Physical, Physiological, and Psychological Factors Determing Sleep Quality in Patients on Maintenance Hemodialysis / 임상간호연구

PURPOSE: The study aimed to examine quality of sleep in hemodialysis patients and explore physical, physiological, and psychological factors determining sleep quality. METHODS: The survey was conducted among 165 patients on maintenance hemodialysis at a university hospital. Data were collected from July to October in 2015. The sleep quality and its related factors were assessed by standardized questionnaires, anthropometric measures, and lab tests after obtaining a written consent from the participant. RESULTS: The mean age of the participants was 62.58 years old, and 67.9% of the participants experienced sleep disorders such as ‘not falling asleep within 30 minutes’ or ‘frequently waking up at night’. Pain (t=-3.29, p=.007) and depression (t=-6.028, p < .001) were significantly different between the group with sleep disorder and the other without. The demographic factors (age, shared room, sleep during the day), physical factors (pain and symptom), and psychological factors (depression and trait and status anxiety) together explained 20.0% of variance in sleep quality. CONCLUSION: Sleep disorder was frequently experienced among the patients on maintenance hemodialysis. The effective nursing strategies should focus on sleep environment, pain and depression management. Further study is warranted to explore the effect of physiological factors related to the disease on sleep disorder in this population.

Effects of Passive Upper Arm Exercise on Range of Motion, Muscle Strength, and Muscle Spasticity in Hemiplegic Patients with Cerebral Vascular Disease

PURPOSE: The purpose of this study was to investigate the effects of passive upper arm exercise on range of motion, muscle strength, and muscle spasticity in hemiplegic patients with cerebral vascular disease. METHODS: A quasi-experimental design with nonequivalent control group was utilized. According to inclusion criteria, 25 patients were assigned to the control group with routine care, followed by 25 to the intervention group with passive exercise for 30 minutes per session, twice a day for 2 weeks. Eighteen patients in the intervention group and 17 in the control group completed the posttest measurement, including range of motion for upper arm joints, manual muscle test, and Modified Ashworth Scale for muscle spasticity. RESULTS: The intervention group had a significantly improved range of motion in the shoulder and wrist joints. No interaction effect was found for the elbow joint. No significant differences were found in muscle strength or muscle spasticity between the groups. CONCLUSION: Results of the study indicate that passive exercise safely applied for two weeks improves range of motion in joints of the upper arm in these patients. Further study with long-term follow-up is needed to verify the role of passive exercise in preventing muscle spasticity in this population.

Effect of Dietary Fibers on Retinol Binding Protein (RBP, cRBP I, cRBPII) Gene Expression in Rats Fed High Fat Diet

Recently it has been reported that vitamin A and retinol binding proteins (RBPs) in blood and urine were changed in the condition of diabetes mellitus or hyperlipidemia. Fruits and vegetables are recommended to consume for the people suffered from these chronic degenerative diseases. The main components of fruits and vegetables are dietary fibers, for example cellulose and pectin, of which function to affect the absorption and excretion of dietary fat and fat-soluble substances. This study was conducted to investigate the effect of dietary fibers on RBPs mRNA expression in liver, small intestine and serum of rat fed high fat diet during 4 weeks. Sprague-Dawley rats, weighing 121g on average, were divided into four groups; (Control; 17% fat & cellulose supplement diet, HF0: 25% fat & fiber free diet, HFC: 25% fat & cellulose supplement diet and HFP: 25% fat & pectin supplement diet). The rats fed high fat diet groups (HF0, HFC, HFP) tended to consume the food less than the control group, but FER of HF0 groups was significantly higher than the control (p < 0.05). The weight of adrenal gland in high fat diet groups (HF0, HFC, HFP) was significantly less than the control. Total lipid in feces daily excreted and in liver did not show any significant differences among the groups. Total cholesterol in HFP group was significantly higher than that of HFC group. Serum total cholesterol and triglyceride in HFP group tended to lower than other groups and HDL cholesterol higher. Consequently, AI (atherogenic index) was the lowest in HFP group. Vit A contents in feces daily excreted tended to lower in high fat diet groups (HF0, HFC, HFP) compared to the control group. That content in adrenal gland was the lowest in HF0 group, but not in liver. In HFP group were down-regulated cRBPI mRNA in liver and cRBPII mRNA in small intestine and up-regulated RBP and transthyretin expression in serum compared to the other groups. In conclusion, dietary fibers, especially pectin, in high fat diet might down-regulate the expression of cRBP I, cRBP II mRNA in liver and small intestine, but increase the secretion of RBP into serum and therefore inhance the bioavailability of Vit A through the body.

Effects of the 8-week Resistance Exercise on Body Composition, Serum Hormone Profiles and Feeding Patterns of Obese Females

This study was designed to investigate the effects of 8-week resistance exercise by using dumbell on the body composition, serum hormone profiles and feeding patterns in young and healthy female students with over 30% of body fat, aged 22 years in Masan, Korea. The subjects were all six, performed successfully the entire exercise-program. Anthropometry, serum lipid and neurohormone profiles of subjects were analyzed at 0, 4 and 8 weeks after exercise. And also their food and nutrient intakes were self-reported by 3-day record and food frequency questionnaire. Triceps skinfoldthickness of the subject students significantly reduced after the exercise to 46% less than before (p < 0.002). The serum concentrations of leptin, insulin and catecholamine appeared to decrease steadily, but not significantly. Total protein in serum increased significantly (p < 0.05), and Na (p < 0.005), K (p < 0.001) and Fe (p < 0.058) concentrations increased remarkably within the normal range. The 8-week resistance exercise tended to induce fiber consumption (p < 0.089) of subject students and changed the P/M/S ratio changed into the desirable way from 0.8 : 1 : 1 to 1 : 1 : 1, and that of n- 6/n-3 PUFA from 11 : 1 to 6 : 1. After taking exercise, the intake frequency of cookies (p < 0.058) and raymeun (p < 0.085) decreased, but finally this feeding pattern returned to the way as before even though at marginal significance. Consequently the resistance exercise may induce the desirable changes of body fat and improve serum lipid profiles and feeding patterns in young obese females.

A Comparison of the Food and Nutrient Intake of Adolescents between Urban Areas and Islands in South Kyungnam / 대한지역사회영양학회지

This study was performed to compare the anthropometric and the food and nutrient intake of the adolescents between urban areas and islands in south Kyungnam and to identify their nutritional problems. A questionnaire survey was distributed among 383 middle school students for the food and nutrient consumption and other nutritional attitudes including socioecomonic status. The height and weight of the students were measured as well. Socioeconomic status, such as income, educational level, and jobs of the urban students parents was better than that of the island students. There was no significant difference in height between the students of both areas, but the body weight of the urban male students was far heavier than that of the other group. It is very interesting to note that the energy intake of the urban male students was much lower than that of the island male students. The students of the two areas consumed more protein, Vit B1, Vit B2, niacin and Vit C than the recommended daily allowances(RDA) but the intake of Ca, Fe, Vit A was less. As to the sources of animal fat, the urban males consumed much more. Regarding the taste preference, the study shows that urban male students are more likely to choose sweet, salty and soft tastes than island male students. In the case of female students, although island students prefer a rather hot taste, urban students are more likely to prefer sweet and soft tastes. The favorite foods of urban students are meat products, fastfoods, chocolate, cheese and milkshakes, while foods like cooked rice with assorted vegetable are the favorite of the island students. In general, the preference degree for meat products and fruits rates higher than for vegetables. Conclusively the urban students had a tendency of being obese and the intake of all nutrients by the urban adolescents was much lower than that of the islanders. In this study, the cause can be found in significant differences in consuming animal fat, of taste preference and of choosing favorite food. Accordingly a nutritional intervention or educational program is required to adjust the imbalanced intake of some nutrients for the adolescents in this province.