ABSTRACT A Qualitative Case Study on the Experience of People with Renal Disease for Returning to Work while Receiving Hemodialysis According to the registration committee of the Korean Society of Nephrology, the number of hemodialysis patients sur... ABSTRACT A Qualitative Case Study on the Experience of People with Renal Disease for Returning to Work while Receiving Hemodialysis According to the registration committee of the Korean Society of Nephrology, the number of hemodialysis patients surveyed in 2015, was 62,834, which was rapidly increasing and its prevalence was shown to be 1,688 people per million. People who are diagnosed with End-stage renal disease are required to have hemodialysis treatments in order to remove waste products in blood, because their renal function is severely reduced at the level of less than 15% normal function so that their kidneys do not function well. Those who have been chronically hemodialyzed for more than 3 months are classified as the second grade kidney disorder and to be registered as the disabled. The standard of care for hemodialysis is 3 times a week and 4 hours per time. People with renal disease live on lifelong hemodialysis treatment. In 2015, 58.1% of patients diagnosed with end-stage renal disease turned out to be 65 years of age or younger. It implies plentiful workable people within ages from 20s to 50s are diagnosed with end-stage renal disease and their work is affected by the disease. Because patients with end-stage renal disease immediately receive hemodialysis, peritoneal dialysis and/or kidney transplantation, they have to quit or suspend their work and focus on health recovery. Their returning to work is practically difficult because of time required for them to receive hemodialysis 3 times a week and 4 hours per time. This study aims to investigate the experiences of patients with renal disease who have to quit their work owing to the diagnosis of end-stage renal disease and hemodialysis treatment, but would like to return to work, in the socio- cultural context of Republic of Korea. Experiences of patients with renal diseases on the diagnosis of end-stage renal disease, their hemodialysis treatment and returning to work were investigated in depth. The physicosocial characteristics and environment of their experience on returning to work were aimed to study. In addition, implications regarding social welfare were suggested from the influential factors and contextual exploration of their returning to work. Social welfare services necessitated by them were to be established by analyzing successful cases of returning to work. All patient-related research was approved by the Institutional Review Board (IRB) of Yonsei University (approval number: 7001988-201610-SB-271-02). Patient-related data had been collected from September, 2016 to December, 2016. Total 10 research participants were intentionally sampled to reflect their ages, sexes, educational status, marital status, occupational types and vocational types. In-depth interviews that took one to one and half hours were conducted. In order to ensure the reliability and validity of the study, experimental results were presented to the experimental participants, who were then asked to review whether the results were true or not. Their responses were used for the review and modification of the results. Finally, the results were consulted with an expert in the field of social welfare and modified, thereby increasing accuracy of the results. Analysis results were based on the transcripts obtained from the in-depth interviews. In-case analysis and case analysis employed in qualitative case studies were presented. In-case studies investigated major issues that each research participant experienced in returning to work, while case studies comprehensively analyzed experiences according to chronicle flow of returning to work. Experiences of people with renal disease while their hemodialysis (HD) on returning to work are classified into 9 main categories with 38 subcategories. The nine main categories were turned out to be ‘feeling desire to work while receiving HD’, ‘experiencing negative social pressure that makes them difficult to return to work’, ‘feeling hardship in the process of returning to work’, ‘utilizing appropriate labor-related systems’, ‘receiving help and support from others’, ‘experiencing difficulty after returning to work’, ‘recovering mental and psychological health after returning to work’ and ‘necessitating social environment for people with renal disease requiring HD’. Comprehensively analyzing the results and theoretical background, characteristics of the experiences that people with renal disease who are receiving HD can be discussed as follows. First, there is no difference in working ability comparing with non-diseased. Second, special accommodation is required for the people with renal disease under HD treatment while they are engaging work-related activities. Third, it is necessary to improve the misperception and prejudice against people with renal disease under HD treatment. Fourth, family support and encouragement is a vital factor for people with renal disease under HD treatment. Theoretical, practical and policy-wise implications based on the results of the study on the experiences of the patients returning to work are as follows. The theoretical implication is that this study investigated patients’ experiences in regard to social welfare to improve the quality of people with renal disease under HD treatment. This study established a new framework of understanding in regard to overall life and environment for returning to work of people with renal disease under HD treatment by comprehensively reviewing their experiences. This study also prepared basic materials for subsequent studies on their returning to work. The practical and policy-wise implications presented in this study are as follows. First, improving awareness and understanding of people with renal disease including patients under HD treatment is desperately imperative. Second, personalized care on people with renal disease is required. Third, a system e.g. ‘flexitime’, which reflects their special needs including allocation of time for HD treatment has to be actively employed. This study based on the analysis results proposed directions for subsequent studies toward improving the quality of the patients’ lives and their returning to work. Key words : Hemodialysis, End-Stage Renal Disease, People with Renal Disease, Return to Work, Qualitative Case Study 참고문헌 (Reference) |
