• Journal of Korean Academy of Nursing Administration
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• v.13 no.4
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• pp.462-472
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• 2007

Purpose: Purpose of the this study is to define the hemodialysis noncompliance Indicators and discriminant standards levels for low Flux Hemodialysis patients and development of Hemodialysis noncompliance measurement - brief form. Method: Data was collected from 269 hemodialysis patients. To establish the hemodialysis noncompliance Indicators and to discriminate standards, 13 hemodialysis nurses and 2 nephrology doctors are participated in professional group. To verify the indicators and discriminant standards, data was ananlyzed by the canonical discriminant analysis method using by SAS 8.3 program. Result: 4 Indicators- interdialysis weight gain(IWG); average of recent 4weeks, serum phophate level, skipping of hemodialysis and hemodialysis time shortening without permission- of hemodialysis noncompliance are established and discriminant standards are developed. Discriminant ability of these 4 noncompliance indicators is 99.7%(p=.000). Hemodialysis noncompliance measurement - brief form has 96.3% discriminant accuracy. Conclusion: Hemodialysis noncompliant patients have high risks. It means that special intervention to noncompliance is needed. Also continuous and objective assessment and standards of noncompliance are needed.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.297-316
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• 1999

The purpose of this study is searching for hemodialysis nursing bahaviors by hemodialysis room nurses and analyzing them. Then, it estimates hemodialysis nursing costs and obtains basic data for development of proper nursing costs. First, it searched for hemodialysis nursing behaviors at a tertiary hospital hemodialysis room in Seoul and classified them. After the content validity was verified by 6 experts, Tool of hemodialysis nursing behaviors was developed. patients who recived hemodialysis were classified by dialysis patient classification tool. The searcher observed hemodialysis nursing behaviors applied to classified patients per 5 minutes. Then hemodialysis nursing hours spent to classified patients were calculated respectively. The direct expenditures and indirect expenditures were estimated. Ultimately, hemodialysis nursing costs were estimated. The results of the study were as follows ; 1. hemodialysis nursing behaviors were grouped by the same knowledge and skills. then, the content validity of them was verified by evaluation tool of nursing intervention classification by expert groups. They consisted of 9 hemodialysis activity domains and 71 hemodialysis nursing behaviors. The predialysis activity domain included 15 nursing behaviors, the activity domain of start-dialysis included 12 nursing behaviors, the activity domain of during- dialysis included 9 nursing behaviors, the activity domain of finish-dialysis included 5 nursing behaviors, the activity domain of after-dialysis included 5 nursing behaviors, the nursing documentation & undertaking and transfering included 5 nursing behaviors, the supply, drug, equipment & environment management activity domain included 7 nursing behaviors, the patient emotional support & education activity domain included 4 nursing behaviors, the emergency activity domain included 9 nursing behaviors. 2. The acute hemodialysis nursing hours were 106.42 minutes per a dialysis and the chroni hemodialysis nursing hours were 72.23 minutes per a dialysis. 3. The direct expenditure was 11.971 won per hour and indirect expenditure was 288won. 4. Finally, the cost of acute hemodialysis was 21,745 won and that of chronic hemodialysis was 14,759 won. By search of hemodialysis nursing behaviors, they will be used as hemodialysis nursing care standard and will be tended toward high qualitative care. Estimation of hemodialysis nursing costs will be used as fundamental data for development of proper nursing costs.

• Journal of Preventive Medicine and Public Health
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• v.43 no.3
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• pp.245-256
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• 2010

Objectives: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. Methods: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). Results: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI = 0.43 - 0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb${\geq}$11 g/dL, blood pressure within the range of 100-140 /60-90 mmHg, calcium x phosphate${\leq}$55 $g^2/dL^2$ and albumin${\geq}$4 g/dL were not significantly different between the groups. Conclusions: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.

• Childhood Kidney Diseases
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• v.24 no.2
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• pp.69-74
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• 2020

Hemodialysis is rarely used in neonates and infants due to the risk of major complications in the very young. Nevertheless, there are clinical situations where hemodialysis is needed and may be helpful in small children. Recently, new developments in specialized hemodialysis equipment and specifically trained personnel have made it possible to implement hemodialysis in neonates and infants. In this review, we will discuss hemodialysis for the treatment of small children with renal replacement therapy-requiring conditions, and consider indications, prescriptions, complications, and ethical issues.

• Journal of Korean Biological Nursing Science
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• v.15 no.3
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• pp.122-132
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• 2013

Purpose: The purpose of this study was to evaluate the effect of periodic video education on knowledge about hemodialysis, patient role behavior and the physiologic index in patients with hemodialysis. Methods: One-group pretest-posttest design was applied. A total of 50 patients with hemodialysis at a university hospital hemodialysis unit in Daegu participated. Periodic video education about kidney function, diet, arteriovenous fistula management, medication, and exercise was administered to them for 12 weeks at intervals of 2 weeks. Before and after the education, the participants completed the self-administered questionnaires of knowledge about hemodialysis and patient role behavior and the measures of serum potassium and phosphorus concentration, weight gain between hemodialysis sessions, and adequacy of dialysis (Kt/V). Statistical analysis was performed using paired t-test. Results: Knowledge about hemodialysis and patient role behavior were significantly different between before and after education (p<.01). For the physiologic index, serum potassium concentration and weight gain between hemodialysis sessions were not significantly different but the serum phosphorus concentration and Kt/V were significantly different between before and after education (p<.05). Conclusion: The results suggest that the periodic video education for patients with hemodialysis contributed to the change and improvement in knowledge about hemodialysis, patient role behavior, and the physiologic index.

• Quality Improvement in Health Care
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• v.23 no.1
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• pp.55-67
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• 2017

Purpose:The purpose of this study was to apply the disinfection method using chlorhexidine in practice on disinfection of vascular access for hemodialysis. Methods: This study was designed as a randomized controlled trial for examining effectiveness on infection of the vascular access device for hemodialysis when using chlorhexidine and betadine/alcohol. One-hundred-thirty study participants were separated into two groups randomly. Infection signs of the vascular access device for hemodialysis were observed and recorded before disinfection on vascular access device. Result: Before the study, there was no difference between the experimental group (chlorhexidine group) and the control group (betadine/alcohol group) in general characteristics and hematological index. Incidence of infection rate of chlorhexidine group was 0 percent and the betadine/alcohol group was 1.5 percent. There was no significant difference between the two groups. Conclusion: This study examined the effectiveness of prevention of infection with the disinfection method using chlorhexidine and betadine/alcohol. The disinfection method using chlorhexidine is considered an effective and alternative method of betadine/alcohol.

• Journal of Korean Academy of Nursing Administration
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• v.11 no.4
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• pp.439-448
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• 2005

Purpose: Purpose of the this study is to define the hemodialysis treatment-related stressors and stress coping methods in hemodialysis noncompliant patients. Method: Hemodialysis treatment-related stressors scale and stress coping style scale were used with 178 patients that received continuous hemodialysis treatment, met the noncompliance criteria. Collected data were analyzed by using the SPSS 12.0 program. Result: In hemodialysis noncompliant patients, Psychosocial stress were higher than physical stress, 'aesthetic thinking' was the most used. As recognition of health status was lower, hemodialysis treatment-related stressors were higher. In terms of causative disease, 'hypertension' pt used more 'problem-focus coping' and 'social support pursuit' than the other groups. As subjective recognition level of health status was higher, 'problem-focus coping' and 'social support pursuit' were more used. It was showed positive correlation between psychosocial stressors and 'aesthetic thinking'. Conclusion: Hemodialysis noncompliant patients had high psychosocial stress, accordingly, used 'aesthetic coping'. It means that they has negative coping to disease and hemodialysis treatment. Therefore, Nurses need to manage psychosocial aspects, which influence on noncompliant behaviors.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.2
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• pp.235-246
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• 1996

The purpose of this study was to discover the experience of hemodialysis which clients confronted hemodialysis at the same time as CRF diagnosis and to understand the nature and meaning of their crisis experience. The research subjects were 6 clients receiving hemodialysis in Seoul from Jan. 1996 to Jul. 1996. Data were collected by informal indepth interview and participant observation. Content Analysis(by Seaman & Verhonick, 1982; Woods & Catanzaro, 1988) was applied to collect similar contents and common experience in order to derivate concepts and categories for better understanding of their hemodialysis experience. As a result, 6 categories derivated to indentify their hemodialysis experience of the CRF clients-confronted hemodialysis at the same time as CRF diagnosis-were as follows: 1) The category of shocking crisis composed the concepts of shock, amagement and suffocation. 2) The category of denial composed the concepts of disease refusal and hemodialysis refusal. They repeatedly visited hospitals or didn't visit hospital in order to refuse disease, then depended on folk remedy or shamanistic method. 3) The category of severe anxiety composed the concepts of abandoned feeling, shame, resentment, neurosis and anger. 4) The category of depression composed the concepts of grief, suffering of unfairness, tearing, desire to death. 5) The category of powerlessness composed the concept of hopelessness. 6) The category of resigned acceptance composed the concepts of resignation and acceptance. In this study, the CRF clients who confronted hemodialysis at the same time as CRF diagnosis experienced six stages in accepting hemodialysis but these stages were mingled simultaneously and went on.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.633-643
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• 2002

Purpose : This study was conducted to develop a patient classification system for hemodialysis and to test its validity and reliability. Method : The process of the system development was as below. The lists of hemodialysis nursing activities were collected from literature and hemodialysis practice guideline and they were classified into 10 factors and 16 elements. And then, 4 classification levels were identified for each element. The content validity and interrater reliability of developed patient classification system were tested. Result & Conclusion : 10 factors of patient classification system for hemodialysis were consisted of psychosocial support, mobility, access, teaching, assessment, stability, supportive therapy, test, general nursing during hemodialysis, hemodialysis room management. According to validity and reliability results and experts' opinions, 4 classification levels revised to 3 classification levels and 2 elements were deleted. Finally, patient classification system were consisted of 10 factors, 14 elements, 3 classification levels, 3 categories.

• Journal of Korean Academy of Nursing Administration
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• v.11 no.1
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• pp.33-44
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• 2005

Purpose: This study was aimed to estimate nursing cost for hemodialysis of tertiary hospitals using Resource Based Relative Value Scale(RVRBS). Method: First, we calculated nursing workload of the each hemodialysis-nursing behaviors compared with basic nursing behavior(check vital sign) for the most severe hemodialysis patients in general hospitals. Second, we measured each spent time according to each nursing behaviors. Third, we computed Resource Based Relative Value(RBRV) scores and nursing expenses of each 14 nursing behavior for hemodialysis. Finally, we estimated nursing cost of each hemodialysis-behavior for the most severe hemodialysis-patients in general hospitals. Result: The mean RBRV scores for each nursing behaviors were from 218.9 to 383.9 points. The highest RBRV socres were 383.9(Complication during hemodialysis). The Nursing behavior that spent the most time was "access the vascular( 31.7 minutes)". Nursing cost per hemodialysis for the patient with severe condition was estimated 63,455(won). Conclusion: Total average workload was 347.6 points and total spent time was 306.5 minutes for 14 hemodialysis nursing behaviors provided to severe patients. There were clear differences in nursing workload and cost according to patient's severity-mild, moderate and severe class.