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3 "Psychological Factors"
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Original Articles
Fatigue and its Related Factors in Patients on Hemodialysis
Hye Ryoung Kim
Journal of Nurses Academic Society 1996;26(1):53-72.   Published online March 30, 2017
DOI: https://doi.org/10.4040/jnas.1996.26.1.53
AbstractAbstract PDF

The Purpose of this study was to identify characteristics of fatigue and the relationship between fatigue and related factors in patients on hemodialysis. This study was a survey study using a cross-sectional design. The subjects for this study were 101 patients on hemodialysis who were registered in the six hemodialysis clinics among a total of eleven clinics in Seoul. The period of data collection was from February 28, 1995 to May 2, 1995. Data were collected through an interview with a structured packet and the physiological data. The tools used in this study were the Visual Analogue Scale-Fatigue developed by Lee et al(1990) and translated by Lee (1991), the fatigue interview schedule developed by this reseacher, Zung's self rating depression scale (Zung, 1965), the self-efficacy scale developed by Sherer et al(1982) and the Norbeck Social Support Questionnaire (NSSQ) translated by Oh (1984). The collected data were analyzed using descriptive statistics (mean, standard deviation, frequency, range), Pearson correlation coefficients and Stepwise multiple regression. The results were as follows: 1. Characteristics of Fatigue of hemodialysis patients: 1) 79 of 101 hemodialysis patients complained fatigue. 2) The mean fatigue score as measured by the VAS-F was 36.2mm. 3) The mean duration of fatigue was 2.9 hours 2. Characteristics of fatigue related factors: 1) The physiologic factor which included Hgb, Hct, BUN, creatinine, potassium and inter-dialytic weight gain deviated from normal range. 2) The psychological factor which included depression and self-efficacy was about the same level as for patients with other chronic diseases. 3) The environmental factor which included social support had wide variation. 3. The relationship between fatigue and related factors: 1) Interdialytic weight gain in the physiological factor was the only valuable with fatigue (p<.05) 2) The relationship between fatigue and the psychological factor of depression showed a positive and strong correlation (p<.05). According to the findings of this study, fatigue was highly correlated with the depression, This indicates that nurses should try to assess and control psychological factors when patients complain of fatigue rather than just considering physiological factors. Nursing has to develop effective nursing interventions to reduce fatigue in patients with chronic diseases using the relationship between fatigue and physiological, psychological and environmental factors.

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Development of a Psychological Insulin Resistance Scale for Korean Patients with Diabetes
Youngshin Song, Younghee Jeon, Jeonghwa Cho, Bohyun Kim
J Korean Acad Nurs 2016;46(6):813-823.   Published online December 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.6.813
AbstractAbstract PDF
Purpose

This study was done to develop and validate a measure to evaluate the Korean version of psychological insulin resistance (K-PIR) in patients with diabetes in Korea.

Methods

Items were initially generated from literature reviews and interviews with 19 patients with diabetes. The content validity of the items was evaluated by experts. Participants were 424 patients with diabetes recruited through convenience sampling. A cross-sectional survey was designed for item-analysis, exploratory factor analysis with principal axis factoring, and confirmatory factor analysis. Cronbach's alpha was calculated to measure the internal consistency.

Results

For the 24 items of the Korean version of psychological insulin resistance, six items were eliminated because of low correlation with the other items. Exploratory factor analysis with 18-item showed that two factors (psycho-cognitive factor and supportive factor) explained 41.8% of the variance, and the factor structure of K-PIR model had a good fit. Internal consistency of K-PIR with 18 items revealed good reliability.

Conclusion

The findings show that the K-PIR is reliable for measuring the psychological resistance to insulin therapy for Korean patients with diabetes. However, further study is needed to evaluate the validation because the proportion of variation of K-PIR was low in this study.

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Concept Analysis for Psychological Insulin Resistance in Korean People with Diabetes
Youngshin Song
J Korean Acad Nurs 2016;46(3):443-453.   Published online June 30, 2016
DOI: https://doi.org/10.4040/jkan.2016.46.3.443
AbstractAbstract PDF
Purpose

The purpose of this study was to define the concept for psychological insulin resistance in the Korean population with diabetes.

Methods

The Hybrid model was used to perform the concept analysis of psychological insulin resistance. Results from both the theoretical review with 26 studies and a field study including 19 participants with diabetes were included in final process.

Results

The preceding factors of psychological insulin resistance were uncontrolled blood glucose and change in daily life. The concept of psychological insulin resistance was found to have three categories with 8 attributes such as emotional factors (negative feeling), cognitive factors (low awareness and knowledge, low confidence for self-injection) and supportive factors (economic burden, dependency life, embarrassing, feeling about supporters, feeling of trust in, vs mistrust of health care providers). The 8 attributes included 30 indicators.

Conclusion

The psychological insulin resistance of population with diabetes in Korea was defined as a complex phenomenon associated with insulin therapy that can be affected by emotional factors, cognitive factors, and supportive relational factors. Based on the results, a tool for measuring psychological insulin resistance of Koreans with diabetes and effective programs for enhancing insulin adherence should be developed in future studies.

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