The impact of age on the relationship between body mass index (BMI) and all-cause mortality in hemodialysis (HD) patients is not clearly understood. Using data from the Korean Renal Data System (2001–2022), we analyzed 66,129 HD patients, stratified into young (<65 years, n = 24,589), younger-old (65–74 years, n = 17,732), and older-old (≥75 years, n = 23,808) groups. Patients were categorized into BMI quartiles, and survival outcomes were evaluated using Kaplan-Meier curves and event time ratios for the relative change in the survival time. During the follow-up period, 14,360 of the patients (21.7%) died, with a median follow-up of 3.4 years. Kaplan-Meier curves revealed poorer outcomes in lower BMI quartiles across all age groups. The lowest BMI quartile was significantly associated with a shorter survival time compared to the highest BMI quartile, with a 15% reduction in the young group (p = 0.001) and a 12% reduction in the older-old group (p = 0.002). Predicted survival time increases with rising BMI in the young group, but the rate of increase slows in the younger-old group and plateaus in the older-old group after a BMI of 25 kg/m2. Lower BMI correlates with higher mortality, particularly in younger HD patients.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Korean Renal Data System (KORDS) is a nationwide end-stage renal disease (ESRD) registry database operated by the Korean Society of Nephrology (KSN). Diabetes mellitus is currently the leading cause of ESRD in Korea; this article provides an update on the trends and characteristics of diabetic ESRD patients. The KORDS Committee of KSN collects data on dialysis centers and patients through an online registry program. Here, we analyzed the status and trends in characteristics of diabetic chronic kidney disease stage 5D (CKD 5D) patients using data from 2001 to 2021. In 2021, the dialysis adequacy of hemodialysis (HD) was lower in diabetic CKD 5D patients than in nondiabetic CKD 5D patients, while that of peritoneal dialysis (PD) was similar. Diabetic CKD 5D patients had a higher proportion of cardiac and vascular diseases and were more frequently admitted to hospitals than nondiabetic CKD 5D patients, and the leading cause of death was cardiac disease. From 2001 to 2020, diabetic CKD 5D patients had a higher mortality rate than nondiabetic CKD 5D patients, but in 2021 this trend was reversed. Diabetic PD patients had the highest mortality rate over 20 years. The mortality rate of diabetic HD patients was higher than that of nondiabetic HD patients until 2019 but became lower starting in 2020. There was a decreasing trend in mortality rate in diabetic CKD 5D patients, but cardiac and vascular diseases were still prevalent in diabetic CKD 5D patients with frequent admissions to hospitals. More specialized care is needed to improve the clinical outcomes of diabetic CKD 5D patients.

With an increasing aging population, the mean age of patients with end-stage kidney disease (ESKD) is globally increasing. However, the current clinical status of elderly patients undergoing hemodialysis (HD) is rarely reported in Korea. The current study analyzed the clinical features and trends of older patients undergoing HD from the Korean Renal Data System (KORDS) database. The patients were divided into three groups according to age: <65 years (the young group), n = 50,591 (35.9%); 65–74 years (the younger-old group), n = 37,525 (26.6%); and ≥75 years (the older-old group), n = 52,856 (37.5%). The proportion of older-old group undergoing HD significantly increased in incidence and decreased in prevalence from 2013 to 2022. The median levels of hemoglobin, serum creatinine, albumin, calcium, phosphorus, and intact parathyroid hormone significantly decreased in the older-old group. The proportions of arteriovenous fistula creation and left forearm placement showed decreased trends with age. Although the utilization of low surface area dialyzers increased with age, the dialysis adequacy, including urea reduction ratio and Kt/V was within acceptable range in the older-old group on HD. Over the past 20 years, the mortality rate in the older-old group has increased, with cardiovascular diseases decreasing and infectious diseases increasing. The incidence of elderly patients undergoing HD has increased over time, but the high mortality of the older-old group needs to be solved. Therefore, it is imperative to develop holistic strategies based on age and individual needs for patients with ESKD.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

Purpose: This study aimed to explore customer perspectives of nursing services in tertiary hospitals. Methods: The data comprised mobile Voice Of Customer (VOC) data related to “nursing” or “nurses” generated from June 25, 2019, to December 31, 2022, in a tertiary hospital. A total of 44,727 VOC data points were collected, of which 4,040 were selected for the final analysis. Text network analysis and topic modeling were conducted using NetMiner 4.5.1. Results: Topic modeling identified five topics for positive aspects and four topics for areas requiring improvement.The positive aspects were: 1) sincere nursing care; 2) rapid response from professional medical staff; 3) teamwork for delivering customer-centric services; 4) provision and coordination of system-based healthcare services; and 5) customer-focused responsiveness. The areas requiring improvement were: 1) demand for skilled nursing care tailored to customer expectations; 2) demand for enhanced communication and reduced mechanical responses; 3) demand for appropriate handling of diverse situations; and 4) demand for overall improvements to the healthcare system, including reservation systems. Conclusion These results may be used to enhance customer and patient experiences in tertiary hospitals and are necessary for utilization from a hospital management perspective.

The number of adults living with type 1 diabetes is increasing due to an increase in the number of newly diagnosed adult type 1 patients, and the longevity of individuals with childhood-onset diabetes.In addition, adults with type 1 diabetes currently span a wide range of ages, from 18 to 100 years of age, and diabetes self-management may vary by developmental stage. A reasonable A1C goal for many nonpregnant adults with type 1 diabetes is < 7%. But, as with all management issues for people with type 1 diabetes, providers need to individualize assessment and treatment options by individual patient.A structured education program for type 1 diabetes patients includes procedures for blood glucose self-monitoring, carbohydrate counting, and insulin dose adjustment at mealtimes to achieve optimal glycemic control and quality of life. Diabetes self-management education is the ongoing process of facilitating the knowledge, skill, and abilities necessary for diabetes patients to accomplish self-care, which includes the needs, goals, and life experiences of each individual with diabetes.

The number of adults living with type 1 diabetes is increasing due to an increase in the number of newly diagnosed adult type 1 patients, and the longevity of individuals with childhood-onset diabetes.In addition, adults with type 1 diabetes currently span a wide range of ages, from 18 to 100 years of age, and diabetes self-management may vary by developmental stage. A reasonable A1C goal for many nonpregnant adults with type 1 diabetes is < 7%. But, as with all management issues for people with type 1 diabetes, providers need to individualize assessment and treatment options by individual patient.A structured education program for type 1 diabetes patients includes procedures for blood glucose self-monitoring, carbohydrate counting, and insulin dose adjustment at mealtimes to achieve optimal glycemic control and quality of life. Diabetes self-management education is the ongoing process of facilitating the knowledge, skill, and abilities necessary for diabetes patients to accomplish self-care, which includes the needs, goals, and life experiences of each individual with diabetes.

Peripheral artery disease (PAD) and diabetes increase the risk of significant morbidity and mortality and can affect quality of life. PAD is a progressive disease, and the presence of diabetes mellitus increases the risk of adverse outcomes among patients with PAD. Diabetes patients should undergo an initial screening for PAD that evaluates walking speed, leg fatigue, claudication, and pedal pulses. Healthcare providers should discuss with their patients controllable risk factors for PAD that can be modified. A comprehensive care plan for patients with PAD and diabetes mellitus is important and may include smoking cessation, structured exercise therapy, foot care, glycemic control and management of other cardiovascular risk factors (weight management, diet, and control of blood pressure and cholesterol). PAD with diabetes mellitus is a lifelong chronic medical condition, and prompt identification and treatment of PAD are crucial. Patient education is needed to prevent complications and to encourage a healthy and active lifestyle.
Blood Pressure ; Diabetes Mellitus ; Diet ; Education ; Exercise Therapy ; Fatigue ; Foot ; Health Education ; Health Personnel ; Humans ; Leg ; Life Style ; Mass Screening ; Mortality ; Patient Education as Topic ; Peripheral Arterial Disease ; Quality of Life ; Risk Factors ; Smoking Cessation ; Walking