoroethylene (expanded PTFE) graft fistulas are widely used as secondary vascu- lar access for patients receiving long-term hemodialysis treatment. We implanted 48 grafts in )5 patients during the period from August 1990 to August 1995. Forty-three grafts in 32 patients were followed for 1 to 46 months. We performed forearm straight grafts in 36 grafts and upperarm straight grafts in 7 grafts. We experienced 3 operative failures, 22 early and late complications(15 graft thrombosis). Cumulative patency for all grafts at 12 months was 63%, at 24 months 32%, at 36 months 32% Forearm graft survival at 12 months was 55%, at 24 months 30%, at )6 months 30%. Upperarm graft survival at 12 months was 8)oyo and 24 months 41%. After reviewing our experience, we think that expanded-PTFE grart as secondary vascular access still have many complications and low survival than autogenous a teriovenous fistula. And so utilization of the expanded PTFE fistula requires better techniques, close observation and maintenance to keep it functional.

• Childhood Kidney Diseases
• /
• v.11 no.1
• /
• pp.41-50
• /
• 2007

Purpose : Dialysis in children with chronic renal failure presents with many difficulies. The purpose of this study is to find an improved method in chronic dialysis in infants and children less than 2 years of age by analyzing the experience with 10 cases. Methods : A retrospective review of the medical records of 10 patients(6 boys and 4 girls) was conducted. The patients had chronic renal failure and underwent chronic dialysis at Samsung medical center from March 1999 to February 2007. Results : At Initiation of dialysis, the median age was 3 months old(22 days-20 months), the median body weight was 3.75 kg(2.2-10.3 kg), and the median serum creatinine level was 4.3 mg/dL(2.0-11.4 mg/dL). The median duration of dialysis was 29.5 months(3-62 months). Dysplastic kidney disease was the most common underlying renal disease. Two patients were treated with hemodialysis, 4 patients with peritoneal dialysis, and 4 patients eventually switched dialysis modality. Nine of the 10 patients took erythropoietin and anti-hypertensive drugs. At the end of the follow up period, 1 patient received kidney transplantation, 2 patients died due to sepsis, and 5 patients were treated with peritoneal dialysis. Two patients were lost to follow up. The most common complication of dialysis was infection. Achieving vascular access and maintaining proper catheter function were the most important factors in treating patients with hemodialysis. The growth status of patients was aggravated after 6 month of dialysis but improved after 1 year of dialysis. Patients showed better growth on peritoneal dialysis than hemodialysis. Conclusion : Chronic dialysis can be performed successfully in infants and children under 2 years of age. Vascular access was the main limitation of hemodialysis, and infection was the common problem in both hemodialysis and peritoneal dialysis. To improve the patients survival rate and quality of life, major efforts should be directed toward the prevention of infection and preservation of catheter function. (J Korean Soc Pediatr Nephrol 2007;11:41-50)

• Childhood Kidney Diseases
• /
• v.22 no.2
• /
• pp.52-57
• /
• 2018

Purpose: Rhabdomyolysis is a metabolic disorder in which the content of damaged muscle cells is released into plasma. Its manifestations include asymptomatic, myalgia, gross hematuria, and complications of acute kidney injury. Because of limited data on rhabdomyolysis in children, we performed this study to determine clinical characteristics of rhabdomyolysis in children. Methods: We retrospectively reviewed the records of patients with rhabdomyolysis who were treated at the Pusan National University Children's hospital from January 2011 to July 2016. The diagnostic criteria were serum myoglobin level of ${\geq}80ng/mL$, exclusive of acute myocardial injury, cardiac arrest, and brain damage. Results: Forty-five patients were enrolled; mean age, $116{\pm}68$ months. Of these, 35 were boys and 10 were girls. Twenty-six patients experienced myalgia and 12 patients showed gross hematuria. Among these, seven patients initially had both myalgia and gross hematuria. The most common causes of rhabdomyolysis were infection, physical exertion, prolonged seizures, metabolic abnormalities, and drug addiction. Acute kidney injury (AKI) was the most common complication, followed by disseminated intravascular coagulation. Thirty-seven patients improved with sufficient fluid supply but two patients underwent hemodialysis due to deterioration of kidney function. Gross hematuria, positive occult blood test, and positive urine protein were more common in patients with AKI than in those without AKI. Conclusions: In children, infection was the most common cause of rhabdomyolysis. Most patients recovered by sufficient fluid therapy. However, in severe cases, especially in patients with underlying kidney disease, hemodialysis may be necessary in the present study.

• Kidney Research and Clinical Practice
• /
• v.36 no.2
• /
• pp.200-204
• /
• 2017

Administration of autologous mesenchymal stem cells (MSCs) has been shown to improve renal function and histological findings in acute kidney injury (AKI) models. However, its effects in chronic kidney disease (CKD) are unclear, particularly in the clinical setting. Here, we report our experience with a CKD patient who was treated by intravenous infusion of autologous MSCs derived from adipose tissue in an unknown clinic outside of Korea. The renal function of the patient had been stable for several years before MSC administration. One week after the autologous MSC infusion, the preexisting renal insufficiency was rapidly aggravated without any other evidence of AKI. Hemodialysis was started 3 months after MSC administration. Renal biopsy findings at dialysis showed severe interstitial fibrosis and inflammatory cell infiltration, with a few cells expressing CD34 and CD117, 2 surface markers of stem cells. This case highlights the potential nephrotoxicity of autologous MSC therapy in CKD patients.