PURPOSE: The purpose of this study is to investigate the degree of sleep disorder and its related factors in hemodialysis patients. METHOD: The subjects of this study consisted of 210 hemodialysis patients. Data were analyzed by descriptive statistics, t-test, ANOVA, pearson's correlation coefficient, or stepwise multiple regression analysis by using SPSS/PC+ program. RESULT: Sleep disorder degree averaged 2.24. Stress of hemodialysis patients averaged 2.52. Depression degree of hemodialysis patients averaged 1.14. There was significant difference in sleep disorder according to age, marriage status, education, family income and help-givers. Sleep disorder was significantly associated with stress and depression. Stress, depression and marriage status explained 31.3% of the variance in the sleep disorder. CONCLUSION: In conclusion, the sleep disorder of hemodialysis patients is the nursing problem. The sleep disorder degree relates with stress, depression. Especially, it is strongly affected by stress among them.
Depression ; Education ; Humans ; Marriage ; Nursing ; Renal Dialysis*

BACKGROUND: Dialysis-induced hypotension is a very common but difficult complication to manage. Amezinium methylsulfate is a newly developed sympatho-mimetic agent which has been reported as effective in postural hypotension. We studied the preventive effect of amezinium methylsulfate on dialysis-induced hypotension in chronic hemodialysis patients. METHODS: Twenty-five hemodialysis(HD) patients who were maintaining on hemodialysis longer than 3 months and had frequent episodes of dialysis hypotension were enrolled in this study. After 4 weeks of observation period, patients received one tablet of ameziniurn 30 minutes prior to every hemodialysis session for 4 weeks. We com mean arterial pressure(MAP), number of hypotensive episodes and number of nursing interventions(defined as position change, bolus injection of saline or 50% dextrose in water, need to decrease transmembrane pressure or discon- tinuation of dialysis) between observation and medication period in each patient. RESULTS: The number of nursing interventions (mean, 2.5+/-0.9 interventions vs. 1.4+/-0.9 interventions, p<0.05) and hypotensive episodes(mean, 1.7+/-0.7 episodes per session vs. 0.9+/-0.7 episodes per session; p<0.05) decreased significantly in the medication period and the nadir MAP(57+/-13mmHg vs 70+/-15mmHg; p<0.05), mid-HD MAP(65+/-15mmHg vs. 79+/-15mmHg; p<0.05) and post-HD MAP(66+/-14mmHg vs 78+/-16 mmHg ; p<0.05) are higher in the medication period compared with observation period. CONCLUSION: These results show that amezinium methylsulfate is useful to prevent dialysis-induced hypotension in chronic hemodialysis patients.
Dialysis ; Glucose ; Humans ; Hypotension* ; Hypotension, Orthostatic ; Nursing ; Renal Dialysis ; Water

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.
Depression* ; Holistic Nursing ; Humans ; Nursing ; Psychotherapy* ; Renal Dialysis* ; Renal Insufficiency, Chronic

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*

PURPOSE: This study investigated the degree of fatigue of hemodialysis patients, and finds the relationship between fatigue and self-efficacy, family support, and sleep factor. Also, this study was purposed to provide fundamental data to help set up a nursing plan and intervention for recovery and mitigation of hemodialysis patient's fatigue. METHOD: The subjects in this study were patients treated as hemodialysis patients in Kwangjoo City. Data, subjects are 143 patients. Fatigue was measured using Lee's scale(1991), Self-efficacy using Kim's scale(1995), and Family support using Kim's scale(1993). For the analysis of collected data, Cronbach alpha, descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, Stepwise multiple regression were used for statistical analysis by SPSSwin(version 11.0) program. RESULT: Fatigue degree of hemodialysis patients averaged 4.22. Among 143 hemodialysis patients, 70.63% patients answered that they had felt fatigue as noted in this study. The weariest time was after hemodialysis for 21.0% patients. There was significant difference according to the diagnosis period. The patients who were diagnosed over one year had felt more fatigue than ones who were diagnosed within one year. Fatigue was significantly associated with self-efficacy, family support, and sleep factor. Self-efficacy could explain 14.6% of fatigue. CONCLUSION: The fatigue degree relates with all, self-efficacy, family support, and sleep factor. Especially, it is affected by self-efficacy among them. Thus, the program should be developed to mitigate fatigue as the self-efficacy of hemodialysis is enhanced.
Diagnosis ; Fatigue* ; Humans ; Nursing ; Renal Dialysis* ; Self Efficacy*

PURPOSE: To develop a substantive theory that represents caring experience from their the spouses perceived by hemodiialysis patients. METHOD: Grounded theory method guided the data collection and analysis. A purposeful sample of 15 hemodiialysis patients participated from April, 2005 to September, 2005. The data were collected through in-depth interviews. All interviews were audio taped and transcribed verbatim. Constant comparative analysis were performed simultaneously. RESULT: The core category on caring experience from their the spouses perceived by hemodialysis patients was identified "Re-establishment for life". The process was categorized into four stage, "Escaping", "Accepting", "Enduring", "Transcending". CONCLUSION: This study provides a framework for the development of individualized nursing intervention to care for the hemodialysis patients.
Data Collection ; Humans ; Nursing ; Qualitative Research ; Renal Dialysis* ; Spouses*

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

The purpose of this study was to provide fundamental data for nursing intervention by assessing self-esteem and quality of life(QL) in patients on hemodialysis and peritoneal dialysis. The subjects of this study were 60 patients on hemodialysis at H university medical center in Seoul and 56 patients on peritoneal dialysis at B company. The analysis was done by using t-test, ANOVA, Scheffe and Stepwise multiple regression. The results were as follows: 1. The average self-esteem score was signifi-cantly higher in patients on hemodialysis (27.98) than in patients on peritoneal dialysis (25.64). And there were no statistically significant differences between patients on hemodialysis(128.45) and patients on peritoneal dialysis(122.83) in the scores on QL. Among four factors of QL, hemodiaysis patients showed higher score than peritoneal dialysis patients in all factors. But, only family had statiscally significant differences. Also family showed the highest score in both groups, but psychomental showed the lowest score. 2. In patients on hemodialysis, self-esteem was significantly different by occupation(t=3.122, p=.003) and in patients on peritoneal dialysis by age(F=4.450, p=.007), education level(F=7.458, p=.001) and occupation (t=2.491, p=.017). Also in patients on hemodialysis, QL was significantly different by occupation(t=2.223, p=.033) and in patients on peritoneal dialysis by education level(F=4.007, p=.024), and occupation (t=2.806, p=.007).3. Self-esteem accounted for 36.3% of variance in QL and monthly income accounted for an additional 6.1% of QL in hemodialysis patients by means of stepwise multiple regression analysis. In peritoneal patients, self-esteem accounted for 65.1% and monthly income accounted for an additional 2.7% in QL.
Academic Medical Centers ; Education ; Humans ; Nursing ; Occupations ; Peritoneal Dialysis* ; Quality of Life* ; Renal Dialysis* ; Seoul

Purpose This research is aimed at developing a substantive theory related to the experience of adjustmented hemodialysis patients by identifying and analyzing the nature, process, and types of adjustmentt experienced by them. For this purpose, this study takes a grounded theory approach. METHOD: Data were collected from April. 2002 through September, 2002 through in-depth interviews and close observations of eleven hemodialysis patients who have experienced adjustment. With their consent, the interviews were recorded by audio tapes and later transcribed. Observation memos were also prepared on the subjects' behavior during the interviews. Data collection continued until saturated. The data were analyzed into concepts, subcategories, and categories with the open coding process. The axial coding was done to identify the relationships of the concepts and categories. And the selective coding was done to develop a core category, which is the central phenomenon of the hemodialysis patients who experienced adjustment. RESULT: This process resulted in 88 concepts, which may be grouped into 24 subcategories and 6 core categories. The 6 categories, in fact, depict the process of changes the patients experience from the sense of crisis, self-control. And its core is self-control, which encompasses the dynamic stages from recognition, change attempts, belief solodification, and empowerment. CONCLUSION: The results of the research offer the following implications. First, research on adjustment is a formative stage in nursing, it is imperative for nursing researchers to develop them, which may be more relevant to nursing. Second, it is important to develop nursing intervention techniques that may be most effective in adjustment of hemodialysis patients and at the same time for each stage of changes taking place in adjustmented hemodialysis patients.
Clinical Coding ; Data Collection ; Humans ; Nursing ; Nursing Research ; Power (Psychology) ; Renal Dialysis*

The purpose of this study is to develop and test a nursing model which can be applied to prediction of the quality of life for the patient receiving hemodialysis. A hypothetical model was constructed on Johns & Meleis's empowerment model framework which has 3 constructs (stress, resource, empowerment). 6 Factor(perceived stress, self-esteem as personal resource, perceived social support as social resource, perceived fertigue, perceived health status & self efficacy as empowerment) were selected to predict the quality of life of receiving hemodialysis patients. 4 Factors(self-esteem, perceived social support, perceived health status & self efficacy) had direct effects on the quality of life significantly. Self-esteem had indirect effect on the quality of life via perceived health status significantly. Perceived social support had indirect effect on the quality of life via self-efficacy significantly. Perceived stress ha no direct and indirect effect on the quality of life significantly. Revised model from hypothetical model showed better fit to the data by eliminating unsignificant path. From results of this study we suggest that to improve quality of life of hemodialysis patient nurses provide nursing interventions which improve self-esteem, perceived social support, self-efficacy & perceived health status.
Humans ; Models, Nursing ; Nursing ; Power (Psychology) ; Quality of Life* ; Renal Dialysis* ; Self Efficacy