The Journal of the Convergence on Culture Technology (문화기술의 융합)

The International Promotion Agency of Culture Technology (국제문화기술진흥원)
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The Effect of Cool Dialysis on Dialytic Stability, Feeling of Fatigue, Pruritus and Dialysis adequacy in Hemodialysis Patients

저온투석이 혈액투석환자의 투석안정성, 피로감, 소양증과 투석적절도에 미치는 영향

  • Received : 2018.08.07
  • Accepted : 2018.09.29
  • Published : 2018.11.30
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Abstract

The purpose of this study was to examine the effect of the application of cool dialysis on dialytic stability, feeling of fatigue, pruritus and dialysis adequacy in hemodialysis. Methods: The study design was nonequivalent control group pretest-posttest design. The subjects were 50 patients who were hospitalized to hemodialysis. The experimental group cool dialysis(n=25) and the control group received only the usual treatment (n=25). The collected data were analyzed using independent t-test to examine study hypothesis. Results: The level of dialytic stability (F=5.53, p=.023) and feeling of fatigue (F=4.01, p<.001) in the experimental group were significantly different from that of the control group. However, the level of pruritus(F=.74, p=.394) and dialysis adequacy(F=1.02, p=.327) in the experimental group were not different from that of the control group. Conclusion: The study findings confirm that cool dialysis as an effective intervention alleviating dialytic stability and feeling of fatigue.

본 연구는 저온투석 적용이 혈액투석환자의 투석안정성, 피로감, 소양증과 투석적절도에 미치는 효과를 규명하기 위하여 시도되었다. 연구설계는 비동등성 대조군 전후 설계를 이용한 유사실험 연구이며, 연구대상자는 B시에 소재한 G 종합병원에 혈액투석을 받는 환자로 저온투석 간호중재를 적용한 실험군 25명, 대조군 25명으로 총 50명을 선정하였다. 결과인 제1가설은 "저온투석요법군과 일반투석요법군은 시간의 경과에 따라 투석안정성에 차이가 있을 것이다"는 수축기압만 지지되었다(p=.023). 제2가설은 "저온투석요법군과 일반투석요법군은 시간의 경과에 따라 피로감에 차이가 있을 것이다"는 지지되었다(p<.001). 제3가설은 "저온투석요법군과 일반투석요법군은 시간의 경과에 따라 소양증에 차이가 있을 것이다"는 기각되었다. 제4가설은 "저온투석요법군과 일반투석요법군은 시간의 경과에 따라 투석적절도에 차이가 없을 것이다"는 지지되어 같은 효과로 나타났다. 결론은 혈액투석환자의 투석안정성, 피로감에 대한 관리 방법으로 저온투석 적용시 효과가 있는 것으로 보인다.

Keywords

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그림 1. 연구설계 Figure 1. The study design

표 1. 특성에 따른 동질성검증 Table. 1. Homogeneity General Characteristics

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표 2. 종속변수에 따른 동질성검증 Table. 2. Difference of Majior Variable between the Experimental and Control group

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표 3. 투석안정성 중 수축기압 비교 Table. 3. Comparison of Contractile Pressure between the Experimental and Control Groups

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표 5. 투석안정성 중 체온 비교 Table. 5. Comparison of Temperature between the Experimental and Control Groups

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표 6. 피로 비교 Table. 6 Comparison of Feeling of Fatigue between the Experimental and Control Groups

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표 7. 소양증 비교 Table. 7. Comparison of Pruritus between the Experimental and Control Groups

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표 8. 투석적절도 중 Kt/V비교 Table. 8. Comparison of Kt/V between the Experimental and Control Groups

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표 9. 투석적절도 중 URR비교 Table. 8. Comparison of URR between the Experimental and Control Groups

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표 4. 투석안정성 중 이완기압 비교 Table. 4. Comparison of Relaxation Pressure between the Experimental and Control Groups

GJMGCK_2018_v4n4_11_t0009.png 이미지

References

  1. National Health Insurance Service. http://www.nhis.or.kr
  2. Korean Society of Nephrology. Current renal replacement therapy in Korea. ESRD Registry Committee, pp24, 2017.
  3. H. J. Woo, I. Y. Kim, M. R. Kim, A. Y. Chun, S. S. Kim. The effect of cool temperature dialysate on blood pressure, physical discomfort, pialysis adequacy in hemodialysis patients. The chung-Ang Journal of Nursing, Vol.13, pp.41-48, 2009.
  4. S. C. J. Yeh, H. C. Chou. Coping strategies and stressors in patients with hemodialysis. Psychosomatic medicine, Vol.69, No.2, pp.182-190, February-March, 2007. doi: 10.1097/PSY.0b013e318031cdcc
  5. M. Bossola, C. Vulpio, L. Tazza. Fatigue in Chronic Dialysis Patients, Seminars in dialysis, Vol.24, No.5, pp. 550-555, September, 2011. https://doi.org/10.1111/j.1525-139X.2011.00956.x
  6. J. J. Bergman, A. M. Berkel. M. J. Bruno et al. A randomized trial of endoscopic balloon dilation and endoscopic sphincterotomy for removal of bile duct stones in patients with a prior Billroth II gastrectomy. Gastrointest Endosc, Vol. 53, pp.19-26, 2001. https://doi.org/10.1067/mge.2001.110454
  7. C. N. Yan, W. G. Yao, Y. J. Bao, X. J. Shi, H. Yu, P. H. Yin et al. Effect of auricular acupressure on uremic pruritus in patients receiving hemodialysis treatment: A randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, Vol. 22, pp.1-8, July, 2015. http://dx.doi.org/10.1155/2015/593196
  8. H. O. An fatigue and physical symptoms of patients after hemodialysis [Master's thesis], Hanyang University, Seoul, pp.91, 2008.
  9. E. J. Lee, B. S. Kim, I. H. Sa, K. E. Moon. The effects of aromatherapy on sleep disorders, satisfaction of sleep and fatigue in hemodialysis patients. Korean Journal of Adult Nursing, Vol.23, No.6, pp615-623, 2011.
  10. H. W. Kim. Fatigue and fatigue-regulation behavior in hemodialysis patients. Journal of Digital Convergence, Vol.10, No.5, pp.301-305, 2012. https://doi.org/10.14400/JDPM.2012.10.5.301
  11. J. C. Shin, G. H, Na, D. H. Lee, C. R. Ryu, W. S. Chae, Y. C. Yoon et al. A case report pruritic dermatoses. Korean Journal Acupuncture. Vol. 22, No.3, pp.157-163, 2005.
  12. M. Murphy, A. J. Carmichael. Renal itch. Clinical and Experimental Dermatology. Vol. 25, No.2, pp.103-106, 2000. DOI: 10.1046/j.1365-2230.2000.00587.x
  13. J. Y. Park, H. S. Hong. The effects of cool dialysis on pruritus of chronic renal failure patients. Vol. 12, No.1, pp.31-38, 2010.
  14. J. Z. Kallenbach. Review of homodialysis for nurses and dialysis personnel, Elsevier, America, pp.419, 2015.
  15. National Kidney Foundation. 2006 Updates Clinical Practice Guidelines and Recommendations. https://www.kidney.org
  16. S. J. Yun, Y. H. Lee. Factors influencing uncertainty in dialysis patient by duration of dialysis. Korean J Adult Nurs, Vol24, No6, pp.597-606, December, 2012. DOI : 10.7475/kjan.2012.24.6.0597
  17. A. K. Lee, G., Hicks, G. Nino-Mucria. Validity and reliability of a scale to assess fatigue. Psychiatry Research, Vol. 36, pp. 291-298, 1991. https://doi.org/10.1016/0165-1781(91)90027-M
  18. L. J. Duo. Electrical needle therapy of uremic pruritus. Nephron, Vol.47, No.3, pp.179-183, 1987. https://doi.org/10.1159/000184487
  19. H. J. Ha. Effect of aromatherapy on skin xerosis and pruritus in patients undergoing maintenance hemodialysis. Journal of Korean Academy of Nursing, Vol.29, No.6, pp. 1284-1293, 1999. https://doi.org/10.4040/jkan.1999.29.6.1284
  20. Health Insurance review and assessment service, 2010, http://www.hira.or.kr/main.do
  21. A. T. Azar. Effect of dialysate temperature on hemodynamic stability among hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation. Vol.20, No.64, pp.596-603, 2009.
  22. J. H. Im. The effects of cool dialysis on pruritus and fatigue in hemodialysis patients. [Master's thesis], Konkuk University, Seoul, pp. 39, 2013.
  23. H. S. Sim, J. K. Seo, S. K. Lee. A clinical study on uremic pruritus in hemodialysis patients. Korean Journal of Dermatology, Vol.47, No.10, pp.1127-1134, 2009.