Quality of Life among End-stage Renal Disease Treatments and Economic Evaluation of Renal Transplantation and Hemodialysis Treatments / 대한이식학회지

BACKGROUND: Although renal transplantation is known as the best treatment for patients with end-stage renal disease, there are few of literature to identify economic evaluation of renal replacement therapies in Korea. This study was conducted to determine the cost-effectiveness of renal replacement treatments, particularly renal transplantation and hemodialysis. METHODS: We used the quality adjusted life year (QALY) calculated from survey data, which was collected from 124 patients who underwent kidney transplantation and 90 patients who were receiving hemodialysis. Medical costs were collected from five hospitals in Korea. The ERA-EDTA registry data (European Renal Association-European Dialysis and Transplant Association) were used for transition probability. A Markov model was used for predicting the cost-utility of transplantation and hemodialysis over the 10-year period. RESULTS: Renal transplantation offers lower cost and better outcome compared to hemodialysis. QALY per year of transplantation patients is higher than that of hemodialysis patients (transplantation 0.9465 vs. hemodialysis 0.8297). Cost per QALY gained is 15,566,000 won in transplantation patients whereas 32,765,000 won per QALY gained in hemodialysis patients was required. CONCLUSIONS: Although cost of first year after transplantation was expensive, over 2 years, transplantation was more effective and less costly than hemodialysis. The results suggest that transplantation is more cost-effective than hemodialysis in Korea.

Illness Experience of Adolescents with Hematologic Malignancies

PURPOSE: The purpose of this study was to describe the experience process of adolescents with hematologic malignancies. The question for the study was "What is the experience of adolescents with hematologic malignancies like?". METHODS: The grounded theory methodology was used for this study. The data were collected through in-depth interview from 10 adolescents with hematologic malignancies. Data collection was done from January to June 2007. Theoretical sampling was used until the data reached saturation. RESULTS: As a result of the analysis, "Reconstructing self-image from deviated and suspended life" was identified as the core category. And 11 subcategories were identified and they were integrated to the core category. 'Establishment of expanded and matured self' was identified as the consequence. CONCLUSION: The results of the study provide a frame for effective individualized nursing intervention strategies in helping adjustment of the adolescents with hematologic malignancies.

A Renal Transplantation and Hemodialysis Cost-Utility Analysis in Patients with End-Stage Renal Disease / 대한이식학회지

BACKGROUND: The purpose of this study was to examine the cost-effectiveness of renal transplantation and hemodialysis among end-stage renal disease patients. METHODS: Empirical data on treatment costs were collected from five hospitals in Korea. We used European Renal Association-European Dialysis and Transplant Association registry data for transition probability. Quality adjusted life year (QALY) values were derived from the literature. A Markov model was used for predicting the cost utility of transplantation and hemodialysis over a 10-year period. RESULTS: Renal transplantation was less costly and resulted in a better outcome than hemodialysis. The cost per QALY gained was 19,450 thousand won in transplantation patients, whereas it was 36,514 thousand won per QALY gained in hemodialysis patients. CONCLUSIONS: Although the cost of the first year after transplantation was expensive, transplantation was more effective over 2 years and was less costly than hemodialysis. The results suggest that transplantation is more cost-effective than hemodialysis in Korea.

Health Problems and Psychosocial Adaptation of Children with Cancer / 간호학회지

PURPOSE: The purpose of this study was to describe health problems and psychosocial adaptation in children with cancer and to determine the relationship between these two variables. METHOD: The data were collected from parents of 61 children with cancer, aged 4-11 years at one university hospital in Seoul. The instruments for this study were the Korea Child Behavior Check List (KCBCL) and a physical symptom checklist developed by the researchers. RESULT: The major health problems were coughing, sleeping disturbances, fatigue and weakness. The total behavior problem score for children in the cancer group was higher than the score for those in the norm group. The scores on the scales for withdrawal, somatic complaints, social immaturity, and internalizing problems were higher in the children with cancer compared to normative findings. Scores on social and school competence in the cancer group were lower than the norms for healthy children. The relationship between health problems and psychosocial adaptation was significant in the subscales of withdrawal, anxiety/depression, internalizing problems and social involvement in the off therapy group. CONCLUSIONS: This study shows the various areas that need further study in caring for children with cancer.

A Study on the Comparison of Psychosocial Adjustment of Children with Cancer between on and off Treatment / 아동간호학회지

PURPOSE: The purpose of this study was to compare psychosocial adjustment in children aged 4-11 years with cancer between on and off treatment. METHOD: The data was collected from parents of children with cancer through interviews with structured questionnaire at the pediatric outpatient department and inpatient ward of one university hospital located in Seoul. The instrument were the Child Behavior Check List(CBCL) developed by Achenbach(1991) and revised to standardize for Korean children by Oh et al(1997). RESULT: Total behavior problem score for children on treatment was greater than the score off treatment but there was no significant difference. Children on treatment reported higher levels of depression/anxiety, withdrawal, internalizing scores than children off treatment. Social competence score of children off treatment was greater than the score on treatment and the difference of school performance score of children between on and off treatment was not significant. The scores on the withdrawal, somatic complaints, social immaturity, internalizing scales in the cancer group including both on and off treatment was greater than normative findings in the general population. The scores on the school competence of children off treatment were lower than the norms for healthy children. CONCLUSION: Findings from this study support the importance of nursing interventions to facilitate the adjustment of children with cancer both on and off therapy.