The purpose of this study was to construct a grounded theory as the basis for nursing intervention by describing and analysing the holistic lived experiences of clients receiving long-term hemodialysis. The subjects of this study were fifteen persons receiving regular hemodialysis regimen at artificial kindly treatment centers in two different university hospitals, and who were able to participate in conversation and were available for long and deep interviews. Eight of the subjects were male and seven were female and their ages ranged from 30's to 60's. The length of the hemodialysis experience ranged from two months to six years. The collection and analysis of data were done in accordance with the grounded theory methodology of Strauss and Corbin. The method to collect the data mainly depended on long and deep interviews, participant observation and focused group interviews and the equipment used to collect data were a portable tape recorder and field notes. The study is summarized as follows: 1. The meaning of holistic lived experiences of clients receiving long-term hemodialysis was found to be uncertainty, which was identified as the core category. 2. The main categories following the core care category were found to be shock, ambiguity, social support and quality of life. 3. Through the main category the type of behavior newly formed by clients receiving long-term hemodialysis was found to be as follows. That is to say, in the circumstances of shock caused by the identified fact and the ambiguity of hemodilysis they formed a quality of life based on social support, which was found to be kind of chaotic phenomenon. 4. The lived experiences of clients receiving long-tern hemodialysis was found to include nine categories ; emotional shock, feelings of isolation, burden, unclearness, dependency, help from others, coping strategies, maintenance of self-esteem and transitional life. 5. The intervening factors influencing each category are as follow : 1) The factors influencing 'emotional shock' were found to be sex, age, the level of knowledge received in advance, locus of control, the period of struggle against the disease before hemodialysis and whether any serious illness existed. 2) The factors influencing 'feelings of isolation' were found to be religion and the length of the hemodialysis experience. 3) The factors influencing 'burden' were found to be sex, economic situation, economic situation, employment status and the length of the hemodialysis experience. 4) The factors influencing 'unclearness' were found to be-sex, age, religion, economic situation, the length of the hemodialysis experience, whether they had a transfusion and whether there were any complications. 5) The factors influencing 'help from others' were found to be religion, economic situation, past experiences and whether family members lived together. 6) The factors influencing 'coping strategies' were found to be age, level of education, experiences of illness and locus of control. 7) The factors influencing 'maintenance of self-esteem' were found to be the length of the hemodialysis experience and self-actualization. 8) The factors influencing 'transitional life' were found to be age, religion, economic situation, employment status, locus of control, past experiences and whether there was a plan for a kidney transplant.

The purpose of this study was to discover practical health problems which hemodialysis clients experienced so as to present basic data for development of a health assessment tool. The research subjects were 70 clients receiving hemodialysis in Seoul and Inchon from Mar. 1996 to Sep. 1996. Data were collected by researcher's informal indepth interview and nurses' open ended question. Content analysis was applied to collect similar contents and common experiences in order to derivate concepts and categories for better understanding of hemodialysis clients' experiences. As a result, 9 categories derivated to identify the health problems of clients receiving hemodialysis were as follows: 1) They experienced 'the decreased digestive function' which contained the changed appetite, nausea, vomiting, constipation and diarrhea. 2) They experienced 'the decreased respiratory and circulatory function' which contained dyspnea, changed blood pressure, tingling sensation and the fear of aggrevated vascular condition. 3) They experienced 'the aggrevated oral condition' which contained dry mouth and destruction of teeth and their soft tissue. 4) They experienced 'the decreased sensory function' which contained visual disturbances, sensation difficulty, and hearing loss. 5) They experienced 'the aggrevated skin condition' which contained dark brown skin color, dry skin (and hyperpigmentatic freckle, seborrheric kera-tosis, scale), itching sense, and alopethia. 6) They experienced 'the decreased urinary reproductive function' which contained anuria or oliguria, dysmenorrhea, sterility and decreased libido. 7) They experienced 'the restricted activity' which contained decreased activity, muscle cramp and stiffness of joint. 8) They experienced 'the changed mental status' which contained memory disturbance, decreased cognition, disorientation, neurosis and psychosis. 9) They experienced 'the aggrevated general condition' which contained kyphosis, weight loss, fatigue, sleep disturbance, bleeding tendency, inflammation, generalized edema and foul Oder of uremia.