혈액투석 환자의 건강상태 예측요인: 2년 종단연구
Predictors of Health Status in Patients with Hemodialysis: A Two-year Longitudinal Study
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초록
목적 : 이 연구의 목적은 종단연구 자료를 바탕으로 신체적, 심리적, 사회적 요인들이 혈액투석 중인 환자들의 건강상태에 미치는 효과를 검토하고자 함이다. 방법 : 두 연구가 2년의 간격을 두고 수행되었다. 총 75명의 환자들이 두 연구 모두에 참여하였다. 8개의 변수: 증상, 치료에 대한 믿음, 희망, 의미중심대처, 가족지지, 친구/환우 지지, 의료제공자 지지, 그리고 건강상태가 측정되었다. 자료는 대응표본 t-test, 피어슨 상관계수, 위계적 다중회귀를 이용하여 분석하였다. 결과 : 참여자의 평균 나이는 47.3세였고 평균 투석기간은 8.3년이었다. 2년 후 시점에서 지각된 건강상태의 점수는 차이가 없었다. 2년 후에 추적한 지각된 건강상태는 기준이었던 지각된 건강상태, 친구/환우 지지, 의미중심대처, 희망, 증상과 관련성이 있었다. 회귀분석에 따르면 친구/환우 지지(β=.31, p=.013)와 기준이었던 지각된 건강상태(β=.30, p=.020)가 추후의 건강상태에 대한 유의한 예측요인으로 39.0%의 설명력을 가졌다. 결론 : 이 연구는 만성질병에서 긍정적인 건강결과를 위해 심리사회적 자원이 중요함을 시사한다. 신장 동료지지를 제공하는 것을 목표로 한 중재가 개발되고 검증될 필요가 있다.
Abstract
Purpose: The purpose of this study was to examine the effects of physical, psychological, and social factors on the health status of patients undergoing hemodialysis using longitudinal data. Methods: Two surveys were conducted within a period of two-year. A total of 75 patients participated in both surveys. Eight variables including symptoms, treatment belief, hope, meaning-focused coping, family support, friend/peer support, healthcare provider support, and health status were measured. Data were analyzed by paired t-test, Pearson’s correlation coefficients, and hierarchical multiple regressions. Results: The mean age of the participants was 47.31 and the average duration of dialysis was 8.27 years. There was no difference in scores on perceived health status between the two year-interval surveys. The two-year follow-up on perceived health status was correlated with baseline perceived health status, friend/peer support, meaning-focused coping, hope, and symptoms. As the result of the regression analysis, friends/peer support (β=.31, p=.013) and baseline perceived health status (β=.30, p=.020) were found to be significant predictors of subsequent health status which explained 39.0% of the variance. Conclusion: This study suggests the importance of psychosocial resources for positive health outcomes in patients with a chronic illness. Nursing interventions aimed to provide renal peer support need to be developed and tested.
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