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목차보기

표제지 1

목차 3

Ⅰ. 서론 6

1. 연구의 필요성 6

2. 연구의 목적 8

3. 용어의 정의 9

Ⅱ. 문헌고찰 10

1. 만성신부전과 투석적절도 10

2. 만성신부전 환자의 간호문제 : 수면장애와 우울 11

Ⅲ. 연구 방법 15

1. 연구 설계 15

2. 연구 대상 및 표집 15

3. 연구 도구 15

4. 자료 수집방법 17

5. 자료 분석방법 17

6. 연구의 제한점 18

Ⅳ. 연구결과 19

1. 대상자의 일반적 특성 19

2. 대상자의 임상적 특성(Clinical profile) 21

3. 대상자의 투석적절도, 수면장애 정도 및 우울 정도 23

4. 대상자의 투석적절도, 수면장애 및 우울의 관계 25

5. 대상자의 투석적절도 별 수면장애 정도 및 우울 정도 차이분석 25

6. 대상자의 투석적절도 변화에 따른 수면장애 및 우울의 변화 26

7. 대상자의 특성에 따른 수면장애 및 우울 27

Ⅴ. 논의 34

Ⅵ. 결론 및 제언 40

참고문헌 43

부록 49

Abstract 57

표목차 5

〈표1〉 복막에 의한 요소 및 크레아티닌 청소율 16

〈표2〉 대상자의 일반적 특성 20

〈표3〉 대상자의 임상적 특성 22

〈표4〉 대상자의 투석적절도 및 투석적절 여부 분석 23

〈표5〉 대상자의 수면장애 정도 및 수면장애 여부 분석 24

〈표6〉 대상자의 우울 정도 및 우울 분류 분석 24

〈표7〉 투석적절도, 수면장애 및 우울의 관계 25

〈표8〉 투석적절도 별 수면장애 정도 및 우울 정도 차이분석 26

〈표9〉 대상자의 투석적절도 변화에 따른 수면장애, 우울의 변화 27

〈표10〉 대상자의 일반적 특성에 따른 수면장애 28

〈표11〉 대상자의 임상적 특성에 따른 수면 장애 30

〈표12〉 대상자의 일반적 특성에 따른 우울 31

〈표13〉 대상자의 임상적 특성에 따른 우울 33

초록보기

 This is a research study designed to provide basic data required to develop appropriate nursing interventions among with peritoneal dialysis patients who have chronic renal failure by investigating the relationship between dialysis adequacy and the patients' sleep disorders and depression.

To perform this study, 41 continuous peritoneal dialysis patients were interviewed for 2 months (from October 1 to November 30, 2010) in K University Medical Center, located in Seoul about their dialysis adequacy, sleep disorders, and depression. To collect authentic data, the targeted patients were given the same questionnaire sheet twice in every 4 weeks during that period. For the measurement of dialysis adequacy, Peritoeal Dialysis Adequacy program developed by Korean Society of Nephrology with the Gotch & Sargent model(1985) was used, Measuring Tools of Sleep Disorders, developed by Jin-ju Oh, Mi-sun Song, and Shin-mi Kim(1998), was applied and BDI-Ⅱ (Beck Depression Inventory version Ⅱ), developed by Beck(1996) designed to match the main depression criteria in the DSM-IV to BDI, was used for the measurement of depression. The collected data was analyzed with SPSS/WIN 12.0. using frequency, percentage, average, standard deviation, t-test, one way ANOVA, Scheffe method, and Pearson's Corelation Analysis.

The results of this study are as follows:

1) Among the patients involved in the two surveys, the dialysis adequacy shows the same results in each survey that a group of being adequate was 73%(30 patients) and another group of not being adequate was 26.8%(11 patients). The average of the dialysis adequacy shows 2.13 in the first survey and 2.16 in the second one.

2) Patients who did not have sleep disorders were 7.3%(3 persons) in the first survey, and 9.3%(4 persons) in the second one. Patients who had sleep disorders were 92.7%(38 persons) in the former one and 90.2%(37 persons) in the latter one. The sleep-disorder point was 36.02 in the former one and 35.63 in the latter one.

3) There appears to be no patient who was in normal or mild state of depression, however, patients who were in the state of moderate depression were 19.5%(8 persons) in both surveys, and patients who were in the state of severe depression were 80.5%(33 persons) in both surveys. The point of depression was 35.39 in the former one and 34.78 in the latter one.

4) The relationship between dialysis adequacy and sleep disorders-depression showed that all the targeted patients suffered from sleep disorders and were in the state of severe depression regardless of dialysis adequacy. Seen in the aspect of the average dialysis adequacy, however, as the dialysis adequacy in the first survey changed from 2.13 to 2.26 in the second one, the point of sleep disorders decreased from 36.02 to 35.63 and the point of depression also decreased from 35.39 to 34.78. The relationship between sleep disorder and depression showed that as the point of sleep disorders decreased from 36.02 in the first survey to 35.63 in the second one, the point of depression also decreased from 35.39 in the former one to 34.78 in the latter one.

5) Seen in the changes in sleep disorders - depression according to the changes in dialysis adequacy, the change in sleep disorders according to that of dialysis adequacy showed an increase from 2.13 KT/V, 56.63 CrCl in the first survey to 2.26 KT/V, 57.25 CrCl and a decrease in the point of sleep disorders from 36.02 in the former one to 35.63 in the latter one(p〈.05).

The change in depression according to that of dialysis adequacy showed an increase from 2.13 KT/V, 56.63 CrCl in the first survey to 2.26 KT/V, 57.25 CrCl and a decrease in the point of depression from 35.39 in the former one to 34.78 in the latter one(p〈.05).

The result of this study shows that most of peritoneal dialysis patients are suffering from sleep disorders and severe depression regardless of the factor whether the dialysis is adequate or not. And it also shows that the severer sleep disorders the patients have, the severer state of depression they are in. However, this study also shows that as the dialysis adequacy changes, sleep disorders and depression also change.

According to the result of this study, however, it can be assumed that if the dialysis adequacy is increased, sleep disorders and depression can be decreased. Therefore, there needs to make much more efforts to maintain a proper state of dialysis, and to develop appropriate nursing interventions in order to resolve the problems of sleep disorders and depression of peritoneal dialysis patients.

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