Obremenjenost bolnikov s presajeno ledvico z neželenimi učinki imunosupresivnih zdravil : poročilo o raziskavi

Đukić, Slavica (author), Bobnar, Albina (mentor), Uštar, Maja (co-mentor)

Uvod: Bolniki s presajeno ledvicozaradi preprečevanja zavrnitvene reakcije potrebujejo dolgotrajno zdravljenje z imunosupresivnimi zdravili. Posledica tega so neželeni učinki imunosupresivnih zdravil, ki so za bolnike pogosto obremenjujoči;kažejo se v spremembi videza, razpoloženja in v fizični zmogljivosti. To vpliva na (ne)uspešnost njihovega zdravljenja in še ni povsem raziskano.Namen: Namen diplomskega dela je pojasniti prisotnost obremenjenosti pri odraslih bolnikih s presajeno ledvico v Sloveniji z neželenimi učinki imunosupresivnih zdravil. Metode dela: Uporabljen je bil del podatkov kvantitativne presečne raziskave o kakovosti življenja odraslih bolnikov s presajeno ledvico v Sloveniji, izvedene leta 2016. 632 bolnikov je izpolnilo prevedeni vprašalnik, iz katerega je bilo za sekundarno obdelavo izbranih 12 neželenih učinkov imunosupresivnih zdravil.Podatki so bili obdelani s programom SPSS,različica 20, in so prikazani opisno, številčno, v odstotkih ter s povprečnimi ocenami in standardnimi odkloni.Rezultati:Sodelovali so odrasli, 56,8 % moških, 88,6 % starih nad 40 let (povprečje 55 let), 75,6 % poročenih, 79,1 % s srednjo izobrazbo ali manj; brez dela ali upokojenih je bilo 75,3 %, z manj kot 1.300 evrov mesečnega dohodka na gospodinjstvo. Četrtina jih je imela sočasne bolezni (sladkorno bolezen, srčno-žilne bolezni). Izkušnje z zavrnitveno reakcijo presajene ledvice je imelo 18,4 %. V povprečju jih je imelo presajeno ledvico 8,9 leta (najmanj 3 mesece, največ 40,5 leta).Skombinacijo dveh ali treh imunosupresivnih zdravil (od šestih najpogosteje uporabljenih) se jih je zdravilo 97,6 %. Največ (83,1 %) jih je bilo obremenjenih z omejeno fizično zmogljivostjo in bolečinami v sklepih (60,3 %), malo več kot polovica pa z negotovostjo glede trajanja delovanja presajene ledvice, živčnostjo, s težavami z zbranostjo in nespečnostjo. Najvišje so ocenili omejeno fizično zmogljivost (1,5), bolečine v sklepih (1,1) in negotovost glede trajanja delovanja presajene ledvice (1,0).Razprava in zaključek: Rezultati kažejo, da so bili bolniki s presajeno ledvico v Sloveniji obremenjeni z 12 neželenimi učinki imunosupresivnih zdravil,predvsem s težavami, ki so jim onemogočale dobro fizično delovanje, toda povprečna stopnja te obremenjenosti je bila nizka. To bo imelo mogoče drugačen vpliv na razumevanje njihovih izkušenj z neželenimi učinki pri zdravstvenih delavcih.

• Language: Slovenian
• Keywords: presaditev ledvice, imunosupresivno zdravljenje, samoocena neželenih učinkov, obremenjenost
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-101217
• COBISS.SI-ID: 5429611
• Publication date in RUL: 15.05.2018

Secondary language

• Language: English
• Title: Overburdened kidney transplanted patients with side effects from immunosuppressive drugs : research report

Abstract

Introduction: Kidney transplanted patients require long term treatment with immunosuppressive drugs due to rejection reaction. The side effects of these drugs often cause the body to change and with it the patients self confidence also declines causing poor results in treatment. Purpose: The purpose of this thesis is to explain the overburdeness of kidney transplanted patients with side effects from immunosuppressive drugs in Slovenia.Methods:Some data was used from a quantitatively intersecting research study about the quality of life of kidney transplanted patients in Slovenia which was performed in 2016. 632 filled out a translated questionnaire, from there 12 side effects from immunosuppressive drugs were chosen and used in the later part of the research. The data was processed with the SPSS program version 20 and was presented in written, numerical form. It was also presented in a percentage form with average grades and standard declines. Results: The participants were adults. 56, 8 % were men. 88, 6 of them were over 40 years old (an average of 55 years). 75, 6 % were married. 79, 1 % had a secondary education or less, 75, 3 % were unemployed ot retired with less than 1300 euros of monthly income. A quarter of them had concomitant diseases (diabetes, cardiovascular disease). An average of 18, 4% had an experience with a rejection reaction. The average living time with an transplanted kidney was 8, 9 years (with 3 months being the smallest and 40, 5 years being the longest). 97,6 % were taking a combination of 2 or 3 types of immunosuppressive medicine (of the 6 most commonly used). Most of the participants (total of 83,1 %) had trouble performing physical tasks and joint pain (60, 3%). A little over half of them had uncertainty about the lasting of the transplanted kidney, some of them were nervous and had trouble sleeping. The highest problem was physical disability (1,5), joint pain (1,1) and uncertainty about the lasting of the transplanted kidney (1).Discussion and conclusion: Results have shown that patients with transplanted kidneys in Slovenia had 12 side effects. Most of them enabled physical abillities, although the average rate of these was low.This study will show a different point of view and change understanding about these experiences regarding side effects from medical staff point of view.

• Keywords: Kidney transplant, Immunosuppressive therapy, Self assessed side effects, Overburdened