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 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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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).