• Childhood Kidney Diseases
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• 제12권2호
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• pp.202-212
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• 2008

목 적 : 본 연구에서는 만성 복막투석 아동용 삶의 질 척도(Quality of Life Scale for Children on Chronic Peritoneal Dialysis: QOLCPD)를 개발하였다. 방 법 : QOLCPD문항 개발을 위한 자료수집을 위해서 서울대학교 어린이병원에서 복막투석 중인 30명의 만성 신부전 환아가 본 연구에 참여하였다. 타 임상 집단으로 28명의 소아정신과 장애 아동과 32명의 소아정형외과 아동이 연구에 포함되었고, 정상 통제집단으로는 초등학교에 재학중인 47명의 아동이 참여하였다. 연구대상 아동들의 연령범위는 7세-16세였다. 56개의 예비문항으로 이루어진 QOLCPD와 한국판 아동용 우울척도(CDI)를 모든 아동들에게 개별적으로 실시하였다. 결 과 : 수집된 자료에 대해 주축 요인분석을 실시하여 문항-전체 상관이 낮고 요인부하량이 .2이하인 16문항을 제외시켜서 총 40문항으로 이루어진 최종 QOLCPD를 개발하였다. QOLCPD의 신뢰도 계수인 Chronbach's $\alpha$는 .87로 양호한 수준이었다. 복막투석 집단과 소아정신과 아동 집단은 정상 집단에 비해 더 낮은 삶의 질 총점을 보였다. 특히 두 집단은 삶의 질 영역 중 신체적 기능과 학업 기능에서 정상집단에 비해 낮은 점수를 보였다. 복막투석 집단의 CDI 점수는 경한 우울 수준에 해당되었다. 결 론: 자기보고형 만성 복막투석 아동용 삶의 질 척도는 임상적 유용성이 있는 것으로 나타났다.

• Clinical and Experimental Pediatrics
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• 제56권4호
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• pp.159-164
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• 2013

Purpose: Indoxyl sulfate and p-cresyl sulfate are important protein-bound uremic retention solutes whose levels can be partially reduced by renal replacement therapy. These solutes originate from intestinal bacterial protein fermentation and are associated with cardiovascular outcomes and chronic kidney disease progression. The aims of this study were to investigate the levels of indoxyl sulfate and p-cresyl sulfate as well as the effect of probiotics on reducing the levels of uremic toxins in pediatric patients on dialysis. Methods: We enrolled 20 pediatric patients undergoing chronic dialysis; 16 patients completed the study. The patients underwent a 12-week regimen of VSL#3, a high-concentration probiotic preparation, and the serum levels of indoxyl sulfate and p-cresyl sulfate were measured before treatment and at 4, 8, and 12 weeks after the regimen by using fluorescence liquid chromatography. To assess the normal range of indoxyl sulfate and p-cresyl sulfate we enrolled the 16 children with normal glomerular filtration rate who had visited an outpatient clinic for asymptomatic microscopic hematuria that had been detected by a school screening in August 2011. Results: The baseline serum levels of indoxyl sulfate and p-cresyl sulfate in the patients on chronic dialysis were significantly higher than those in the children with microscopic hematuria. The baseline serum levels of p-cresyl sulfate in the peritoneal dialysis group were significantly higher than those in the hemodialysis group. There were no significant changes in the levels of these uremic solutes after 12-week VSL#3 treatment in the patients on chronic dialysis. Conclusion: The levels of the uremic toxins p-cresyl sulfate and indoxyl sulfate are highly elevated in pediatric patients on dialysis, but there was no significant effect by probiotics on the reduction of uremic toxins in pediatric dialysis patients. Therefore, studies for other medical intervention to reduce uremic toxins are also necessary in pediatric patients on dialysis.

• 기본간호학회지
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• 제10권2호
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• pp.163-170
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• 2003

Purpose: This study was done to identify stress, fatigue, and self efficacy in patients on dialysis and identify their effect on quality of life. Method: The participants (n=149) who agreed to participate in the research were selected from among those who were on dialysis treatment at C University Medical Centers in Seoul and Inchon, and at C University Medical Center in Jeju. The data were collected from July, 2001 to March, 2002 using interviews. Data analysis was done with t-test, ANOVA, and multiple stepwise regression using the SAS program. Result: Quality of life was significantly different according to economic status, and type of dialysis. Quality of life for the group with higher economic status was better than for the group with lower economic status, and the group on peritoneal dialysis had higher quality of lift scores than the group on hemodialysis. As for self-efficacy, there were significant difference according to duration of disease, type of dialysis, and duration of dialysis. Stress was significantly different according to marital status. Quality of life was significantly predicted by stress (40.02%) and fatigue (3.85%). Conclusion: To improve quality of life for people on dialysis, their stress should be treated positively, also multi-dimensional nursing interventions to provide emotional support and nursing interventions to diminish fatigue are required.

• Clinical and Experimental Pediatrics
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• 제57권3호
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• pp.135-139
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• 2014

Purpose: Adult Korean patients on chronic dialysis have a 9-year survival rate of 50%, with cardiovascular problems being the most significant cause of death. The 2011 annual report of the North American Pediatric Renal Trials and Collaborative Studies group reported 3-year survival rates of 93.4% and relatively poorer survival in younger patients. Methods: In this study, we have reviewed data from Korean Pediatric Chronic Kidney Disease Registry from 2002 to 2010 to assess survival rates and causes of death in Korean children on chronic dialysis. Results: The overall estimated patient survival rates were 98.4%, 94.4%, and 92.1% at 1, 3, and 5 years, respectively. No significant difference was observed in survival rates between patients on peritoneal dialysis and those on hemodialysis. Patients for whom dialysis was initiated before 2 years of age (n=40) had significantly lower survival rates than those for whom dialysis was initiated at 6-11 years of age (n=140). In all, 26 patients had died; the mortality rate was 19.9 per 1,000 patient years. The most common causes of death were infections and comorbidities such as malignancy and central nervous system (CNS) or liver diseases. Conclusion: The outcomes observed in this study were better than those observed in adults and comparable to those observed in pediatric studies in other countries. To improve the outcomes of children on chronic dialysis, it is necessary to prevent dialysis-related complications such as infection, congestive heart failure, or CNS hemorrhage and best control treatable comorbidities.

• Childhood Kidney Diseases
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• 제12권1호
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• pp.38-46
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• 2008

목적 : 성장장애는 만성 신부전에서 중요한 합병증으로 최근 성장호르몬 사용으로 이를 극복하려는 시도가 이루어지고 있다. 본 연구에서는 소아 만성 복막투석 환자에서 성장호르몬의 치료 효과와 성장에 영향을 주는 요인을 알아보고자 하였다. 방법 : 2001년부터 2007년까지 7년간 삼성서울병원에서 만성신부전으로 복막투석을 시행한 적이 있거나 현재 투석 중인 36명의 환자 중에서 1년 이상 성장호르몬을 사용한 환자 17명을 대상으로 후향적으로 의무기록을 분석하였다. 17명 중 1년 간 성장호르몬을 사용한 후의 Ht-SDS가 치료 후 감소되었거나 혹은 증가하지 않은 6명과 성장호르몬 치료 1년 후 Ht-SDS가 증가된 11명으로 나누어 두 그룹간의 차이를 비교하였다. 결과 : 17명의 환자 중 남자가 12명 여자가 5명이었으며, 투석 시작시의 평균 연령은 7.7${\pm}$5.2 세, 성장호르몬 투여 시작시의 평균 연령은 8.5${\pm}$4.8 세였다. 성장이 잘 된 그룹과 그렇지 않은 그룹간의 비교에 있어서는 성장이 잘된 군이 그렇지 않은 군에 비해 성장호르몬 투여시의 Ht-SDS가 더 작았으며(-1.72${\pm}$1.00 vs. -0.77${\pm}$0.88, P=0.048), 잔여 신기능(residual renal Kt/V)이 더 좋았다(1.54${\pm}$0.51 vs. 0.15${\pm}$0.26, P=0.02). 17명의 환자 중 성장호르몬을 3년 간 사용한 8명의 환자들을 분석해보면 성장호르몬 치료 초기 Ht-SDS 의 증가가 없었던 군은 지속적인 성장호르몬 사용에도 불구하고 여전히 Ht-SDS의 증가가 없었다. 결론 : 만성 복막투석 환자들에게 있어 성장장애가 심한 환자 일수록 성장호르몬 치료효과가 좋았고, 복막투석 중 잔여신기능 유지가 성장호르몬의 효과를 높이기 위해 중요하였다. 또한 성장호르몬 치료 시작 1년 후 Ht-SDS가 증가하였는지를 평가하는 것이 장기간 성장호르몬을 사용할 때의 효과를 예측하기 위해 중요할 것으로 생각된다.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.423-423
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• 2018

• 의학교육논단
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• 제3권2호
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• pp.35-43
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• 2001

Development and Evaluation of the Effectiveness of a Web-Based Learning System Program for Nursing Education on Peritoneal Dialysis Ji-Soo Yoo(Professor, College of Nursing, Yonsei University, Seoul, Korea) Seong-Mi Moon(Doctoral Candidate, College of Nursing, Yonsei University, Seoul, Korea) The purpose of this study was to develop a nursing education program using a web-based learning system to teach peritoneal dialysis and to evaluate the effectiveness of the program. The program was developed in two steps. The first step was to develop the content using CVI, and the second was to program it using HTML. The program which was developed was evaluated with 50 nurses of whom 48 responded to the questionnaire. The results are as follows: Of the subjects, 85.4% responded that they were satisfied with this web-based learning system and 87.5% stated that they would recommend this system to nurses who are in other nursing education programs. Of the educational material charac- teristics, the item that the subjects evaluated as most valuable was "accuracy of the content". For system related charact- eristics, the item to which the subjects gave the most positive response was "clarity of the system tool marking" (81.3%). In conclusion, it was verified that a web-based learning system is an effective and satisfactory method for nursing education.

• 보건교육건강증진학회지
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• 제18권1호
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• pp.17-33
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• 2001

The purpose of this study was to identify the major factors affecting performance in health promoting lifestyles in continuous ambulatory peritoneal dialysis(CAPO) patients. The subjects for this study were 98 CAPO patients living in Pusan city. The data for this study were collected from October 15th, 1999 to January 15th, 2000 by structured questionaries. Statistical analysis was done using SPSS softwares. The results were as follows: 1. The average score of performance in the health promoting lifestyles was 2.34. The variable with the highest degree of performance was self-actualization and nutrition, whereas the one with the lowest degree was exercise. 2. In the subscale of the health promoting lifestyles, especially educational level, marital state and CAPO period, there was significant differences between demographic variables and performance in the health promoting lifestyles. 3. The activity-related affect, situational influences, self-efficacy, and perceived barriers in the behavior-specific cognitions and affect have a significant correlation with performance in the health promoting lifestyles. 4. The most important variable that affects the performance in the health promoting lifestyles was situational influences, and the self-efficacy, perceived barriers, every monthly treatment cost, duration of chronic renal failure followed in order, activity-related affect. Those six variables accounted for 38.3% among the variables in health promoting lifestyles.

• 기본간호학회지
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• 제5권2호
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• pp.313-323
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• 1998

This study was a descriptive research on the level of self-care available to continous ambulatory peritoneal dialysis patients (hereinafter referred to as 'CAPD patient') related to the specific area of infection management. The method employed for the collection of data was a modified instrument of the self-care survey essentially based on Young Sook Choi's instrument. The relevant data was collected from september 1, 1996 to september 30, 1996. The subjects were provided with an open-ended question regarding the reasons behind why they did not seek self-care. The answers provided about self-care compliance were analyzed by SPSS for frequency, percentage, mean, t-test, ANOVA. Reasons for non-compliance were analyzed by content analysis. The results of the study were as follows : 1. The percentage of patients engaging in self-care were according to the following self performed tasks : preparation of dialysis : 30.58 points Dialysate exchange procedures : 49.40 points - Two bag type : 50.50 points - Spike type : 48.80 points - Neo type : 48.90 points Catheter exit site care : 25.13 points More specifically, in relation to the preparation of dialysis as referred to above, those patients engaging in self care was relatively high with respect to the cleaning of the dialysis before use and for the preservation of peritosol. However, in dialysate exchange procedures, data revealed that those patients engaging in self-care are relatively low with respect to putting on a mask during the performance of peritosol exchange. Similary in peritosol exchange procedure and catheter exit care, low levels of self-care performance were found in the area of putting on a mask during the peritosol exchange procedures and catheter line testing procedures, respectively. 2. In general characteristics, there appeared to be no distinction in self-care compliance among CAPD patients. 3. The main reasons for non-compliance were based in the following factor : intellectual, attitude, enviromental surrounding and physical. As a result of the foregoing finding, nurses should provide adequate assistance to promote self-care compliance by CAPD patients by checking the preparation of dialysis, dialysate exchange procedure, and catheter exit site care which recieved low point in this research.

• Asian Journal for Public Opinion Research
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• 제7권2호
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• pp.94-112
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• 2019

Objective: The objective of this study was to compare the quality of life (QOL) of patients with end-stage renal disease (ESRD) between patients receiving hemodialysis (HD) and patients receiving continuous ambulatory peritoneal dialysis (CAPD) and to compare personal characteristic factors relating to the quality of life in patients with ESRD. Method: This study used a descriptive research design. The sample was recruited using purposive sampling that included 76 ESRD patients receiving either HD or CAPD at a dialysis clinic in Phraphutthabat Hospital, Saraburi Province, Thailand. Data was collected using the Quality of Life Questionnaire for Chronic Kidney Disease ($KDQOL-SF^{TM}$) version 1.3. Independent t-test and ANOVA procedures were used to analyze study data. Results: The results revealed that the HD patients had a moderate level of QOL. The highest scoring dimension of QOL was the encouragement of staff at the dialysis unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=89.29$, SD =16.88) and cognitive function (${\bar{X}}=88.57$, SD=11.82). On the other hand, the lowest scoring QOL dimension was physical problems (${\bar{X}}=50$, SD=51.89), and pain (${\bar{X}}=50$, SD=39.03), followed by work status (${\bar{X}}=53.57$, SD=45.84) and burden from kidney disease (${\bar{X}}=58.48$, SD=31.07). The CAPD patients also had a moderate QOL. The highest scoring QOL dimension was the encouragement of staff in the renal unit and patient satisfaction with the treatment (${\bar{X}}=100$, SD=.00), followed by social support (${\bar{X}}=95.61$, SD=14.20) and cognitive function (${\bar{X}}=88.83$, SD=13.52). The worst scoring QOL dimensions were work status (${\bar{X}}=44.44$, SD=42.72), general health (${\bar{X}}=53.61$, SD=39.05), and pain (${\bar{X}}=62.70$, SD=41.14). The difference overall and in each dimension of QOL in ESRD patients who were treated with HD and CAPD was not statistically significantly different. The QOL was not significantly different among patients with different personal characteristics except for income and duration of treatment; in those cases, the difference in QOL was statistically significant (p=.05). Conclusion: The overall QOL and life expectancy of patients with ESRD treated with HD and CAPD are not affected by gender, age, marital status, education, occupation, or type of health coverage. QOL was not significantly different, except for patients with different incomes and duration of renal replacement therapy, whose QOL was significantly different. The QOL of patients receiving dialysis should be studied to develop a QOL program for patients with chronic kidney disease who receive dialysis.