Relationships among Family Support, Medical Staff Support, Sick Role Behavior and Physiological Indicators in Hemodialysis Patients

Background@#Family support and medical staff support of hemodialysis patients are related to sick-role behavior, and sick-role behavior is related to physiological indicators such as interdialytic weight gain and control of potassium and phosphorus in the blood. @*Methods@#The subjects were 139 hemodialysis patients. Data were collected on demographic and disease- related characteristics, social support (family support and medical staff support), sick-role behavior, and physiological indicators (interdialytic weight gain, blood potassium, and blood phosphorus). @*Results@#Degrees of family support and medical staff support were both nearly 3.85 points, and sick-role behavior was 3.96 points. Family support (r=0.449, P<0.001) and medical staff support (r=0.421, P<0.001) were positively correlated with sick-role behavior, and sick-role behavior was inversely correlated with interdialytic weight gain (r=-0.218, P=0.010) and blood phosphorus (r=-0.170, P=0.045). @*Conclusions@#The higher the degree of family support and medical staff support, the higher the degree of sick-role behavior. In addition, the higher the level of sick-role behavior, the lower the physiological indicators of interdialytic weight gain and blood phosphorus. Therefore, in order to improve sick-role behavior and physiological indicators, it is necessary to develop and apply an enhanced intervention program through family support and medical staff support.

Comparison of Skin Stimulation Method and Topical Anesthetic Cream on Pain and Heart Rate Variability during Arteriovenous Fistula Puncture in Hemodialysis Patients

PURPOSE: The purpose of this was to compare effects of application of the skin stimulation method and topical anesthetic cream on pain, heart rate variability and satisfaction according to nursing intervention methods during arteriovenous fistula puncture in chronic renal failure hemodialysis patients. METHODS: This study was a crossover design. Participants were 36 patients with chronic renal failure receiving hemodialysis treatment. Two forms of intervention were applied to participants, and then pain and heart rate variability were measured during the puncture. RESULTS: There were no statistically significant differences according to each treatment in vein pain and artery pain. Also, there were no statistically significant differences according to each treatment in stress index, sympathetic activity (LF), parasympathetic activity (HF) and sympathetic activity/parasympathetic activity (LF/HF ratio). Satisfaction with application of skin stimulation method was statistically higher than that of topical anesthetic cream application. CONCLUSION: This suggests that application of the skin stimulation method complements disadvantages of topical anesthetic cream application and demonstrates possibility of application as a nursing intervention method which can be conveniently used by nurses in clinical practice.

A Grounded Theory Approach on the Parting Experience of Korean Middle-aged Women with their Children / 성인간호학회지

PURPOSE: This research was conducted to explore the experience of middle-aged women parting with their children and to develop a grounded theory. METHOD: The participants were 11 women in their 50's who had experienced parting with their children due to schooling, military service and marriage. The grounded theory methodology based on symbolic interactionism was used. RESULTS: 106 concepts, 30 subcategories and 14 categories were derived from the analysis through processes of open coding, axial coding and selective coding. The central phenomenon was 'happy but sad' and the core category was a process of 'independence that is sorrowful yet delightful'. Four types were identified; the independent-type; submissive -type; family-reliant-type ; and fragile-type; based on the attachment to the child, state of mind, satisfaction of the situation, family support system and self-achievement. CONCLUSION: This research identified that the modern Korean middle-aged women who are considered to be the 'sandwich generation' since they have experienced a turbulent history and the change from a confucian parent-child lifestyle to a couple-oriented one, moved away from an attitude dependent on children in parting with them and started preparing for an independent late life. Based on the results, the verification research is advised on the variables that affect the experience of parting with children.