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최윤정,김형방,김문규,심명숙,이준상,김미진,정춘희 대한당뇨병학회 2002 임상당뇨병 Vol.3 No.3
연구배경: 현대의학의 급속적인 발달로 사람의 평균수명이 연장되고 경제가 고도성장함에 따라 생활양식이 서구화되면서 당뇨병의 유병률이 증가하고 있다. 최근 여성의 사회참여율 증가와 부부만 사는 가정, 노인 혼자 사는 가정들이 늘어나는 추세이다. 그러므로 노인 당뇨병 환자에 대한 가족의 지지와 삶의 질에 관해 알아보고 자 본 연구를 시행하였다. 방법: 연세대학교 원주기독병원 내분비대사내과에 내원하는 60세 이상의 노인 당뇨병 환자147명을 대상으로 조사하였으며 노인 당뇨병 환자의 가족지지의 하위영역인 치료적지지, 심리적 지지와 삶의 질의 하위영역인 정서적 삶의질, 신체적 삶의 질, 사회·경제적 삶의 질을 분석하였다. 결과: 첫째, 노인 당뇨병 환자는 주로 부부만 사는 가정이 50.3%로 나타났으며, 혼자 산다가 9.5%로 조사되었다. 둘째, 수발의 도움에서는 배우자가 51.7%로 나타났고, 도움이 필요하나 도와 줄 사람이 없다가 12.9%로 나타났다. 셋째, 사회복지 서비스는 필요하다가 68.0%, 모르겠다 22.5%로 조사되었다. 넷째, 가족지지와 심리적지지의 신뢰도는 0.8331로 높게 조사되었다. 다섯째, 신체적 삶의 질(p<0.05), 사회·경제적 삶의 질(p<0.01)에서 여자보다 남자가 의미가 있었고, 교육정도에서는 학력이 높으면(p<0.001)로 상당히 유의하게 나타났다. 여섯째, 정서적, 신체적삶의 질의 신뢰도 계수는 0.681, 사회·경제적 삶의 질의 신뢰도 계수는 0.7521로 비교적 양호하게 조사되었다. 결론: 노인 당뇨병 환자에게 가족의 지지는 꼭 필요하며 더불어 국가차원에서 노인들의 재가복지의 확대와 의료보험수가의 차등화 정책을 실행한다면 노인 당뇨병 환자의 삶의 질은 향상 될 것이다. Background: With the extension of average life span of human being by rapid medical development and robust economical growth, lifestyle of the domestic individual have become westernized causing an increase in the prevalence of diabetes. Nowadays, working females, no-kid couples and old people who live alone are increasing. This study was carried out to investigate the family support, quality of life and social welfare of old age diabetic patient Methods: The study was carried out in 147 diabetics over the age of 60 .at the Wonju Christian Hospital. Treatment and psychological support as well as emotional, physical and socioeconomic quality of life were investigated. Results: First, 50.3% of the old age diabetics were no-children couples and 9.5% lived alone. Second, 51.7% were receiving aid from their spouses and 12.9% had no one to ask for aid. Third, 68.0% replied 'yes' to the 'necessity of social welfare services' category, 22.5% replied 'not sure' asked for leisure activities. Fourth, 43.7% of the old aged diabetics replied 'no' to the 'did your family accompany you to the education programs?' category. The reliability index for the treatment support was 0.8934. Fifth, the reliability index for family support and psychological support recorded as 0.8331. Sixth, men took more meaning in the physical(p<0.05) and socioeconomic of life(p<0.01) categories and education levels seemed to take much influence from 'level of school education taken' category. Seventh, the reliability index for emotional and physical quality of life recorded as 0.681 and the index for socioeconomic quality of life recorded as 0.7521. Judging from the results above, the quality of life for old age diabetic patients can be improved if the 'reliance on family' index of the family support and quality of life categories are increased. Conclusion: Family support is crucial in old age diabetic patients in order to improve their quality of life.
투석전 만성신부전 환자의 영양상태 평가 및 식습관 조사
노숙령,최윤정 동아시아식생활학회 2003 동아시아식생활학회지 Vol.13 No.5
The purpose of this study was to analyze the nutritional status and dietary habits in predialysis patients of chronic renal failure(CRF). The patients group was composed of total 35 persons with chronic renal failure(diabetes exclusion), male 20, female 15 who were treated in the kidney internal department and the control group also composed of 35 persons, male 18, female 17 who were classified as normal by the medical examination. Their dietary habits, nutritional status and nutritional knowledge were investigated from two general hospitals in Inchon, middle of this year 2002. There were 31.4% of low weight patients (BMI below 20), 77.1% of anemia patients (serum hemoglobin below 12g/㎗), 68.6% of hypertension patients with diastolic blood pressure over 90㎜Hg, 80% with systolic blood pressure over 140㎜Hg, 20% of hypercholesterolemia patients (serum cholesterol over 230㎎/㎗), and 22.9% of hyperlipemia patients (serum triglyceride over 200㎎/㎗). The cardiovascular disease seemed to be caused by the abnormality of lipid metabolism The possibility of the bone disease was shown from patients of hyperphosphatemia (serum phosphorus over 4.7㎎/㎗, 22.9%) and hypocalcemia (serum calcium below 8.4㎎/㎗, 25.7%). Intake of insufficient calories which was caused by the lack of appetite affected on the nutritional status. The intake of most nutrients was not significantly different from the RDA for Koreans. Consequently, the patient groups took a lot of salt even after the diagnosis of CRF. But patients ate 6.1g of salt which were more than the recommended amount 2~4g for patients with CRF. The patient groups, who had the experiences of nutritional counselling, had significantly higher nutritional knowledge related to CRF than control group. Unfortunately, patients could not have enough chances for nutritional counselling by the nutritionist even though they needed the nutritional informations and dietetic treatments. The continuous research is expected with regard to the detail plan for the improvement of nutritional support and the nutritional counselling because it is important to decide the requirements of nutrients for patients with kidney disease, considering the kidney function and status of nutrition.