Kvaliteta života zaposlenih majki u Primorsko-goranskoj županiji The quality of life of working mothers in the Croatiain Primorje-Gorski Kotar County

Uvod: Današnji način života uvelike je povezan s globalnim poslovnim i obiteljskim trendovima u kojima majka mora biti i uspješna poslovna žena i brižna majka, što ponekada dovodi do izgaranja. Metode: Istraživanje je provedeno tijekom tri mjeseca uporabom anketnog upitnika. U istraživanje su uključene zaposlene majke s prebivalištem u Primorsko-goranskoj županiji. Za potrebe istraživanja izrađen je upitnik koji se sastojao od više kategorija. Kvaliteta života određivala se tzv. validiranom metodologijom, uporabom skraćene modifikacije upitnika o kvaliteti života SF-12. Rezultati: Dobiveni rezultati nisu verificirali hipotezu o boljoj kvaliteti života zaposlenih majki. Zaključak: Postotak visokoobrazovanih ispitanica ukazuje da su iste imale veći stupanj kvalitete života u odnosu na nižeobrazovanemajke što se objašnjava većim stupnjem neovisnosti

ASSESSMENT OF NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON MAINTANCE HEMODIALYSIS

Prema dostupnoj literaturi 18 % do 80 % bolesnika na dijalizi ima neki oblik nutritivnog deficita. Cilj rada bio je analizirati nutritivni status bolesnika koji se liječe postupcima hemodijalize (HD) te analizirati primjenjivost mjerenja masnog tkiva (FAT) kaliperom. Ispitanici su bili bolesnici koji se liječe postupcima redovite HD duže od šest mjeseci (129 bolesnika). Razdoblje praćenja trajalo je šest mjeseci. Za procjenu nutritivnog statusa koristili smo suhu tjelesnu težinu (STT), indeks tjelesne mase (ITM), mjerenje FAT-a kaliperom, mjerenje opsega mišića nadlaktice (OMN) te određivanje serumskih albumina i kolesterola. Analizirajući učinkovitost mjerenja FAT-a preko kožnog nabora kaliperom, uočili smo da je FAT dobiven kaliperom pokazao statistički značajnu pozitivnu korelaciju s drugim pokazateljima stanja uhranjenosti, s ITM-om (r = 0,364; p<0,0001), STT-om (r = 0,206; p = 0,005) i OMN (r = 0,399; p<0,0001). Isto tako, FAT je pokazao statistički značajnu pozitivnu korelaciju s vrijednostima serumskih albumina (r = 0,299; p = 0,01) i kolesterolom (r = 0,225; p = 0,002). Nije bilo statistički značajne korelacije između duljine trajanja HD i FAT-a (p=NS). Zaključujemo da je za redovitu procjenu nutritivnog statusa važno da je metoda koju primjenjujemo što učinkovitija, preciznija, brza, uz što manje ekonomsko opterećenje. Iz vlastitog iskustva možemo ustvrditi da je mjerenje FAT-a kožnim naborom s kaliperom primjenjiva, brza i jeftina metoda koja se može koristiti u svakodnevnoj kliničkoj praksi.Introduction: It is well established that nutritional status is an important factor affecting the outcome and recovery from disease or injury. Assessment of nutritional status is an integral part of care for patients with chronic kidney disease, especially for those treated with dialysis procedures. According to available literature, 18%-80% of patients on dialysis have some form of nutritional deficiency. Furthermore, in patients treated with dialysis procedures there is a rule called ‘reverse epidemiology’, according which patients with better nutritional status have better survival rate. Therefore, nutritional assessment should detect malnutrition and rate the overall nutritional status of each patient through clinical data categories: medical history, physical examination, nutrition physical examination, psychosocial history, demographics, physical activity, and current medical/surgical issues. Consequently, the main aim of our study was to analyze the nutritional status of our patients treated with hemodialysis procedures. Another aim was to analyze the applicability of measuring skinfold by caliper as a method of nutritional status assessment. Subjects and Methods: During a six-month period, we analyzed 129 patients (57.4% of men and 42.6% of women), mean age 68.1±12.4 years, treated with hemodialysis procedures (24.8% of patients were treated with online hemodiafiltration and 75.2% with standard, conventional hemodialysis) as the method of choice of renal replacement therapy (RRT) for more than 6 months. All patients were dialyzed three times a week for four hours on biocompatible synthetic membranes. The patients treated with online hemodiafiltration were dialyzed on high-flux helixone membranes, while those treated with standard, conventional hemodialysis were dialyzed on polysulfone membranes and helixone low-flux membranes. The mean time of RRT was 71.2±56.7 months. During the study period, in each patient we followed medical history, and clinical and laboratory parameters of nutritional status at 3 and 6 months. To assess the nutritional status, we used dry weight (DW), body mass index (BMI), skinfold caliper measurement (result is correlated with total body fat, FAT), and common laboratory indicators of nutritional status (serum albumin and cholesterol). Results: Analyzing the efficiency of skinfold thickness measurement with caliper, we found that the FAT obtained by caliper showed a statistically significant positive correlation with clinical indicators of nutritional status, and with BMI (r=0.364, p<0.0001), DW (r=0.206, p=0.005) and volume of muscle circumference (r=0.399, p<0.0001). Also, FAT showed statistically significant positive correlation with laboratory indicators of nutritional status, including serum albumin (r=0.299, p=0.01) and cholesterol (r=0.225, p=0.002). There was no statistically significant correlation between the duration of RRT and FAT (p=NS). Conclusion: In clinical practice, as well as for regular evaluation of nutritional status, it is important that the method we used proved efficient, precise, relatively fast and posing less economic burden. From our experience, the measurement of skinfold with caliper is an applicable, relatively quick and inexpensive method for regular assessment of nutritional status in patients treated with hemodialysis procedures. Therefore, all patients treated with RRT should undergo nutritional screening and expert help should be available from dietitians or nutritional support teams in order to identify this problem properly in its early stage and to reduce its high prevalence

ASSESSMENT OF NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON MAINTANCE HEMODIALYSIS

Prema dostupnoj literaturi 18 % do 80 % bolesnika na dijalizi ima neki oblik nutritivnog deficita. Cilj rada bio je analizirati nutritivni status bolesnika koji se liječe postupcima hemodijalize (HD) te analizirati primjenjivost mjerenja masnog tkiva (FAT) kaliperom. Ispitanici su bili bolesnici koji se liječe postupcima redovite HD duže od šest mjeseci (129 bolesnika). Razdoblje praćenja trajalo je šest mjeseci. Za procjenu nutritivnog statusa koristili smo suhu tjelesnu težinu (STT), indeks tjelesne mase (ITM), mjerenje FAT-a kaliperom, mjerenje opsega mišića nadlaktice (OMN) te određivanje serumskih albumina i kolesterola. Analizirajući učinkovitost mjerenja FAT-a preko kožnog nabora kaliperom, uočili smo da je FAT dobiven kaliperom pokazao statistički značajnu pozitivnu korelaciju s drugim pokazateljima stanja uhranjenosti, s ITM-om (r = 0,364; p<0,0001), STT-om (r = 0,206; p = 0,005) i OMN (r = 0,399; p<0,0001). Isto tako, FAT je pokazao statistički značajnu pozitivnu korelaciju s vrijednostima serumskih albumina (r = 0,299; p = 0,01) i kolesterolom (r = 0,225; p = 0,002). Nije bilo statistički značajne korelacije između duljine trajanja HD i FAT-a (p=NS). Zaključujemo da je za redovitu procjenu nutritivnog statusa važno da je metoda koju primjenjujemo što učinkovitija, preciznija, brza, uz što manje ekonomsko opterećenje. Iz vlastitog iskustva možemo ustvrditi da je mjerenje FAT-a kožnim naborom s kaliperom primjenjiva, brza i jeftina metoda koja se može koristiti u svakodnevnoj kliničkoj praksi.Introduction: It is well established that nutritional status is an important factor affecting the outcome and recovery from disease or injury. Assessment of nutritional status is an integral part of care for patients with chronic kidney disease, especially for those treated with dialysis procedures. According to available literature, 18%-80% of patients on dialysis have some form of nutritional deficiency. Furthermore, in patients treated with dialysis procedures there is a rule called ‘reverse epidemiology’, according which patients with better nutritional status have better survival rate. Therefore, nutritional assessment should detect malnutrition and rate the overall nutritional status of each patient through clinical data categories: medical history, physical examination, nutrition physical examination, psychosocial history, demographics, physical activity, and current medical/surgical issues. Consequently, the main aim of our study was to analyze the nutritional status of our patients treated with hemodialysis procedures. Another aim was to analyze the applicability of measuring skinfold by caliper as a method of nutritional status assessment. Subjects and Methods: During a six-month period, we analyzed 129 patients (57.4% of men and 42.6% of women), mean age 68.1±12.4 years, treated with hemodialysis procedures (24.8% of patients were treated with online hemodiafiltration and 75.2% with standard, conventional hemodialysis) as the method of choice of renal replacement therapy (RRT) for more than 6 months. All patients were dialyzed three times a week for four hours on biocompatible synthetic membranes. The patients treated with online hemodiafiltration were dialyzed on high-flux helixone membranes, while those treated with standard, conventional hemodialysis were dialyzed on polysulfone membranes and helixone low-flux membranes. The mean time of RRT was 71.2±56.7 months. During the study period, in each patient we followed medical history, and clinical and laboratory parameters of nutritional status at 3 and 6 months. To assess the nutritional status, we used dry weight (DW), body mass index (BMI), skinfold caliper measurement (result is correlated with total body fat, FAT), and common laboratory indicators of nutritional status (serum albumin and cholesterol). Results: Analyzing the efficiency of skinfold thickness measurement with caliper, we found that the FAT obtained by caliper showed a statistically significant positive correlation with clinical indicators of nutritional status, and with BMI (r=0.364, p<0.0001), DW (r=0.206, p=0.005) and volume of muscle circumference (r=0.399, p<0.0001). Also, FAT showed statistically significant positive correlation with laboratory indicators of nutritional status, including serum albumin (r=0.299, p=0.01) and cholesterol (r=0.225, p=0.002). There was no statistically significant correlation between the duration of RRT and FAT (p=NS). Conclusion: In clinical practice, as well as for regular evaluation of nutritional status, it is important that the method we used proved efficient, precise, relatively fast and posing less economic burden. From our experience, the measurement of skinfold with caliper is an applicable, relatively quick and inexpensive method for regular assessment of nutritional status in patients treated with hemodialysis procedures. Therefore, all patients treated with RRT should undergo nutritional screening and expert help should be available from dietitians or nutritional support teams in order to identify this problem properly in its early stage and to reduce its high prevalence

Role of the nurse in nephrology care

Nefrološke medicinske sestre članice su medicinskog tima koji skrbi za bolesnike u svim stadijima bubrežne bolesti, uključujući i stadij kada je potrebno nadomjestiti bubrežnu funkciju. Njihov rad usmjeren je na sprječavanje bubrežne bolesti te procjenu zdravstvenih potreba bolesnika i njihovih obitelji. Osim osnovnog znanja stečenog tijekom školovanja, one se moraju dodatno educirati za rad u dijaliznim jedinicama. Svoju ulogu ostvaruju u različitim ambulantama polikliničke službe, na odjelima standardne ili intenzivne njege, jedinicama za dijalizu i u domovima bolesnika. U svom okruženju medicinske sestre djeluju kao izravni isporučitelji zdravstvene njege, zastupnici, pedagozi, savjetnici i koordinatori skrbi.Renal nurses are members of the medical team who care for patients in all stages of kidney disease, including the stage when it is necessary to replace renal function. Their work is focused on prevention of kidney diseases and assessment of health needs of patients and their families. In addition to basic knowledge acquired during the training, they need to be further trained to work in dialysis units. They realize their role in various clinics of polyclinic services, departments of standard or intensive care, dialysis units and also in patients’ homes. In their environment the nurses act as direct suppliers of health care, representations, educators, counselors and coordinators of care

ASSESSMENT OF NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON MAINTANCE HEMODIALYSIS

Prema dostupnoj literaturi 18 % do 80 % bolesnika na dijalizi ima neki oblik nutritivnog deficita. Cilj rada bio je analizirati nutritivni status bolesnika koji se liječe postupcima hemodijalize (HD) te analizirati primjenjivost mjerenja masnog tkiva (FAT) kaliperom. Ispitanici su bili bolesnici koji se liječe postupcima redovite HD duže od šest mjeseci (129 bolesnika). Razdoblje praćenja trajalo je šest mjeseci. Za procjenu nutritivnog statusa koristili smo suhu tjelesnu težinu (STT), indeks tjelesne mase (ITM), mjerenje FAT- a kaliperom, mjerenje opsega mišića nadlaktice (OMN) te određivanje serumskih albumina i kolesterola. Analizirajući učinkovitost mjerenja FAT-a preko kožnog nabora kaliperom, uočili smo da je FAT dobiven kaliperom pokazao statistički značajnu pozitivnu korelaciju s drugim pokazateljima stanja uhranjenosti, s ITM-om (r = 0, 364 ; p<0, 0001), STT-om (r = 0, 206 ; p = 0, 005) i OMN (r = 0, 399 ; p<0, 0001). Isto tako, FAT je pokazao statistički značajnu pozitivnu korelaciju s vrijednostima serumskih albumina (r = 0, 299 ; p = 0, 01) i kolesterolom (r = 0, 225 ; p = 0, 002). Nije bilo statistički značajne korelacije između duljine trajanja HD i FAT-a (p=NS). Zaključujemo daje za redovitu procjenu nutritivnog statusa važno da je metoda koju primjenjujemo što učinkovitija, preciznija, brza, uz što manje ekonomsko opterećenje. Iz vlastitog iskustva možemo ustvrditi da je mjerenje FAT-a kožnim naborom s kaliperom primjenjiva, brza i jeftina metoda koja se može koristiti u svakodnevnoj kliničkoj praksi

ASSESSMENT OF NUTRITIONAL STATUS IN PATIENTS WITH CHRONIC KIDNEY DISEASE ON MAINTANCE HEMODIALYSIS

Prema dostupnoj literaturi 18 % do 80 % bolesnika na dijalizi ima neki oblik nutritivnog deficita. Cilj rada bio je analizirati nutritivni status bolesnika koji se liječe postupcima hemodijalize (HD) te analizirati primjenjivost mjerenja masnog tkiva (FAT) kaliperom. Ispitanici su bili bolesnici koji se liječe postupcima redovite HD duže od šest mjeseci (129 bolesnika). Razdoblje praćenja trajalo je šest mjeseci. Za procjenu nutritivnog statusa koristili smo suhu tjelesnu težinu (STT), indeks tjelesne mase (ITM), mjerenje FAT- a kaliperom, mjerenje opsega mišića nadlaktice (OMN) te određivanje serumskih albumina i kolesterola. Analizirajući učinkovitost mjerenja FAT-a preko kožnog nabora kaliperom, uočili smo da je FAT dobiven kaliperom pokazao statistički značajnu pozitivnu korelaciju s drugim pokazateljima stanja uhranjenosti, s ITM-om (r = 0, 364 ; p<0, 0001), STT-om (r = 0, 206 ; p = 0, 005) i OMN (r = 0, 399 ; p<0, 0001). Isto tako, FAT je pokazao statistički značajnu pozitivnu korelaciju s vrijednostima serumskih albumina (r = 0, 299 ; p = 0, 01) i kolesterolom (r = 0, 225 ; p = 0, 002). Nije bilo statistički značajne korelacije između duljine trajanja HD i FAT-a (p=NS). Zaključujemo daje za redovitu procjenu nutritivnog statusa važno da je metoda koju primjenjujemo što učinkovitija, preciznija, brza, uz što manje ekonomsko opterećenje. Iz vlastitog iskustva možemo ustvrditi da je mjerenje FAT-a kožnim naborom s kaliperom primjenjiva, brza i jeftina metoda koja se može koristiti u svakodnevnoj kliničkoj praksi