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Objective To explore the value of bioelectrical impedance analysis in evaluating hemodialysis patients′nutritional status. Methods Cross-sectional design was employed to evaluate 193 hemodialysis patients′ nutritional status in a Level 3 hospital in Zhuhai, with bioelectrical impedance analysis, modified quantitative subjective global assessment, physical and biochemical measurement. The correlation between each index and the predictive effect of bioelectrical impedance analysis on malnutrition of patients were analyzed. Results According to bioelectrical impedance analysis, hemodialysis patients′ average muscle mass was (44.06±8.84) kg, body fat rate was (19.81±8.89)%, fat free mass index was (17.70±2.45) kg/m2, presumed bone mass was (2.49±0.46) kg, and extracellular water rate was (40.54±3.75)%. The bioelectrical impedance analysis indexes were significantly correlated with most other nutritional evaluation indexes (P<0.05). The muscle mass and bone mass of the malnourished group were lower than that of the well-nourished group (P<0.01). Multivariable logistic regression analysis found that body fat rate ( OR=0.94, 95% CI 0.89-0.99), fat free body mass index ( OR=0.79, 95% CI 0.66-0.93) were associated with lower risk of malnutrition, age ( OR=1.08, 95% CI 1.04-1.12), dialysis age ( OR= 1.02, 95% CI 1.01-1.04), high sensitive C reactive protein ( OR=1.11, 95% CI 1.03-1.23) were associated with higher risk of malnutrition. Conclusion Bioelectrical impedance analysis is a valid measurement on evaluating maintenance hemodialysis patients′ nutritional status. There has a high prevalence of malnutrition in hemodialysis patients. The lower risk of malnutrition is associated with higher body fat rate and higher fat free mass index, and the higher risk of malnutrition is associated with older age, longer dialysis age and higher level of high sensitive C reactive protein.
ABSTRACT
Objective@#To explore the value of bioelectrical impedance analysis in evaluating hemodialysis patients′ nutritional status.@*Methods@#Cross-sectional design was employed to evaluate 193 hemodialysis patients′ nutritional status in a Level 3 hospital in Zhuhai, with bioelectrical impedance analysis, modified quantitative subjective global assessment, physical and biochemical measurement. The correlation between each index and the predictive effect of bioelectrical impedance analysis on malnutrition of patients were analyzed.@*Results@#According to bioelectrical impedance analysis, hemodialysis patients′ average muscle mass was (44.06±8.84) kg, body fat rate was (19.81±8.89)%, fat free mass index was (17.70±2.45) kg/m2, presumed bone mass was (2.49±0.46) kg, and extracellular water rate was (40.54±3.75)%. The bioelectrical impedance analysis indexes were significantly correlated with most other nutritional evaluation indexes (P<0.05). The muscle mass and bone mass of the malnourished group were lower than that of the well-nourished group (P<0.01). Multivariable logistic regression analysis found that body fat rate (OR=0.94, 95%CI 0.89-0.99), fat free body mass index (OR=0.79, 95%CI 0.66-0.93) were associated with lower risk of malnutrition, age (OR=1.08, 95% CI 1.04-1.12), dialysis age (OR=1.02, 95%CI 1.01-1.04), high sensitive C reactive protein (OR=1.11, 95%CI 1.03-1.23) were associated with higher risk of malnutrition.@*Conclusion@#Bioelectrical impedance analysis is a valid measurement on evaluating maintenance hemodialysis patients′ nutritional status. There has a high prevalence of malnutrition in hemodialysis patients. The lower risk of malnutrition is associated with higher body fat rate and higher fat free mass index, and the higher risk of malnutrition is associated with older age, longer dialysis age and higher level of high sensitive C reactive protein.
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Objective To study the coping strategies of patients with mood disorders and explore the corresponding nursing strategies.Methods A survey,using the coping strategies questionnaire,was conducted among 32 patients with unipolar disorder and 55 patients with bipolar disorder including 34 with current depressive episode,14 with current manic episode and 7 with mixed episode.Results As for coping strategies,no difference was found between unipolar depression and bipolar disorder with current depressive episode or mixed episode(P>0.05);while significant difference was found between bipolar depression and bipolar mania on problem solving(t=-2.869,P=0.006),help seeking(t=-2.443,P=0.018),self accusation(t=2.461,P=0.018)and withdrawing(t=2.870,P=0.006).The patients with unipolar disorder,bipolar depressive or mixed episode tended to use mixed coping strategies,with the percentages of 50.00%,41.18%and 42.86%respectively and 64.29%of the patients with bipolar mania tended to use mature coping strategies.Conclusions Coping strategies of patients with mood disorder are associated with the status of the diseases but independent of the categories of the diseases.Therefore,the corresponding nursing strategies include setting aside the problems,encouraging family member to make decisions and conducting active guidance.