• Journal of Korean Neurosurgical Society
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• v.30 no.3
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• pp.381-383
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• 2001

Neurological symptoms may develope when the blood urea nitrogen is lowered too rapidly by hemodialysis. It is known that these symptoms, known as dialysis disequilibrium are associated with cerebral edema. However, the pathogenesis of brain swelling and neurological deterioration after rapid hemodialysis is controversial. The reverse urea hypothesis suggests that hemodialysis removes urea more slowly from the brain than from the plasma, creating an osmotic gradient that results in cerebral edema. The idiogenic osmole hypothesis proposes that an osmotic gradient between brain and plasma develops during rapid dialysis because of newly formed brain osmoles. Authors report a such case and discuss the possible mechanism and preventive methods.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.28-34
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• 2018

Purpose : The purpose of this study was to compare the effect of recirculation rate according to cannulation direction and interval among hemodialysis patients with arteriovenous fistula (AVF). Method : The research used repeated measures design. This study was conducted among thirty patients who received hemodialysis three times a week for longer than a year through AVF at the I University hospital. Three different types of interventions were administered to the participants each week for three weeks. Needles were placed at a different distance and in a different direction each week: 7 cm apart from each other in antegrade direction during the first week, 5 cm apart in retrograde direction in the following week, and 7 cm apart in retrograde direction in the third week. Results : No significant differences in the recirculation rate were found due to any of the three tested methods (p = 1.00). Conclusion : This finding suggests that, if the patients have well-functioned AVF, we can choose an appropriate intervention from among the three methods in consideration of the patient's diverse needs.

• The Journal of the Korea Contents Association
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• v.14 no.11
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• pp.829-837
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• 2014

This study was conducted to investigate the factors that influence the psychosocial adaptation and quality of life of hemodialysis patients. The study participants consisted of 246 hemodialysis patients from 8 hemodialysis centers located in 3 cities ('K', 'P', and 'U') in South Korea. The questionnaire used for data collection was administered between April 1 and 30 of 2014. SPSS/WIN 18 program was used to perform descriptive, correlation, and stepwise regression analyses. It was found that stress response and acceptance were significantly correlated with psychosocial adaptation and quality of life. In the stepwise regression analysis, stress response appeared to be the most important influencing factor for psychosocial adaptation (${\beta}$=-.443, p<.001) and quality of life (${\beta}$=-.553, p<.001). Based on the study results, it is determined that in order to improve psychosocial adaptation and quality of life among hemodialysis patients, an intervention program to reduce stress response is needed, along with evaluating its efficacy.

• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.5-16
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• 2009

Purpose: This study was done to provide effective nursing interventions using an individualized educational program designed to contribute to the knowledge, compliance and physiologic parameters (serum potassium, phosphorus and interdialytic weight gain) of non-compliant hemodialysis patients. Methods: There were 22 participants in the experimental group and 19 in the control group. Nurses with rapport with patients provided education to non-compliant hemodialysis patients for 20 minutes three times a week for six weeks. This education program consisted of individual consulting, telephones conversations regarding hemodialysis, and requests for patient support from patients' families and colleagues. Results: Hypothesis 1; "Knowledge about hemodialysis in the experimental group will be higher than the control. group" was not supported. Hypothesis 2; "Compliance will be higher in the experimental group than in the control group", and Hypothesis 3; "Physiologic parameters of experimental group will improve" were supported as serum potassium and interdialytic weight gain decreased, but results were not consistent for phosphorous. Conclusion: This program for non-compliant patients increased compliance and improved physiologic parameters. Therefore, this educational program should be effective as a nursing intervention.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.260-266
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• 2004

Objectives : To assess the impacts of implementing case payment system (CPS) to Medical Aid (MA) hemodialysis patients on the frequencies and expenditure of dialysis. Methods : Fifty-eight clinics and 35 tertiary care hospitals were identified as having a minimum of 10 hemodialysis patients for each of the MA and Medical Insurance (MI) programs, who received hemodialysis from the same dialysis facilities for both periods of July 2001 and July 2002. From these facilities, a total of 2,167 MA and 2,928 MI patients were identified as the study subjects. Using electronic claims data, the changes in the total number of monthly treatments and charges for outpatient hemodialysis treatments for each patient after the introduction of the CPS were compared between the MA and MI patients. Multiple regression analyses were performed to examine the independent impact of the CPS on the utilization and expenditure of dialysis treatments among the MA patients. Results : There was a significant decrease in the total charges for the hemodialysis treatments of the MA patients, 3.4% (p<0.05), whereas a significant increase was observed for the MI patients, 2.5% (p<0.05). For both the MA and MI patients, the frequency of the monthly hemodialysis treatments were significantly increased, 5.5 (from 12.1 to 12.7) and 7.8% (from 11.6 to 12.5), for the MA and MI patients, respectively. However, a multivariate regression analysis showed no significant difference in the changes in the total number of monthly hemodialysis treatments between the MA and MI patients after implementation of the CPS. Another regression model, regressing on the changes in the monthly claims of dialysis treatments, showed a significant negative coefficient for the MA ((=-70725, p<0.05). Conclusion : The significant decrease in the total charges for hemodialysis treatments among MA as compared to MI patients suggests that there was a cost reduction in the MA program following the introduction of the CPS.

• Journal of Korean Academy of Nursing
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• v.11 no.2
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• pp.83-104
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• 1981

Hemodialysis is essential treatment for the chronic renal failure patient's long-term cure and for the patient management before and after kidney transplantation. It sustains the endstage renal failure patient's life which didn't get well despite strict regimen and furthermore it becomes an essential treatment to maintain civil life. Bursing implementation in hemodialysis may affect the significant effect on patient's life. The purpose of this study was to obtain the basic data to solve the hypotension problem encountable to patient and the blood loss problem affecting hemodialysis patient'a anemic states by incomplete rinsing of blood in coil through all process of hemodialysis. The subjects for this study were 44 patients treated hemodialysis 691 times in the hemodialysis unit, The .data was collected at Gang Nam 51. Mary's Hospital from January 1, 1981 to April 30, 1981 by using the direct observation method and the clinical laboratory test for laboratory data and body weight and was analysed by the use of analysis of Chi-square, t-test and anlysis of varience. The results obtained an follows; A. On clinical laboratory data and other data by dialysis Procedure. The average initial body weight was 2.37 ± 0.97kg, and average body weight after every dialysis was 2.33 ± 0.9kg. The subject's average hemoglobin was 7.05±1.93gm/dl and average hematocrit was 20.84± 3.82%. Average initial blood pressure was 174.03±23,75mmHg and after dialysis was 158.45±25.08mmHg. The subject's average blood ion due to blood sample for laboratory data was 32.78±13.49cc/ month. The subject's average blood replacement for blood complementation was 1.31 ±0.88 pint/ month for every patient. B. On the hypotensive state and the coping approaches occurrence rate of hypotension was 28.08%. It was 194 cases among 691 times. 1. In degrees of initial blood pressure, the most 36.6% was in the group of 150-179mmHg, and in degrees of hypotension during dialysis, the most 28.9% in the group of 40-50mmHg, especially if the initial blood pressure was under 180mmHg, 59.8% clinical symptoms appeared in the group of“above 20mmHg of hypotension”. If initial blood pressure was above 180mmHg, 34.2% of clinical symptoms were appeared in the group of“above 40mmHg of hypotension”. These tendencies showed the higher initial blood pressure and the stronger degree of hypotension, these results showed statistically singificant differences. (P=0.0000) 2. Of the occuring times of hypotension,“after 3 hrs”were 29.4%, the longer the dialyzing procedure, the stronger degree of hypotension ann these showed statistically significant differences. (P=0.0142). 3. Of the dispersion of symptoms observed, sweat and flush were 43.3%, and Yawning, and dizziness 37.6%. These were the important symptoms implying hypotension during hemodialysis accordingly. Strages of procedures in coping with hypotension were as follows ; 45.9% were recovered by reducing the blood flow rate from 200cc/min to 1 00cc/min, and by reducing venous pressure to 0-30mmHg. 33.51% were recovered by controling (adjusting) blood flow rate and by infusion of 300cc of 0,9% Normal saline. 4.1% were recovered by infusion of over 300cc of 0.9% normal saline. 3.6% by substituting Nor-epinephiine, 5.7% by substituting blood transfusion, and 7,2% by substituting Albumin were recovered. And the stronger the degree of symptoms observed in hypotention, the more the treatments required for recovery and these showed statistically significant differences (P=0.0000). C. On the effects of the changes of blood pressure and osmolality by albumin and hemofiltration. 1. Changes of blood pressure in the group which didn't required treatment in hypotension and the group required treatment, were averaged 21.5mmHg and 44.82mmHg. So the difference in the latter was bigger than the former and these showed statistically significant difference (P=0.002). On the changes of osmolality, average mean were 12.65mOsm, and 17.57mOsm. So the difference was bigger in the latter than in the former but these not showed statistically significance (P=0.323). 2. Changes of blood pressure in the group infused albumin and in the group didn't required treatment in hypotension, were averaged 30mmHg and 21.5mmHg. So there was no significant differences and it showed no statistical significance (P=0.503). Changes of osmolality were averaged 5.63mOsm and 12.65mOsm. So the difference was smaller in the former but these was no stitistical significance (P=0.287). Changes of blood pressure in the group infused Albumin and in the group required treatment in hypotension were averaged 30mmHg and 44.82mmHg. So the difference was smaller in the former but there is no significant difference (P=0.061). Changes of osmolality were averaged 8.63mOsm, and 17.59mOsm. So the difference were smaller in the former but these not showed statistically significance (P=0.093). 3. Changes of blood pressure in the group iutplemented hemofiltration and in the Uoup didn't required treatment in hypotension were averaged 22mmHg and 21.5mmHg. So there was no significant differences and also these showed no statistical significance (P=0.320). Changes of osmolality were averaged 0.4mOsm and 12.65mOsm. So the difference was smaller in the former but these not showed statistical significance（P=0.199). Changes of blood pressure in the group implemented hemofiltration and in the group required treatment in hypotension were averaged 22mmHg and 44.82mmHg. So the difference was smatter in the former and these showed statistically significant differences (P=0.035). Changes of osmolality were averaged 0.4mOsm and 17.59mOsm. So the difference was smaller in the former but these not showed statistical significance (P=0.086). D. On the changes of body weight, and blood pressure, between the group of hemofiltration and hemodialysis. 1, Changes of body weight in the group implemented hemofiltration and hemodialysis were averaged 3.340 and 3.320. So there was no significant differences and these showed no statistically significant difference, (P=0.185) but standard deviation of body weight averaged in comparison with standard difference of body weight was statistically significant difference (P=0.0000). Change of blood Pressure in the group implemented hemofiltration and hemodialysis were averaged 17.81mmHg and 19.47mmHg. So there was no significant differences and these showed no statistically significant difference (P=0.119), But in comparison with standard deviation about difference of blood pressure was statistically significant difference. (P=0.0000). E. On the blood infusion method in coil after hemodialysis and residual blood losing method in coil. 1, On comparing and analysing Hct of residual blood in coil by factors influencing blood infusion method. Infusion method of saline 200cc reduced residual blood in coil after the quantitative comparison of Saline Occ, 50cc, 100cc, 200cc and the differences showed statistical significance (p < 0.001). Shaking Coil method reduced residual blood in Coil in comparison of Shaking Coil method and Non-Shaking Coil method this showed statistically significant difference (P < 0.05). Adjusting pressure in Coil at OmmHg method reduced residual blood in Coil in comparison of adjusting pressure in Coil at OmmHg and 200mmHg, and this showed statistically significant difference (P < 0.001). 2. Comparing blood infusion method divided into 10 methods in Coil with every factor respectively, there was seldom difference in group of choosing Saline 100cc infusion between Coil at OmmHg. The measured quantity of blood loss was averaged 13.49cc. Shaking Coil method in case of choosing saline 50cc infusion while adjusting pressure in coil at OmmHg was the most effective to reduce residual blood. The measured quantity of blood loss was averaged 15.18cc.

• The Korean Journal of Rehabilitation Nursing
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• v.2 no.1
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• pp.95-108
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• 1999

The purpose of this study was to identify the effect of the humor intervention program, administred to the hemodialysis patient as an adaptive coping mechanism. The research design was non-equivalent control group non-synchronized design. The study method had been done by investigating the experimental group and control group through the questionnaire on 36 patients who had been out patient hemodialysis room at B hospital in Pusan from August 18 to September 15, 1998. The humor intervention program consisted of 1 TV comedy, 1 home video and 1 comedy film. The humor intervention program was provided to the experimental group for 20-30 minute 3 times every other day at hemodialysis room. Dependent variables were measured by Spielberger's State Anxiety Inventory, Zung's Self Rating Depression Scale, Lefcourt & s Humor Coping Scale. The analysis of the collected data had been done for the hemogeneity test in which general characteristics of the experimental group and the control group had been tested by $X^2$-test and the hemogeneity test had been tested by t-test before using the humor intervention program which is for anxiety, depression and coping of humor. To test the hypothesis the t-test had been given for the difference of anxiety, depression and coping of humor between the two groups. The result were summarized as follows : 1. Anxiety score in the experimental group and control group was not significant difference. 2. Depression score in the experimental group and control group was not significant difference. 3. Coping of humor score in the experimental group and control group was not significant difference. In conclusion, even though humor intervention program did not have any efficient effect on hemodialysis patients in reacting to anxiety, depression and coping humor, it caused very positive reactions from patients, and it also reducted anxiety of patients among the experimental group a little bit. If this program could be sufficiently applied ac cording to the character of every patients with a little bit different appliences such as selection of humor intervention program, frequency and period, it will be used as an efficient the humor intervention program.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.688-698
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• 2017

This study was conducted to identify the conceptual definitions and attributes of fatigue in hemodialysis patients based on the Hybrid Model of concept development. The Hybrid Model was used to investigate the main attributes and indicators of the concept by applying three stages. After a literature review, data were collected through observation and interviews including qualitative research in the field work stage. The participants included 10 patients in hemodialysis center of two hospitals in Gwang-ju, Korea. The attributes of fatigue concept in the hemodialysis patients were divided into four dimensions, physical activity, affective mood, social role, and cognitive reflection. The definition of fatigue by hemodialysis patients was defined as 'subjective feeling usually experienced in four dimensions during the process to recognize and adjust energy deficiency and limited functions caused by uremia and repeated hemodialysis for chronic renal failure'. Considering the dimensions and attributes derived from this study, it may be possible to develop an effective intervention program for fatigue in hemodialysis patients.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.2
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• pp.129-132
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• 2004

Ethylene glycol poisoning can cause profound morbidity and is almost universally fatal if untreated. Central nervous system depression, pulmonary edema, and acute oligulic renal failure with crystalluria are among the most commonly encountered complication of ingestion. Ingestion of ethylene glycol may be an important contributor in patients with metabolic acidosis and subsequent renal failure. The diagnosis of ethylene glycol poisoning is based on nonspecific clinical symptoms and signs and indirect and direct laboratory measurement of ethylene glycol. As a result, diagnosis and treatment sometimes can be delayed. We describe 52-year-old man who visited to emergency department with mental change of unknown origin. The patient has high anion gap metabolic acidosis and renal failure due to ingestion of antifreeze that contained ethylene glycol. We used hemodialysis for elimination technique. The patient was discharged with minimal complication.

• Journal of Korean Clinical Nursing Research
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• v.20 no.3
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• pp.395-405
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• 2014

Purpose: This study was a descriptive correlation research designed to provide basic data on family nursing interventions by examining burden, social support and quality of life for family caregivers of patients on hemodialysis. Methods: Data were collected from 132 family caregivers of patients on hemodialysis and analyzed using frequency analysis, correlation analysis, independent samples t-test method, one-way ANOVA and post-hoc analysis of $Scheff{\grave{e}}$, and multiple regression analysis. Results: Burden for family caregivers of patients on hemodialysis was 3.03, social support, 4.77, and quality of life, 3.26. Burden showed a negative correlation with social support (r=-.34, p<.001), and with quality of life (r=-.54, p<.001). There was a positive correlation between social support and quality of life (r=.54, p<.001). Factors predicting quality of life for family caregivers, were a significant and positive effect from social support (t=5.72, p<.001) and a negative effect from family burden (t=-5.62, p<.001). Conclusion: Results of the study indicate that burden of these family caregivers can be reduced by social support which plays an important role in improving quality of life. A nursing intervention program which goes beyond simply caring for patients and includes assessment of family burden and support for overall family caretaking needs to be developed.