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  Frontiers in Public Health.2024;[Epub]     CrossRef
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  Meg E. Letton, Thái Bình Trần, Shanae Flower, Michael A. Wewege, Amanda Ying Wang, Carolina X Sandler, Shaundeep Sen, Ria Arnold
  Journal of Medical Systems.2024;[Epub]     CrossRef
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  PLOS ONE.2024; 19(1): e0297107.     CrossRef
• The effect of an educational app on hemodialysis patients’ self-efficacy and self-care: A quasi-experimental longitudinal study
  Amin Hosseini, Alun C Jackson, Najmeh Chegini, Mohsen Fooladzadeh Dehghan, Danyal Mazloum, Shima Haghani, Fatemeh Bahramnezhad
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  Haegyeong Lee, Gyuli Baek, Eunju Lee
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• The effectiveness of structured educational programs for hemodialysis patients in Korea: an integrated literature review
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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 identify the effect of structured patient education on knowledge and behavior about selfcare in hemodialysis patients, and to find the strategy to promote their selfcare behavior. In conclusion, structured patient education in hemodialysis patients was improved the level of knowledge and behavior about selfcare. But there was a little relationship between the knowledge and behavior about selfcare. That is ; structured patient education is the effective nursing intervention to improve their selfcare knowledge and behavior, but further research is needed to find the factor to increase selfcare behavior in hemodialysis patients.

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.

It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calroie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis, which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon -rank sums test, Scheffe test, Kruskal -Wallis test and Pearson correlation coefficients. The results are following; 1. There was no significant difference in the calorie and proten intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index, triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea mtrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine incresed significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However, each of biochmical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status mearsured with protein and calroie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

The purpose of this study is to develop self-efficacy promotion program and to test its effects on self-efficacy, self-care, physiologic index of hemodialysis patients after applying this program to them. Preliminary study was carried out to identify the levels and types of self-care, self-efficacy of hemodialysis patients. To develop self-efficacy promoting program, several discussions with nursing professors and nurse specialists on hemodialysis patients were made after in-depth literature review on the area. Through these processes, the self-efficacy promoting program including 20 minutes long videotape and other counciling documents were completed. This videotape consisted of specific self-care techniques for hemodialysis patients including management of fistula, measurement of blood presure and body weight, special diets, medications, exercise and rest, management of physical problems and social adjustment. Two group equivalent pre and post test quasai-experimental research design was used in this study. The total subjects were 34 hemodialysis patients who received hemodialysis three time per week at 1 university hospital. Seventeen experimental group subjects were matched with control group subjects in sex and age. Data were analysed with the SPSS window program. Homogeniety between experimental and control group pretest data was tested by 2 and t-test. There were no significanct differences in general characteristics, illness history, specific self-efficacy and self-care between the two groups. The differences of general self-efficacy of two groups were tested with the Repeated Measure ANCOVA because of significant differences of pretest data of general self efficacy between two groups. The differences of self-efficacy and self-care of two groups were tested with Repeated Measure ANOVA and the differences of physiologic indecies including blood potassium level and blood phosphorus level and interdialytic weight gain were tested by t-test. The results were as follows: 1. There was no significant difference in general self-efficacy between the two groups over four different time, and no interaction by groups and by time. 2. There was significant difference in specific self-efficacy between the two groups over four different time, and interaction by groups and by time. 3. There was significant difference in self-care between the two groups over four different time, and interaction by groups and by time. 4. There were no significant differences of blood potassium level and blood phosphorus level, but there was significant difference of interdialytic weight gain between the two groups. From the results above, it can be concluded that the self-efficacy promotion program for hemodialysis patients was effective to improve degree of specific self-efficacy and self-care and to decrease interdialytic weight gain. Considering results, the followings are recommended: 1) Repeated studies are needed for another hemodialysis patients. 2) This program can be used for improving degree of self-efficacy and self-care of hemodialysis patients by nurse practitioner and nurse educator.

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  Yoon Jung Chae, Hee Sun Kim
  Japan Journal of Nursing Science.2024;[Epub]     CrossRef
• The Effects of Spiritual Well-being on Self-care Practices in People Undergoing Hemodialysis: The Mediating Effect of Hope
  Bu Kyung Kim, Pok-Ja Oh
  Korean Journal of Adult Nursing.2022; 34(6): 592.     CrossRef
• The Effect of Uncertainty on the Physiological Indexes of Hemodialysis Patients: Serial Mediating Effects of Uncertainty Appraisal and Self-care Behavior
  Mi Kyung Kim, Eun Hee Jang
  Korean Journal of Adult Nursing.2022; 34(1): 51.     CrossRef
• The Effects of Tailored Dietary Education among Role Failure Hemodialysis Patients on Self-care Compliance, Self-efficacy and Physiologic Indices
  Sangsuk Kim, Youngsil Choi
  The Korean Journal of Rehabilitation Nursing.2021; 24(1): 46.     CrossRef
• Factors Influencing Self-Care Behavior and Treatment Adherence in Hemodialysis Patients
  Hana Kim, Mi-Kyoung Cho
  International Journal of Environmental Research and Public Health.2021; 18(24): 12934.     CrossRef
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  Youngsoon Min, Myonghwa Park
  Healthcare Informatics Research.2020; 26(2): 93.     CrossRef
• Effects of a Repeated Hemodialysis Diet Education Program for Older Adults
  Sangsuk Kim, Youngsil Choi
  Korean Journal of Adult Nursing.2020; 32(5): 515.     CrossRef
• Factors Influencing Self-Care Behaviors of Renal Dialysis Patients
  Yoonjung Kim, Sanggeon Park
  STRESS.2019; 27(4): 320.     CrossRef
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  Eun Sook Kim
  Journal of Clinical Nursing.2018; 27(21-22): 4179.     CrossRef
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  Kyungmi Lee, Semi Lim, Younhee Kang
  Korean Journal of Adult Nursing.2017; 29(6): 637.     CrossRef
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  Mi‐Kyoung Cho
  Nursing & Health Sciences.2013; 15(1): 86.     CrossRef
• Effects of a Face-to-face Self-management Program on Knowledge, Self-care Practice and Kidney Function in Patients with Chronic Kidney Disease before the Renal Replacement Therapy
  Eun Sung Choi, Jia Lee
  Journal of Korean Academy of Nursing.2012; 42(7): 1070.     CrossRef

The hemodialysis patients with chronic renal disease have experienced negative emotions, especially depression among with physical, social, and psychological changes. Based upon a stress-coping theory, group imago psychotherapy which can induce effective coping through self awareness and positive emotional responses is implemented to the hemodialysis patients. The effects of the imago psychotherapy in regards to comfort and depression are studied here. Group imago psychotherapy was performed on forty-three subjects(twenty subjects in the experimental group and twenty-three subjects in the control group). The results of the study were as follows. After being given group imago psychotherapy, the comfort scores of the experimental group were significantly higher than those of the control group (F=15.33, p= .003). Moreover, after being given treatment, the depression scores of the experimental group were significantly lower than those of the control group (F=9.14. p=.0044). Specifically, the scores on comfort in the experimental group under emotion-focused coping style were significantly higher than those of the control group (F=18.59, p= .0002). The mean difference on comfort scores in the experimental group under problem - focused coping style was higher than that of the control group. But their scores were not significant (F=0.19, p= .6729). The scores on depression in the experimental group under emotion-focused coping style were significantly lower than those of the control group (F=14.62, p= .0006). The mean difference on depression scores in the experimental group under problem - focused coping style was much lower than that of the control group. But their scores were not significant (F=0.31, p=.5947). There was a significant positive correlation between comfort and depression variables. After group imago psychotherapy the hemodialysis patients recognized positive changes in emotional reponses, self awareness, self control, ease of mind, and felt overall more relaxed. Imago psychotherapy is a nursing intervention which as this study has shown can improve to comfort. The
results
of this study can be applied to general nursing practices. In the view of holistic nursing, the development of the nursing practice combined with imago psychotherapy will contribute to the enlargement of the nursing field with conventional nursing practices.

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 alphain 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 alphawas .9333. Depression instrument was 20 questions modified BDI(Beck Depression Inventory) to meet hemodialysis patients' conditions, and Cronbach's alpha was .92. The period of collecting data was from March 6 to 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 - 1.13618X1 + 2.66213X2(X1: Depression, X2 : Marriage), The explanation of the total regression expression appeared to be 52.578%.

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• Factors Related to Suicidal Ideation of Kidney Patients
  Eun-mi Lee, Nam-Soo Hong, Su-Jin Lee
  Journal of Health Informatics and Statistics.2018; 43(3): 184.     CrossRef
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  Young-Mi Chun, Sang-Youn Park
  Journal of the Korea Academia-Industrial cooperation Society.2015; 16(7): 4816.     CrossRef
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  Mi Kyung Kang, Sun Mi Kang, Soo Young Kim
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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.

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• The Effects of Auricular Acupressure on Pruritus, Skin Dryness, and Depression in Hemodialysis Patients
  Eunyoung Choi, Kyungsook Park
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• Interventions for chronic pruritus of unknown origin
  Andrea Andrade, Chii Yang Kuah, Juliana Esther Martin-Lopez, Shunjie Chua, Volha Shpadaruk, Gloria Sanclemente, Juan VA Franco
  Cochrane Database of Systematic Reviews.2020;[Epub]     CrossRef
• Interventions for pruritus of unknown cause
  Andrea Andrade Miranda, Juan VA Franco, Gloria Sanclemente, Chii Yang Kuah, Ashley M Yu, Volha Shpadaruk, Marta Roqué i Figuls, Juliana Esther Martin-Lopez, Sean Chua
  Cochrane Database of Systematic Reviews.2018;[Epub]     CrossRef

The purpose of this study was to investigate the spiritual well-being of hemodialysis patients and the correlation between spiritual well-being and demographic characteristics and disease related characteristics. The subjects for this study were 98 patients who were diagnosed as having chronic renal failure and were being treated at the hemodialysis units of three hospitals located in Seoul, Pusan and Taegu, Korea. Data were collected from October 27, 1997 to November 15, 1997 by an investigator interviewing with a structured questionnaire. Palautizion and Ellison(1982)'s spiritual well-being scale was used after some modification. The results of this study are as follows; To analyze the differences between demographic characteristics, spiritual well-being, and disease characteristics and the spiritual well-being, T-test and ANOVA were used. 1. There were statistically significant differences in spiritual well-being for the demographic characteristics of age(p=0.0145) religious affiliation(p=0.0001) and level of education(p=0.04). 2. There were statistically significant differences in spiritual well-being for the disease characteristics perceived health status(p=0.0014) and vigor(p=0.01). 3. The mean score for spiritual well-being in hemodialysis patients was 57.10of a possible range 22-88. Among the components of spiritual well-being, the mean score for religious well-being was 27.01 of a possible range 11-44, and for existential well-being 30.09 of a possible range of 11-44. 4. Correlation between general characteristics and spiritual well-being showed that there were significantly positive correlations for level f education(p=0.0036), perceived health status(p=0.0001), vigor(p=0.0036), perceived health status(p=0.0001), vigor(p=0.0036) and religion (p=0.0004).

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