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Öğe Are sleep and life quality of family caregivers affected as much as those of hemodialysis patients?(ELSEVIER SCIENCE INC, 2012) Celik, Gulperi; Annagur, Bilge Burcak; Yilmaz, Mumtaz; Demir, Tarik; Kara, FatihObjective: The purpose of this study was to determine and compare the quality of sleep, quality of life, and anxiety and depression symptoms reported by hemodialysis (HD) patients and family caregivers of HD patients. Methods: The study included 142 pairs of HD patients and their caregivers. To assess quality of sleep, quality of life, and anxiety and depressive symptoms, the 36-item Short Form, Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale, respectively, were used. Results: For the patients, 73.9% were poor sleepers. Low Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were found in 89.1% and 76.3% of HD patients, respectively. For the caregivers, 88% were poor sleepers. Low PCS and MCS scores were found in 62% and 70.4% of the caregivers, respectively. Mean PSQI scores, subjective sleep quality scores, sleep latency, sleep efficiency, sleep disturbance, use of sleep medications, and daytime dysfunction scores of the caregivers were significantly higher than the scores of the HD patients (P<.001). Conclusions: Caregivers of dialysis patients experience adverse effects on their quality of sleep and quality of life. Educational, social, and psychological support interventions should be considered to improve their ability to cope. (C) 2012 Elsevier Inc. All rights reserved.Öğe Comparison of Nutritional Parameters among Adult and Elderly Hemodialysis Patients(IVYSPRING INT PUBL, 2011) Celik, Gulperi; Oc, Bahar; Kara, Inci; Yilmaz, Mumtaz; Yuceaktas, Ali; Apiliogullari, SezaAim: The aim of this study was to compare the nutritional biochemical parameters, prealbumin levels, and bioimpedance analysis parameters of adult and elderly hemodialysis (HD) patients. Methods: This prospective cross-sectional study included 50 adult HD patients (42.0 % female). Nutritional status was assessed by post-dialysis multifrequency bioimpedance analysis (BIA), serum prealbumin and other nutritional biochemical parameters. Results: Mean age of patients was 57.4 +/- 15.1 years (range: 30-83 years) and mean dialysis duration was 68.3 +/- 54.5 months (range: 3-240 months). When the patients were divided into two groups according to age of patients (<65 and >= 65), prealbumin (p=0.003), blood urea nitrogen (BUN) (p=0.000), serum creatinine (p=0.013), albumin (p=0.016), protein catabolic rate per normalized body weight (nPCR) (p=0.001), intracellular water (ICW)/total body weight (0.003), body fat mass (p00.000), lean body mass (p=0.031), lean dry mass (p=0.001), illness marker (p=0.005), basal metabolism (p=0.007), body mass index (BMI) (p=0.028), body fat mass index (BFMI) (p=0.000), fat free mass index (FFMI) (p=0.040) values were significantly different between the groups. In the elderly patients (age >= 65), body fat mass, illness marker, BMI, BFMI were higher compared to adult patients (age <65). Additionally, in the elderly patients, prealbumin, BUN, creatinine, albumin, nPCR, ICW/ total body weight, lean body weight, lean dry weight, basal metabolism and FFMI were lower than adult patients. Conclusions: Our results indicate that BFMI were higher, albumin, prealbumin, nPCR and lean body mass and FFMI were lower in elderly patients compared to adults. These results imply that elderly HD patients may be prone sarcopenic obesity and may require special nutritional support.Öğe Findings of multidimensional instruments for determining psychopathology in diabetic and non-diabetic hemodialysis patients(E-CENTURY PUBLISHING CORP, 2012) Celik, Gulperi; Annagur, Bilge Burcak; Yilmaz, Mumtaz; Kara, FatihObjective: The aim of this study was to expand the research on psychiatric complications of end-stage renal disease (ESRD), as well as to examine the prevalence of a broad range of psychopathology in diabetic and nondiabetic hemodialysis (HD) patients. Methods: One hundred nineteen HD patients were invited to enter the cross-sectional study. To assess quality of life, quality of sleep, mental status and depression and anxiety symptoms, the 36-item Short Form, Pittsburgh Sleep Quality Index (PSQI), Mini-Mental State Examination and Hospital Anxiety and Depression Scale, respectively, were used. Results: The mean age of all patients was 56.9 +/- 16.1 years; 54 (45.4%) were female. In the diabetic patients group, 84.8% of the patients had low MCS scores, and 89.2% patients had low PCS scores; 73.9% were poor sleepers; 63.0% had cognitive decline; 62.0% patients were depressive symptoms; and 28.3% had symptoms of anxiety. When comparing the diabetic and non-diabetic patients, the diabetic patients had lower role-emotional, sleep duration, and sleep efficiency scores. Conclusions: Incorporating a standard assessment and, eventually, treatment of psychopathologic symptoms into the care provided to diabetic and hemodialysis patients might improve quality of life and sleep, depressive symptoms and, reduce mortality risk.Öğe Vapocoolant Spray vs Lidocaine/Prilocaine Cream for Reducing the Pain of Venipuncture in Hemodialysis Patients: A Randomized, Placebo-Controlled, Crossover Study(IVYSPRING INT PUBL, 2011) Celik, Gulperi; Ozbek, Orhan; Yilmaz, Mumtaz; Duman, Ipek; Ozbek, Seda; Apiliogullari, SezaObjective: Patients undergoing hemodialysis are repeatedly exposed to stress and pain from approximately 300 punctures per year to their arteriovenous fistula. This study was designed to measure pain associated with venepuncture during AVF cannulation and to compare the effectiveness of ethyl chloride vapocoolant spray, topical eutectic mixture of local anesthetics (EMLA) cream and placebo in controlling pain caused by venepuncture of arteriovenous fistula patients undergoing chronic hemodialysis. Methods: This randomized, placebo-controlled, crossover study, included 41 patients undergoing conventional hemodialysis three times a week. First intervention was conducted as baseline pain assessment (control). In the three consecutive dialysis sessions, every patient randomly received 1) ethyl chloride vapocoolant spray, 2) EMLA, or 3) placebo cream before venepuncture. Pain perception was recorded by patients immediately after cannulation on a 0-100 mm visual analogue scale (VAS). p<0.05 was considered as significant. Results: VAS scores presented a marked inter-individual variation during venepuncture. EMLA application resulted in significantly lower total pain scores compared to control and all other interventions (p<0.05). No patient experienced severe pain with EMLA or vapocoolant. The patients reported less moderate and severe pain with EMLA, and vapocoolant spray compared to control and placebo interventions. Moderate and severe pain scores were similar between EMLA and vapocoolant spray (p>0.05). Conclusion: Venipuncture for AVF cannulation causes mild to moderate pain in hemodialysis patients. Although local application of EMLA is more effective than in preventing venepuncture pain, ethyl chloride vapocoolant is as effective as EMLA for preventing mild to moderate puncture pain in patients undergoing hemodialysis.