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투석 전 만성 신부전 환자의 사구체 여과율에 따른 삶의 질
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  • 투석 전 만성 신부전 환자의 사구체 여과율에 따른 삶의 질
  • Quality of Life in Pre-dialysis patients with Chronic Kidney Disease at Glomerular Filtration Rates
저자명
김혜원,최스미
간행물명
Journal of Korean Biological Nursing ScienceKCI,SCOPUS
권/호정보
2013년|15권 2호(통권33호)|pp.82-89 (8 pages)
발행정보
한국기초간호학회|한국
파일정보
정기간행물|KOR|
PDF텍스트(0.56MB)
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서지반출

국문초록

만성 신부전 환자는 기술적, 약물적 중재의 효과로 생존율이 증가하고 있으나 이들은 동반 질환, 치료와 관련한 부작용 등의 결과로 인해 신체적, 정신적 문제에 직면해 있다(Tong et al., 2009). 최근에는 생명 보존과 수명 연장을 중시했던 기존의 가치관에서 벗어나 생의 의미와 환자의 삶의 질에 대한 관심이 증대되고 있어 만성 신부전 환자의 삶의 질을 증진시키기 위한 다차원적이고 포괄적인 관심과 간호가 필요하다. 만성 신부전은 신장의 구조적, 기능적 이상이 3개월 이상 지속된 경우와 신장의 손상과 무관하게 3개월 이상 사구체 여과율이 60 mL/min/1.73 m2 미만으로 유지되는 경우로 정의된다(The National Kidney Foundation, 2002). 투석 전 만성 신부전 환자는 사구체 여과율이 60 mL/min/1.73 m2 미만이며 아직 투석을 시작하지 않은 환자로 사구체 여과율에 따른 분류상 3단계에서 5단계에 해당하는 환자이다(NKF, 2002). 투석 전 만성 신부전 환자의 경우, 수분 및 전해질 불균형, 산-염기 불균형, 칼슘과 인의 대사 문제, 빈혈, 면역 기능, 피부 기능, 성 기능, 약물의 배설 등의 문제로(Dinwiddie, Burrows-Hudson, & Peacock, 2006), 피로, 수면 장애, 식욕 부진 등의 신체적 문제뿐 아니라 두려움과 불안, 우울 등의 정신적인 문제를 경험한다(Dinwiddie et al., 2006; Gutierrez Vilaplana, Zampieron, Craver, & Buja, 2009; Tong et al., 2009). 따라서 지속적인 신기능의 감소로 인해 환자의 삶의 질은 장기적으로 저하될 수 있다(Fukuhara et al., 2007). 이에 우리나라와 미국에서 는 신기능의 지표인 추정 사구체 여과율이 60 mL/min/1.73 m2 이하인 환자들은 규칙적으로 삶의 질에 대한 평가를 할 것을 권고하고 있다(œe Korean Society of Nephrology, 2009; NKF, 2006). 따라서 투석 전 만성 신부전 환자의 사구체 여과율에 따른 각 단계별 삶의 질의 정도를 조사하여 단계별 특성을 이해하고, 잔여 신기능의 차이가 삶의 질에 미치는 영향을 파악하는 연구가 필요하다.

영문초록

Purpose: To examine the quality of life in pre-dialysis patients with chronic kidney disease. Methods: The subjects were 91 patients who visited the nephrology outpatient department of a tertiary hospital located in Seoul. Data on demographic and clinical characteristics, and quality of life (QOL) were collected between July 19 and July 23, 2010. The relationship between QOL and various Stages of dependence on glomerular filtration rates (GFRs) and factors related to QOL were investigated. Collected data was analyzed with the SPSS WIN 12.0 program. Results: There was a significant difference in the quality of life of the subjects in different stages (F=18.12, p<.001). The Scheffe post hoc test confirmed that patients at higher stages had a lower level quality of life. In addition, GFRs, uremic symptoms, gender and age predicted value accounted for 38.5% of the variance on QOL (F=25.09, p<.001). Conclusion: Strategies to develop a systematic management program for improving QOL of pre-dialysis patients are urgently needed.

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REFERENCES

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