• The Korean Journal of Rehabilitation Nursing
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• v.5 no.2
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• pp.166-179
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• 2002

The purpose of this study was to the relationship between powerlessness, self-efficacy and quality of life in hemodialysis patients. The subjects were compromised of 198 hemodialysis patients from Pusan, Kyung-Sang Namdo and Kyung-Sang Bukdo 6 hemodialysis clinics. Data were collected by questionnaires from Sep. 19 to Oct. 27, 2001. The instrument used for study were the Powerlessness Behavioral Assessment Tool(Miller, 1983) and self-efficacy developed by Kim, Ju-Hyun(1995) and quality of life developed by Kim, Ok-Soo(1993). Collected data were analyzed by frequency, percentage, mean, standard deviation, t-test, ANOVA, Scheffe test, pearson correlation. The results were as follows. 1. The mean score of powerlessness was $52.41{\pm}6.93$, mean mark $3.28{\pm}0.43$, and the mea score of self-efficacy was $45.44{\pm}7.75$, mean mark $2.87{\pm}0.49$, and the mea score of quality of life was $121.27{\pm}23.81$, mean mark $2.96{\pm}0.58$. 2. There were significant differences in the level of powerlessness according to sex(t=2.148, p=.033), occupation(t=3.682, p=.000), economic status(F=3.094, p=.048), experience of hospitalization (t=-2.002, p=.047). 3. There were significant differences in the level of self-efficacy according to age(F=3.271, p=.013), economic status (F=5.759, p=.004), religion(F=2.667, p=.048), hemodialysis period(F=2.991, p=.032), hemodialysis frequency(t=9.045, p=.003), experience of hospitalization (t=4.40, p=.037). 4. There were significant differences in the level of quality of life according to occupation(t=3.796, p=.053), economic status(F=11.478, p=.000), hemodialysis frequency(t=7.573, p=.006). 5. There were significant negative correlation between powerlessness and self-efficacy (r=- .401, p<.001) powerlessness and quality of life(r=- .562, p<.001). There were significant positive correlation between self-efficacy and quality of life(r= .512, p<.001).

• International Journal of Vascular Biomedical Engineering
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• v.2 no.2
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• pp.16-26
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• 2004

The object of this study is to develop a mathematical model of the hemodialysis system including the mechanism of solute kinetics, water exchange and also cardiovascular dynamics. The cardiovascular system model used in this study simulates the short-term transient and steady-state hemodynamic responses such as hypotension and disequilibrium syndrome (which are main complications to hemodialysis patients) during hemodialysis. It consists of a 12 lumped-parameter representation of the cardiovascular circulation connected to set-point models of the arterial baroreflexes, a kinetic model (hemodialysis system model) with 3 compartmental body fluids and 2 compartmental solutes. We formulate mathematically this model in terms of an electric analog model. All resistors and most capacitors are assumed to be linear. The control mechanisms are mediated by the information detected from arterial pressoreceptors, and they work on systemic arterial resistance, heart rate, and systemic venous unstressed volume. The hemodialysis model includes the dynamics of urea, creatinine, sodium and potassium in the intracellular and extracellular pools as well as fluid balance equations for the intracellular, interstitial, and plasma volumes. Model parameters are largely based on literature values. We have presented the results on the simulations performed by changing some model parameters with respect to their basal values. In each case, the percentage changes of each compartmental pressure, heart rate (HR), total systemic resistance (TSR), ventricular compliance, zero pressure filling volume and solute concentration profiles are represented during hemodialysis.

• Korean Journal of Adult Nursing
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• v.23 no.6
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• pp.615-623
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• 2011

Purpose: The purpose of this study was to identify the effects of aromatherapy on sleep disorders, satisfaction of sleep and fatigue in hemodialysis patients. Methods: The study design was a quasi-experimental study with nonequivalent control group pretest-posttest design. The subjects were assigned an experimental group (N=17) and a control group (N=17). The experimental group had inhaled lavender and sweet orange for 2 minutes three times a day for 7 days. Sleep disorders were measured using Sleep Measuring Instrument and satisfaction of sleep was gauged using Visual Analogue Scale. Fatigue was checked using Fatigue Measuring instrument. Collected data were analyzed by ${\chi}^2$-test, t-test, Fisher's exact test, and paired t-test using SPSS/WIN 17.0 program. Results: There are significant differences in the sleep disorders, satisfactions of sleep and fatigue between experimental group and control group. Conclusion: Aromatherapy reduced the sleep disorders and the fatigue and increased satisfactions of sleep in hemodialysis patients. Based on the results of this study, aromatherapy can be used at the any setting as a safe and effective independent nursing intervention to sleep disorders and fatigue in hemodialysis patients.

• Journal of Korean Academy of Nursing
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• v.46 no.5
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• pp.642-652
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• 2016

Purpose: In this single repeated measures study, an examination was done on the effects of dialysate flow rate on dialysis adequacy and fatigue in patients receiving hemodialysis. Methods: This study was a prospective single center study in which repeated measures analysis of variance were used to compare Kt/V urea (Kt/V) and urea reduction ratio (URR) as dialysis adequacy measures and level of fatigue at different dialysate flow rates: twice as fast as the participant's own blood flow, 500 mL/min, and 700 mL/min. Thirty-seven hemodialysis patients received all three dialysate flow rates using counterbalancing. Results: The Kt/V ($M{\pm}SD$) was $1.40{\pm}0.25$ at twice the blood flow rate, $1.41{\pm}0.23$ at 500 mL/min, and $1.46{\pm}0.24$ at 700 mL/min. The URR ($M{\pm}SD$) was $68.20{\pm}5.90$ at twice the blood flow rate, $68.67{\pm}5.22$ at 500 mL/min, and $70.11{\pm}5.13$ at 700 mL/min. When dialysate flow rate was increased from twice the blood flow rate to 700 mL/min and from 500 mL/min to 700 mL/ min, Kt/V and URR showed relative gains. There was no difference in fatigue according to dialysate flow rate. Conclusion: Increasing the dialy-sate flow rate to 700 mL/min is associated with a significant increase in dialysis adequacy. Hemodialysis with a dialysate flow rate of 700 mL/min should be considered in selected patients not achieving adequacy despite extended treatment times and optimized blood flow rate.

• Journal of Korean Academy of Nursing
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• v.30 no.3
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• pp.791-798
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• 2000

The hemodialysis patients with chronic renal disease have experienced negative emotions, especially depression among with physical, social, and psychological changes. Based upon a stress-coping theory, group imago psychotherapy which can induce effective coping through self awareness and positive emotional responses is implemented to the hemodialysis patients. The effects of the imago psychotherapy in regards to comfort and depression are studied here. Group imago psychotherapy was performed on forty-three subjects(twenty subjects in the experimental group and twenty-three subjects in the control group). The results of the study were as follows. After being given group imago psychotherapy, the comfort scores of the experimental group were significantly higher than those of the control group (F=15.33, p= .003). Moreover, after being given treatment, the depression scores of the experimental group were significantly lower than those of the control group (F=9.14. p=.0044). Specifically, the scores on comfort in the experimental group under emotion-focused coping style were significantly higher than those of the control group (F=18.59, p= .0002). The mean difference on comfort scores in the experimental group under problem - focused coping style was higher than that of the control group. But their scores were not significant (F=0.19, p= .6729). The scores on depression in the experimental group under emotion-focused coping style were significantly lower than those of the control group (F=14.62, p= .0006). The mean difference on depression scores in the experimental group under problem - focused coping style was much lower than that of the control group. But their scores were not significant (F=0.31, p=.5947). There was a significant positive correlation between comfort and depression variables. After group imago psychotherapy the hemodialysis patients recognized positive changes in emotional reponses, self awareness, self control, ease of mind, and felt overall more relaxed. Imago psychotherapy is a nursing intervention which as this study has shown can improve to comfort. The results of this study can be applied to general nursing practices. In the view of holistic nursing, the development of the nursing practice combined with imago psychotherapy will contribute to the enlargement of the nursing field with conventional nursing practices.

• Journal of Korean Academy of Nursing
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• v.50 no.1
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• pp.52-65
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• 2020

Purpose: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients. Methods: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records. Results: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change. Conclusion: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.258-266
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• 2017

Purpose: The study aimed to examine quality of sleep in hemodialysis patients and explore physical, physiological, and psychological factors determining sleep quality. Methods: The survey was conducted among 165 patients on maintenance hemodialysis at a university hospital. Data were collected from July to October in 2015. The sleep quality and its related factors were assessed by standardized questionnaires, anthropometric measures, and lab tests after obtaining a written consent from the participant. Results: The mean age of the participants was 62.58 years old, and 67.9% of the participants experienced sleep disorders such as 'not falling asleep within 30 minutes' or 'frequently waking up at night'. Pain (t=-3.29, p=.007) and depression (t=-6.028, p<.001) were significantly different between the group with sleep disorder and the other without. The demographic factors (age, shared room, sleep during the day), physical factors (pain and symptom), and psychological factors (depression and trait and status anxiety) together explained 20.0% of variance in sleep quality. Conclusion: Sleep disorder was frequently experienced among the patients on maintenance hemodialysis. The effective nursing strategies should focus on sleep environment, pain and depression management. Further study is warranted to explore the effect of physiological factors related to the disease on sleep disorder in this population.

• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.1-10
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• 2024

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.

• 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.

• Korean Journal of Adult Nursing
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• v.26 no.6
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• pp.614-620
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• 2014

Purpose: The purpose of this study was to examine the levels of resilience, depression, and self-esteem of hemodialysis(HD) patients, and to find out the factors influencing resilience. Methods: The subjects of this descriptive correlational study was 83 outpatients in H hospital in Seoul, Korea, who receive hemodialysis regularly. Data was analyzed by SPSS/WIN 18.0 program. Results: The resilience of HD patients were statistically different by gender, job, economical state, most supportive person, and recent condition. Self-esteem had positive correlation, while depression had moderate negative correlation with the resilience of HD patients. In regression analysis, depression had significant explanation power, which accounted for 25.4% of the resilience. Conclusion: The results of this study provide basic data for developing a resilience promoting program. Since health-related conditions of HD patients affect their levels of resilience, individualized assessment and management of complications are necessary. Also, as the resilience is related to family support, activating support groups for HD patients and their spouses would be helpful to promote their resilience.