PURPOSE: The purpose of this study was to determine the effects of empowerment education program on self-efficacy, self-care agency, self-care activities and physiologic parameters among hemodialysis patients. METHOD: Nonequivalent control group pretest-posttest design was used. There were 36 subjects in the experimental group and 35 subjects in the control group. The empowerment education program was administered for 4 weeks (1 time per week). Data were collected pre-treatment and post treatment. The chi2-test or Fisher's exact test, ANCOVA, t-test and paired t-test were performed to determine the group differences, using SPSS 14.0 version. RESULTS: Self-efficacy, self-care agency, self-care activities and weight variation significantly improved after the empowerment education program in hemodialysis patients. CONCLUSION: The empowerment education program for hemodialysis patients was effective to improve the degree of self-efficacy, self-care activities and self-care agency and to decrease interdialytic weight variation.
Humans ; Power (Psychology) ; Renal Dialysis ; Self Care

No abstract available.
Humans ; Psychology* ; Quality of Life* ; Renal Dialysis*

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*

Since end-stage renal disease leads to a variety of problems such as disability,reduced quality of life,and mental and psychological disorders,it has become a serious public health problem around the globe.Renal palliative care integrates palliative care philosophy in the care for patients with end-stage renal disease.As a planned,comprehensive,patient-centered care,renal palliative care focuses on the patient's symptoms and needs,aiming to reduce the suffering throughout the course of the disease,including but not limited to end-of-life care.This study reports the palliative care practice for a patient on maintenance dialysis in the Blood Purification Center of Peking Union Medical College Hospital and reviews the present situation of palliative care in end-stage renal disease.
Humans ; Palliative Care/psychology* ; Quality of Life ; Kidney Failure, Chronic/therapy* ; Terminal Care/psychology* ; Renal Dialysis/psychology*

A series of clinical studies on the psychiatric aspects of hemodialysis and kidney transplantation were done with Korean patients, kidney donors, their families and unit nurses. All subjects were interviewed and evaluated for their psychiatric reactions and symptoms and for the underlying causes. Depression was the most common reaction, although the clinical features were somewhat different between groups studied. In addition, a unique and episodic psychotic syndrome was found in four patients. Depression and psychotic episodes seemed to reflect the psychodynamic components such as instinctual frustration, physical, familial and financial loss, dependency on a machine, sensory deprivation and the so-called fear of death and fear of life. These seemed to follow the unique features of hemodialysis and transplantation. The main defense mechanism seemed to be denial. The possible role of psychiatrists was discussed for evaluation, treatment, and prevention of these reactions and for the support of the family and the treatment team.
dult ; Aged ; Female ; Human ; Kidney Transplantation* ; Korea ; Male ; Middle Age ; Renal Dialysis/psychology* ; Transplantation, Homologous/psychology*

OBJECTIVETo probe the effect of moxihustion on the quality of life in the end-stage renal failure patients in hemodialysis.

METHODSSeventy-one hemodialysis patients were randomly divided into 2 groups, and the quality of life of all the patients was evaluated with the Kidney Disease Quality of Life Short Form (KDQOL-SF). The Control group were treated with routine comprehensive therapy (including hemodialysis and medication), and the observation group with the routine comprehensive therapy and moxibustion at Zusanli (ST 36), Guanyuan (CV 4), Sanyinjiao (SP 6). Changes of the quality of life in the patients before and after hemodialysis were recorded and analyzed.

RESULTSAfter treatment there were significant differences between the two groups in DSF, RE and GH (P<0.05), and 7 fields including RE, BP, QSI and others significantly improved in the both groups (P<0.05). Additionally, the 4 fields including RP, EB, VT and WS significantly improved in the observation group (P<0.05).

CONCLUSIONMoxibustion can improve physical strength and mood in the quality of life of the hemodialysis patients; to evaluate the quality of life of hemodialysis patients should consider effects of society, climate and geographical condition and other factors.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Quality of Life ; Renal Dialysis ; psychology

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

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

BACKGROUND AND OBJECTIVES: Contrast-induced nephropathy (CIN) is a common complication of primary percutaneous coronary intervention (pPCI) and is associated with high mortality and morbidity and long hospital stay in patients with ST elevation myocardial infarction (STEMI). The Syntax Score (SS) has previously been studied in STEMI patients, and it was associated with increased CIN development and long-term mortality. This study investigates a possible relationship between CIN development and Syntax Score II (SSII) and compares SS and SSII by assessing CIN risk in STEMI patients treated with pPCI. METHODS: A total of 1,234 patients who underwent pPCI were divided into 2 groups according to CIN development. Patients with CIN were further divided into 2 groups according to whether or not they required hemodialysis. Reclassification tables, net reclassification improvement, and integrated discriminative improvement methods were used to assess the additive predictive value of SSII for predicting CIN. RESULTS: In the present study, 166 patients (13.5%) had CIN. Although both SS and SSII were significantly higher in CIN patients, only SSII was an independent predictor of CIN (odds ratio [OR], 1.031; 95% confidence interval [CI], 1.012–1.051; p < 0.001) and hemodialysis requirement (OR, 1.078; 95% CI, 1.046–1.078; p < 0.001). When comparing SSII and SS in their ability to determine CIN risk, we found SSII to have a reclassification improvement of 27.59% (p < 0.001) and an integrated discrimination improvement of 9.1% (p < 0.001). CONCLUSIONS: The combination of clinical and anatomic variables can more accurately identify patients who are at high risk for CIN after pPCI. While SSII is harder to calculate than SS, it provides better prediction for CIN and hemodialysis requirement than SS.
Discrimination (Psychology) ; Humans ; Length of Stay ; Mortality ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Renal Dialysis