Background : Nervous system dysfunction is a major complication of end stage renal disease. Although severe neurologic symptoms are partially or completely reversed by adequate hemodialysis, even optimally dialyzed patients will usually not return to normal neurocognitive function. To investigate the influence of chronic renal failure and hemodialysis on higher cognitive function electrophysiologically, we studied auditory P300 event-related potentials in 14 hemodialysis patients and 14 age- and sex-matched normal healthy controls. Methods : The subjects consisted of 14 patients(M: 6, F: 8) with chronic renal failure(CRF) for 1 to 10 years and 14 age- and sex-matched healthy controls(M: 5, F: 9). For the reliability of study, patients with diabetes mellitus, abnormal brain CT findings, or low mini-mental state score(below 20) were excluded. Event related potentials(ERPs) for hemodialysis patients were performed at pre- and post-hemodialysis. To obtain ERPs, subjects underwent 2-tone auditory discrimination test(oddball paradigm). Results : Although the age(control: $48.79{\pm}10.31years$, CRF: $51.21{\pm}7.61years$) and mini-mental state score(control: $27.00{\pm}1.71points$, predialysis CRF: $25.07{\pm}3.58points$) were not different in normal control and CRF groups significantly(P>0.05), P300 latencies at Cz(control: $288.11{\pm}17.36msec$, predialysis CRF: $332.35{\pm}42.34msec$) were significantly delayed(P<0.05)and the duration of Trail making test A was significantly prolonged(control: $64.2{\pm}24.2sec$, CRF: $118.9{\pm}101sec$) in CRF group. P300 latencies between pre- and post-hemodialysis CRF patients(predialysis CRF: $332.35{\pm}42.34msec$, postdialysis CRF: $325.82{\pm}38.69msec$) were not significantly different. The P300 latency was not related with the duration of CRF(Spearman's correlation test, r=0.25, P>0.05) and the frequency of hemodialysis(Spearman's correlation test, r=0.28, P>0.05). Conclusions : From these results, we suggest that P300 latency is valuable in evaluating cognitive brain dysfunction in patients with CRF and hemodialysis does not have a significant effect on cognitive brain dysfunction in patients with CRF.
Journal of Korean Academy of Nursing Administration
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v.5
no.2
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pp.297-316
/
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.
Purpose: The purpose of this study was to examine the effect of topical lidocaine cream on pain and anxiety during the AV fistula puncture among hemodialysis patients. Methods: The study employed one group repeated measurement design. The data were collected from 50 hemodialysis patients who received AV fistula puncture. The topical lidocaine cream was applied 30 minutes before the puncture. The data were measured total 3 times (T1=without lidocaine, T2=2% lidocaine, T3=5% lidocaine). Pain was measured by VAS and a behavioral checklist. Anxiety was measured by Korean manual of SCL-90-R. Results: Patients with 5% lidocaine cream reported significantly lower of VAS pain score than those with 2% lidocaine and without lidocaine. Patients with 2% lidocaine cream reported significantly lower of behavioral pain scores than those without lidocaine, but less effective than 5% lidocaine cream. Patients with 2% lidocaine cream reported significantly lower of anxiety scores than those without lidocaine, but less effective than 5% lidocaine cream. Conclusion: Topical application of lidocaine cream for 30 minutes before AV fistula puncture significantly decreased pain and anxiety among hemodialysis patients. Specifically 5% lidocaine was more effective than 2% lidocaine for both pain and anxiety.
This study examined and identified the relationship between the level of hope and self-care agency in hemodialysis patients. The purpose of the study was to reveal that hope is an essential factor to enhance self-care agency and to prepare the basic materials to help nurse the patients. The subjects for this study consisted of 108 persons who undergoing hemodialysis from 2 hospital, 2 hemodialysis center in Pusan, Korea. The degree of hope was measured by the questionnaire that has been developed by Miller. The self-care agency was measured by the questionnaire that has been developed by Kearney B.Y & Fleisher B.J. The collected data were analyzed by descriptive statistics and t-test. one-way ANOVA and Pearson's Correlation Coefficient with SPSS WIN program. Results were obtained as follows: 1) The mean scores of hope were $131.77{\pm}25.77$(range 67-195). The rate of hope classified said that the lowest hope was 2.8% and low hope was 27.8%. 2) The mean scores of self-care agency were $143.78{\pm}23.63$(range 74-187). The degree of self-care agency classified said that the rate of self-care agency deficiency was 0.9% and low self-care agency was 12.0%. 3) The hope was significantly related to self-care agency. That is, the higher the hope score was, the higher the level of self-care agency score(r=0.668,p=0.001) was. In this result, there were hemodialysis patients who have very low hope score and self-care agency score. In this cases self-care agency can be increased by encouraging the patients to be more hopeful. Conclusively nurses should access the degree of hope and self-care agency of hemodialysis patients individually and apply the hope therapy in order that the patient have higher hope than before.
Purpose : This research is aimed at developing a substantive theory related to the experience of adjustmented hemodialysis patients by identifying and analyzing the nature, process, and types of adjustment experienced by them. For this purpose, this study takes a grounded theory approach. Method : Data were collected from April, 2002 through September, 2002 through in-depth interviews and close observations of eleven hemodialysis patients who have experienced adjustment. With their consent, the interviews were recorded by audio tapes and later transcribed. Observation memos were also prepared on the subjects' behavior during the interviews. Data collection continued until saturated. The data were analyzed into concepts, subcategories, and categories with the open coding process. The axial coding was done to identify the relationships of the concepts and categories. And the selective coding was done to develop a core category, which is the central phenomenon of the hemodialysis patients who experienced adjustment. Result : This process resulted in 88 concepts, which may be grouped into 24 subcategories and 6 core categories. The 6 categories, in fact, depict the process of changes the patients experience from the sense of crisis, self-control, new life meaning, support system, coping ability, and quality of life improvement. And its core is self-control, which encompasses the dynamic stages from recognition, change attempts, belief solidification, and empowerment. Conclusion : The results of the research offer the following implications. First, research on adjustment is a formative stage in nursing, it is imperative for nursing researchers to develop them, which may be more relevant to nursing. Second, it is important to develop nursing intervention techniques that may be most effective in adjustment of hemodialysis patients and at the same time for each stage of changes taking place in adjustmented hemodialysis patients.
Sohn, Hyun Sook;Lee, Mi Jin;Kang, Seon Mi;Han, Young Ok;Moon, Kyung Hee;Kim, Dong Il;Lee, Yun Joo;Jeon, Justin Y.;Chu, Sang Hui
Journal of Korean Biological Nursing Science
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v.15
no.1
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pp.15-23
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2013
Purpose: The purpose of this study was to identify the relationship among the attitudes on exercise, physical activity and quality of life (QOL) in hemodialysis patients. Methods: A total of 42 patients in a hemodialysis unit participated in this study. Physical activity level was measured directly by 6 minute walking test and grip strength test. Structured questionnaires were also used for measuring their attitudes on exercise, physical activity and QOL. Participants' medical records were reviewed for obtaining their biochemical and clinical information. Statistical analysis was performed using Pearson correlation, and multiple liner regression. Results: A significant positive correlation between participants' attitudes and physical activity level measured by International Physical Activity Questionnaire (IPAQ) was found. And the physical activity level measured by Korea Activity Scale/Index (KASI) was significantly related to QOL. Conclusion: This study shows that QOL of the hemodialysis patients was significantly associated with their physical activity level.
Purpose: The purpose of this study was to explore the meaning and essence of good nursing from the perspective of patients undergoing hemodialysis. Methods: The data were collected through in-depth interviews of five hemodialysis patients who have been dialyzed for one year or longer. The data analysis was conducted using the Giorgi's phenomenological method. Results: The findings included six constituents and 13 sub-constituents. The six constituents were 'prompt and skillful response to mitigate distress', 'careful attention to provide relief', 'individualized education to promote self-management', 'an intimate relationship to regain isolated ego', 'warmhearted support to encourage strength to live in a exhausting life', and 'providing of comfortable environment to maintain stability'. Conclusion: From the perspective of the hemodialysis patients, the concept of good nursing should stem from the integration of nurses' scientific knowledge, expert skills, and moral sensitivity. The finding suggests that strategies to develop nursing interventions for hemodialysis patients will be required on the basis of understanding of their sociocultural contexts and familism.
Journal of Korean Academy of Fundamentals of Nursing
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v.26
no.1
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pp.23-31
/
2019
Purpose: This study was a descriptive survey research to identify the factors that influence sick role behavior compliance in patients on hemodialysis. Methods: Structured surveys were used to collect data from 170 patients who are on hemodialysis three times a week through outpatient care at a university hospital located in G City using tools measuring resilience, family support, and sick role behavior compliance. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficient, and Stepwise multiple linear regression. Results: The results showed that factors that influenced sick role behavior compliance in the subjects were in the order of family support (${\beta}=.27$, p<.001), age (${\beta}=.27$, p<.001), and resilience (${\beta}=.23$, p=.003). Resilience, family support, and sick role behavior compliance were positively correlated. Factors influencing hemodialysis patients' sick role behavior compliance included family support, age, and resilience. These variables explained 30.2% of the variance in sick role behavior compliance. Conclusion: Based on these results, care intervention and the development of a training program that involves family in the treatment plan and process to support and encourage patients are needed to increase the sick role behavior compliance in patients on hemodialysis.
This study was a qualitative investigation into hemodialysis patients' dietary practices. The purpose of this study was to explore the obstacles and requirements to maintain a recommended diet therapy in hemodialysis patients. Five patients undergoing hemodialysis in the renal chamber of the general hospital were interviewed individually. The interviews were based on an interview guide and analyzed by Giorgi's method of analysis. As a result of this study, five elemental factors and 12 subelemental factors were derived. Derived elements were "difficulty in dietary guidelines", "recognizing necessity of diet therapy", "awareness of importance of diet", "difficulty practicing diet therapy", and "looking for ways to practice diet therapy". Patients not only felt difficulties in practicing dietary guidelines but also recognized the need and importance of diet therapy. Patients seemed to have difficulty practicing meal therapy and eating with their families or others. They were also stressed by the limited selection of dietary components and rapid dietary changes before and after dialysis. However, patients showed a willingness to implement dietary management to improve their quality of life and to practice dietary therapy. In order to improve the practice of dietary management in hemodialysis patients, nutritional education should be focused on long-term dietary habits through continuous education and monitoring, not just one-off education. Moreover, patients should be educated that adherence to dietary control may be less burdensome on their families.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.7
/
pp.4816-4827
/
2015
The purpose of this study was to identify the experience symptoms and severity of hemodialysis patients and to determine the effects of each symptom on health related quality of life. This research involved 102 patients who were receiving hemodialysis at one university hospital and two Kidney Center in D city. Data collection were collected from April to May 2014. Data analysis was performed by SPSS/WIN 18.0 using ANOVA, t-test, Pearson correlation and stepwise multiple regression. Fatigue was the highest among symptoms on hemodialysis patients and dry skin, itching was in order. Factors affecting health related quality of life were income and symptoms level. These factors explain 42.2% of the variance in health related quality of life. Based on the results, it is necessary to develop various programs and apply for nursing interventions to alleviate the experience symptoms and severity and expand support in social service perspective in hemodialysis patients. Especially, we suggest that further research for developing nursing interventions for relieving fatigue, itching, and sleep disorders of hemodialysis patients.
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