PURPOSE: This research is to describe and identify the difficulties of compliance to medical regimen, by implementing interviews with hemodialysis patients. METHODS: The research data was collected from July, 2017 to October, 2017. In-depth interviews were implemented using a semi-structured questionnaire. The data were analyzed by qualitative content analysis method. RESULTS: The fourteen subjects diagnosed with chronic renal failure were attended. The difficulties of adherence to medical regimen that the hemodialysis patients feel consisted of 14 themes and they were categorized into five subjects; ‘Difficulty in practicing self-care’, ‘Repetition of Negative feelings’, ‘Withdrawal of Social activity’, ‘Lack of expertise’, ‘Uncertainty about the future’. CONCLUSION: To facilitate the hemodialysis patients' adherence to medical regimen, the change of their basic life style is required. Also, tailored nursing intervention considering not only their physical characteristics but also their psychological and affective characteristics is required to increase their self-management and adaptation to the disease.
Adult* ; Compliance ; Humans ; Kidney Failure, Chronic ; Life Style ; Methods ; Nursing ; Renal Dialysis* ; Self Care

Purpose: The purpose of this study was to construct and test a structural model of nursing students’ performing communication skills. Methods: The data collection was conducted from October 13 to October 20, 2020. The participants were 286 students from nursing colleges located in three cities. The data analysis method was a covariance structure analysis with using IBM SPSS statistics version 23.0 and AMOS 21.0 statistical programs. Results: The hypothetical model showed a proper fit with the data: root mean square error of approximation=.08, standardized root mean square residual=.06, adjusted goodness of fit=.85, normed fit index=.91, and comparative fit index=.94. The model fit indices were normed to fit index=2.96. Statistically significant explanatory variables for the performing communication skills of nursing students were peer support, emotional intelligence, ethical sensitivity, and communication self-efficacy. The variables accounted for 66.1% of the performing communication skills of nursing students. Conclusion Based on the above results, it appears necessary to develop strategies for improving the performing communication skills of nursing students, and having positive effects on health outcomes of the subjects by considering the variables of peer support, emotional intelligence, ethical sensitivity, and communication self-efficacy. Such strategies could potentially have positive effects on the health outcomes of the patients.

PURPOSE: Hospice volunteers are serving an invisible yet pivotal role in the hospice and palliative care team. This study investigated how effectively a continuing education program could enhance hospice volunteers' competency.METHODS: A total of 20 hours (four hours per week) of training was provided to 30 hospice volunteers who participated in the continuing education for hospice volunteers. Efficiency of the education was analyzed with an exploratory mixed-methods design. For quantitative analysis, the volunteers were asked, before and after the training, about their attitudes towards hospice care, what makes a meaningful life, self-efficacy and satisfaction with their volunteer service. Descriptive statistics, paired t-tests, and Wilcoxon signed-rank test were performed using SPSS Window 20.0. For qualitative research, participants were placed in three groups for a focus group interview, and data were analyzed by content analysis.RESULTS: A quantitative study result shows that this training can significantly affect hospice volunteers' attitudes and improve their self-efficacy. A qualitative study result shows that participants wanted to receive continuous education from the physical/psychosocial/spiritual aspects to better serve end-of-life patients and their family members even though they have to spare significant time for the volunteer service. They wanted to know how to take good care of patients without getting themselves injured and how to provide spiritual care.CONCLUSION: The continuing education program reflecting volunteers' requests is strongly needed to improve their competency. An effective continuing education requires continuous training and support in areas where hospice volunteers are interested in. A good alternative is to combine web-based and hands-on training, thereby allowing hospice volunteers freely take training that suits their interest.
Education ; Education, Continuing ; Focus Groups ; Hospice Care ; Hospices ; Hospital Volunteers ; Humans ; Palliative Care ; Qualitative Research ; Volunteers

PURPOSE: The aim of this study was to compare the measurements of diameter and volume of hepatic metastases from CT images with the overall survival and tumor response, in patients with unresectable liver metastases of colorectal cancer treated with a targeted agent. MATERIALS AND METHODS: We recruited 43 patients with unresectable liver metastases of colorectal cancer, in whom targeted therapy was used as the first-line treatment. Three-dimensional quantification of the volume of hepatic metastases was performed for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors guidelines was performed and compared to the volumetric measurement. Overall survival was evaluated using the Kaplan-Meier analysis and compared to the Cox proportional hazard ratios (HRs) following univariate and multivariate analyses. RESULTS: In patients classified as non-progressing and progressing by the volumetric criteria, the median overall survival time was 21 months [95% confidence interval (CI): 491.25–768.75] and 11 months (95% CI: 0–949.42), respectively (p = 0.001). Using a multivariate analysis, we found that volumetric response (HR: 3.467; p = 0.002) was a significant factor affecting the overall survival in patients with liver metastases of colorectal cancer. CONCLUSION Volumetric assessment of liver metastases could be an alternative predictor of the overall survival of patients with liver metastases of colorectal cancer treated with a targeted agent.