투석치료 중인 만성신부전 환자의 영양지식 수준과 식사요법 실천 정도 및 교육요구도 Level of Nutrition Knowledge, Diet Practice and Education Demands in Dialysis Patients with Chronic Renal Failure원문보기
The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the ...
The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.
The number of patients is increasing and their mean age is also increasing. Proper dietary adjustments are necessary to prevent protein-calorie malnutrition or complications but it is difficult for dialysis patients to adapt to diet therapy due to stress or anorexia. Education does not consider the individual characteristics, knowledge, dietary inhabit education demands, and initial education. The purpose of this study was to identify dialysis patient's nutrition knowledge and, dietary practice and compare those with nutrition education or counseling demands for providing basic data of desirable nutrition management. The data were collected by a survey consisting of the general characteristics, disease related characteristics, nutrition education and counsel characteristics, level of nutrition knowledge, diet therapy, and nutrition education and counsel demands from the 28th March to 22th July 2017. The total number of subjects were 33 patients among dialysis patients at two tertiary medical institutions and an artificial kidney room at a private hospital in Incheon Gyeonggi. The data collected were analyzed statistically using the SPSS program 23.0, followed by further analyses using frequency analysis, one-way ANOVA, cross analysis, and correlation analysis. The results of the dialysis patients showed that younger (P<0.05), female (P<0.05), abnormal high school diploma (P<0.001) groups had high nutrition scores. In addition, dietary practice and nutrition education and counsel demands showed a positive correlation (P<0.05, P<0.01). In particular, females were higher than males in nutrition knowledge, dietary practice, nutrition education, and counseling demand scores.
만성신부전은 당뇨병, 고혈압, 만성사구체신염 등으로 인해 신장에 구조적ㆍ기능적 손상이 일어나 신장 기능이 지속적으로 떨어지는 질환이다(Kim 등2001). 신장 기능이 5% 이하로 떨어지면 말기신부전(End Stage Renal Disease, ESRD)이라고 하며, 신대체요법에 의지해야만 생명을 유지할 수 있다.
혈액투석을 하는 투석 환자들에게 식사조절이 중요한 이유는 무엇인가?
혈액투석을 5년 이상 시행한 환자는 45%를 차지한다. 투석치료를 하는만성신부전 환자는 투석 과정에서 많은 양의 단백질손실이 일어나 단백질-에너지 영양실조가 많이 발생하며, 이는 이환율 및 치사율을 결정하는 중요인자로알려져 있다. 혈액투석은 신장 기능의 많은 부분을 수행할 수 있지만 정상적인 신장만큼 노폐물, 수분, 전해질을 효과적으로 제거해줄 수 없기 때문에 투석 합병증을 예방하기 위해서 적절한 식사조절이 필요하다(Blackburn 1977). 그러나 투석 환자들은 식사 제한에대한 스트레스나 식욕부진 등으로 식사요법 적응을힘들어하며, 영양실조 및 합병증을 유발할 수 있다.
신대체요법은 어떤것들이 있는가?
신장 기능이 5% 이하로 떨어지면 말기신부전(End Stage Renal Disease, ESRD)이라고 하며, 신대체요법에 의지해야만 생명을 유지할 수 있다. 신대체요법으로는 신장이식과 혈액투석, 복막투석 등의 투석요법이 있다(Shin 1996). 대한신장학회(ESRD RegistryCommittee 2017)의 ‘2016년 우리나라 신대체요법의현황’ 자료에 따르면 2016년 신대체요법을 받은 환자는 93,884명이며, 특히 혈액투석을 시행하는 환자의 수는 68,852명이다.
참고문헌 (16)
Blackburn SL (1977): Dietary compliance of chronic hemodialysis patients. J Am Diet Assoc 70(1):31-37
ESRD Registry Committee, Korean Society of Nephrology (2017): Current renal replacement therapy in Korea-Insan memorial dialysis registry, 2016-. Korean Society of Nephrology. Seoul. pp.1-8
Hwang KM (2007): Study on the knowledge about hemodialysis and the needs for education in hemodialysis patients. Doctoral degree dissertation. Chungnam National University. pp.7-20
Jung YH, Ko SJ, Kim EJ (2013): A study on the effective chronic disease management. Research report. Korea Institute for Health and Social Affairs. Sejong. pp.79-104
Kim SS, Jo HS, Kang MS (2017): Effects of an individualized dietary education program for hemodialysis patients on diet knowledge, diet self-care compliance, and physiological indices. J Korean Biol Nurs Sci 19(2):51-59
Kim YH, Seo HY, Kim SR (2001): A study of the nutritional status, nutritional knowledge, and dietary habits of the hemodialysis patients. Korean J Nutr 34(8):920-928
Lee JJ, Kim JM, Kim YR (2013): Association of diet-related quality of life with dietary regimen practice, health-related quality of life, and gastrointestinal symptoms in end-stage renal disease patients with hemodialysis. Korean J Nutr 46(2):137-146
Lee SH (2016): A survey of knowledge and educational needs in therapeutic diet for patients with diabetic nephropathy. Masters degree thesis. Inha University. pp.36-39
Lim HS (2004): Level of knowledge and educational demands in pre-dialysis patients with chronic renal failure. Masters degree thesis. Yonsei University. pp.22-41, 64-73
Na YJ (2013): The effect of nutritional education on hyperphosphatemic end-stage renal failure patients. Doctoral degree dissertation. Chungnam National University. pp.62-66
Park KA, Sim YM, Kim SB, Choi KS (2006): A study of the nutritional status and its related factors in the elderly hemodialysis patients. Korean J Nutr 39(2):133-144
Seo JY, Kim NH, Heo YR (2012): A study on nutritional status during dialysis in patients undergoing continuous ambulatory peritoneal dialysis. Korean J Nutr 45(1):30-43
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