• Journal of Korean Biological Nursing Science
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• v.22 no.1
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• pp.23-35
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• 2020

Purpose: Compliance in kidney transplant recipients is critical for a positive prognosis. Especially compliance with medications after kidney transplantation is a major health care issue with implications for graft rejection and graft loss. But the definition of compliance in transplantation varies among centers. The purpose of this study was to clarify the concept of compliance in kidney transplant recipients. Methods: A literature search was conducted using RISS, MEDLINE, CINAHL. The concept analysis was guided by the methodology posited by Walker and Avant. Results: In this study, we found the attributes of the concept: 'compliance with immunosuppressive medication', 'compliance with follow-up', 'compliance with early detection of graft rejection and complication', and 'compliance with prevention of complication'. The antecedents of 'compliance in kidney transplant recipients' included 'having a kidney transplant surgery' and 'normal function of transplanted kidney'. The consequences of 'compliance in kidney transplant recipients' included 'affecting the function of the transplanted kidney' and 'affecting the health of kidney transplant recipients. Conclusion: This study may contribute to the development of tools for measuring compliance in kidney transplant recipients, as well as benefit nursing interventions research to increase compliance in kidney transplant recipients.

• Journal of Korean Academy of Nursing
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• v.39 no.4
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• pp.518-527
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• 2009

Purpose: The purpose of this study was to identify factors influencing quality of life in kidney transplant recipients and to understand the concrete pathway of influence and the power of each variable, so that integrated prediction model to promote the quality of life of kidney transplant recipients could be developed. Methods: The sample was composed of 218 patients in follow-up care after a kidney transplant in one of 4 university hospitals in the Honam area. A structured questionnaire was used and the collected data were analyzed for fitness, using the LISREL program. Results: This model was concise and extensive in predicting the quality of life of kidney transplant recipients. Conclusion: The research verified the factors influencing quality of life for kidney transplant recipients and it verified that direct factors such as perception of health state, compliance, self-efficacy, stress and indirect factors such as self-efficacy and social support can be important factors to predict the quality of life for recipients. Moreover, those variables represent 87% of variance in explaining quality of life in a prediction model so that the variables can be utilized to predict quality of life for kidney transplant recipients.

• Journal of Korean Academy of Nursing
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• v.54 no.1
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• pp.93-105
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• 2024

Purpose: The study aimed to understand the semantic structure and nature of the disease experience of kidney transplant recipients with kidney graft failure by applying phenomenological research methods. Methods: Data were collected between February and September 2021 through individual in-depth interviews with 12 kidney transplant recipients with kidney graft failure. Colaizzi's phenomenological analysis was used to analyze the meaning of the participants' illness experiences. Results: 5 theme clusters and 15 themes were derived. The five theme clusters are as follows: (1) First transplant giving me a second life; (2) Body and mind becoming sick again; (3) Waiting for a re-transplant with hope and worry; (4) Life supported by gratefulness; (5) Having control over my own life. Conclusion: This study shows that kidney transplant recipients with kidney graft failure experience physical and psychological difficulties during the long disease period and require help from many people, including family members, friends, colleagues, and health care providers, to overcome their difficulties.

• Journal of Korean Academy of Nursing
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• v.36 no.7
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• pp.1145-1153
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• 2006

Purpose: The purpose of this study was to discover kidney transplant and hemodialysis patients' quality of life(QOL) and provide basic data to improve their QOL. Method: One hundred two hemodialysis patients and 106 kidney transplant patients were given a self-administered questionnaire from Mar. 6 to Mar 31, 2006. The instrument consisted of demographic variables, therapeutic-related characteristics and QOL. Collected data was processed using the SPSS 12.0 statistical program for real numbers, percentages, ANCOVA, t-test, ANOVA, Stepwise multiple regression and the Scheffe test. Results: Kidney transplantpatients' QOL was higher than hemodialysis patients. The demographic variables which showed a significant difference in overall QOL were religion, children and monthly income for kidney transplantpatients and educational background for hemodialysis patients. The therapeutic-related variable which showed a significant difference in overall QOL was the patients' perceived health condition for both groups. The influencing factor on overall QOL for both groups was the health condition perceived by themselves. The total variance of the variable for QOL was 42% for kidney transplant patients and 19% for hemodialysis patients. Conclusion: This study revealed that kidney transplant patients have a higher QOL and how patients perceive their health is the strongest influencing factor for QOL. However, there is a large difference between the demand and supply of kidney donors. To solve this problem the standards for donation should be reviewed and revised.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.678-689
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• 2000

The purpose of this study was to explore the educational needs of kidney transplant patients and educational importance perceived by their nurses to develop a rehabilitational and educational program. Data were collected from January 29, 1999 to July 30, 1999 with interviews using a structured questionnaire. The subjects for this study were 173, of whom 107 were patients who had had a kidney transplant and had visited the out-patient department and 66 were transplant ward nurses who were taking care of the kidney transplant patients at six general hospitals located in Seoul. The questionnaire used for this study was developed by the investigator through a literature review and collected and modified by 11 professional personnel and 3 kidney transplant patients. The data were analyzed using the SAS program for numbers, percentiles, mean, standard deviation, t-test, ANOVA, and $Scheff{\acute{e}}$ test. The results were as follows; 1) In the patient group, the total mean score for educational needs was 154.61 and the item mean score was 3.96. In the nurses group, the total mean score for perceived educational importance was 166.26 and the item mean score was 4.26. In the nurses group, perceived educational needs were scored higher than by the patient group. With regard to domains, both patient and nurses group had the highest educational needs and perceived educational importance in the domain of physical condition and the top five items in the educational needs and perceived educational importance were also in the domain of physical condition. 2) In the patient group, women and the divorce/bereavement group had higher educational needs in the domain of nutritional management, those who had been admitted longer than 4 weeks from their kidney transplant time had higher educational needs in the domains of physical condition and those who were less than 4 years from their transplant had higher educational needs in the domain of follow-up care. In the nurses group, those who were married had higher perceived educational importance in the domain of physical condition.

• Kidney Research and Clinical Practice
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• v.37 no.4
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• pp.323-337
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• 2018

Infectious complications have been considered as a major cause of morbidity and mortality after kidney transplantation, especially in the Asian population. Therefore, prevention, early detection, and prompt treatment of such infections are crucial in kidney transplant recipients. Among all infectious complications, viruses are considered to be the most common agents because of their abundance, infectivity, and latency ability. Herpes simplex virus, varicella zoster virus, Epstein-Barr virus, cytomegalovirus, hepatitis B virus, BK polyomavirus, and adenovirus are well-known etiologic agents of viral infections in kidney transplant patients worldwide because of their wide range of distribution. As DNA viruses, they are able to reactivate after affected patients receive immunosuppressive agents. These DNA viruses can cause systemic diseases or allograft dysfunction, especially in the first six months after transplantation. Pretransplant evaluation and immunization as well as appropriate prophylaxis and preemptive approaches after transplant have been established in the guidelines and are used effectively to reduce the incidence of these viral infections. This review will describe the etiology, diagnosis, prevention, and treatment of viral infections that commonly affect kidney transplant recipients.

• Journal of Korean Academy of Nursing
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• v.48 no.6
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• pp.731-742
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• 2018

Purpose: The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory. Methods: Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0. Results: The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients. Conclusion: It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.

• Annals of Surgical Treatment and Research
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• v.95 no.5
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• pp.278-285
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• 2018

Purpose: We investigated the clinical outcomes of deceased donor kidney transplantation (KT) using kidneys with terminal acute kidney injury (AKI). Methods: Between February 2000 and December 2013, we performed 202 deceased donor renal transplants from 159 brain dead donors. According to the expanded criteria donor (ECD) and AKI network criteria, we divided 202 recipients into 4 groups: Group I: Non-AKI & standard criteria donor (SCD) (n = 97); group II: Non-AKI & ECD (n = 15); group III: AKI & SCD (n = 52); and group IV: AKI & ECD (n = 38). Results: The incidence of delayed graft function (DFG) was significantly higher in patients with AKI than it was in the non-AKI group (P = 0.008). There were no significant differences among the 4 groups in graft survival (P = 0.074) or patient survival (P = 0.090). However, the long-term allograft survival rate was significantly lower in group IV than it was in other groups (P = 0.024). Conclusion: Allografts from deceased donors with terminal AKI had a higher incidence of DGF than did those from donors without AKI. However, there is no significant difference in graft and patient survival rates among the groups. So, the utilization of renal grafts from ECDs with terminal AKI is a feasible approach to address the critical organ shortage.

• Clinical and Experimental Pediatrics
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• v.62 no.11
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• pp.422-427
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• 2019

Background: Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients. Purpose: The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation. Methods: This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the study period, and each transplant was analyzed independently. Total number of cases is 33 cases with 31 patients. BKV infection was confirmed from blood samples via periodic quantitative polymerase chain reaction. Results: The mean age at kidney transplantation was 11.0±4.7 years, and the male-to-female ratio was 2.7:1. Three patients had a past medical history of high-dose chemotherapy and autologous stem-cell transplantation for solid tumors. Nine patients (27.3%) developed BKV infection. The median period from kidney transplantation to BKV detection in blood was 5.6 months. There was no statistically significant difference in estimated glomerular filtration rate between patients with and those without BKV infection. Among 9 patients with BKV viremia, 7 were treated by reducing their immunosuppressant dose, and BKV was cleared in 6 of these 7 patients. In the other 2 BKV-positive patients, viremia improved without immunosuppressant reduction. Conclusion: BKV infection is common in children with kidney transplantation and might not have affected short-term renal function in our patient sample due to early immunosuppressant reduction at the time of BKV detection.

• Korean Journal of Adult Nursing
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• v.18 no.1
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• pp.136-145
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• 2006

Purpose: This study was performed to identify relationships among stress, hardiness, and the level of self-care in kidney transplant patients and use the results of this study as baseline data for developing self-care promotion programs. Method: Subjects were 41 patients who undergone a kidney transplantation surgery at least one month before and were receiving regular follow-up care via OPD. Four researchers interviewed each subjects by filling out questionnaires. Results: The mean score of the level of stress was 2.32(SD=0.54) on a 4 point scale and the mean score of hardiness was 4.68(SD=0.62) on a 6 point scale. The mean score of self-care among the subjects was 3.83(SD=0.55). There was statistically a significant positive relationship between selfcare and hardiness(r=0.42). Especially, relationships between self-care and commitment (r=.51) and control(r=.36) as the subdimensions of hardiness were significant. The item suggested as most stressful was economic burden and the item suggested as least stressful was sexual activity. Conclusion: Although transplant patients have various stressors, the positive self-care activities of the patients could be increased if the commitment and control were enhanced by proper intervention programs.