투석환자에서 수면장애에 향을 주는 심리학적 요인과 의학적 요인
Psychological and Medical Factors Affecting Sleep Disturbance in Hemodialysis Patients
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objectives：The purpose of this study is to determine the factors affecting sleep problems and assess the relationship between sleep quality and quality of life in hemodialysis patients. Methods：One hundred forty three patients participated in this study. The Pittsburgh Sleep Quality Index(PSQI) and World Health Organization Quality of Life Scale Abbreviated Version(WHOQOL-BREF) were used to assess sleep quality and quality of life respectively. The psychological status was measured using Hospital Anxiety and Depression scale(HADS). Results：The percentage of poor sleepers was 74.8%. The mean of all WHOQOL-BREF domains in the poor sleeper were significantly lower than in the good sleepers. The factors showing statistical difference between good and poor sleepers were Body Mass Index(p=0.035), Calcium(p=0.049), Kt/V(p=0.001), HADS-Depression(p=0.045), HADS-Anxiety(p＜0.001) and HADS-Total(p＜0.001). The PSQI score correlated positively with phosphorus, kt/V, Urea reduction ratio(URR), HADS-Anxiety(HADS-A), HADS-Depression(HADS-D) and HADS-Total(HADS-T) and correlated inversely with all domain except social relationships and overall QOL. Multiple linear regression analysis revealed that phosphorus and HADS-Total were independent variables associated with PSQI score. Conclusion：Our results demonstrated that sleep problems are common and associated with decreased quality of life in hemodialysis patients. We propose the management of psychological factors as well as medical factors affecting sleep problems to improve the quality of life of hemodialysis patients.
Abstract
Objectives：The purpose of this study is to determine the factors affecting sleep problems and assess the relationship between sleep quality and quality of life in hemodialysis patients. Methods：One hundred forty three patients participated in this study. The Pittsburgh Sleep Quality Index(PSQI) and World Health Organization Quality of Life Scale Abbreviated Version(WHOQOL-BREF) were used to assess sleep quality and quality of life respectively. The psychological status was measured using Hospital Anxiety and Depression scale(HADS). Results：The percentage of poor sleepers was 74.8%. The mean of all WHOQOL-BREF domains in the poor sleeper were significantly lower than in the good sleepers. The factors showing statistical difference between good and poor sleepers were Body Mass Index(p=0.035), Calcium(p=0.049), Kt/V(p=0.001), HADS-Depression(p=0.045), HADS-Anxiety(p＜0.001) and HADS-Total(p＜0.001). The PSQI score correlated positively with phosphorus, kt/V, Urea reduction ratio(URR), HADS-Anxiety(HADS-A), HADS-Depression(HADS-D) and HADS-Total(HADS-T) and correlated inversely with all domain except social relationships and overall QOL. Multiple linear regression analysis revealed that phosphorus and HADS-Total were independent variables associated with PSQI score. Conclusion：Our results demonstrated that sleep problems are common and associated with decreased quality of life in hemodialysis patients. We propose the management of psychological factors as well as medical factors affecting sleep problems to improve the quality of life of hemodialysis patients.
참고문헌 (34)
- 진동찬, "우리나라 말기신부전 환자의 투석현황", 대한의사협회지, 56(7), pp.562~568 (2013), 대한의사협회
- Gotts ZM, "The association between daytime napping and cognitive functioning in chronic fatigue syndrome", PLoS One, 10, pp.e0117136~ (2015)
- Ohayon MM, "Daytime sleepiness and cognitive impairment in the elderly population", Arch Intern Med, 162, pp.201~208 (2002)
- Schwartz S, "Insomnia and heart disease: a review of epidemiologic studies", J Psychosom Res, 47, pp.313~333 (1999)
- Vgontzas AN, "Insomnia with objective short sleep duration is associated with type 2 diabetes A population-based study", Diabetes care, 32, pp.1980~1985 (2009)
- Wolk R, "Sleep and cardiovascular disease", Curr Probl Cardiol, 30, pp.625~662 (2005)
- Ford DE, "Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?", JAMA, 262, pp.1479~1484 (1989)
- Ohayon MM, "Epidemiology of insomnia: what we know and what we still need to learn", Sleep Med Rev, 6, pp.97~111 (2002)
- Ohayon MM, "Place of chronic insomnia in the course of depressive and anxiety disorders", J Psychiatr Res, 37, pp.9~15 (2003)
- Zeitlhofer J, "Sleep and quality of life in the Austrian population", Acta Neurol Scand, 102, pp.249~257 (2000)
- Harris TJ, "Pain, sleep disturbance and survival in hemodialysis patients", Nephrol Dial Transplant, 27, pp.758~765 (2012)
- Walker S, "Sleep complaints are common in a dialysis unit", Am J Kidney Dis, 26, pp.751~756 (1995)
- Benz RL, "Potential novel predictors of mortality in end-stage renal disease patients with sleep disorders", Am J Kidney Dis, 35, pp.1052~1060 (2000)
- Tada T, "The predictors of central and obstructive sleep apnoea in haemodialysis patients", Nephrol Dial Transplant, 22, pp.1190~1197 (2007)
- Gigli GL, "Restless legs syndrome in end-stage renal disease", Sleep Med, 5, pp.309~315 (2004)
- Kraus MA, "Sleep apnea in renal failure", Adv Perit Dial, 13, pp.88~92 (1997)
- Iliescu EA, "Quality of sleep and health-related quality of life in haemodialysis patients", Nephrol Dial Transplant, 18, pp.126~132 (2003)
- Elder SJ, "Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study(DOPPS)", Nephrol Dial Transplant, 23, pp.998~1004 (2008)
- Bjelland I, "The validity of the Hospital Anxiety and Depression Scale", An updated literature review, 52, pp.69~77 (2002)
- Choi H, "Psychometric Properties of the Korean Versions of Three Sleep Evaluation Questionnaires", Clin Nurs Res, 24, pp.526~538 (2015)
- 박영주, "혈액투석 환자의 신체활동 수준과 우울, 삶의 질, 수면장애 및 생리적 지수와의 관련성", 성인간호학회지, 27(6), pp.718~727 (2015), 성인간호학회[DOI]
- 이경규, "혈액투석요법을 받는 만성 신부전증 환자의 수면의 질과 삶의 질", 생물치료정신의학, 14(2), pp.185~193 (2008), 대한생물치료정신의학회
- Guney I, "Predictors of sleep quality in hemodialysis patients", Int J Artif Organs, 33, pp.154~160 (2010)
- Shen Q, "Sleep quality, daytime sleepiness and health-related qualityof-life in maintenance haemodialysis patients", J Int Med Res, 44, pp.698~709 (2016)
- Masoumi M, "Sleep quality in patients on maintenance hemodialysis and peritoneal dialysis", Int J Prev Med, 4, pp.165~172 (2013)
- Jackowska M, "Sleep and biomarkers in the English Longitudinal Study of Ageing:associations with C-reactive protein, fibrinogen, dehydroepiandrosterone sulfate and hemoglobin", Psychoneuroendocrinology, 38, pp.1484~1493 (2013)
- Lee YJ, "Association of depression and anxiety with reduced quality of life in patients with predialysis chronic kidney disease", Int J Clin Pract, 67, pp.363~368 (2013)
- Estrella MM, "Perceptions and use of the national kidney foundation KDOQI guidelines: a survey of US renal healthcare providers", BMC nephrol, 14, pp.230~ (2013)
- Himmelfarb J, "Hemodialysis", N Engl J Med, 363, pp.1833~1845 (2010)
- Macaron G, "Anxiety, depression and suicidal ideation in Lebanese patients undergoing hemodialysis", Community Ment Health J, 50, pp.235~238 (2014)
- Smith MT, "Comparative meta-analysis of pharmacotherapy and behavior therapy for persistent insomnia", Am J Psychiatry, 159, pp.5~11 (2002)
- Morin CM, "Behavioral and pharmacological therapies for late-life insomnia:a randomized controlled trial", JAMA, 281, pp.991~999 (1999)
- Ezzat H, "Prevalence of sleep disorders among ESRD patients", Renal failure, 37, pp.1013~1019 (2015)
- Azar S, "Evaluation of effect of renal transplantation in treatment of restless legs syndrome", Transplant Proc, 39, pp.1132~1133 (2007)