장기 혈액투석환자의 신체적, 심리적, 사회적 요인이 질병 부담감에 미치는 영향
The Impact of Physical, Psychological, Social Factors on Illness Burden of Long-term Hemodialysis Patients in South Korea
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Objectives: The purpose of this study was to examine to impact of symptom severity, hope and social support on illness burden in patients undergoing long-term hemodialysis. Methods: A secondary analysis using survey data was performed for 130 patients receiving hemodialysis for more than five years. To measure illness burden, symptom severity, hope, and social support, the burden of kidney disease and the symptoms/problem list of the kidney disease quality of life short form, heath hope index, and multidimensional scale of perceived social support were utilized. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and hierarchical multiple regressions. Results: Illness burden scored 3.36 out of 5 points on average. There were differences in scores for illness burden according to primary disease, especially diabetic nephropathy (F=3.41, p=0.020), and monthly family income (F=3.79, p=0.025). Illness burden was positively correlated with symptom severity (r=0.40, p<0.001) and negatively correlated with hope (r=-0.33, p<0.001) and social support (r=-0.22, p=0.012). In the final multivariate regression model, symptom severity (β=0.32, p<0.001) and hope (β=-0.18, p=0.047) were significantly associated with more illness burden accounting for 23.0% for the variability. Conclusions: There is a large burden of illness in hemodialysis patients. Diabetic nephropathy could impose even larger burden on individuals. More aggressive interventions should be implemented to manage complex chronic disease and prevent diabetes. Better assessment and alleviation of patients’ symptom and positive attitude toward their illness would seem to have the potential to reduce illness burden in patients underdoing hemodialysis.
Abstract
Objectives: The purpose of this study was to examine to impact of symptom severity, hope and social support on illness burden in patients undergoing long-term hemodialysis. Methods: A secondary analysis using survey data was performed for 130 patients receiving hemodialysis for more than five years. To measure illness burden, symptom severity, hope, and social support, the burden of kidney disease and the symptoms/problem list of the kidney disease quality of life short form, heath hope index, and multidimensional scale of perceived social support were utilized. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson correlation, and hierarchical multiple regressions. Results: Illness burden scored 3.36 out of 5 points on average. There were differences in scores for illness burden according to primary disease, especially diabetic nephropathy (F=3.41, p=0.020), and monthly family income (F=3.79, p=0.025). Illness burden was positively correlated with symptom severity (r=0.40, p<0.001) and negatively correlated with hope (r=-0.33, p<0.001) and social support (r=-0.22, p=0.012). In the final multivariate regression model, symptom severity (β=0.32, p<0.001) and hope (β=-0.18, p=0.047) were significantly associated with more illness burden accounting for 23.0% for the variability. Conclusions: There is a large burden of illness in hemodialysis patients. Diabetic nephropathy could impose even larger burden on individuals. More aggressive interventions should be implemented to manage complex chronic disease and prevent diabetes. Better assessment and alleviation of patients’ symptom and positive attitude toward their illness would seem to have the potential to reduce illness burden in patients underdoing hemodialysis.
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