PURPOSE: To examine the effects of a smartphone application-based exercise program on self-efficacy expectations (SEE) and outcome expectations regarding exercise (OEE), physical fitness, activity level, physiological indices, and health-related quality of life in a sample of hemodialysis patients.METHODS: A quasi-experimental control group pre-test post-test design was used. Subjects were recruited from two university hospitals in G city. The subjects were assigned randomly by coin toss: 33 participants to the experimental group and 30 to the control group. A literature review and the self-efficacy theory were used to develop the smartphone program. Experts designed and verified the program to be userfriendly and in consideration of user interaction. Data were collected through a self-report pre-test post-test questionnaire and online medical records.RESULTS: In the experimental group, the levels of physical fitness and physical activity were significantly improved post-test, but the scores on health-related quality of life and the physical indices did not improve. In the experimental group, the SEE and OEE post-test scores were also significantly higher than the pre-test scores, but the control group's scores did not change.CONCLUSION: The smartphone application-based exercise program based on self-efficacy theory significantly improved the level of physical fitness and activity, SEE, and OEE for hemodialysis patients. The use of this application-based exercise program for hemodialysis patients might be an effective nursing intervention tool for improving SEE, OEE, level of physical fitness, and physical activity.
Hospitals, University ; Humans ; Medical Records ; Motor Activity ; Numismatics ; Nursing ; Physical Fitness ; Quality of Life ; Renal Dialysis ; Self Efficacy ; Smartphone

PURPOSE: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. METHODS: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. RESULTS: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. CONCLUSION: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.
Arteries ; Arteriovenous Fistula ; Complement System Proteins ; Cross-Over Studies ; Heart Rate ; Heart ; Humans ; Kidney Failure, Chronic ; Methods ; Nursing ; Punctures ; Renal Dialysis ; Skin ; Veins

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 study aimed to examine quality of sleep in hemodialysis patients and explore physical, physiological, and psychological factors determining sleep quality. METHODS: The survey was conducted among 165 patients on maintenance hemodialysis at a university hospital. Data were collected from July to October in 2015. The sleep quality and its related factors were assessed by standardized questionnaires, anthropometric measures, and lab tests after obtaining a written consent from the participant. RESULTS: The mean age of the participants was 62.58 years old, and 67.9% of the participants experienced sleep disorders such as ‘not falling asleep within 30 minutes’ or ‘frequently waking up at night’. Pain (t=-3.29, p=.007) and depression (t=-6.028, p < .001) were significantly different between the group with sleep disorder and the other without. The demographic factors (age, shared room, sleep during the day), physical factors (pain and symptom), and psychological factors (depression and trait and status anxiety) together explained 20.0% of variance in sleep quality. CONCLUSION: Sleep disorder was frequently experienced among the patients on maintenance hemodialysis. The effective nursing strategies should focus on sleep environment, pain and depression management. Further study is warranted to explore the effect of physiological factors related to the disease on sleep disorder in this population.
Accidental Falls ; Demography ; Depression ; Humans ; Nursing ; Psychology ; Renal Dialysis ; Sleep Wake Disorders

PURPOSE: The purpose of this study was to evaluate food carving among hemodialysis patients and to identify factors affecting the food carving. METHODS: hemodialysis between March 15 and April 15, 2017. Measurement instruments included the general food craving questionnaire trait, the center for epidemiological studiesdepression scale, and stress response inventory-modified form. The statistical analysis included t-test, analysis of variance, pearson correlation analysis, and stepwise multiple regression analysis. RESULTS: Mean food craving score was 53.00±12.36. Food craving was higher in patients younger than 40 years (F=4.36 p=.006) and having occupation (t=2.18 p=.031). Patients receiving hemodialysis demonstrated higher levels of depression (21.37±9.62) and stress (39.68±15.95). Factors influencing food craving were depression (β=.52, p<.001), stress (β=.65, p<.001), and age 50~59 years old (β=−.28, p=.001) and 60~69 years old (β=−.19, p=.026), which accounted for 25.6% of total variance. CONCLUSION: Food craving among hemodialysis patients was influenced by patients' depression, stress and age. Assessment and management of depression and stress needs to be incorporated as a nursing strategy for dietary management for hemodialysis patients.
Craving ; Depression ; Humans ; Nursing ; Occupations ; Renal Dialysis ; Stress, Psychological

PURPOSE: This study was done to investigate the effects of acupressure on pruritus and sleep among patients undergoing hemodialysis. METHODS: The study design was a nonequivalent control group repeat measures quasi-experimental study. Data were collected from June to September 2015 in the kidney center at a hospital located in B city. Participants were 42 patients; 20 in the experimental group and 22 in the control group. For the experimental group, acupressure on the spots of Sameumgyo (SP6), Zoksamli (ST36), Hyolhae (SP10), and Gokji (LI11) was provided at the time of hemodialysis three times a week for 12 weeks. The numeric rating scale (NRS) was used to measure pruritus, and sleep was measured with the sleep scale developed by Jinju Oh et al. RESULTS: There was a significant decrease in pruritus (F=7.80, p=.008) and increase in sleep (F=80.90, p<.001) in the experimental group compared to the control group. CONCLUSION: The findings confirmed in the study show that acupressure is an effective nursing intervention to decrease pruritus felt by patients on hemodialysis and to increase the quality of their sleep.
Acupressure* ; Gyeongsangnam-do ; Humans ; Kidney ; Non-Randomized Controlled Trials as Topic ; Nursing ; Pruritus* ; Renal Dialysis*

PURPOSE: The purpose of this study was to examine effects of a dietary program based on self-efficacy theory on dietary adherence, physical status and quality of life (QoL) in hemodialysis patients. METHODS: A non-equivalent control group pre-post test design was used. The intervention group received the dietary program for 8 weeks from August 4 to September 26, 2014. The control group received only usual care. RESULTS: ANCOVA showed that dietary adherence (F=64.75, p<.001) was significantly different between the two groups. Serum albumin (F=12.13, p =.001), interdialytic weight gain (F=56.97, p<.001), calories (F=15.80, p<.001) as physical status indices were significantly different, but serum potassium (F=2.69, p=.106) and serum phosphorus (F=1.08, p=.303) showed no significant difference between the two groups. In terms of health-related QoL, the physical component scale (F=10.05, p=.002) and the mental component scale (F=16.66, p<.001) were significantly different between the two groups. In addition, in terms of diet related QoL, diet level (F=35.33, p<.001) and satisfaction level (F=15.57, p<.001) were significantly different between the two groups, but dietary impact level (F=1.23, p =.271) was not significantly different. CONCLUSION: Findings show that the dietary program based on self-efficacy theory is an effective nursing intervention program to improve adherence to diet, and to maintain physical status and QoL for hemodialysis patients.
Diet ; Evaluation Studies as Topic ; Humans ; Nursing ; Patient Compliance ; Phosphorus ; Potassium ; Quality of Life* ; Renal Dialysis* ; Self Efficacy ; Serum Albumin ; Weight Gain

PURPOSE: This study was performed to investigate the effect of work environment on nursing performance and the effect of job satisfaction and empowerment on nurses performance in hemodialysis units. METHODS: Participants in this study were 206 nurses from 22 hemodialysis units in local clinics, general and university hospitals in two metropolitan areas. The work environment, nursing performance, job satisfaction and empowerment of the participants were measured using four self-report questionnaires. Data were analyzed using SPSS/WIN 18.0. RESULTS: Nursing performance correlated significantly with work environment, job satisfaction, and empowerment in the participants. Predictability of work environment for nursing performance was 28%. Job satisfaction and empowerment showed complete mediating effects, but not moderating effects in the relationship of work environment and nursing performance in the participants. CONCLUSION: Findings indicate that work environment is an important variable affecting nursing performance in nurses in hemodialysis units and that job satisfaction and empowerment are mediating variables in the relationship of work environment and nursing performance in nurses in hemodialysis units. Improvements in the work environment are needed to induce the high job satisfaction and empowerment that can lead to improvement of nursing performance.
Hospitals, University ; Job Satisfaction* ; Negotiating ; Nursing* ; Power (Psychology)* ; Renal Dialysis*

The Korean Society of Nephrology (KSN) launched a nationwide official survey program about dialysis therapy in 1985. Nowadays, the accumulated data for 30 years by this "Insan Prof. Min Memorial end-stage renal disease (ESRD) Registry" program have been providing the essential information for dialysis clinical practice, academic nephrology research, and health management policy. We reviewed 30 years of data to identify important changes and implications for the future improvement of dialysis therapy in Korea. Hemodialysis patients, especially diabetics and elderly patients have increased in number very rapidly during recent years in Korea. The Korean prevalence rate of ESRD patients was about 70% of the United States and about 50% of Japan according to the international comparisons in the annual data report of United States Renal Data System. The blood pressure control, anemia control, and dialysis adequacy have continuously improved year by year. The importance of calcium and phosphorus control has also been increasing because of the increase in long-term dialysis patients. In addition, chronic dialysis complications should be closely monitored and dialysis modifications, such as hemodiafiltration therapy, might be considered. Because of the increase of private clinics and nursing hospitals in dialysis practice, the role of dialysis specialists and continuing education are thought to be essential. For strict cost-effective dialysis control of increasing elderly, diabetic, and long-term dialysis patients, the KSN ESRD patient registration should be run by the KSN and health ministry in cooperation, in which the dialysis fee reimbursement should be accompanied.
Aged ; Anemia ; Blood Pressure ; Calcium ; Dialysis ; Education, Continuing ; Fees and Charges ; Hemodiafiltration ; Humans ; Information Systems ; Japan ; Kidney Failure, Chronic* ; Korea ; Nephrology ; Nursing ; Peritoneal Dialysis ; Phosphorus ; Prevalence ; Renal Dialysis ; Specialization ; United States

PURPOSE: The purpose of this study was to understand nurses' experience of managing diet and fluid in hemodialysis patients and to provide helpful information in improving care of hemodialysis patients. METHODS: Data were collected through in-depth interviews with ten nurses who had experience of providing care to hemodialysis patients. Colazzi's phenomenological method was used to analyze data. RESULTS: Twenty themes were identified in the first stage of data analysis and were later categorized into ten theme clusters, of which four categories were derived. The four categories were 'developing a strong feeling of responsibility for management', 'acknowledging limits in performing duties', 'providing patient-centered education' and 'becoming a guide for the long treatment process'. CONCLUSION: The study results will be useful for improving nursing curriculum to ensure more effective and successful diet and fluid management in hemodialysis patients.
Curriculum ; Diet* ; Hemodiafiltration ; Humans ; Nursing ; Qualitative Research ; Renal Dialysis* ; Statistics as Topic