Böbrek nakli yapılan hastalarda fiziksel aktivitenin metabolik parametrelere etkisinin incelenmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Giriş: Böbrek nakli hastalarında en sık görülen ölüm nedenleri arasında kalp damar hastalıkları yer almaktadır. Fiziksel aktivite, nakil sonrasında görülen kalp damar hastalıklarının önlenmesinde büyük öneme sahiptir. Uluslararası kılavuzlarda böbrek nakli hastalarında nakil sonrası mortalite ve morbiditeyi engellemek için düzenli fiziksel aktivite önerilse de yapılan çalışmalarda hastaların düzenli fiziksel aktivite talimatlarına uymadıkları belirlenmiştir. Böbrek nakli hastalarında egzersiz düzeyi ve egzersizin bireylerinin fiziksel fonksiyonlarını nasıl etkilediği konusunda sınırlı çalışma bulunmaktadır. Bunun yanı sıra, ülkemizde bu konu ile ilgili yapılmış çalışmaya rastlanmamıştır. Bu projede, böbrek nakli sonrasında pedometre destekli fiziksel aktivitenin metabolik parametrelere etkisinin incelenmesi amaçlandı. Gereç ve Yöntem: Bu araştırma, böbrek nakli olan hastalarda pedometre destekli yürümenin fiziksel aktivite düzeyi ve metabolik parametrelere etkisinin incelenmesi amacıyla yapılan prospektif randomize kontrollü bir çalışmadır. Araştırmanın örneklemini, 1 Ekim 2020-05.03.2024 tarihleri arasında Ege Üniversitesi Organ Nakli Araştırma ve Uygulama Merkezi'nde böbrek nakli olan 36 hasta oluşturdu. Hastalar nakil tarihine göre sırayla Girişim ve Kontrol grubu olarak randomize edildi. Girişim ve Kontrol grubuna taburculuk eğitimi esnasında fiziksel aktivitenin önemine ilişkin aynı eğitim verildi. Girişim grubuna aktivite düzeyinin değerlendirilmesi için pedometre verilirken, kontrol grubuna yalnızca günlük aktivitelerini kaydetmeleri önerildi. Ardından, Girişim ve Kontrol grubundaki hastaların nakil sonrası 4. ay ve 12. aylarda metabolik parametreleri değerlendirildi. Verilerin analizinde tanımlayıcı istatistikler, ShapiroWilk normallik testi, bağımsız örneklem t testi, Mann Whitney U testi ve Fisher Exact testi kullanıldı. Bulgular: Hastaların yaş ortalaması, 36.50±12.39 (18-59) yıl olup, %69.4'ü erkekti. Hastaların %86.1'i nakil öncesi böbrek replasman tedavisi almış, %61.1'i en az bir kronik hastalığa sahipti. Nakil sonrası taburculuk döneminde hastalara reçete edilen immünsüpresif ilaçlar incelendiğinde, hastaların %100'ü steroid, %94.4'ü'i takrolimus ve %80.6'sı mikofenolat mofetil alıyordu. Nakil sonrası kısa dönemde (4.ay) girişim grubundaki hastaların metabolik parametrelerinden olan beden kitle indeksi (p: 0.036) ve alkalen fosfataz (ALP) düzeyi (p: 0.046) ile kontrol grubu arasında istatistiksel olarak anlamlı bir fark saptandır. Uzun dönemde (12.ay) ise, girişim grubu ve kontrol grubundaki hastaların beden kitle indeksi ortalamaları arasında istatistiksel olarak anlamlı bir fark saptandı (p: 0.010). Sonuç: Araştırma bulgularına göre, böbrek nakli sonrası pedometre destekli yürüyüş yapan hastaların, yalnızca nakil sonrası yürüyüş kaydı önerilen hastalara göre, kısa dönem (4. Ay) ve uzun dönem (12.ay) beden kitle indeksi ortalamaları, yalnızca nakil sonrası yürüyüş kaydı önerilen hastalara göre daha düşük saptanmıştır. Pedometre destekli yürümenin fiziksel aktiviteye ilişkin davranış değişikliği oluşturulmasında, kilo alımının kontrolü veya sınırlanmasında etkin olabileceği, uzun vadede pozitif hasta sonuçlarını iyileştirebileceği düşünülmektedir.
Introduction: Cardiovascular diseases are among the most common causes of death in kidney transplant patients. Physical activity is of great importance in preventing cardiovascular diseases seen after transplantation. Although regular physical activity is recommended in international guidelines to prevent post-transplant mortality and morbidity in kidney transplant patients, studies have shown that patients do not comply with regular physical activity instructions. There are limited studies on exercise level in kidney transplant patients and how exercise affects their physical functions. In addition, no studies on this subject have been found in our country. This project aimed to examine the effect of pedometer-supported physical activity on metabolic parameters after kidney transplantation. Materials and Methods: This research is a prospective randomized controlled study to examine the effect of pedometer-assisted walking on physical activity level and metabolic parameters in kidney transplant patients. The sample of the study consisted of 36 patients who received kidney transplantation at Ege University Organ Transplantation Research and Application Center between October 1, 2020 and 05.03.2024. Patients were randomized into Intervention and Control groups, respectively, according to the date of transplantation. The Intervention and Control groups were given the same training regarding the importance of physical activity during discharge training. While the intervention group was given a pedometer to evaluate the activity level, the control group was advised to record only their daily activities. Then, the metabolic parameters of the patients in the Intervention and Control groups were evaluated at the 4th and 12th months after transplantation. Descriptive statistics, ShapiroWilk normality test, independent samples t test, Mann Whitney U test and Fisher Exact test were used to analyze the data. Results: The average age of the patients was 36.50±12.39 years (min-max 18-59), and 69.4% were male. Before transplantation, 86.1% of the patients had undergone renal replacement therapy, and 61.1% had at least one chronic illness. Upon discharge after transplantation, 100% of the patients were prescribed steroids, 94.4% tacrolimus, and 80.6% mycophenolate mofetil. In the short term (4th month post-transplant), there was a statistically significant difference in the body mass index (BMI) (p=0.036) and alkaline phosphatase (ALP) levels (p=0.046) between the intervention group and the control group. In the long term (12th month), a statistically significant difference in BMI was found between the intervention group and the control group (p=0.010). Conclusion: According to the research findings, patients who engaged in pedometer-supported walking after kidney transplantation had lower average body mass index (BMI) in both the short term (4th month) and long term (12th month) compared to those who were only advised to walk post-transplant. It is suggested that pedometer-supported walking could be effective in promoting behavior change related to physical activity, controlling or limiting weight gain, and improving long-term positive patient outcomes
Introduction: Cardiovascular diseases are among the most common causes of death in kidney transplant patients. Physical activity is of great importance in preventing cardiovascular diseases seen after transplantation. Although regular physical activity is recommended in international guidelines to prevent post-transplant mortality and morbidity in kidney transplant patients, studies have shown that patients do not comply with regular physical activity instructions. There are limited studies on exercise level in kidney transplant patients and how exercise affects their physical functions. In addition, no studies on this subject have been found in our country. This project aimed to examine the effect of pedometer-supported physical activity on metabolic parameters after kidney transplantation. Materials and Methods: This research is a prospective randomized controlled study to examine the effect of pedometer-assisted walking on physical activity level and metabolic parameters in kidney transplant patients. The sample of the study consisted of 36 patients who received kidney transplantation at Ege University Organ Transplantation Research and Application Center between October 1, 2020 and 05.03.2024. Patients were randomized into Intervention and Control groups, respectively, according to the date of transplantation. The Intervention and Control groups were given the same training regarding the importance of physical activity during discharge training. While the intervention group was given a pedometer to evaluate the activity level, the control group was advised to record only their daily activities. Then, the metabolic parameters of the patients in the Intervention and Control groups were evaluated at the 4th and 12th months after transplantation. Descriptive statistics, ShapiroWilk normality test, independent samples t test, Mann Whitney U test and Fisher Exact test were used to analyze the data. Results: The average age of the patients was 36.50±12.39 years (min-max 18-59), and 69.4% were male. Before transplantation, 86.1% of the patients had undergone renal replacement therapy, and 61.1% had at least one chronic illness. Upon discharge after transplantation, 100% of the patients were prescribed steroids, 94.4% tacrolimus, and 80.6% mycophenolate mofetil. In the short term (4th month post-transplant), there was a statistically significant difference in the body mass index (BMI) (p=0.036) and alkaline phosphatase (ALP) levels (p=0.046) between the intervention group and the control group. In the long term (12th month), a statistically significant difference in BMI was found between the intervention group and the control group (p=0.010). Conclusion: According to the research findings, patients who engaged in pedometer-supported walking after kidney transplantation had lower average body mass index (BMI) in both the short term (4th month) and long term (12th month) compared to those who were only advised to walk post-transplant. It is suggested that pedometer-supported walking could be effective in promoting behavior change related to physical activity, controlling or limiting weight gain, and improving long-term positive patient outcomes
Açıklama
Anahtar Kelimeler
Nakil, böbrek, egzersiz, kalp hastalıkları, hemşirelik bakımı., Transplant, kidney, exercise, heart diseases, nursing care.
