| Co-Investigator(Kenkyū-buntansha) |
KAWATA Chieko Aichi Prefectural College of Nursing and Health, 看護学部, professor (60010013)
SHIKATA Kenichi Okayama University, Graduate School of Medicine Dentistry, Pharmaceutical Sciences, associate professor (00243452)
NAKAO Miyuki Kawasaki University of Medical welfare, Department of Nursing, Assistant Professor (00316126)
NAKANISHI Yoshiko Okayama University, Graduate School of Health Science, Assistant Professor (50217783)
一村 光子 岡山大学, 医学部, 助教授 (40203111)
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| Budget Amount *help |
¥2,480,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥180,000)
Fiscal Year 2007: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2006: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2005: ¥1,000,000 (Direct Cost: ¥1,000,000)
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| Research Abstract |
A questionnaire survey was conducted among diabetic outpatients to identify their disease-related coping behaviors, disease complexity, future anxiety and uncertainty, physical symptoms, awareness of kidney status, knowledge of nephropathy, and dietary self-management. Path analysis showed that coping behaviors and uncertainty directly affected dietary management. Based on this finding, an educational program was developed by reviewing these interactions with diabetic patients who had stage II-IV nephropathy.
A patient with stage II nephropathy was told by Ms attending physician that a test detected micro albuminuria. The patient then worriedly contacted a nurse and told the nurse about Ms test result. The nurse explained the meaning of micro albuminuria and diabetic nephropathy and told the patient that his renal function would recover with proper glycemic control. Since the patient indicated that he would do his best to improve his renal function, the nurse talked to the patient about
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measures that he could take to improve glycemic control. For the last several years, the patient's HbAlc had been 〓8.0%; by eliminating snacks, his HbAlc improved to around 7%. The patient had kidney failure, and though he knew that he needed to restrict his protein and salt intakes, he failed to do so, and his serum creatinine continued increasing. The patient indicated that he felt anxious about his future and isolated from his family. The nurse explained the patient's condition to his family, and she told the family that the patient was trying to do his best. Afterwards, the family was more helpful towards the patient.
Based on the above, the following program was designed for diabetics with stage II nephropathy. Since these patients lack symptoms, they are not fully aware that they have nephropathy. However, by mentioning that they have micro albuminuria, nurses can explain how patients can improve their kidney function. For patients who need to restrict their protein intake, nurses provide not only conventional dietary guidance, but they also explain the necessity and effectiveness of protein-restricted diets and ask the family members to support their diabetic relative. Less
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