• Journal of Korean Biological Nursing Science
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• v.21 no.3
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• pp.207-216
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• 2019

Purpose: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. Methods: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. Results: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. Conclusion: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.265-275
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• 2018

This study is a qualitative investigation that used Colaizzi's (1978) phenomenological method to evaluate the meaning and nature of the experience of dialysis of eight long-term (>30 years) hemodialysis patients with chronic renal failure. Data were collected from February 27, 2017 to May 30, 2017 by in-depth interviews. Respondents were then divided into three categories, 'entirely different life', 'getting back up again' and 'focusing on survival' with nine theme clusters and 22 themes. In general, patients initially experienced an entirely different life and overcame a difficult situation when beginning dialysis, then came to know methods for self-care, shared the experience of dialysis, and focused on survival while receiving dialysis over the long-term. Development of variety of education methods depending on long-term experience of dialysis and nursing care intervention to enable chronic patients to adapt to dialysis and continue their own self-management is necessary.

• Clinical Nutrition Research
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• v.12 no.4
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• pp.293-303
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• 2023

Patients with chronic renal failure, many of which treated with hemodialysis, present a high prevalence of impaired muscle strength which suggest that muscle mass parameters may be used as markers for changes in muscle in these patients. Measurement of handgrip strength (HGS) is a common, simple, and quick measure of muscle function an indicator of overall muscle strength which has been associated with physical activity and several anthropometric traits. Intercellular adhesion molecule-1 (ICAM-1) and insulin-like growth factor-1 (IGF-1) are biochemical markers associated with inflammatory processes which are a common consequence of dialysis. Additionally, hemodialysis patients frequently present signs of malnutrition and depression. This cross-sectional study aimed to evaluate if muscle and biochemical markers could be used to predict the risk of depression in hemodialysis patients. Several anthropometric parameters, nutrient intake, depression state and the serum levels of ICAM-1 and IGF-1 were determined and Pearson's correlation coefficient and/or Spearman's correlation coefficient were used to test the correlation between them. Our results do not show a correlation between HGF, IGF-1 and ICAM-1 with the depression status of the patients, but mid-arm muscle circumference (MAMC) was statistically and positively correlated with depression. Additionally, ICAM-1 levels were negatively correlated with HGS, MAMC, and IGF-1. Overall, the results of the present study suggest that HGS may be used as an indicator of cardiovascular diseases and MAMC may be a good predictor of the level of depression in hemodialysis patients, although further studies are required.

• Journal of Chest Surgery
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• v.27 no.9
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• pp.764-769
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• 1994

From november, 1985 to May, 1993, 222 arteriovenous fistulae were made in 201 patients with chronic renal failure. Among them, a total of 183 arteriovenous fistulae in 173 patients were reviewed to evaluate the factors influencing patency rate of the vascular access. The results were revealed as follows: There were 102 men and 71 women,aged 10 to 76 years [mean = 45.7 years]. Sixteen patients of them had previous shunts. The procedures included establishment of 214 radiocephalic or brachioocephalic fistulae, 203 side to end, 9 side to side, 2 end to end, 2 autologous saphenous vein grafts, 6 Gore-Tex grafts. There were 28 early shunt failures[12%] due to use of 23 inadequate veins and 5 thrombosis.There were 32 late complications[14%]; 19 thrombosis, 4 aneurysm, 4 venous hypertension, 3 steal syndrome, 2 infections. There were 32 diabetic patients [17 %]. No significant differences in graft patency were noted between diabetic and nondiabetic individuals. There were no significant difference in graft patency between male and female. Overall shunt patency in 183 cases with chronic renal failure was 96% at I month, 95% at 3 months, 93% at I year, 91% at 2 years, 84% at 3 years, 56% at 5years.This Study showed that early postoperative thrombosis and diabetic vasculopathy were most causes of the vascular access failure and suggested that prevention of thrombi and well control of diabetes mellitus were most important to enhance patency rates of the vascular access.

• Journal of Nutrition and Health
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• v.22 no.1
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• pp.32-35
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• 1989

Serum lipid peroxide levels in 25 chronic renal failure patients undergoing hemodialysis were examined by determining TBA reaction with spectrofluorometry. The lipid peroxide levels, 208.9$\pm$88.4nmol/ml, in the patient group was significantly higher than 152.4$\pm$43.9nmol/ml of 48 control healthy subjects. It is likely that the elevated serum lipid peroxide levels can play a role in increasing tendency of hemorrhage and incidence of atherosclerosis in chronic renal failure patients.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.297-316
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• 1999

The purpose of this study is searching for hemodialysis nursing bahaviors by hemodialysis room nurses and analyzing them. Then, it estimates hemodialysis nursing costs and obtains basic data for development of proper nursing costs. First, it searched for hemodialysis nursing behaviors at a tertiary hospital hemodialysis room in Seoul and classified them. After the content validity was verified by 6 experts, Tool of hemodialysis nursing behaviors was developed. patients who recived hemodialysis were classified by dialysis patient classification tool. The searcher observed hemodialysis nursing behaviors applied to classified patients per 5 minutes. Then hemodialysis nursing hours spent to classified patients were calculated respectively. The direct expenditures and indirect expenditures were estimated. Ultimately, hemodialysis nursing costs were estimated. The results of the study were as follows ; 1. hemodialysis nursing behaviors were grouped by the same knowledge and skills. then, the content validity of them was verified by evaluation tool of nursing intervention classification by expert groups. They consisted of 9 hemodialysis activity domains and 71 hemodialysis nursing behaviors. The predialysis activity domain included 15 nursing behaviors, the activity domain of start-dialysis included 12 nursing behaviors, the activity domain of during- dialysis included 9 nursing behaviors, the activity domain of finish-dialysis included 5 nursing behaviors, the activity domain of after-dialysis included 5 nursing behaviors, the nursing documentation & undertaking and transfering included 5 nursing behaviors, the supply, drug, equipment & environment management activity domain included 7 nursing behaviors, the patient emotional support & education activity domain included 4 nursing behaviors, the emergency activity domain included 9 nursing behaviors. 2. The acute hemodialysis nursing hours were 106.42 minutes per a dialysis and the chroni hemodialysis nursing hours were 72.23 minutes per a dialysis. 3. The direct expenditure was 11.971 won per hour and indirect expenditure was 288won. 4. Finally, the cost of acute hemodialysis was 21,745 won and that of chronic hemodialysis was 14,759 won. By search of hemodialysis nursing behaviors, they will be used as hemodialysis nursing care standard and will be tended toward high qualitative care. Estimation of hemodialysis nursing costs will be used as fundamental data for development of proper nursing costs.

• Journal of Nutrition and Health
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• v.34 no.8
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• pp.920-928
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• 2001

Malnutrition is a common problem in patients undergoing maintenance hemodialysis(HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in chronic HD patients. We investigated the nutritional parameters of 50 Korean HD patients(mean age: 46.9 $\pm$ 10.3y, men : 23, women : 27) by measuring anthropometric and biochemical blood indices and assessing food intake using 24-h recall method. Also we administered two questionnaires, one for assessing nutritional knowledge about renal disease and dietary therapy, the other for measuring dietary habits related to dietary therapy. According to the distribution of BMI, 21.3% of HD patients were underweight. The hematological values of HD patients, such as plasma hemoglobin, hematocrit, and total lymphocyte count were below the normal range. The serum cholesterol levels were 133.2 $\pm$ 30.5mg/dl. HD patients took energy and protein only 77.5% and 83.1%, respectively, of their RDA. There were significantly positive correlations between nutritional knowledge and intake of nutrients, such as energy, fat, cholesterol, iron, potassium, vitamin B$_1$, vitamin B$_2$, and niacin. Also, there was a significantly positive correlation between nutritional knowledge and dietary habits(r = 0.317, p < 0.05). In conclusion, Korean HD patients showed mild malnutrition and suboptimal nutrition intake. It can be postulated that the dietary intake can be increased by nutrition education improving nutritional knowledge and correcting the dietary habits of HD patients.

• Journal of Korean Academy of Nursing
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• v.45 no.2
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• pp.271-279
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• 2015

Purpose: This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management. Methods: A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program. Results: The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management. Conclusion: The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.9
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• pp.5578-5584
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• 2014

In this study, 46 patients from a local hemodialysis center were enrolled to assess the effects of a self-motivated virtual reality (VR) exercise program on the heart rate variability and quality of life control in hemodialysis patients. The VR group (n = 23) completed a VR exercise program, where the subjects performed the exercise 40 min per session, 3 sessions per week, for 8weeks. After the exercise program, the heart rate variability and quality of life were measured. The VR group showed significant improvement in the heart rate variability and quality of life. The self-motivated VR exercise program provided both the role of supervisor as well as feedback, which is important for hemodialysis patients.Therefore, a self-motivated VR exercise program may be a useful tool for improving the psychosocial function in chronic disease patients undergoing hemodialysis.

• Journal of Chest Surgery
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• v.11 no.2
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• pp.227-231
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• 1978

Since January 1973 we have performed 47 arteriovenous shunts and 22 arteriovenous fistulas for 57 patients with acute or chronic renal failure. Of these 57 cases, 50 cases had chronic renal failure and the other 7 cases had acute renal failure. The most frequent complications after operations were thrombosis, bleeding and infection. Less frequently dislodgement of shunt and aneurysmal change of the fistula were found. After 47 arteriovenous shunts, 21 those complications [44%] were found. On the other hand after 22 arteriovenous fistulas, 5 complications were found. Now we are using the arteriovenous shunt only for the patients who need emergency short term hemodialysis and temporary dialysis until arteriovenous fistula could be used.