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PubMed2003

Nursing values and a changing nurse workforce: values, age, and job stages.

OBJECTIVES: To identify the extent values are associated with age group and job stage; job satisfaction, productivity, and organizational commitment; as well as education, generation, ethnicity, gender, and role. BACKGROUND: Values direct the priorities we live by and are related to employee loyalty and commitment. Lack of congruency between a nurse's personal values and those of the organization decrease satisfaction and effectiveness and may lead to burnout and turnover. Little research has been done on whether values differ by age, generations, or job stages. METHODS: Nurses in all roles (N = 412) in three hospitals in Los Angeles County were randomly surveyed, using valid and reliable instruments to measure the variables of interest. RESULTS: Nurses in the top third for job satisfaction, organizational commitment, and productivity showed higher scores for many values including their associates, creativity, esthetics, and management, while those in the bottom third scored higher in economic returns only. Nurses in different generations differed little; younger generations placed higher values on economic returns and variety. CONCLUSIONS AND IMPLICATION: Management strategies to meet nurses' values and increase their satisfaction and retention are presented.

Adult↗
PubMedDate not supplied

Social and professional support for pregnant and parenting women.

PURPOSE: A literature review to contrast the role of social and professional support in improving maternal and infant outcomes in pregnant and parenting women. In addition, recommendations are made for future research and policy and program development concerning support needed by pregnant and parenting women. DATA SOURCES: Data were limited to published studies. Searches of computerized databases, hand searches of journals, and backward searches from reference lists of studies were conducted. Nursing, medicine, psychology, public health, sociology, and social work literatures were searched (CINAHL, Medline, PsychLit, Social Sciences Abstracts, Social Sciences Citation, and Social Work Abstracts). STUDY SELECTION: The studies focused on outcomes of social support and professional support to pregnant and parenting women. The samples of the studies included pregnant women and parenting women up to 2 years postpartum. Studies reviewed were conducted in the United States or Canada and included maternal and/or infant outcomes. All ages and races of pregnant and parenting women were considered. DATA EXTRACTION: Data were extracted from each study concerning the theoretical framework, variables, sample, design, measuring instruments, interventions, and outcomes. DATA SYNTHESIS: Social support outcomes were summarized in paragraphs while a table was used to summarize professional support intervention outcomes. CONCLUSIONS: Outcomes associated with specific support interventions should be clearly identified, informed by theory, and include assisting the pregnant and parenting woman to improve her social support.

Clinical Competence↗
PubMed1994

Risk factors associated with pelvic inflammatory disease of differing microbial etiologies.

OBJECTIVE: To compare the prevalences of demographic, historic, and behavioral risks for pelvic inflammatory disease among women with sexually transmitted disease (STD) pelvic inflammatory disease versus those with non-STD pelvic inflammatory disease. METHODS: Subjects included patients diagnosed with acute pelvic inflammatory disease at San Francisco General Hospital between January 1, 1981 and August 20, 1989, who had been entered into clinical treatment trials. At a minimum, endocervical cultures for Neisseria gonorrhoeae and Chlamydia trachomatis were required for study eligibility. All but nine women also had upper reproductive tract cultures for N gonorrhoeae, C trachomatis, and anaerobic and facultative bacteria. Five hundred eighty-nine patients were included in this analysis. The medical records of study subjects enrolled between January 1981 and October 1986 were abstracted (n = 321). Subjects recruited after October 1986 were interviewed during hospitalization using a standardized data base instrument (n = 268). Independent variables examined included age, race, insurance status, education, pregnancy history, menstrual history, contraceptive history, sexual history, douching history, STD history, and pelvic inflammatory disease history. Both univariate associations and multivariate (multiple logistic regression) analysis were performed. RESULTS: An STD organism was present in 65% of pelvic inflammatory disease cases. Neisseria gonorrhoeae and C trachomatis were recovered from 324 (55%) and 129 (22%) of the patients, respectively. In 30% of cases only anaerobic and/or facultative bacteria were isolated. In univariate analysis of STD versus non-STD pelvic inflammatory disease, statistically significant increases in STD risks were found for the following: black race (relative risk [RR] 1.76; 95% confidence interval [CI] 1.39-2.24), two or more sexual partners in the past 30 days (RR 1.25; 95% CI 1.08-1.45), no contraception (RR 1.36; 95% CI 1.18-2.57), N gonorrhoeae with previous episode of pelvic inflammatory disease (RR 1.97, 95% CI 1.39-2.80), and reported duration of pain 3 days or less (RR 1.17; 95% CI 1.02-1.35). Risks associated with non-STD pelvic inflammatory disease included: current intrauterine device (IUD) use (RR 0.25; 95% CI 0.11-0.61), history of IUD use (RR 0.82; 95% CI 0.68-0.98), and pelvic surgery in the past 30 days (RR 0.48; 95% CI 0.30-0.76). Multivariate analysis of the risks found that black race was associated with STD pelvic inflammatory disease (odds ratio 2.56; 95% CI 1.68-3.90), and current IUD use was associated with non-STD pelvic inflammatory disease (odds ratio 3.87; 95% CI 1.30-11.53). Neither univariate nor multivariate analysis identified douching as a risk differentiating STD from non-STD pelvic inflammatory disease. CONCLUSIONS: Pelvic inflammatory disease is a complex polymicrobial disease. This study demonstrates that risk factors associated with pelvic inflammatory disease cases can be differentiated by microbial etiology. We found that black race was associated with STD pelvic inflammatory disease and recent IUD use was associated with non-STD pelvic inflammatory disease.

Acute Disease↗
PubMed2005

Decision-making capacity of inpatients with schizophrenia in Hong Kong.

This is a prospective study examining decision-making abilities in Chinese schizophrenia patients in Hong Kong. We interviewed patients before their discharge from hospital after a psychotic relapse, examining their decision regarding whether or not they would take maintenance neuroleptic treatment. Decision-making abilities were assessed by the MacArthur Competence Assessment Tool-Treatment, a semistructured questionnaire. We examined their relationships with demographic, clinical, and cognitive variables, measured by standardized instruments. Eighty-one participants were seen. Weaknesses were noted in a range of relevant decision-making abilities. Positive and negative schizophrenic symptoms, specifically lack of judgment and insight, difficulty in abstract thinking, unusual thought content, and conceptual disorganization, were found to be correlated with performance in decision-making abilities, as were cognitive deficits. Verbal working memory was a moderate predictor of the ability to understand treatment information. Decision-making impairments and negative treatment attitude were related to the decision not to adhere to medication.

Adolescent↗
PubMed1995

Factors affecting the clinical efficiency of ultrasonic endodontics: a scanning electron microscopy study.

The purpose of this pilot study was to investigate some of the clinical variables in ultrasonic endodontics. forty extracted human teeth with a single, straight root 21-25 mm in length were prepared using combinations of the following variables: hand or ultrasonic instrumentation; apical seat prepared to file sizes 35, 40, 45 or 50; 1 ml of water, 4% sodium hypochlorite or EDTAC as irrigant between each instrument size; three brands of ultrasound generator and inserts; a 'low', 'medium' or 'high' effective power output; a tuned or untuned circuit; post-instrumentation ultrasonic irrigation with either 4% sodium hypochlorite, EDTAC, or the two used in sequence. The specimens were viewed in a scanning electron microscope and scored for the presence or absence of a smear layer at levels < 1 mm, 5 mm and 10 mm from the apical seat. The most effective combination, as tested, was hand instrumentation to file size 40 with 1 ml EDTAC irrigation between each instrument size, supplemented by intermittent flush irrigation with EDTAC with ultrasound then 4% sodium hypochlorite with ultrasound. This technique left a minimum smear layer restricted to the apical seat. Other combinations of instrumentation and irrigation were not consistent in their effectiveness.

Dentin↗
PubMed2006

Do physicians always flee from HMOs? New results using dynamic panel estimation methods.

OBJECTIVE: To assess the impact of changes in relative health maintenance organization (HMO) penetration on changes in the physician-to-population ratio in California counties when changes in the economic conditions in California counties relative to the U.S. average are taken into account. DATA SOURCES: Data on physicians who practiced in California at any time from 1988 to 1998 were obtained from the AMA Masterfile. The analysis was restricted to active, patient care physicians, excluding medical residents. Data on other covariates in the model were obtained from the Bureau of Economic Analysis, InterStudy, the Area Resource File, and the California state government. Data were merged using county FIPS codes. STUDY DESIGN: Changes in the physician-to-population ratio in California counties include the effects of both intrastate migration and interstate migration. A reduced-form model was estimated using the Arellano-Bond dynamic panel estimator. Economic conditions in California relative to the U.S. were measured as the ratio of county-level real per capita income to national-level real per capita income. Relative HMO penetration in California was measured as the ratio of county-level HMO penetration to HMO penetration in the U.S. relative HMO penetration was instrumented using five identifying variables to address potential endogeneity. Omitted-variable bias was controlled for by first differencing the model. The model also incorporated eight other covariates that may be associated with the demand for physicians: the percentage of the population enrolled in Medicaid, beds in short-term hospitals per 100,000 population, the percentage of the population that is black, the percentage of the population that is Hispanic, the percentage of the population that is Asian, the percentage of the population that is below age 18, the percentage of the population that is aged 65 and older, and the percentage of the population that are new legal immigrants in a given year. All of the above variables were lagged one period. The lagged physician-to-population ratio was also included to control for the supply of physicians. Separate equations were estimated for primary care physicians and specialist physicians. PRINCIPAL FINDINGS: Changes in lagged relative HMO penetration are negatively associated with changes in specialist physicians per 100,000 population. However, this effect of HMO penetration is attenuated and at times reversed in areas where the magnitude of the difference in relative economic conditions is sufficiently large. We did not find any statistically significant effects for primary care physicians. CONCLUSIONS: Consistent with prior studies, we find that changes in physician supply are associated with changes in relative HMO penetration. Relative economic conditions are an important moderator of the effect of changes in relative HMO penetration on physician migration.

California↗
PubMed1991

Aggressive and nonaggressive behavior as a function of alcohol intoxication and frustration in women.

An experiment tested whether alcohol increases aggression in women in a situation in which both an aggressive and a nonaggressive response alternative of equal instrumentality and of equal variability are available. Subjects were assigned to one of three groups, namely, an alcohol, a placebo, or a control group. The alcohol dose was 1.0 ml of pure alcohol/kg body weight. After drinking their respective drink, subjects were instructed to supervise a bogus partner on a visual scan test over a series of trials. Each time this partner made a mistake, subjects could either give an uncomfortable electric shock (scale 1 to 10) or a comfortable vibration (scale 1 to 10) to the partner. Aggressive and nonaggressive behavior was measured as numbers, intensities, and durations of shocks or vibrations, respectively. Neither alcohol nor frustration differentiated the groups on aggressive or nonaggressive behavior. All groups were significantly more inclined to use the nonaggressive alternative irrespective of alcohol dose and level of frustration. In conclusion it was stated that women do not increase their aggression as a function of alcohol in a situation with more than one response alternative available. The need to incorporate gender differences as to aggressive effects of alcohol was stressed.

Adult↗
PubMedDate not supplied

Submaximal exercise testing using lactate threshold and venous oxygen tension as endpoints in normal dogs and in dogs with heart failure.

Twelve normal dogs and 7 dogs with experimentally induced heart failure were chronically instrumented to measure hemodynamic variables and blood gas tensions at rest and during graded treadmill exercise. Three groups of 4 normal dogs each (group 1, 15 to 20 kg; group 2, 21 to 30 kg; group 3, 31 to 40 kg) were exercised on a treadmill at a 16% grade at 1, 2, and 3 miles per hour, and at a 22% and a 26% grade at 3 miles per hour (5 total exercise levels) until blood lactate concentration increased to a value greater than 1 mmol/L. Blood lactate concentration and blood gas tensions were measured 5 and 15 minutes after starting exercise, and cardiac output was measured between 8 and 10 minutes of exercise. Results indicated that the same exercise protocol could be used for dogs ranging in size from 15 to 40 kg. Blood lactate concentration increased in normal dogs at varying workloads, but always at or above a workload of 3 miles per hour at a 16% grade. Dogs with class IV heart failure always experienced an increase in blood lactate concentration when walked at 1 mile per hour at a 16% grade for 5 minutes. A femoral vein PO2 between 21 and 24 mm Hg in normal dogs, and between 16 and 22 mm Hg in dogs with heart failure was always associated with an increase in blood lactate concentration. The primary problem with this exercise protocol was the unwillingness of some dogs to walk on the treadmill during the preselection phase. We conclude that we have devised a submaximal exercise test that can be used to evaluate exercise capability in dogs ranging in size from 15 to 40 kg, that the described exercise protocol can be used to identify decreased flow reserve in dogs with class IV heart failure induced by rapid ventricular pacing, and that either femoral vein oxygen tension or blood lactate concentration can be used as the endpoint for submaximal exercise testing in dogs.

Analysis of Variance↗
PubMed1997

Cardiac contractile function during coronary stenosis in dogs: association of adenosine in glycolytic dependence.

We tested the hypothesis that during critical coronary stenosis, endogenous adenosine alters myocardial glucose utilization to support myocardial contractile function (MCF). Anesthetized mongrel dogs were instrumented to measure hemodynamic variables, regional MCF (sonomicrometry), and substrate uptakes. Critical coronary artery stenosis was established with a screw clamp on the left circumflex coronary artery (LCX). Either 8-phenyltheophylline (3 x 10(-7) mol/min; adenosine-receptor blockade), iodoacetate (1 x 10(-5) mol/min; glycolysis blockade), or vehicle was infused into the LCX and the left anterior descending coronary artery (LAD). Critical coronary stenosis caused small decreases in arterial blood pressure and LCX blood flow, but no significant changes in MCF or other hemodynamics. There was a significant decrease in the O2 supply-to-consumption ratio in the stenotic region and an increased glucose uptake. Infusion of either 8-phenyltheophylline or iodoacetate caused a decrease in MCF in the stenotic LCX region concomitant with a decreased glucose uptake and without further changes in blood flow. This was not seen in the nonstenotic (LAD) region. These data support the hypothesis, indicating that glycolysis is vital for maintaining regional MCF during a decrease in the myocardial O2 supply-to-consumption ratio and that adenosine is important in this regard, independent of its vasoactive properties.

Adenosine↗
PubMedDate not supplied

Social support for school-aged siblings of children with cancer: a comparison between parent and sibling perceptions.

This descriptive, exploratory study investigated the social support interventions received by school-aged siblings of children with cancer and which of those interventions are perceived as being helpful. A comparison between the siblings' and parents' perceptions was made. The conceptual framework was guided by House's (1981) work on social support, which includes major categories of support variables including emotional, informational, instrumental, and appraisal support. A nonprobability purposive sample consisted of 50 school-aged siblings of children with cancer and their parents. Subjects completed either the sibling or parent version of the Nurse-Sibling Social Support Questionnaire (NSSSQ). Descriptive statistical analyses were performed to examine NSSSQ helpfulness and frequency scores for both siblings and parents. Paired t tests were used to test the difference between the responses given by siblings and by their parents on the NSSSQ helpfulness and frequency scales. Results demonstrated that siblings perceive interventions aimed at providing emotional and instrumental support as the most helpful. Parents perceived interventions aimed at meeting the siblings' need for emotional and informational support the most beneficial. Parents reported that siblings receive emotional, informational, and appraisal support more frequently than siblings did.

Adult↗
PubMed2005

Changes in accessibility and preferences predict children's future fruit and vegetable intake.

BACKGROUND: Most children eat fewer fruits and vegetables than recommended. To be able to design effective interventions, understanding the aetiology of the behaviour is important. Accessibility and preferences have shown to be strong correlates of fruit and vegetable intake in several cross-sectional studies. The aim of this study was to identify predictors of future fruit and vegetable intake and to explore longitudinal patterns of interactions between accessibility and preferences. METHODS: Data presented are based on baseline (September 2001) and follow-up (May/June 2002) surveys of 20 control schools in the Norwegian intervention study Fruits and Vegetables Make the Marks. A total of 816 pupils (77%) completed both baseline and follow-up questionnaires. The average age of the sample at baseline was 11.8 years. The research instrument assessing potential predictor variables was guided by Social Cognitive Theory, and included Accessibility at home, Accessibility at school, Modelling, Intention, Preferences, Self-Efficacy and Awareness of the 5-a-day recommendations. Multiple regression analyses were performed. RESULTS: All independent variables (measured at baseline) were significantly correlated to future fruit and vegetable intake (measured at follow-up). When reported fruit and vegetable intake at baseline (past intake) was included in this model, the effect of the other independent variables diminished. Together with past intake, the observed change in the independent variables from baseline to follow-up explained 43% of the variance in the reported intake at follow-up. Past intake remained the strongest predictor, but changes in accessibility at home and at school, as well as changes in preferences for fruits and vegetables, also explained significant amounts of the variance in fruit and vegetable intake at follow-up. In addition, baseline accessibility was found to moderate the relationship between change in preferences and change in intake. CONCLUSION: Change in accessibility and preferences appear to be important predictors of future fruit and vegetable intake among school children. Interventions should focus on strategies to modify these factors.

Journal Article↗
PubMed2002

In vitro evaluation of dissolution behavior for a colon-specific drug delivery system (CODES) in multi-pH media using United States Pharmacopeia apparatus II and III.

United States Pharmacopeia dissolution apparatus II (paddle) and III (reciprocating cylinder) coupled with automatic sampling devices and software were used to develop a testing procedure for acquiring release profiles of colon-specific drug delivery system (CODES) drug formulations in multi-pH media using acetaminophen (APAP) as a model drug. System suitability was examined. Several important instrument parameters and formulation variables were evaluated. Release profiles in artificial gastric fluid (pH 1.2), intestinal fluid (pH 6.8), and pH 5.0 buffer were determined. As expected, the percent release of APAP from coated core tablets was highly pH dependent. A release profile exhibiting a negligible release in pH 1.2 and 6.8 buffers followed by a rapid release in pH 5.0 buffer was established. The drug release in pH 5.0 buffer increased significantly with the increase in the dip or paddle speed but was inversely related to the screen mesh observed at lower dip speeds. It was interesting to note that there was a close similarity (f2 = 80.6) between the release profiles at dip speed 5 dpm and paddle speed 100 rpm. In addition, the release rate was reduced significantly with the increase in acid-soluble Eudragit E coating levels, but lactulose loading showed only a negligible effect. In conclusion, the established reciprocating cylinder method at lower agitation rates can give release profiles equivalent to those for the paddle procedure for CODES drug pH-gradient release testing. Apparatus III was demonstrated to be more convenient and efficient than apparatus II by providing various programmable options in sampling times, agitation rates, and medium changes, which suggested that the apparatus III approach has better potential for in vitro evaluation of colon-specific drug delivery systems.

Acetaminophen↗
PubMed2004

Driver route-following and safety errors in early Alzheimer disease.

OBJECTIVE: To assess navigation and safety errors during a route-following task in drivers with Alzheimer disease (AD). DESIGN/METHODS: Thirty-two subjects with probable AD (by National Institute of Neurological and Communicative Disorders criteria) of mild severity and 136 neurologically normal older adults were tested on a battery of visual and cognitive tests of abilities that are critical to safe automobile driving. Each driver also performed a route-finding task administered on the road in an instrumented vehicle. Main outcome variables were number of 1) incorrect turns; 2) times lost; and 3) at-fault safety errors. RESULTS: The drivers with mild AD made significantly more incorrect turns, got lost more often, and made more at-fault safety errors than control subjects, although their basic vehicular control abilities were normal. The navigational and safety errors were predicted using scores on standardized tests sensitive to visual and cognitive decline in early AD. CONCLUSIONS: Drivers with Alzheimer disease made more errors than neurologically normal drivers on a route-following task that placed demands on driver memory, attention, and perception. The demands of following route directions probably increased the cognitive load during driving, which might explain the higher number of safety errors.

Aged↗
PubMed1999

Air pollution and health effects: A study of medical visits among children in Santiago, Chile.

Many epidemiological studies conducted in the last several years have reported associations between exposure to airborne particulate matter, measured as PM10 (<10 microm in diameter), and daily morbidity and mortality. However, much of the evidence involves effects on the elderly population; there is less evidence about the effects of particulates on children, especially those under 2 years of age. To examine these issues, we conducted time-series analyses of 2 years of daily visits to primary health care clinics in Santiago, Chile, where counts were computed for either upper or lower respiratory symptoms and for cohorts of children 3-15 years of age and below age 2. Daily PM10 and ozone measurements and meteorological variables were available from instruments located in downtown Santiago. The multiple regression analysis indicates a statistically significant association between PM10 and medical visits for lower respiratory symptoms in children ages 3-15 and in children under age 2. PM10 is also associated with medical visits related to upper respiratory symptoms in the older cohort, while ozone is associated with visits related to both lower and upper respiratory symptoms in the older cohort. For children under age 2, a 50- microg/m3 change in PM10 (the approximate interquartile range) is associated with a 4-12% increase in lower respiratory symptoms. For children 3-15 years of age, the increase in lower respiratory symptoms ranges from 3 to 9% for a 50- microg/m3 change in PM10 and 5% per 50 ppb change in ozone. These magnitudes are similar to results from studies of children undertaken in Western industrial nations.

Adolescent↗
PubMed1996

Seasonal variation in alcohol use.

OBJECTIVE: The objective of this article is to describe and quantify seasonality in a number of indicators on alcohol use. METHOD: The data analyzed cover a period between 1988 and 1994, and are collected by a telephone survey of persons living in Glasgow and Edinburgh, Scotland. The analysis is on data from 29,256 respondents. Cosinor analysis is the analytical instrument applied; a dummy variable is incorporated in the analysis to model the December peak in alcohol use. RESULTS: Annual seasonality in alcohol use excluding drinking behavior in December, is highest in the summer. Seasonality with regard to changes in the proportion of respondents who report drinking alcohol in the previous month, or in the proportion of less regular heavy drinkers, is, although statistically significant, not very pronounced. With regard to drinking five or more drinks on 11 or more occasions in the past month the level of seasonality is very pronounced. The December peak in alcohol use powerfully influences the proportion of respondents who report drinking alcohol in the previous month, and the proportion of irregular and regular heavy drinkers. CONCLUSIONS: The data support previous advice that health promotion and health policy activities in relation to alcohol use should take place during the December festive period and, if one aims at heavy drinking, the summer.

Alcohol Drinking↗
PubMed2003

Physician collective bargaining in a U.S. public hospital.

In a study to investigate the factors that would drive attending physicians employed in a public hospital to seek collective bargaining with their employer, the authors developed an instrument to determine which variables and which hypotheses were predictive of union proneness. The findings reveal that a desire for voice was the number one reason for physicians' wanting to join a union. Union-prone physicians had a lower salary on average, were more dissatisfied with their income, were more likely to feel the effects of work "speed up" (too many patients and too little time), were less likely to have administrative functions (thus a larger patient care role), had a strong sense of entitlement to collective bargaining, believed that unions improve participation in decisions affecting their jobs (reinforcing their desire for voice), and had a sense that a union would improve their treatment by supervisors (reinforcing their desire for due process and equity).

Adult↗
PubMed2001

[A survey on how medical student consider end-if-life care in the elderly].

We examined the way medical students think about end-of-life care in the elderly by a questionnaire survey. The major variables of the evaluation instrument included the students' idea of the special nature of end-of-life care for the elderly, the necessity for disclosure of the name of disease, consideration for patient's age on disclosure, advance directives concerning their life-sustaining treatment, and communication concerning preferences for end-of-life care. The final items on the instrument asked for student comments about end-of-life care in the elderly. We analyzed this qualitative data using the process of immersion/crystallization. We received 95 responses, and of these 65 (68%) provided written commentaries that were analyzed using qualitative techniques. Fifty-nine (62%) students pointed out the special nature of end-of-life care in the elderly and most of them (96%) needed the disclosure of the name of disease. Fifty-two (55%) students agreed with advance directives for end-of-life care and 88 (93%) students pointed out the importance of communication with regard to patients' preferences. Medical students' concerns about end-of-life care in the elderly related to three major domains: 1) patient-physician relationship; 2) the procedures of end-of-life care; and 3) emotional and intuitive comments. These results suggest that in the education of geriatric medicine the patient-physician's relationship about end-of-life care is important and we may need to introduce systematic lectures and practical training.

Aged↗
PubMed2006

[Comparison of quality of life between kidney transplant and hemodialysis patients].

PURPOSE: The purpose of this study was to discover kidney transplant and hemodialysis patients' quality of life(QOL) and provide basic data to improve their QOL. METHOD: One hundred two hemodialysis patients and 106 kidney transplant patients were given a self-administered questionnaire from Mar. 6 to Mar. 31, 2006. The instrument consisted of demographic variables, therapeutic-related characteristics and QOL. Collected data was processed using the SPSS 12.0 statistical program for real numbers, percentages, ANCOVA, t-test, ANOVA, Stepwise multiple regression and the Scheffe test. RESULTS: Kidney transplantpatients' QOL was higher than hemodialysis patients. The demographic variables which showed a significant difference in overall QOL were religion, children and monthly income for kidney transplantpatients and educational background for hemodialysis patients. The therapeutic-related variable which showed a significant difference in overall QOL was the patients' perceived health condition for both groups. The influencing factor on overall QOL for both groups was the health condition perceived by themselves. The total variance of the variable for QOL was 42% for kidney transplant patients and 19% for hemodialysis patients. CONCLUSION: This study revealed that kidney transplant patients have a higher QOL and how patients perceive their health is the strongest influencing factor for QOL. However, there is a large difference between the demand and supply of kidney donors. To solve this problem the standards for donation should be reviewed and revised.

Adult↗