Hemodiyalize girmekte olan hastalarda volüm durumunun yaşam kalitesi, anksiyete, depresyon ve uyku kalitesi üzerine etkisi
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Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Son dönem böbrek hastalığı; böbrek fonksiyonlarının geri dönüşümsüz kaybını ifade eden ve renal replasman tedavisi gerektiren bir durumdur. Aşırı hidrasyon, diyaliz hastalarında sıktır ve önemli mortalite nedenlerinden biridir. Bu çalışmada hemodiyaliz hastalarında volüm durumunun yaşam kalitesi, anksiyete, depresyon, ve uyku kalitesi üzerine etkisi araştırılmıştır. YÖNTEM: Bu çalışma kesitsel niteliktedir. Çalışmaya en az 3 aydır hemodiyalize giren 18-75 yaş arası son dönem böbrek hastalığına sahip 100 hasta alındı. Hastalara hafta ortası diyaliz seansı öncesinde vücut kompozisyon monitörü ile biyoimpedans analizi yapıldı. Aynı seansta hastalara sosyodemografik verilere ait anket, SF-36 Yaşam Kalitesi Ölçeği, Beck Depresyon ve Anksiyete Ölçeği ile Pittsburg Uyku Kalitesi İndeksi uygulandı. Hastalar hücre dışı sıvı (HDS) ve total vücut suyu (TVS) oranına göre 3 gruba ayrıldı. Grup1; < 25 persentil (HDS/TVS<0.426 Lt, n=24), grup2; 25-50 persentil (HDS/TVS:0.426-0.438 Lt, n=37), grup3; 50-75 persentil (HDS/TVS:0.438-0.481 Lt, n=39) BULGULAR: Grup 1 ile grup 2 arasında fiziksel komponent skoru (FKS) (p=0,01), fiziksel fonksiyon (p<0,001), fiziksel rol güçlüğü (p=0,03), genel sağlık algısı (p=0,03), mental komponent skoru (MKS) (p=0,02), mental sağlık (p=0,01), sosyal fonksiyon (p<0,001) ve vitalite (p=0,01), skorları arasında anlamlı fark saptandı. Grup 1 ve grup 3 arasında fiziksel komponent (p=0,01), fiziksel fonksiyon (p=0,02), fiziksel rol güçlüğü (p=0,03), genel sağlık algısı (p=0,02), vitalite (p=0,02) skorları arasında anlamlı fark saptandı. Grup 1'de skorlar grup 2 ve grup 3'den daha yüksekti. HDS/TVS oranı ile fiziksel fonksiyon skoru (r:-0,201, p: 0.045) ve fiziksel rol güçlüğü skoru (r:-0,225, p:0.025) negatif koreleydi. HDS/TVS oranı arttıkça, fiziksel rol güçlüğü arttı, fiziksel fonksiyon ve vitalite azaldı. PUKİ analizinde hastaların tamamında PUKİ total skoru 5'in üzerinde bulundu. Grup 2'nin PUKİ total skoru, grup 1'den daha yüksekti (p=0,02). Grup 3'ün uyku süresi (p=0,02), (p<0,001) ve uyku verimi (p=0,03), (p=0,04) skorları sırasıyla grup 1 ve grup 2'den yüksekti. HDS/TVS oranı arttıkça, uyku süresi ve uyku verimi azalmaktaydı. Hastaların tamamında düşük derecede anksiyete saptandı. Tüm hastalarda depresyon oranı %40, grup 1'de depresyon oranı % 25, grup 2'de depresyon oranı %43, grup 3'de ise %45 tespit edildi. Beck Depresyon Skoru, yaş ve medeni durum, yaşam kalitesi komponentlerinden FKS ile volüm durumundan bağımsız olarak ilişkiliydi. Medeni durum ve Beck depresyon skoru MKS ile de volüm durumundan bağımsız olarak ilişkiliydi. SONUÇ: Bu çalışma, hemodiyaliz hastalarında volüm durumunun yaşam kalitesi, uyku kalitesi, anksiyete ve depresyon ile ilişkisini araştıran literatürdeki ilk çalışmadır. Sonuç olarak, özellikle yaşlı ve yalnız yaşadığı için sosyal desteği az olan veya hiç olmayan hastalara etkin psikososyal destek sağlanması ve bu hastalardaki depresyonun erken teşhis ve tedavisi ile hastaların yaşam kalitesini artırmak mümkün olacaktır. Bu hastalarda psikososyal desteğin ve depresyon tedavisinin uygun kuru ağırlığa erişme üzerine etkisinin araştırılacağı prospektif çalışmalara ihtiyaç vardır.
End-stage renal failure is a condition that indicates irreversible loss of renal function and requires renal replacement therapy. Excessive hydration is common in haemodialysis patients and is one of the major causes of mortality. In this study, we have investigated the effect of volume status on quality of life, anxiety, depression, and sleep quality in haemodialysis patients. METHOD: This study is a cross-sectional study. A total of 100 patients with the end-stage renal disease between the ages of 18 and 75 who had been on haemodialysis for at least 3 months were included in the study. Bio-impedance analysis was performed with body composition monitor before and after the midweek dialysis session in the patients. In the same session, the Sociodemographic Survey, the SF36 Quality of Life Scale, the Beck Depression and Anxiety Scale and the Pittsburgh Sleep Quality Index were administered to the patients. The patients were divided into 3 groups according to the ratio of extracellular fluid (ECF) to total body water (TBW). Group1; <25 percentile (ECF/TBW <0.426 Lt, n=24), group2; 25-50 percentile (ECF/TBW:0.426-0.438 Lt, n=37), group3; 50-75 percentile (ECF/TBW:0.438-0.481 Lt, n=39) FINDINGS: There was a significant difference between the group 1 and 2 in terms of physical component score (PCS) (p=0.01), physical function (p<0.001), physical role difficulty (p=0.03), general health perception (p=0.03), mental component score (MCS) (p=0.02), mental health (p=0.01), social functioning (p<0.001) and vitality (p=0.01). There was a significant difference between the group 1 and 3 in terms of physical component score (PCS) (p=0.01), physical function (p=0.02), physical role difficulty (p=0.03), general health perception (p=0.02) and vitality (p=0.02). The scores were higher in the group 1 than the group 2 and 3. The ECF/TBW ratio was negatively correlated with physical function (r:-0.201, p:0.045) and physical role difficulty (r:-0.225, p:0.025). While the ECF/TBW ratio increased, physical role increased but physical function and vitality decreased. In the analysis of PSQI, PSQI total score was above 5 in all patients. PSQI total score was higher in the group 2 than the group 1 (p=0.02). Sleep duration (p=0.02), (p<0.001) and sleep efficiency (p=0.03), (p=0.04) were higher in the group 3 than the group 1 and 2, respectively. While the ECF/TBW ratio increased, sleep duration and sleep efficiency decreased. Low-level anxiety was seen in all patients. The rate of depression was 40% in all patients. Moreover, it was 25% in the group 1 and 43% in the group 2 and 45% in the group 3. The Beck Depression Score, age, and marital status had an effect on PCS from the components of the quality of life, regardless of the volume status. The Beck Depression Score and marital status had an effect on MCS, regardless of the volume status. RESULT: This study is the first study in the literature to investigate the effect of volume status on quality of life, anxiety, depression and sleep quality in haemodialysis patients. As a result, by providing effective psychosocial support and early diagnosis and treatment of depression in these patients, it will be possible to increase the quality of life. Prospective studies are needed to investigate the effect of psychosocial support and depression treatment on achieving appropriate dry weight.
End-stage renal failure is a condition that indicates irreversible loss of renal function and requires renal replacement therapy. Excessive hydration is common in haemodialysis patients and is one of the major causes of mortality. In this study, we have investigated the effect of volume status on quality of life, anxiety, depression, and sleep quality in haemodialysis patients. METHOD: This study is a cross-sectional study. A total of 100 patients with the end-stage renal disease between the ages of 18 and 75 who had been on haemodialysis for at least 3 months were included in the study. Bio-impedance analysis was performed with body composition monitor before and after the midweek dialysis session in the patients. In the same session, the Sociodemographic Survey, the SF36 Quality of Life Scale, the Beck Depression and Anxiety Scale and the Pittsburgh Sleep Quality Index were administered to the patients. The patients were divided into 3 groups according to the ratio of extracellular fluid (ECF) to total body water (TBW). Group1; <25 percentile (ECF/TBW <0.426 Lt, n=24), group2; 25-50 percentile (ECF/TBW:0.426-0.438 Lt, n=37), group3; 50-75 percentile (ECF/TBW:0.438-0.481 Lt, n=39) FINDINGS: There was a significant difference between the group 1 and 2 in terms of physical component score (PCS) (p=0.01), physical function (p<0.001), physical role difficulty (p=0.03), general health perception (p=0.03), mental component score (MCS) (p=0.02), mental health (p=0.01), social functioning (p<0.001) and vitality (p=0.01). There was a significant difference between the group 1 and 3 in terms of physical component score (PCS) (p=0.01), physical function (p=0.02), physical role difficulty (p=0.03), general health perception (p=0.02) and vitality (p=0.02). The scores were higher in the group 1 than the group 2 and 3. The ECF/TBW ratio was negatively correlated with physical function (r:-0.201, p:0.045) and physical role difficulty (r:-0.225, p:0.025). While the ECF/TBW ratio increased, physical role increased but physical function and vitality decreased. In the analysis of PSQI, PSQI total score was above 5 in all patients. PSQI total score was higher in the group 2 than the group 1 (p=0.02). Sleep duration (p=0.02), (p<0.001) and sleep efficiency (p=0.03), (p=0.04) were higher in the group 3 than the group 1 and 2, respectively. While the ECF/TBW ratio increased, sleep duration and sleep efficiency decreased. Low-level anxiety was seen in all patients. The rate of depression was 40% in all patients. Moreover, it was 25% in the group 1 and 43% in the group 2 and 45% in the group 3. The Beck Depression Score, age, and marital status had an effect on PCS from the components of the quality of life, regardless of the volume status. The Beck Depression Score and marital status had an effect on MCS, regardless of the volume status. RESULT: This study is the first study in the literature to investigate the effect of volume status on quality of life, anxiety, depression and sleep quality in haemodialysis patients. As a result, by providing effective psychosocial support and early diagnosis and treatment of depression in these patients, it will be possible to increase the quality of life. Prospective studies are needed to investigate the effect of psychosocial support and depression treatment on achieving appropriate dry weight.
Açıklama
Anahtar Kelimeler
Hemodiyaliz, Yaşam kalitesi, Depresyon, Uyku kalitesi, Biyoimpedans, Volüm durumu, Haemodialysis, Life quality, Depression, Sleep quality, Bio-impedance, Volume status
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Çelikdelen, S. Ö. (2016). Hemodiyalize girmekte olan hastalarda volüm durumunun yaşam kalitesi, anksiyete, depresyon ve uyku kalitesi üzerine etkisi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
