Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Influence of Uncertainty and Uncertainty Appraisal on Self-management in Hemodialysis Patients

혈액투석 환자의 불확실성과 불확실성 평가가 자기관리에 미치는 영향

  • 장형숙 (단국대학교 대학원 간호학과) ;
  • 이창숙 (단국대학교병원 혈액투석부) ;
  • 양영희 (단국대학교 간호학과)
  • Received : 2014.11.13
  • Accepted : 2015.01.26
  • Published : 2015.04.30
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Abstract

Purpose: This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management. Methods: A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program. Results: The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management. Conclusion: The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.

Keywords

References

  1. Smeltzer SC, Bare BG, Hinkle JL, Cheever KH. Brunner and Suddarth's textbook of medical surgical nursing. 12th ed. Kang IS, Kang JH, Kang JY, Kwon KN, Kwon BE, Kim KM, et al., translator. Philadelphia, PA: Lippincott Williams & Wilkins; 2009.
  2. The National Kidney Foundation. KDOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. New York, NY: Author; 2002 [cited 2014 October 16]. Available from: http://www2.kidney.org/professionals/KDOQI/guidelines_ckd/p4_class_g1.htm.
  3. ESRD Registry Committee, Korean Society of Nephrology. Current renal replacement therapy in Korea: Insan memorial dialysis registry, 2013 [Internet]. Seoul: The Korean Society of Nephrology; 2013 [cited 2014 October 16]. Available from: http://www.ksn.or.kr/journal/2014/index.html.
  4. Chiou CP, Chung YC. Effectiveness of multimedia interactive patient education on knowledge, uncertainty and decision-making in patients with end-stage renal disease. Journal of Clinical Nursing. 2012;21(9-10):1223-1231. http://dx.doi.org/10.1111/j.1365-2702.2011.03793.x
  5. Kaba E, Bellou P, Iordanou P, Andrea S, Kyritsi E, Gerogianni G, et al. Problems experienced by haemodialysis patients in Greece. British Journal of Nursing. 2007;16(14):868-872. http://dx.doi.org/10.12968/bjon.2007.16.14.24325
  6. Hutchinson TA. Transitions in the lives of patients with end stage renal disease: A cause of suffering and an opportunity for healing. Palliative Medicine. 2005;19(4):270-277. https://doi.org/10.1191/0269216305pm1028oa
  7. Mishel MH. Uncertainty in illness. Image the Journal of Nursing Scholarship. 1988;20(4):225-232. https://doi.org/10.1111/j.1547-5069.1988.tb00082.x
  8. Mishel MH. Reconceptualization of the uncertainty in illness theory. Image the Journal of Nursing Scholarship. 1990;22(4):256-262. https://doi.org/10.1111/j.1547-5069.1990.tb00225.x
  9. Kim YJ, Choi H. The influence of uncertainty and social support on general well-being among hemodialysis patients. The Korean Journal of Rehabilitation Nursing. 2012;15(1):20-29. https://doi.org/10.7587/kjrehn.2012.20
  10. Yun SJ, Lee YH. Factors influencing uncertainty in dialysis patient by duration of dialysis. Korean Journal of Adult Nursing. 2012;24(6):597-606. https://doi.org/10.7475/kjan.2012.24.6.0597
  11. Lee MJ. Uncertainty, appraisal of uncertainty and health-related quality of life in recovering clients discharged from hospital after CABG. Ewha Journal of Nursing Science. 2009;21(1):49-63.
  12. Koo JY. Uncertainty and quality of life in ostomates with colorectal cancer patient [master's thesis]. Seoul: Yonsei University; 2008.
  13. Cha KS, Kim KH. Impact of uncertainty on resilience in cancer patients. Asian Oncology Nursing. 2012;12(2):139-146. http://dx.doi.org/10.5388/aon.2012.12.2.139
  14. Lee JH. The effect of self-efficacy promotion program on hemodialysis patients' self-efficacy, self-care practice and physiologic index [master's thesis]. Jinju: Gyeongsang National University; 2003.
  15. Song MR, Kim MJ, Lee ME, Lee IB, Shu MR. A study on the correlation between self-efficacy and self-care in hemodialysis patients. Journal of Korean Academy of Nursing. 1999;29(3):563-575. https://doi.org/10.4040/jkan.1999.29.3.563
  16. Curtin RB, Mapes DL. Health care management strategies of long-term dialysis survivors. Nephrology Nursing Journal. 2001;28(4):385-394.
  17. Kim AY, Kim SJ. The effect of education program on early hemodialysis patients' knowledge, self-care practice and physiologic index. Chonnam Journal of Nursing Science. 2008;13(1):95-109.
  18. Stiegelis HE, Hagedoorn M, Sanderman R, Bennenbroek FT, Buunk BP, van den Bergh AC, et al. The impact of an informational self-management intervention on the association between control and illness uncertainty before and psychological distress after radiotherapy. Psycho-Oncology. 2004;13(4):248-259. http://dx.doi.org/10.1002/pon.738
  19. Bailey DE, Jr., Wallace M, Mishel MH. Watching, waiting and uncertainty in prostate cancer. Journal of Clinical Nursing. 2007;16(4):734-741. http://dx.doi.org/10.1111/j.1365-2702.2005.01545.x
  20. Joe YJ, Shin YH. Depression, self care compliance and physiological indices of hemodialysis patients. Keimyung Journal of Nursing Science. 2011;15(1):115-122.
  21. Mishel MH. The measurement of uncertainty in illness. Nursing Research. 1981;30(5):258-263.
  22. Chung CW, Kim MJ, Rhee MH, Do HG. Functional status and psychosocial adjustment in gynecologic cancer patients receiving chemotherapy. Korean Journal of Women Health Nursing. 2005;11(1):58-66.
  23. Mishel MH, Sorenson DS. Uncertainty in gynecological cancer: A test of the mediating functions of mastery and coping. Nursing Research. 1991;40(3):167-171.
  24. Kang YH. The relationships among uncertainty, appraisal of uncertainty, depression, anxiety and perceived health status in patients with atrial fibrillation. Journal of Korean Academy of Adult Nursing. 2005;17(2):230-238.
  25. Park MK, Kim IS. The comparative perceived family support, self-efficacy and quality of life between hemodialysis and peritoneal dialysis patients. The Medical Journal of Chosun University. 2006;31(3):54-63.
  26. Jang YH, Oh HS, Jang GS. Self-care behaviors and physiological index according to cognitive function of hemodialysis patients. The Korean Journal of Health Service Management. 2012;6(2):57-69. https://doi.org/10.12811/kshsm.2012.6.2.057
  27. Na DM, Lee KO, Seo CS. The relationship between family support and self-care performance of hemodialysis patients. The Medical Journal of Chosun University. 2002;27(2):231-239.
  28. Kim HR. Relationship between uncertainty, sick role behaviors, and quality of life of rehospitalized patients underwent percutaneous coronary intervention. Journal of Korean Clinical Nursing Research. 2014;20(3):279-289. https://doi.org/10.22650/JKCNR.2014.20.3.279
  29. Lee JE, Kim SS, Kim SA, Han KH, Kim SH, Ji EJ, et al. Factors influencing health behavior of patients with chronic hepatitis B. Korean Journal of Adult Nursing. 2011;23(1):20-30.
  30. Lee JM. A study on the subjectivity of cancer patients who have chemotherapy about uncertainty [master's thesis]. Seoul: Korea University; 2014.

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