• Journal of Preventive Medicine and Public Health
• /
• v.43 no.3
• /
• pp.245-256
• /
• 2010

Objectives: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. Methods: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). Results: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI = 0.43 - 0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb${\geq}$11 g/dL, blood pressure within the range of 100-140 /60-90 mmHg, calcium x phosphate${\leq}$55 $g^2/dL^2$ and albumin${\geq}$4 g/dL were not significantly different between the groups. Conclusions: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.

• Korean Journal of Adult Nursing
• /
• v.17 no.3
• /
• pp.435-443
• /
• 2005

Purpose: This study investigated the degree of fatigue of hemodialysis patients, and finds the relationship between fatigue and self-efficacy, family support, and sleep factor. Also, this study was purposed to provide fundamental data to help set up a nursing plan and intervention for recovery and mitigation of hemodialysis patient's fatigue. Method: The subjects in this study were patients treated as hemodialysis patients in Kwangjoo City. Data, subjects are 143 patients. Fatigue was measured using Lee's scale(1991), Self-efficacy using Kim's scale(1995), and Family support using Kim's scale(1993). For the analysis of collected data, Cronbach alpha, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, Stepwise multiple regression were used for statistical analysis by SPSSwin(version 11.0) program. Result: Fatigue degree of hemodialysis patients averaged 4.22. Among 143 hemodialysis patients, 70.63% patients answered that they had felt fatigue as noted in this study. The weariest time was after hemodialysis for 21.0% patients. There was significant difference according to the diagnosis period. The patients who were diagnosed over one year had felt more fatigue than ones who were diagnosed within one year. Fatigue was significantly associated with self-efficacy, family support, and sleep factor. Self-efficacy could explain 14.6% of fatigue. Conclusion: The fatigue degree relates with all, self-efficacy, family support, and sleep factor. Especially, it is affected by self-efficacy among them. Thus, the program should be developed to mitigate fatigue as the self-efficacy of hemodialysis is enhanced.

• Journal of Korean Academy of Nursing Administration
• /
• v.11 no.4
• /
• pp.439-448
• /
• 2005

Purpose: Purpose of the this study is to define the hemodialysis treatment-related stressors and stress coping methods in hemodialysis noncompliant patients. Method: Hemodialysis treatment-related stressors scale and stress coping style scale were used with 178 patients that received continuous hemodialysis treatment, met the noncompliance criteria. Collected data were analyzed by using the SPSS 12.0 program. Result: In hemodialysis noncompliant patients, Psychosocial stress were higher than physical stress, 'aesthetic thinking' was the most used. As recognition of health status was lower, hemodialysis treatment-related stressors were higher. In terms of causative disease, 'hypertension' pt used more 'problem-focus coping' and 'social support pursuit' than the other groups. As subjective recognition level of health status was higher, 'problem-focus coping' and 'social support pursuit' were more used. It was showed positive correlation between psychosocial stressors and 'aesthetic thinking'. Conclusion: Hemodialysis noncompliant patients had high psychosocial stress, accordingly, used 'aesthetic coping'. It means that they has negative coping to disease and hemodialysis treatment. Therefore, Nurses need to manage psychosocial aspects, which influence on noncompliant behaviors.

• The Korean Journal of Rehabilitation Nursing
• /
• v.2 no.2
• /
• pp.184-192
• /
• 1999

Hemodialysis is a way of treatment for the patients with acute and chronic renal failure. "Marginal man" depicts the enormous amount of stress that hemodialytic patients suffer. It is known that family with chronic illness get stressed along with the patients and they need nursing care also. This qualitative study was conducted in order to identify the family adaptation process in patients with hemodialysis. 6 dyads of hemodialytic patients and caregivers were interviewed for this research. By way of grounded theoretical strategy the data was collected from October 20, 1999 to November 20, 1999. at a hemodialytic unit that was located in Iksan, Chonbuk by the researcher. The main research questions were "What's the adaptation experience of a patient since after being received with hemodialysis?" to the patients, and "What's the family adaptation experience of hemodialysis?" to the caregivers. The collected data was analyzed by grounded theoretical strategy built by Glaser & Strauss in 1967. Results were as follows; 7 grounded concepts were observed from the patients with hemodialysis and 4 grounded concepts were found from the caregivers. Two categories were derived ; 1) Holding hope that is related with treatment 2) Changing a value system.

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

• Journal of Korean Biological Nursing Science
• /
• v.11 no.1
• /
• pp.59-67
• /
• 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.

• Journal of Korean Biological Nursing Science
• /
• v.15 no.3
• /
• pp.122-132
• /
• 2013

Purpose: The purpose of this study was to evaluate the effect of periodic video education on knowledge about hemodialysis, patient role behavior and the physiologic index in patients with hemodialysis. Methods: One-group pretest-posttest design was applied. A total of 50 patients with hemodialysis at a university hospital hemodialysis unit in Daegu participated. Periodic video education about kidney function, diet, arteriovenous fistula management, medication, and exercise was administered to them for 12 weeks at intervals of 2 weeks. Before and after the education, the participants completed the self-administered questionnaires of knowledge about hemodialysis and patient role behavior and the measures of serum potassium and phosphorus concentration, weight gain between hemodialysis sessions, and adequacy of dialysis (Kt/V). Statistical analysis was performed using paired t-test. Results: Knowledge about hemodialysis and patient role behavior were significantly different between before and after education (p<.01). For the physiologic index, serum potassium concentration and weight gain between hemodialysis sessions were not significantly different but the serum phosphorus concentration and Kt/V were significantly different between before and after education (p<.05). Conclusion: The results suggest that the periodic video education for patients with hemodialysis contributed to the change and improvement in knowledge about hemodialysis, patient role behavior, and the physiologic index.

• Journal of Digital Convergence
• /
• v.18 no.11
• /
• pp.433-441
• /
• 2020

The specific purpose was to determine the effect of walking on the body composition and hematological index of hemodialysis patients in order to confirm the relationship between activity and health level of hemodialysis patients. The research method is a cross-sectional descriptive survey conducted in hemodialysis patients.The subjects were 66 hemodialysis patients undergoing hemodialysis treatment in B city. As a result of the study, walking was decreased in hemodialysis patients, and there was a difference in hematological index according to walking, but there was no difference in body composition. As body weight increased, skeletal mass, body fat mass, body mass index, abdominal fat percentage, basal metabolism, and protein increased, but total cholesterol and high-density cholesterol decreased. This study proposes to expand the number of subjects of hemodialysis patients to investigate by adding nutritional intake in addition to walking, body composition and hematological index.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.18 no.3
• /
• pp.310-316
• /
• 2011

Purpose: In the present study, the difference in patients' nursing demands and nursing performance as perceived by the patients was examined. Methods: The participants were 272 patients on maintenance hemodialysis at five university hospitals. Nursing need and nursing performance were measured using the tool developed by Lee for this study. Results: The mean score for nursing demand was 3.35 points out of 4. The scores were higher for participants with middle school graduation or less, those not professing religion, and those whose medical insurance was of the medicaid type. The mean score for perceived nursing performance was 3.22 points out of 4. Nursing performance as perceived by hemodialysis patients was lower than nursing demand for 22 of 28 items. The item with the largest difference between nursing performance and nursing demand was 'Give a pain-free injection', followed by 'Explain about insurance benefits and supports' and 'Maintain quiet environment in the hemodialysis unit enabling rest during hemodialysis'. Conclusion: The results show that nursing performance as perceived by hemodialysis patients was lower than nursing demand. This result indicates a need to develop appropriate strategies to enhance nursing performance, especially for items that showed low nursing performance.

• The Korean Journal of Health Service Management
• /
• v.6 no.2
• /
• pp.57-69
• /
• 2012

The purpose of this study was to investigate correlation with self-care behaviors and physiological index according to cognitive function of hemodialysis patients. The data were collected from 108 patients on hemodialysis in university hospital. The period of data collection was from January 4 to January 31, 2010. The instruments of research were MMSE, Self-care behavior scale for hemodialysis patients. The 17.6% of patients showed the cognitive disorder. Self-care behaviors of patients showed that normal cognitive function group was significantly higher than dysfunction group. Creatinine and parathyroid hormone of patients showed that normal cognitive function group was significantly lower than dysfunction group. The cognitive function of patients showed positive correlations with self-care behavior(r=.283, p=.003) and Kt/V(r=.214. p=.026), showed significant negative correlations with phosphorus(r=-.223, p=.020) and creatinine(r=-.318, p=.001). The results of this study can be used to develop nursing education program to improve self-care behaviors according to cognitive function of hemodialysis patients.