혈액투석기간에 따른 불안의 변화

Change of Severity of Anxiety During the Course of Hemodialysis

Hemodialysis has become one of the indispensible choice of treatment for the patients with chronic renal failure and also has become popular and practical in the clinical field. However, it has been known that during hemodialysis most patients develop various neuropsychiatric problems, of which depression and anxiety are the most fequent and serious responses to the situation of survival dependent on dialysis machine. Most of the reports about the change of depression according to the period of time on hemodialysis has been consistent but that of anxiety has been controversial. This study was designed to evaluate whether there are change of severity of anxiety following hemodialysis. Subjects were consisted of 17 short-term hemodialysis patients, 18 mid-term hemodialysis patients and 19 long-term hemodialysis patients who were undergoing maintenance hemodialysis at Kangnam St. Mary’s hospital, St. Vincent hospital and Holy family hospital from March to July 1987. Two different self-rating scales, Spielberger’s state-trait anxiety inventory and Zung’s self-rating anxiety scale, were applied to the subjects for elucidating the change of severity of anxity according to the period of time on hemodialysis. The results were as following ： 1) On Spielberger’s state anxiety inventory, the scores of short-term hemodialysis patients was 41.8土 2.1, mid-term hemodialysis patients was 41.1 土 2.0 and long-term hemodialysis patients was 44.9± 2.1. There were no statistically significant differences among 3 groups. 2) The scores of Spielberger’s trait anxiety inventory for short-term, mid-term and long-term hemodialysis patients were 41.9土 2.4,44.8土 2.3 and 48.7± 2.4 respectively. 3 patient groups did not showed statistically significant differences. 3) The scores of Zung self-rating anxiety scale were 40.0± 2.1 in short-term hemodialysis patients, 43.6土 2.0 in mid-term hemodialysis patients and 46.6± 1.9 in long-term hemodialysis patients. They also had no significant differences in statitics. 4) But all the scores of 3 sets of psychological tests were similar to those of Korean high school students, chronic medical patients and cancer patients but lower than those of the anxiety disorder patients. In conclusion, it was implicated that most of hemodialysis patients have mild to moderate anxiety with superimposed transient episodic severe fear for death during maintenance hemodialysis, which appeared to be not significantly changed during the course of hemodialysis.