• Journal of Yeungnam Medical Science
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• 제34권1호
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• pp.69-74
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• 2017

Background: Chronic kidney disease is considered a risk factor for thyroid nodules as well as thyroid dysfunction such as hypothyroidism. Among patients on hemodialysis, we assessed the size of thyroid nodule and goiter at baseline and 1 year later with ultrasonography. Methods: We prospectively selected 47 patients with hemodialysis at January 2012 and reviewed their medical records. We checked goiter and thyroid nodules at January 2012 and December 2012. Results: In the hemodialysis patients (n=47), 24 patients (51.1%) had thyroid nodules and 33 patients (70.2%) had goiter at baseline. Parathyroid hormone (PTH) was higher in patients with thyroid nodules ($204.4{\pm}102.9$ vs. $129.9{\pm}93.6pg/mL$, p=0.01). Thyroid ultrasonography was conducted in 29 patients after 1 year. The thickness of the thyroid isthmus increased ($2.8{\pm}1.6$ vs. $3.2{\pm}1.9mm$, p=0.003), but the number of nodules did not change ($1.2{\pm}1.9$ vs. $1.4{\pm}2.0$, p=0.109). PTH was associated with the enlargement of thyroid nodules significantly through logistic regression analysis. Conclusion: Thyroid goiter and nodules in hemodialysis patients were more prevalent than in the general population. PTH influenced the production of thyroid nodules in hemodialysis patients. Regular examination with thyroid ultrasonography and thyroid function test should be considered in hemodialysis patients.

• 대한불안의학회지
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• 제2권2호
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• pp.128-135
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• 2006

Objective : In this study, we investigated the prevalence of depression and its impact on the healthrelated Quality of life (HRQoL) of the patients with End-Stage Renal Disease (ESRD) on Hemodialysis. Method : The Quality of life (QOL) of patients was evaluated by HRQoL Questionnaire, "Medical Outcome Survey 36-Item Short Form Health Survey Korean Version (SF-36-K)". The patients on Hemodialysis in ESRD, were chosen from the hemodialytic room at Wonkwang University and Jeongeup-Asan Hospital. The number of patients was 95 (64 from Wonkwang University Hospital and 31 from Jeongeup-Asan Hospital) and all of them were above 19 years old. We performed various investigations to find a statistical correlations between HRQoL and physical & psychosocial factors such as the demographic characteristics, clinical characteristics (hemoglobin level and albumin level etc), and the score of Beck's depressive inventory (BDI). Results : The HRQoL value of patients on hemodialysis in ESRD is far poorer than the HRQoL reference value of Koreans and Americans, who are in normal healthly. The prevalence of depressive symptoms by BDI of the ESRD patients on hemodialysis is 68.6%, and age and depression have negative correlations with HRQoL of the patients. However, education level, serum albumin level, and social support have positive correlations with HRQoL. The patient group with depression has significantly poorer HRQoL than the group without depression. Conclusion : The HRQoL of ESRD patients on hemodialysis is not good in both physical and mental aspects. The prevalence of depression is very high and depression has negative impact of HRQoL of patients. Based on our study, it is essential to accompany with therapeutic Strategy to improve the HRQoL of ESRD patients on hemodialysis.

• 임상간호연구
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• 제23권3호
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• pp.388-397
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• 2017

Purpose: The purpose of this study was to explore the effects of the lower limb muscle strength exercise program during hemodialysis on the leg strength and falls efficacy (fall-related self-efficacy) of hemodialysis patients. Methods: The study was designed to be a quasi-experimental, nonequivalent control group pre and post test design. A total of 42 patients participated in the study. We applied lower limb muscle strength exercise program to the experimental group in every hemodialysis three times a week for 8 weeks. Data were analyzed using ${\chi}^2$ test, fisher's exact test, t-test and repeated measures ANOVA. Results: The mean age was 58 years old (t=-1.54, p=.132), the mean hemodialysis period was 67 months (t=1.949, p=.058) and there was no significant difference of dependent variable (t=1.17, p=.251)(t=-.89, p=.381) between the two groups before the experiment. After the experiment, leg strength was significantly improved in the experimental group compared to that of the control group (F=6.63, p=.004). However, falls efficacy was not significantly different between the experimental group and the control group (F=2.33, p=.104). Conclusion: The study results indicated that the lower limb muscle strength exercise program during hemodialysis may improve leg strength and potentially to prevent falls for hemodialysis patients. Further studies are warranted in which larger number of participants and longer duration of intervention are recommended.

• 근관절건강학회지
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• 제22권3호
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• pp.160-166
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• 2015

Purpose: The purpose of this study is to examine the effect of leg crossing on reducing orthostatic hypotension and orthostatic hypotension symptoms in hemodialysis patients. Methods: A one-group pretest-posttest design was used. A total of 40 post-hemodialysis adult patients were enrolled, excluding the case of intradialysis hypotension, unbalance of standing with leg crossing, adding antihypertensive medications. Blood pressure (BP) and heart rate (HR) were measured in supine and standing positions. After a week, BP and HR were measured in supine and standing with leg crossing position. Orthostatic hypotension symptoms were also measured by self-reported structured questionnaire in standing without leg crossing and with leg crossing position. Results: We found out that systolic blood pressure, diastolic blood pressure, and mean arterial pressure increased significantly in standing with crossing leg position applied (p=.006, p=.001, p=.006). However, presences of orthostatic hypotension symptoms were not significantly decreased in standing with leg crossing position (p=.500, p=.318, p=.306, p=.241, p=.356, p=.500, p=.241, p=.308). Conclusion: This study shows that leg crossing is effective for reducing orthostatic hypotension without additional cost or instruments. Leg crossing as one of the preventive interventions to reduce orthostatic hypotension is easier and simpler to be implemented in hemodialysis patients.

• 한국융합학회논문지
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• 제10권8호
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• pp.299-308
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• 2019

본 연구는 당뇨병성 신증 혈액투석환자들의 자가관리와 자기효능감이 혈액투석 관련 증상에 미치는 영향을 파악하고자 시행되었다. 2017년 9월부터 11월까지 3곳의 대학병원과 7곳의 개인병원에서 254명을 대상으로 시행되었다. 자료 분석은 t-test, ANOVA, Scheffe test, Pearson correlation, 다중회귀분석을 이용하였다. 연구결과 경제상태가 안정되고 당뇨합병증이 없을 경우, 자가관리와 투석 관련 자기효능감이 높을수록 환자의 혈액투석 관련 증상이 낮았다. 이에 경제적인 지원이 국가적인 차원에서 이루어져야 하고 당뇨합병증을 미리 예방하기 위한 관리가 필요하며, 질병 특이적인 자가관리 프로그램을 운영하여 관리에 대한 자기효능감을 높일 수 있도록 해야 할 것이다.

• 임상간호연구
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• 제21권2호
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• pp.215-222
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• 2015

Purpose: For hemodialysis, a vascular access which can maintain a certain speed for a long time is required. The prevention of the vascular access dysfunction is very important to decrease morbidity and to improvethe quality of life of patients receiving hemodialysis It is reported that far infrared heat increases the blood flow by expanding capillaries and micro-arteriovenouses. This study aimed to evaluate the effect of far infrared heat therapy as a new nursing intervention for maintaining vascular access function and improving the blood flow of patients receiving hemodialysis. Methods: The quasi-experimental research of nonequivalent control group pre-post test design was carried out for 59 patients receiving hemodialysis 3 times per week at K medical center. A far infrared heat was applied to the experimental group for 3 months. Results: The arteriovenous fistula blood flow of the experimental group (far infrared heat therapy group) increased significantly when compared to the control group (p=.047). However, static intra-access pressure ratio(SIAPR)was not different statistically (p=.101). Conclusion: The far infrared therapy could be considered as nursing intervention of choice as it demonstrated increase in the arteriovenous fistula blood flow in the patients receiving hemodialysis.

• 디지털융복합연구
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• 제15권9호
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• pp.321-333
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• 2017

본 연구의 목적은 만성신부전환자의 혈액투석 후 삶의 재구성 경험을 이해하고, 그들의 생생한 경험의 의미를 밝히기 위함이며, 연구 방법은 질적연구 방법 중 Colaizzi의 현상학적 연구방법을 이용하였다. 연구대상은 만성신부전증을 진단받고 혈액투석 중인 8명의 환자를 대상으로 개별 심층면담을 통해 자료수집을 진행하였다. 연구결과 도출된 5개의 범주는 '예기치 못한 어려움의 시작', '혈액투석이 가져온 생존의 버거움', '재기의 원동력', '내일을 살기 위한 오늘의 선택과 집중', '정성껏 엮어가야만 하는 일상'으로 나타났다. 본 연구결과를 통해 의료인들은 만성신부전환자가 혈액투석을 하면서 경험하는 신체적, 정신적 고통과 변화된 삶의 방식에 적응하기 위하여 그들이 부단히 노력하는 방법을 심층적으로 이해하는데 도움이 될 것이다. 또한 향후 혈액투석 환자의 건강관리를 위한 효율적인 간호중재를 개발하는 데 기초자료가 될 수 있을 것이라 생각된다.

• 임상간호연구
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• 제19권2호
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• pp.285-297
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• 2013

Purpose: This study was conducted to investigate the differences in sleep disturbance, stress, self-efficacy and depression by fatigue level and to identify the factors influencing fatigue in hemodialysis patients. Methods: This study used a cross-sectional design and the subjects were 195 patients undergoing hemodialysis in a local unit. Data were collected using a structured questionnaire and medical records from June to August 2012. The data were analyzed using descriptive statistics, independent t-test, one way ANOVA, $Scheff{\grave{e}}$ test, and Pearson's correlation coefficients. Also a multiple regression analysis was used to assess the independent association between fatigue status and indices of sleep disturbance, stress, self-efficacy and depression. Results: A total of 99 (50.8%) subjects experienced a high level of fatigue and 96 (49.2%) experienced a low level of fatigue. There were significant differences in the levels of sleep disturbance, stress, self-efficacy and depression between the two groups. Fatigue was significantly correlated to sleep disturbance, stress, self-efficacy and depression. The most important factor related to fatigue was stress, followed by sleep disturbance. These factors explained about 37% of fatigue of the respondents. Conclusion: The results of this study showed that sleep disturbance and stress were significant predictors of fatigue in hemodialysis patients. Possible interventions for minimizing fatigue in patients undergoing long-term hemodialysis should be aimed to manage the known contributing factors.

• 임상간호연구
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• 제21권1호
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• pp.21-30
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• 2015

Purpose: The study was conducted to identify the effects of holistic breathing using biofeedback on fatigue, depression, and sleep disorders of hemodialysis patients. Methods: A quasi-experimental study was conducted with a nonequivalent control group non-synchronized design and pre-post tests. Data were collected from August 20, 2012 to April 6, 2013. Twenty-five patients were assigned to an experimental group and twenty-five patients were assigned to a control group. Holistic breathing using biofeedback was applied during hemodialysis in a hospital with a frequency of twice a week for five weeks. Patients practiced 10 minutes of the holistic breathing twice daily for while at home. Chi-square and t-test were utilized for analyzing the data using SPSS 18.0. Results: Hemodialysis patients who practiced the holistic breathing using biofeedback experienced significantly lower levels of fatigue (t=2.612, p=.012), depression (t=3.390, p=.001), and sleep disorders (t=2.016, p=.049) when compared to the control group. Conclusion: The results indicate that the holistic breathing using biofeedback is an effective nursing intervention for patients receiving hemodialysis for the management of fatigue, depression, and sleep disorders.

• Journal of Korean Biological Nursing Science
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• 제3권1호
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• pp.29-40
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• 2001

The purpose of this study was to investigate the effect of exercise training on work capacity, psychologic functions and quality of life in hemodialysis patients. Forteen hemodialysis patients, 3 males, 11 females, age ranged from $23{\sim}58$ years($42.3{\pm}0.4$) were selected and assessed using a modified Bruce protocol on a treadmill. The 3 months supervised exercise training consisted of 60 minites session thrice weekly on the treadmill, bicycle and arm ergometer at $40{\sim}60%$ of maximum $O_2$ consumption. The changes of maximum $O_2$ consumption, psychologic test and quality of life questionnaire in 14 patients before and after 3 months exercise training have been measured. The mean maximum $O_2$ consumption($VO_2$ max) of exercises increased by 23% after training(pre-and postexercise $26.3{\pm}4.6ml$/kg/min vs $29.8{\pm}4.9ml$/kg/min, p=0.013). There was significant reduction in anxiety score(p=0.004) and significant improvement in quality of life score(p=0.031) after training. The result of this study indicated that a structured exercise training for hemodialysis patients provides many benefits. These result suggest the exercise training can improve the work capacity, psychologic functions and quality of life outcomes in hemodialysis patients.