• Journal of Hospice and Palliative Care
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• v.27 no.1
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• pp.11-20
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• 2024

Purpose: Advance directives (ADs) are legal documents that outline a person's preferences or decisions regarding end-of-life care ahead of time. In Korea, there is insufficient awareness and knowledge about ADs among patients undergoing hemodialysis. This study explored the relationship between perceptions of a good death, knowledge about ADs, and attitudes toward ADs in this patient population. Methods: This cross-sectional survey enrolled 119 hemodialysis patients from a secondary hospital in 2021. The participants completed a self-administered questionnaire, and the data were analyzed using the t-test, analysis of variance, Pearson correlation coefficients, Spearman rank correlation coefficients, and multiple regression analysis. Results: The average score for perceptions of a good death among hemodialysis patients was 2.80 out of 4, with clinical symptoms identified as the most critical factor. The average scores for knowledge about ADs and attitudes toward ADs were 5.69 out of 9 and 2.79 out of 4, respectively. There was a positive correlation between perceptions of a good death and attitudes toward ADs (r=0.34, P<0.001), as well as between knowledge about Ads and attitudes toward ADs (r=0.19, P=0.037). Factors influencing attitudes toward Ads included employment status (β=0.22, P=0.011), education level (β=0.22, P=0.013), and perceptions of a good death (β=0.29, P=0.001), which accounted for 24.8% of the variance in attitudes toward ADs. Conclusion: A positive perception of a good death among patients undergoing hemodialysis was associated with a positive attitude toward ADs. Educational programs are needed to improve individuals' understanding of a good death and encourage the development of end-of-life care plans.

• Journal of Korean Academy of Nursing
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• v.30 no.2
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• pp.413-424
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• 2000

The purpose of this study was to analyze the effect of anticipated variables on hemodialysis that was impact patients' quality of life. The subjects of the study were 104 patients who were over 18 years old. They were enrolled at Kidney dialysis unit in General Hospital located in T and M city, Republic Korea. And the duration of treatment was more than 6 months. They all met the research criteria and agreed to participate in the research. The research instrument have 25 questionnaire which were originally Ferrans' (1985) instrument to measure the quality of life for hemodialysis patients and later changed by Lee, Suk-Ja into the 35 items after eliminating repeated contents, the Cronbach's $\alpha$in this study was .87. The stress instrument was measured by 36 items which were modified and supplemented the instrument developed by Kim, Yong-Kyong(15) for hemodialysis patients, and the Cronbach's $\alpha$was .9333. Depression instrument was 20 questions modified BDI(Beck Depression Inventory) to meet hemodialysis patients' conditions, and Cronbach's $\alpha$ was .92. June 25, 1999 and the data was analyzed by SPSS/PC, and the statistical techniques were ANOVA(variables analysis), Scheffe test, Multiple Regression. The findings of this study were as follows: 1. The effect of general characteristics on hemodialysis patients' quality of life, the characteristics showing a statistically, significant difference were the existence of an occupation(t=6.7353, P= .0109), marital status (F=4.3550, P= .0290), economic status (F=4.6475, P= .0118) and presence of care support (F=2..4738, P= .0494). 2. The effect of general characteristics on the patient's stress, the characteristics showing a significant difference were gender (t= 4.1143, p= .0451), education level (F= 4.3550, p= .008), the existence of an occupation (t=8.7498, p= .0038), and presence of care support(F=3.1715, p= .0169). 3. The effects of general characteristics on depression, the characteristics were education level (F=3.7517, P= .0069), the existence of religion(t=9.4843, p= .0027), an occupation (t=15.3745, p= .0002), marital status (F=3.3400, P= .0223) and presence of care support (F=3.7605, p= .0069). 4. The Multiple Regression is used to identify the effect of anticipated variables on the patient's quality of life. The variables were depression (T=-9.656, P=.000), marital status (T=-2.287, P=.0243) and the regression expression was Y=117.62053 - 1.13618Χ$_1$ + 2.66213Χ$_2$(Χ$_1$: Depression, Χ$_2$ : Marriage), The explanation of the total regression expression appeared to be 52.578%.

• 한국노년학
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• v.30 no.1
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• pp.179-194
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• 2010

The purpose of this study examines the elderly hemodialysis patients' Health-related quality in life(HRQL) and investigates the relationship between HRQL and transition of health condition. The subject were 443 elderly hemodialysis patients(over 65 years old) in Seoul and Gyeonggi province. The Health-related quality of life scale was used in this research, in which were analysed a wide range of statistical descriptive analysis, Pearson's correlation, reliability analysis, multiple regression and the Scheffe test. The results were as follows. The HRQL were statiscally significant difference by Gender, Educational level, Live with spouse, Best supporter, and Number of Disease. Also the factor related to transition of health condition was Number of Disease. The transition of health condition accounted for 13.9% of variance in HRQL and Number of Disease accounted for an additional 7.4% of HRQL. The factors, which influenced finally on the HRQL in the elderly hemodialysis patients, were transition of health condition and number of disease. In conclusion adequate hemodialysis treatment and social services should be provided in accordance with the factors affecting HRQL in order to improve the HRQL for elderly hemodialysis patients.

• 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 Academy of Nursing
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• v.29 no.6
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• pp.1284-1293
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• 1999

This study was designed to investigate the effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. Twenty one subjects of this study were selected from St. Paul's Hosipital in Seoul. All the subjects were received the mineral oil massage at the arm without fistular three timesper week for 4 weeks. After 2 weeks period of wash-out, the subjects were received the aromatherapy of lavender and tea tree essence oil in the same way. This study was carried out from March 20 to June 13, 1998. Pruritus score, skin pH and stratum corneum hydration were measured before and after each treatment. But, biochemical parameters were measured before the treatment of the mineral oil massage, after the treatment of the mineral oil massage and the aromatherapy. Data of this study were analyzed by paired t-test, repeated measures ANOVA, Bonferroni multiple comparisons and Pearson correlation coefficient. The results were as follows ; 1. Pruritus score was significantly decreased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the priritus score between the two treatments. 2. Stratum corneum hydration was significantly increased after the aromatherapy, while no significant change after the treatment of the mineral oil massage. Therefore, there was a significant difference in the stratum corneum hydration between the two treatments. 3. Skin pH was significantly increased after the treatment of the mineral oil massage, while no significant change after the aromatherapy. Therefore, there was no significant difference in the skin pH between the two treatments.4. After the aromatherapy, the serum calcium was significantly increased. Whereas the serum parathyroid hormone intact was significantly decreased compared with the treatment of the mineral oil massage. But the level of the serum Ca and PTH-intact were within the normal range. 5. Stratum corneum hydration was decreased corresponding to the duration of hemodialysis, while pruritus score and skin pH showed no change corresponding to the duration of hemodialysis and the age of the subjects. The correlation of pruritus score on skin pH, stratum corneum hydration and biochemical parameters was not significant. In conclusion, this findings indicate that aromatherapy may be effective in decreasing skin xerosis and pruritus score in uremic pruritus patients undergoing maintenance hemodialysis.

• Journal of Korean Biological Nursing Science
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• v.25 no.3
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• pp.143-159
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• 2023

Purpose: The purpose of this study was to provide evidence for future research by analyzing the contents, delivery methods, and educational effects of educational programs for hemodialysis patients. Methods: A literature review was conducted in the following order: problem identification, literature search and data collection, data evaluation, data analysis, and data presentation. In total, 936 documents were retrieved from the search, and 24 documents were finally included in this study. Results: The contents of the educational programs were comprehensive hemodialysis-related knowledge education in seven studies, exercise-related education in 10 studies, diet-related education in four studies, drug-related education in one study, and complex education in two studies. The delivery methods were pamphlets in six studies, audio-visual materials in four studies, direct guidance by researchers in six studies, and multiple methods in seven studies. The effects of the educational program were divided into physical indicators, emotional indicators, and knowledge and performance related to hemodialysis. Sixteen out of 20 articles using physical indicators showed significant outcomes, and 10 out of 12 articles using emotional indicators derived positive results. Hemodialysis-related knowledge and performance were measured in eight and 10 studies, respectively, and meaningful results were found in six studies for knowledge and seven studies for performance. Conclusion: Future research will require the development of a systematic and standardized educational program with comprehensive content that can be provided to all hemodialysis patients, as well as a highly accessible education delivery method to enhance the effectiveness of education.

• Korean Journal of Community Nutrition
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• v.22 no.5
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• pp.426-440
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• 2017

Objectives: The valid assessment of food and nutrients intakes using appropriate dietary intake method is necessary to improve the nutritional status of the hemodialysis (HD) patients. This study was conducted to compare the method between newly developed, semi-quantitative food frequency questionnaire (Semi-FFQ) and 7-day dietary records (7-DRs) for hemodialysis patients. Methods: We conducted both methods on 53 maintenance HD patients in two university hospitals. We calibrated the frequency, portion size and daily intake of 47 food items reported in Semi-FFQ. The food and nutrients intake was compared and the correlation of the two methods was analyzed. Also each nutrient intake was compared to recommended dietary allowance for Korean (KDRIs) and recommended nutrient reference value for HD patients. Results: Energy and energy-yielding nutrients intakes were significantly higher in the two methods (p<0.01). These support the possible reliability between Semi-FFQ and 7-DRs that is similar with regard to most mineral and vitamin intakes. Thus, the Semi-FFQ used in this study for the assessment of nutrient intakes of HD patients can be reliable for the assessment of the nutrient intake along with the 7-DRs. The correlation coefficients were higher for foods consumed daily, such as steamed rice, meat and chicken, bean, egg, milk, coffee and alcohol than for those of foods eaten rarely (p<0.01). Conclusions: The Semi-FFQ used in this study can be a reliable tool for the assessment of the HD patients' nutrient intake along with the 7-DRs, despite its limitations.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2165-2168
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• 2014

Background: Today, survival rate of patients with chronic renal failure/hemodialysis has increased so that chronic illnesses are more likely to occur. Cancer is the main cause of morbidity and mortality in such patients. Aim: In this study, physician attitudes were examined about cancer screening in patients with renal failure. Materials and Methods: This study was done by face to face questionnaire in the $27^{th}$ National Nephrology Congress to determine if the physicians dealing with chronic renal failure, hemodialysis or renal transplanted patients, recommend cancer screening or not and the methods of screening for cervix, prostate, breast and colon cancer. Results: One hundred and fifty six physicians were included in the survey. A total of 105 (67%) participants were male and the age of responders was $48{\pm}9$ years. About 29% were specialists in nephrology, 28% internal medicine, and 5% were other areas of expertise. Some 48% of participants were hemodialysis certified general practitioners. Patients were grouped as compensated chronic renal failure, hemodialysis or renal transplanted. Of the 156 responders, 128 (82%) physicians recommended breast cancer screening and the most recommended subgroup was hemodialysis patients (15%). The most preferred methods of screening were combinations of mammography, self breast examination and physicianbreast examination. 112 (72%) physicians recommended cervix cancer screening, and the most preferred method of screening was pap-smear. Colon cancer screening was recommended by 102 (65%) physicians and prostate screening by 109 (70%) physicians. The most preferred methods of screening were fecal occult blood test and PSA plus rectal digital test, respectively. Conclusions: It is not obvious whether cancer screening in renal failure patients is different from the rest of society. There is a variety of screening methods. An answer can be found to these questions as a result of studies by a common follow-up protocol and cooperation of nephrologists and oncologists.

• 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).

• Journal of Korean Clinical Nursing Research
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• v.14 no.2
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• pp.71-81
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• 2008

Purpose: The objective of this study was to determine the cause-effect and dynamic change mechanism among factors that affect calculation of the nursing workforce in the hemodialysis room and to establish a system dynamics model and create a strategic simulation to be used to increase efficiency in the clinical situation. Method: The system dynamics approach was adapted to build a simulation model for calculating the nursing workforce. The model was built using Vensim 5.0b DSS. Results: The results were as follows for Scenario A: The highest level of nursing service quality, patient satisfaction, and nurse satisfaction, and the lowest level of turnover intention is maintained when the ratio of patients to nurse is 3.5:1 compared to all other situations. Scenario B: At the ratio of patients to nurse 4.0:1 nursing service quality, patient satisfaction, and nurse satisfaction dropped slightly, and turnover intention also rose slightly. However with time the results showed improvement. Conclusion: In terms of economic efficiency in the hemodialysis room, the ratio of patients to nurse for the best nursing workforce should not exceed 4.0:1.