臺灣博碩士論文加值系統

本研究的主要目的：(一）建立國內血液透析和腹膜透析患者身體活動度、體適能、疲憊和骨密度之資料。(二）比較血液透析和腹膜透析患者身體活動度、體適能、疲憊和骨密度之差異。(三）分析身體活動度對體適能、疲憊和骨密度之影響。期望結果可以作為制定透析患者健康政策及提升照護品質之依據。
本研究採橫斷面的相關性研究。採立意取樣法，收集血液透析(n=44)和腹膜透析患者(n=44)，並從家屬中招募年齡、性別配對符合之健康成人44位作為對照組。
研究結果以SPSS/PC+13.0版進行資料建檔與分析，統計方法依研究目的及變項的性質，描述性統計以次數分配、百分比、平均值、標準差、序位等呈現。推論統計，採獨立t-檢定、單因子變異數分析、卡方檢定及線性複迴歸分析等統計方法進行檢定各變項間的差異。
研究結果發現：一、骨質密度在健康族群及血液透析患者顯著高於腹膜透析患者(F= 12.33, p< .0001)。二、每週相對身體活動量為健康族群高於血液透析患者及腹膜透析患者，達統計上顯著差異(F= 4.65, p= .011)。三、疲憊總平均在血液透析患者及腹膜透析患者皆高於健康族群，統計上達顯著差異(F= 8.75, p < .0001)。四、體脂肪百分比均分數為：健康族群高於血液透析及腹膜透析病患(F= 5.22, p= .007)；坐姿體前彎為健康族群及血液透析患者皆高於腹膜透析患者(F= 4.71, p= .011)；六分鐘走距為健康族群及血液透析病患高於腹膜透析病患(F= 9.41, p< .0001)；30秒坐椅站立為健康族群高於血液透析及腹膜透析病患(F= 7.59, p= .001)。
血液透析病患的每週相對中重度活動與骨密度呈正相關；腹膜透析病患的每週相對中重度活動與骨密度、六分鐘走距、30秒坐椅站立次數呈正相關、與疲憊及體脂肪呈負相關。血液透析病患骨密度的主要預測因子是每週相對中重度活動；腹膜透析病患骨密度、疲憊、有氧適能及肌肉適能的主要預測因子是每週相對中重度活動。
本研究結果可提供護理人員在擬定透析病人身體活動相關護理措施之依據，以提升透析病人健康照護之品質。

The main purpose of this study was to (1) establish data for physical activity status, physical fitness, fatigue, and bone mineral density of hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) patient; (2) compare the difference in physical activity status, physical fitness, fatigue, and bone mineral density between hemodialysis and CAPD patient; (3) analyze the impacts of physical activity status on physical fitness, fatigue, and bone mineral density of hemodialysis and CAPD patient. The results can be used to make the healthy policy for CAPD patient and improvement for quality of caring accordingly.
The research was conducted by using the cross-sectional cohort design. The hemodialysis (n=44) and CAPD patients (n=44) were recruited by purposive sampling and 44 healthy adults matched in age and gender from families were selected as the comparison group. The data were analyzed by frequency, percentage, mean, rang, independent t-test, one way ANOVA, chi-square test, and linear multiple regression using SPSS Window 13.0 version statistical software package.
The results found, (1) In bone mineral density, the healthy and hemodialysis subjects was significantly better than the CAPD patient. (F= 12.33, p< .0001), (2) In physical activity, the healthy was significantly better than the dialysis patient. (F= 4.65, p= .011), (3) In fatigue, the healthy subjects was significantly better than the dialysis patient. (F= 8.75, p< .0001), (4) In percentage of body fat, the healthy was significantly higher than the dialysis patient. (F= 5.22, p= .007). In sit-and-reach test, the healthy and hemodialysis subjects were significantly better than the CAPD patient. (F= 4.71, p= .011). In six-minute walk test, the healthy and hemodialysis subjects were significantly better than the CAPD patient. (F= 9.41, p< .0001). The 30-sec chair sit-to-stand test, the healthy subjects were significantly higher than the dialysis patient. (F= 7.59, p= .001). In hemodialysis patient, the relative amount of moderate to vigorous physical activity significantly correlated with bone mineral density. In CAPD patient, the relative amount of moderate to vigorous physical activity significantly correlated with bone mineral density, six-minute walk test, and 30-sec chair sit-to-stand test; relative amount of moderate to vigorous physical activity was negatively correlated to fatigue and percentage of body fat.
The relative amount of moderate to vigorous physical activity is a predictive factor for the bone mineral density in hemodialysis patients. The relative amount of moderate to vigorous physical activity is a predictive factor for the bone mineral density, fatigue, aerobic fitness, and muscular fitness in CAPD patients. The results would be valuable in promoting the physical activity among dialysis patients and enhancing the quality of care.

目 錄
致謝………………………………………………………………… Ⅰ
中文摘要…………………………………………………………… Ⅱ
英文摘要…………………………………………………………… Ⅳ
目錄………………………………………………………………… Ⅵ
圖表目次…………………………………………………………… Ⅸ

第一章 緒論
第一節 研究動機與重要性………………………………… 1
第二節 研究目的…………………………………………… 4
第三節 名詞界定…………………………………………… 4
第二章 文獻查證
第一節 血液透析與腹膜透析的身體活動狀態…………… 7
第二節 血液透析與腹膜透析的骨密度…………………… 12
第三節 血液透析與腹膜透析的疲憊……………………… 20
第四節 血液透析與腹膜透析的體適能…………………… 25
第五節 身體活動度與骨密度、疲憊及體適能的相關性… 29
第三章 研究方法
第一節 研究設計…………………………………………… 39
第二節 研究對象…………………………………………… 39
第三節 研究工具…………………………………………… 40
第四節 資料收集過程……………………………………… 58
第五節 資料統計與分析…………………………………… 58
第四章 研究結果
第一節 研究對象的基本資料……………………………… 60
第二節 骨質密度…………………………………………… 65
第三節 身體活動狀態……………………………………… 67
第四節 疲憊………………………………………………… 69
第五節 體適能……………………………………………… 72
第六節 身體活動度與骨密度、疲憊感及體適能相關性… 74
第七節 血液透析病患骨密度、疲憊及體適能的預測因素 78
第八節 腹膜透析病患骨密度、疲憊及體適能的預測因素 81
第五章 討論
第一節 研究對象的基本資料……………………………… 84
第二節 身體活動狀態、骨密度、疲憊感及體適能的現況 87
第三節 透析病患身體活動狀態與骨密度、疲憊感及體適能
的相關性…………………………………………… 93
第六章 結論與建議
第一節 結論………………………………………………… 99
第二節 研究限制…………………………………………… 100
第三節 應用與建議………………………………………… 100
參考文獻
中文文獻……………………………………………………… 103
英文文獻……………………………………………………… 107
附錄
附錄一 個人基本資料表…………………………………… 132
附錄二 七日身體活動回憶量表…………………………… 134
附錄三 疲憊評量表………………………………………… 135
附錄四 體適能測量紀錄表………………………………… 138
附錄五 暖身運動…………………………………………… 139
附錄六 主觀整體營養評估表……………………………… 140
附錄七 臺北醫學大學人體試驗志願書…………………… 142






圖表目次
圖一 超音波骨質密度儀………………………………………… 47
圖二 六分走路測驗……………………………………………… 50
圖三 30秒連續坐椅站立………………………………………… 52
圖四 坐姿體前彎………………………………………………… 54
圖五 生物電阻分析儀…………………………………………… 56
表一 研究對象基本資料………………………………………… 62
表二 血液透析、腹膜透析病患與健康族群骨密度分佈……… 66
表三 血液透析、腹膜透析病患與健康族群身體活動量分佈… 68
表四 疲憊量表得分……………………………………………… 70
表五 血液透析、腹膜透析病患與健康族群體適能情形……… 73
表六 血液透析病患不同的身體活動度與骨密度、疲憊感及體適能
之相關性…………………………………………………………… 76
表七 腹膜透析病患不同的身體活動度與骨密度、疲憊感及體適能
之相關性…………………………………………………………… 77
表八 血液透析病患的骨密度、疲憊感及體適能之線性複迴歸分析
……………………………………………………………………… 80
表九 腹膜透析病患的骨密度、疲憊感及體適能之線性複迴歸分析
……………………………………………………………………… 83

參考資料
中文部份
中華民國腎臟基金會(2004)‧九十二年度台灣地區透析總人數統計圖‧取自4月1日，2006，http://www.kidney.org.tw/a92.gif.
中華民國腎臟基金會(2004)‧九十四年度台灣地區透析總人數統計圖‧取自6月1日，2006，http://www.kidney.org.tw/a94.gif
中央健康保險局(2005)‧94年第3季門診透析總額專業醫療服務品質報告‧取自6月28日，2006，http://210.69.214.131/webdata/AttachFiles/Attach_5553_1_94Q3專業醫療服務品質報告(透析總額).doc
方進隆(1997)‧有氧運動‧教師體適能指導手冊，104-118頁‧臺灣師範大學體育研發中心，台北巿。
王順正(2001)‧Live-high, train-low ? 運動生理週訊‧取自6月28日，2006，http://epsport.ccu.edu.tw/epsport/ week/show.asp?repno=91
台灣腎臟醫學會(2005)‧台灣腎臟醫學會609全國腎臟保健宣導記者會新聞稿。
台灣腎臟醫學會(2004)‧台灣血液透析診療指引‧台北：作者。
朱任公(1993)‧骨礦物質含量測定雙光子吸收法‧臨床醫學，32(2)，91-94。
江惠英、鍾信心(1997)‧血液透析病人疲倦感與社會支持、憂鬱傾向及血液生化檢驗值相關性探討‧護理研究，5(2)，115-126。
行政院衛生署(2005)‧台灣地區主要死亡原因‧取自3月30日，2006，http://www.doh.gov.tw/statistic/data/全民健康保險統計年報/新版93醫療統計年報/5/93年十大死因第八位腎炎腎徵候群及腎性病變.xls
行政院衛生署(2005)‧醫療保健支出統計‧取自3月30日，2006，http://www.doh.gov.tw/statistic/data/衛生動向/92/伍醫療保健支出全文.doc
行政院衛生署(2002)‧預防「骨質疏鬆症」‧取自5月13日，2006，http://www.hmlife.com.tw/health/j9-2.htm
行政院衛生署國名健康局(2005)‧各縣市男、女性重要健康促進知識、態度與行為指標‧取自5月13日，2006，http://www.bhp.doh.gov.tw/statistics/file/200311121037432ZR5YS/D.個人健康行為.pdf
呂昌明、林旭龍、黃奕清、李明憲、王淑芳(2001)‧身體活動自我報告量表之效度及信度的研究-以Tritrac-R3D三度空間加速器為校標‧衛生教育學報，15，99-114。
姚維仁、吳重慶(1999)‧骨密度測量方法的最新進展‧秀傳醫學雜誌，1(4)，179-185。
施嫈瑜、林易賢、蘇昭儒、鄭振鴻、李世代及郭聖達(2005)‧慢性疲勞及其症候群‧北市醫學雜誌，2(12)，1082-1088。
張芙美、賴惠玲、張惠君、彭台珠(2003)‧原住民社區以定量超音波篩檢骨質疏鬆症之現況分析‧慈濟護理雜誌，2(1)，34-41。
鈕淑芬(2004)‧透析病患之生活品質及其相關因素探討‧臺灣腎臟護理學會雜誌，3(2)，88-101。
彭台珠、李明憲、張芙美、黃森芳、張惠君(2002)‧定量超音波骨密度儀於社區護理篩檢活動使用之可行性‧慈濟護理雜誌，1(2)，56-63。
楊悌幼(2004)‧洗腎患者休閒阻礙之研究‧未發表的論文，大葉大學，彰化。
陳思遠(2001)‧身體活動與身體組成‧國家衛生研究院。
陳美玲、顧乃平(1998)‧血液透析病患生活品質及其相關因素之探討‧護理研究，6(5)，393–404。
陳俊吉，宋玉峰，林裕峰，朱柏齡及林石化(2006)‧腹膜透析患者的鉀離子變化‧腎臟與透析，18(1)，4-7。
潘景月(2004)‧接受連續可活動性腹膜透析治療末期腎病青少年疲憊感之經驗‧未發表的論文，台北醫學院，台北。
蔡克嵩(2004)‧骨密度測定的迷思與建議‧中華民國內分泌暨糖尿病學會會訊，18(1)，1-5。
鍾麗娟、高紀惠(1995)‧血液透析患者疲憊感定義特徵及相關因素之臨床效度測定‧長庚護理，6(2)，13-25。
蕭美玉(2004)‧職業舞者身體組成之研究‧未發表的論文，國立臺灣體育學院，台北。















英文部分
Aaronson, L. S., Teel, C. S., Cassmeyer, V., Neuberger, G. B., Pallikkathayil, L., & Pierce, J., et al. (1999). Defining and measuring fatigue. The Journal of Nursing Scholarship, 31, 45-50.
Alem, A. M., Sherrard, D. J., Gillen, D. L., Weiss, N. S., Beresford, S. A., & Heckbert, S. R., et al. (2000). Increased risk of hip fracture among patients with end-stage renal disease. Kidney International, 58, 396-9.
Allen, K. L., & Gappmaier, E. (2001). Exercise Habits and Attitudes of Hemodialysis Patients. Cardiopulmonary Physical Therapy, 12(1), 11-16.
Aloia, J. F., Rasulo, P., Deftos, L. J., Vaswani, A., & Yeh, J. K. (1985). Exercise-induced hypercalcemia and the calciotropic hormones. The Journal of Laboratory and Clinical Medicine, 106(3), 229-32.
Alvarez-Ude, F., Fernandez-Reyes, M. J., Vazquez, A., Mon, C., Sanchez, R., & Rebollo, P. (2001). Physical symptoms and emotional disorders in patient on a periodic hemodialysis program. Nefrologia, 21, 191-9.
American Alliance of Health, Physical Education, Recreation, and Dance. (1980). Health Related Physical Fitness Test Manual, April 1981, Washington, DC: Author.
American College of Sports Medicine. (1986). Guidelines for Exercise Testing and Prescription (3rd ed.). Washington, DC: Author.
American College of Sports Medicine. (1991). Guidelines for Exercise Testing and Prescription (4th ed.). Washington, DC: Author.
American College of Sports Medicine. (1995). Physical Activity and Bone Health replaces, Washington, DC: Author.
Aoki, K., & Muraoka, K. (1993). Analysis of continuous ambulatory peritoneal dialysis (CAPD) stressors in CAPD patients. The Japanese Journal of Nursing Research, 26(6), 553-62.
Arici, M., Erturk, H., Altun, B., Usalan, C., Ulusoy, S., & Erdem, Y. et al. (2000). Bone mineral density in haemodialysis patients, A comparative study of dual-energy X-ray absorptiometry and quantitative ultrasound. Nephrology Dialysis Transplantation, 15(11), 1847-51.
Augestad, L. B., Schei, B., Forsmo, S., Langhammer, A., & Flanders, W. D. (2004). The association between physical activity and forearm bone mineral density in healthy premenopausal women. Journal of Women's Health, 13(3), 301-13.
Baker, J. P., Detsky, A. S., Wesson, D. E., Wolman, S. L., Stewart, S., & Whitewell, J., et al. (1982). Nutritional assessment, a comparison of clinical judgment and objective measurements. The New England Journal of Medicine, 306, 969–972.
Ball, G. D., Marshall, J. D., & McCargar, L. J. (2005). Physical activity, aerobic fitness, self-perception, and dietary intake in at risk of overweight and normal weight children. Canadian Journal of Dietetic Practice and Research, 66(3), 162-9.
Barnas, U., Schmidt, A., Seidl, G., Kaider, A., Pietschmann, P., & Mayer, G. (2001). A comparison of quantitative computed tomography and dual X-ray absorptiometry for evaluation of bone mineral density in patients on chronic hemodialysis. American Journal of Kidney Disease, 37(6), 1247-52.
Barnea, N., Drory, Y., Iaina, A., Lapidot, C., Reisin, E., & Eliahou, H., et al. (1980) Exercise tolerance in patients on chronic hemodialysis. Israel Journal of Medical Sciences, 16(1), 17-21.
Baszko-Blaszyk, D., Grzegorzewska, A. E., Horst-Sikorska, W., & Sowinski, J. (2001). Bone mass in chronic renal insufficiency patients treated with continuous ambulatory peritoneal dialysis. Advances in peritoneal dialysis, 17, 109-13.
Beasley, C. R., Smith, D. A., & Neale, T. J. (1986). Exercise capacity in chronic renal failure patients managed by continuous ambulatory peritoneal dialysis. Australian and New Zealand Journal of Medicine, 16(1), 5-10.
Blanchet, C., Giguere, Y., Prud'homme, D., Turcot-Lemay, L., Dumont, M., & Leduc, G., et al. (2003). Leisure physical activity is associated with quantitative ultrasound measurements independently of bone mineral density in postmenopausal women. Calcified Tissue International, 73(4), 339-49.
Brage, S., Wedderkopp, N., Ekelund, U., Franks, P.W., Wareham, N. J., & Andersen, L. B., et al. (2004). Objectively measured physical activity correlates with indices of insulin resistance in Danish children, The European Youth Heart Study (EYHS). Diabetes Care, 28, 1503-8.
Brodin, E., Ljungman, S., Hedberg, M., & Sunnerhagen, K. S. (2001) Physical activity, muscle performance and quality of life in patients treated with chronic peritoneal dialysis. Scandinavian Journal of Urology & Nephrology, 35(1), 71-8.
Brownbill, R. A., Lindsey, C., Crncevic-Orlic, Z., & Ilich, J. Z. (2003). Dual hip bone mineral density in postmenopausal women, geometry and effect of physical activity. Calcified Tissue International, 73(3), 217-24.
Brunier, G., & Graydon, J. (1996). A comparison of two methods of measuring fatigue in patients on chronic haemodialysis, Visual analogue vs Likert scale. International Journal of Nursing Studies, 33, 338-348.
Brunier, G. M., & Graydon, J. (1993). The influence of physical activity on fatigue in patients with ESRD on hemodialysis. ANNA journal / American Nephrology Nurses' Association, 20(4), 457-461.
Cardenas, D. D., & Kutner, N. G. (1982). The problem of fatigue in dialysis patients. Nephron, 30(4), 336-340.
Caspersen, C. J., Powell, K. E., & Christenson, G. M. (1985). Physical activity, exercise, and physical fitness, definitions and distinctions for health-related research. Public Health Reports, 100, 126-31.
Centers for Disease Control and Prevention. (2003, August 14). Physical activity definitions broadened to include daily activities. Retrieved June, 1, 2006, from http://www.cdc.gov/od/oc/media/pressrel/r030814.htm
Chan, E. W., Au, E. Y., Chan, B. H., Kwan, M. K., Yiu, P. Y., & Yeung, E. W. (2003). Relations among physical activity, physical fitness, and self-perceived fitness in Hong Kong adolescents. Perceptual and Motor Skills, 96(3), 787-97.
Chan, T. M., Pun, K. K., & Cheng, I. K. (1992). Total and regional bone densities in dialysis patients. Nephrology Dialysis Transplantation, 7(8), 835-9.
Chang, W. K., Hung, K. Y., Huang, J. W., Wu, K. D., & Tsai, T. J. (2001). Chronic fatigue in long-term peritoneal dialysis patients. American Journal of Nephrology, 21(6), 479-85.
Cheng, M., Zaman, G., Rawlinson, S.C., Mohan, S., Baylink, D.J., & Lanyon, L. E. (1999). Mechanical strain stimulates ROS cell proliferation through IGF-II and estrogen through IGF-I. Journal of Bone and Mineral Research, 14, 1742–1750.
Chu, T. S., Tsai, T. J., Lee, S. H., & Yen, T. S. (1993). Evaluation of cardiovascular autonomic function tests in dialysis patients. Journal of the Formosan Medical Association, 92(3), 237-40.
Coco, M., & Rush, H. (2000). Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone. American Journal of Kidney Disease, 36(6), 1115-21.
Coronel, F., Herrero, J. A., Montenegro, J., Fernandez, C., Gandara, A., & Conesa, J., et al. (2003). Erythropoietin requirements, a comparative multicenter study between peritoneal dialysis and hemodialysis. Journal of Nephrology, 16(5), 697-702.
Curtin, R. B., Bultman, D. C., Thomas-Hawkins, C., Walters, B., & Schatell, D. (2002). Hemodialysis patients? symptom experiences, Effects on physical and mental functioning. Nephrology Nursing Journal, 29(6), 562-574.
Deligiannis, A., Kouidi, E., & Tourkantonis, A. (1999). Effects of physical training on heart rate variability in patients on hemodialysis. American Journal of Cardiology, 84(2), 197-202.
Detsky, A. S., McLaughlin, J. R., Baker, J. P., Johnston, N., Whittaker, S., & Mendelson, R. A., et al. (1987). What is subjective global assessment of nutritional status? Journal of Parenteral and Enteral Nutrition, 11(1), 8-13.
Duppe, H., Gardsell, P., Johnell, O., Nilsson, B. E., & Ringsberg, K. (1997). Bone mineral density, muscle strength and physical activity. A population-based study of 332 subjects aged 15-42 years. Acta Orthopaedica Scandinavica, 68(2), 97-103.
Eknoyan, G., Hostetter, T., Bakris, G. L., Hebert, L., Levey, A. S., Parving, & H. H., et al. (2003). Proteinuria and other markers of chronic kidney disease, a position statement of the national kidney foundation (NKF) and the national institute of diabetes and digestive and kidney diseases (NIDDK). American Journal of Kidney Disease, 42(4), 617-22.
Emslander, H. C. , Sinaki, M. , Muhs, J. M. , Chao, E. Y. , Wahner, H. W. , & Bryant, S. C., et al. (1998). Bone mass and muscle strength in female college athletes (runners and swimmers). Mayo Clinic Proceedings, 73(12), 1151-60.
Eriksrud, O., & Bohannon, R. W. (2003). Relationship of knee extension force to independence in sit-to-stand performance in patients receiving acute rehabilitation. Physical Therapy, 83(6), 544-51.
Erlichman, M., & Holohan, T. V. (1996). Bone densitometry, patients with end-stage renal disease. Health Technology Assessment, 8, 1-27.
Fitts, S. S. (1997). Physical benefits and challenges of exercise for people with chronic renal disease. Journal of Renal Nutrition, 7(3), 123-128.
Fontaine, M., Albert, A., Dubois, R., Saint-Remy, A., & Rorive, G. (2000). Fracture and bone mineral density in hemodialysis patients. Clinical Nephrology, 54, 218–226.
Frost, M. (1989). Mechanical usage, bone mass, bone fragility, a brief overview. In M. Kleerekoper & S. Krane (Eds), Clinical Disorder of Bone and Mineral Metabolism (pp. 15-40). New York: Mary Ann Liebert Press.
Fuhrmann, I., & Krause, R. (2004). Principles of exercising in patients with chronic kidney disease, on dialysis and for kidney transplant recipients. Clinical Nephrology, 61, Suppl 1, S14-25.
Gabay, C., Ruedin, P., Slosman, D., Bonjour, J. P., Leski, M , & Rizzoli, R. (1993). Bone mineral density in patients with end-stage renal failure. American Journal of Nephrology, 13, 115-123.
Girouard, C. K., & Hurley, B. F. (1995). Does strength training inhibit gains in range of motion from flexibility training in older adults? Medicine and Science in Sports and Exercise, 27(10), 1444-9.
Gokal, R., Figueras, M., Olle, A., Rovira, J., & Badia, X. (1999). Outcomes in peritoneal dialysis and haemodialysis--a comparative assessment of survival and quality of life. Nephrology Dialysis Transplantation, 14, Suppl 6, 24-30.
Gupta, A., Kallenback, L. R., & Divine, G. W. (1997). Increased risk of hip fractures in US Medicare end-stage renal disease (ESRD) patients. Journal of the American Society of Nephrology, 8, 552.
Gustavsson, A., Thorsen, K., & Nordstrom, P. (2003). A 3-year longitudinal study of the effect of physical activity on the accrual of bone mineral density in healthy adolescent males. Calcified Tissue International, 73, 108-114.
Gutin, B., Yin, Z., Humphries, C. M., & Barbeau, P. (2005). Relations of moderate and vigorous physical activity to fitness and fatness in adolescents. American Journal of Clinical Nutrition, 81, 746-750.
Gutman, R. A., Stead, W. W., & Robinson, R. R. (1981). Physical Activity and Employment Status of Patients on Maintenance Dialysis. New England Journal of Medicine, 304, 309-313.
Hageman, P. A., Walker, S. N., Pullen, C. H., Boeckner, L. S., & Oberdorfer, M. K. (2005). Physical Activity and Fitness Among Midlife and Older Rural Women. Journal of Aging and Physical Activity, 13, 347-362.
Hampson, G., Vaja, S., Evans, C., Chesters, C. A., Pettit, R., & Evans, W., et al. (2002). Comparison of the humoral markers of bone turnover and bone mineral density in patients on haemodialysis and continuous ambulatory peritoneal dialysis. Nephron, 91(1), 94-102.
Hart, L. K., Freel, M. I., & Milde, F. K. (1990). Fatigue. Nursing Clinics of North America, 25(4), 967-976.
Heiwe, S., Clyne, N., & Dahlgren, M. A. (2003). Living with chronic renal failure, patients' experiences of their physical and functional capacity. Physiotherapy Research International, 8(4), 167-77.
Huang, Y. C., & Malina, R. M. (1996). Physical activity and correlates of estimated energy expenditure in Taiwanese adolescents 12-14 years of age. American Journal of Human Biology, 8(2), 225-236.
Hui, S. L., Slemenda, C. W., & Johnston, Jr C. C. (1989). Baseline measurement of bone mass predicts fracture in white women. Annals of Internal Medicine, 111, 355-361.
Jacobs, D. R. Jr., Ainsworth, B. E., Hartman, T. J., & Leon, A. S. (1993). A simultaneous evaluation of 10 commonly used physical activity questionnaires. Medicine & Science in Sports and Exercise, 25, 81-91.
Johansen, K. (1999). Physical functioning and exercise capacity in patients on dialysis. Advanced Rennal Replacement Therapy, 6(2), 141-148.
Johansen, K. L., Chertow, G. M., da Silva, M., Carey, S., & Painter, P. (2001). Determinants of physical performance in ambulatory patients on hemodialysis. Kidney International, 60, 1586–91.
Johansen, K. L., Chertow, G. M., Ng, A. V., Mulligan, K., Carey, S., & Schoenfeld, P. Y., et al. (2000). Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney International, 57, 2564-2570.
Johansen, K. L., Doyle, J., Sakkas, G. K., & Kent-Braun, J. A. (2005). Neural and metabolic mechanisms of excessive muscle fatigue in maintenance hemodialysis patients. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology, 289(3), R805-13.
Johansen, K. L., Kaysen, G. A., Young, B. S., Hung, A. M., da Silva, M., & Chertow, G. M. (2003). Longitudinal study of nutritional status, body composition, and physical function in hemodialysis patients. The American Journal of Clinical Nutrition, 77(4), 842-6.
Johansen, K. L., Painter, P., Kent-Braun, J. A., Ng, A. V., Carey, S., & Da Silva, M., et al. (2001). Validation of questionnaires to estimate physical activity and functioning in end-stage renal disease. Kidney International, 59(3), 1121-7.
Johansen, K. L., Shubert, T., Doyle, J., Soher, B., Sakkas, G. K., & Kent-Braun, J. A. (2003). Muscle atrophy in patients receiving hemodialysis, effects on muscle strength, muscle quality, and physical function. Kidney International, 63(1), 291-7.
Jones, C. J., Rikli, R. E., Max, J., & Noffal, G. (1998). The reliability and validity of a chair sit-and-reach test as a measure of hamstring flexibility in older adults. Research Quarterly for Exercise and Sport, 69(4), 338-43.
Kaizu, Y., Ohkawa, S., Odamaki, M., Ikegaya, N., Hibi, I., Miyaji, K., et al. (2003). Association between inflammatory mediators and muscle mass in long-term hemodialysis patients. American Journal of Kidney Disease, 42(2), 295-302.
Kaleta, D., Makowiec-Dabrowska, T., & Jegier, A. (2004). Leisure-time physical activity, cardiorespiratory fitness and work ability, a study in randomly selected residents of Lodz. International Journal of Occupational Medicine and Environmental Health, 17(4), 457-64.
Kanis, J. A., Johnell, O., Oden, A., Jonsson, B., De Laet, C., & Dawson, A. (2000). Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone, 27(5), 585-90.
Kettner-Melsheimer, A., Weiss, M., & Huber, W. (1987). Physical work capacity in chronic renal disease. The International Journal of Artificial Organs, 10, 23-30.
Kielistein, R. (1995). Goal and results of physical exercise training in ESRF patients. Nephrology News & Issues, 3(2), S7-S8, S26.
Klang, B., & Clyne, N. (1997). Well-being and functional ability in uremic patients before and after having started dialysis treatment. Scandinavian Journal of Caring Sciences, 11, 159-166.
Kolbe-Alexander, T. L., Charlton, K. E., & Lambert, E. V. (2004). Lifetime physical activity and determinants of estimated bone mineral density using calcaneal ultrasound in older South African adults. The Journal of Nutrition, Health & Aging, 8(6), 521-30.
Kop, W. J., Lyden, A., Berlin, A. A., Ambrose, K., Olsen, C., & Gracely, R., et al. (2005). Ambulatory monitoring of physical activity and symptoms in fibromyalgia and chronic fatigue syndrome. Arthritis and Rheumatism, 52(1), 296-303.
Kostka, T., Bonnefoy, M., Arsac, L. M., Berthouze, S. E., Belli, A., & Lacour, J. R. (1997). Habitual physical activity and peak anaerobic power in elderly women. European Journal of Applied Physiology and Occupational Physiology, 76(1), 81-87.
Kutner, N. G., Brogan, D., & Fielding, B. (1997). Physical and psychosocial resource variables related to long-term survival in older dialysis patients. Geriatric Nephrology and Urology, 7, 23-28.
Kutner, N. G., Zhang, R., & McClellan, W. M. (2000). Patient-reported quality of life early in dialysis treatment, effects associated with usual exercise activity. Nephrology Nursing Journal, 27(4), 357-67.
Lai, M. N., Hsu, I. S., Chen, Y. Y., Gee, M. J., & Kao, M. T. (2002). Osteoporosis and Associated Risk Factors for Chronic Hemodialysis Patients. Acta Nephrologica, 16(1), 25-30.
Laudanski, K., Nowak, Z., & Wankowicz, Z. (2002). Mood and illness-related stress in dialysed patients. Polski Merkuriusz Lekarski, 13(77), 376-9.
Lennon, D., Shrago, E., Madden, M., Nagle, F., Hanson, P., & Zimmerman, S. (1986). Carnitine status, plasma lipid profiles, and exercise capacity of dialysis patients, Effects of a submaximal exercise program. Metabolism, 35(8), 728-735.
Levendoglu, F., Altintepe, L., Okudan, N., Ugurlu, H., Gokbel, H., & Tonbul, Z., et al. (2004). A twelve week exercise program improves the psychological status, quality of life and work capacity in hemodialysis patients. Journal of Nephrology, 17(6), 826-32.
Libetta, C., Villa, G., Pirrelli, S., Sepe, V., Gori, E., & Zucchi, M., et al. (2001). Homocysteine plasma levels correlate with intimal carotid artery thickness in haemodialysis patients. Nephrology, Dialysis, Transplantation, 16(12), 2444-5.
Lindberg, J. S., & Moe, S. M. (1999). Osteoporosis in end-stage renal disease. Seminars in Nephrology, 19 (2), 115-122.
Liu, K. Y., Wu, C. C., Lin, Y. F., Lin, S. H., Chu, P., & Diang, L. K., et al. (2000). Evaluation of Nutritional Status in Dialysis Patients with Bioelectrical Impedance Analysis (BIA). Acta Nephrologica, 14(4), 338-338.
Lochen, M. L., & Rasmussen, K. (1992). The Tromso study, physical fitness, self reported physical activity, and their relationship to other coronary risk factors. Journal of Epidemiology and Community Health, 46(2), 103-7.
Lok, P. (1996). Stressors, coping mechanisms and quality of life among dialysis patients in Australia. Journal of Advanced Nursing, 23(5), 873-81.
Lundin, A. P., Stein, R. A., Brown, C. D., LaBelle, P., Kalman, F. S., & Delano, B. G., et al. (1987). Fatigue, acid-base and electrolyte changes with exhaustive treadmill exercise in hemodialysis patients. Nephron, 46(1), 57-62.
Lyhne, N., & Pedersen, F. B. (1995). Changes in bone mineral content during long-term CAPD. Indication of a sex-dependent bone mineral loss. Nephrology Dialysis Transplantation, 10(3), 395-8.
Macdonald, J. H., Phanish, M. K., Marcora, S. M., Jibani, M., Bloodworth, L. L., & Holly, J. M., et al. (2004). Muscle insulin-like growth factor status, body composition, and functional capacity in hemodialysis patients. Journal of Renal Nutrition, 14(4), 248-52.
MacAuley, D., McCrum, E. E., Stott, G., Evans, A. E., Gamble, R. P., & McRoberts, B., et al. (1998). Levels of physical activity, physical fitness and their relationship in the Northern Ireland health and activity survey. International Journal of Sports Medicine, 19, 503-511.
Majchrzak, K. M., Pupim, L. B., Chen, K., Martin, C. J., Gaffney, S., & Greene, J. H., et al. (2005). Physical activity patterns in chronic hemodialysis patients, comparison of dialysis and nondialysis days. Journal of Renal Nutrition, 15(2), 217-24.
Malyszko, J., Brzosko, S., Wolczynski, S., Malyszko, J. S., & Mysliwiec, M. (2003). Bone metabolism in dialysis patient assessed by biochemical markers and densitometry. Polskie Archiwum Medycyny Wewn Inverted Question Marktrznej, 110(3), 967-72.
Mark, H. B., & Robert, B. (1999). The Merck Manual of Diagnosis and Therapy. Dialysis, 17, 223.
Matera, M., Bellinghieri, G., Costantino, G., Santoro, D., Calvani, M., & Savica, V. (2003). History of L-carnitine, implications for renal disease. Journal of Renal Nutrition, 13(1), 2-14.
McCann, K., & Boore, J .R. P. (2000). Fatigue in persons with renal failure who require maintenance dialysis. Journal of Advanced Nursing, 32, 1132-1142.
Merkus, M. P., Jager, K. J., Dekker, F.W., Hann, R. J., Boeschoten, E. W., & Kredict, R. T. (1999). Physical symptoms and quality of life in patients on chronic dialysis, Results of the netherlands cooperative study on adequacy of dialysis. Nephrology Dialysis and Transplantation, 14(5), 1163-1170.
Micklesfield, L., Rosenberg, L., Cooper, D. D., Hoffman, M., Kalla, A. A., & Stander, I. et al. (2003). Bone mineral density and lifetime physical activity in South African women. Calcified Tissue International, 73, 463-469.
Miller D. J., Freedson, P. S., & Kline, G. M. (1994). Comparison of activity levels using the Caltrac accelerometer and five questionnaires. Medicine and Science in Sports and Exercise, 26(3), 376-82.
Minck, M. R., Ruiter, L. M., Van Mechelen, W., Kemper, H. C., & Twisk, J. W. (2000). Physical fitness, body fatness, and physical activity, The Amsterdam Growth and Health Study. American Journal of Human Biology, 12(5), 593-599.
Morris, J. N., Heady, J. A., Raffle, P. A. B., Roberts, C. G., & Parks, J. W. (1953). Coronary heart disease and physical activity of work. Lancet, 28, 265(6796), 1111-20.
Mottet, J. J., Horber, F. F., Casez, J. P., Descoeudres, C., & Jaeger, P. (1996). Evidence for preservation of cortical bone mineral density in patients on continuous ambulatory peritoneal dialysis. Journal of Bone and Mineral Research, 11(1), 96-104.
Negri, A. L., Barone, R., Quiroga, M. A., Bravo, M., Marino, A., & Fradinger, E., et al. (2004). Bone mineral density, serum markers of bone turnover and their relationships in peritoneal dialysis. Peritoneal Dialysis International, 24(2), 163-8.
Neville, C. E., Murray, L. J., Boreham, C. A., Gallagher, A. M., Twisk, J., & Robson, P. J., et al. (2002). Association between physical fitness and activity patterns during adolescence and cardiovascular risk factors in young adulthood, The Northern Ireland young hearts project. International Journal of Sports Medicine, 23, S22-S26.
Nordin, B. E., Chatterton, B. E., Walker, C. J., & Wishart, J. (1987). The relation of forearm mineral density to peripheral fractures in postmenopausal women. The Medical Journal of Australia, 16, 146(6), 300–304.
Nowak, Z., Tlustochowicz, W., & Wankowicz, Z. (2001). Bone mineral density in patients with irreversible renal failure treated with peritoneal dialysis. Polskie Archiwum Medycyny Wewn Inverted Question Marktrznej, 106(5), 1035-40.
Okano, G., Miyake, H., & Mori, M. (2003). Leisure time physical activity as a determinant of self-perceived health and fitness in middle-aged male employees. Journal of Occupational Health, 45(5), 286-92.
Ossareh, S., Roozbeh, J., Krishnan, M., Liakopoulos, V., Bargman, J. M., & Oreopoulos, D. G. (2004). Fatigue in chronic peritoneal dialysis patients. International Urology and Nephrology, 36(3), 477.
Osteoporosis Consensus Development Conference. (1993).Consensus development conference, Diagnosis, prophylaxis, and treatment of osteoporosis. The American Journal of Medicine, 94, 646-650.
Paffenbarger, R. S., Laughlin, M. E., Gima, A. S., & Black, R. A. (1970). Work activity of longshoremen is related to death from coronary heart disease and stroke. The New England Journal of Medicine, 14, 282(20), 1109-14.
Painter, P. (1993). End-stage renal disease. In J. S. Skinner (Eds.), Exercise Testing and Exercise Prescription for Special Cases (pp. 351-362). Philadelphia: Author.
Painter P., & Johansen, K. (1999). Introduction, a call to activity. Advances in Renal Replacement Therapy, 6, 107-9.
Painter, P., Messer-Rehak, D., Hanson, P., Zimmerman, S. W., & Glass, N. R. (1986). Exercise capacity in hemodialysis, CAPD and renal transplant patients. Nephron, 42, 47-51.
Painter P., & Zimmerman, S. W. (1986). Exercise in end-stage renal disease. American Journal of Kidney Disease, 7(5), 386-394.
Pasadakis, P., Thodis, E., Manavis, J., Mourvati, E., Panagoutsos, S., & Vargemezis, V. (1995). The identification of bone mineral density in CAPD in comparison with HD patients. Advances in Peritoneal Dialysis, 11, 247-53.
Pasadakis, P., Thodis, E., Mourvati, E., Euthimiadou, A., Margaritis, D., & Manavis, J., et al. (1996). Evaluation of bone mineral density in CAPD patients with dual energy X-ray absorptiometry. Advances in Peritoneal Dialysis, 12, 245-9.
Pecovnik Balon, B., Hojs, R., Zavratnik, A., & Kos, M. (2002). Bone mineral density in patients beginning hemodialysis treatment. American Journal of Nephrology, 22, 14–17.
Pereira, M. A., FitzerGerald, S. J., Gregg, E. W., Joswiak, M. L., Ryan, W. J., & Suminski, R. R., et al. (1997). A collection of Physical Activity Questionnaires for health-related research. Medicine and Science in Sports and Exercise, 29(suppl), S1-S205.
Peterson, M. J., Crowley, G. M., Sullivan, R. J., & Morey, M. C. (2004). Physical function in sedentary and exercising older veterans as compared to national norms. Journal of Rehabilitation Research and Development, 41(5), 653-8.
Piper, B. E. (1989). Fatigue, Current bases for practice. In S. G. Funk, E. M. Tornquist, M. T. Champagne, L. A. Gopp, & R. A. Wiese (Eds.), Key Aspects of Comfort, Management of Pain, Fatigue, and Nausea (pp. 187-198). New York: Springer.
Piper, B. F. (1993). Fatigue. In V. Carrieri, A. Lindsey, & C. West (Eds.), Pathophysiological Phenomena in Nursing, Human Responses to Illness (pp. 279-302). Philadelphia: Author.
Piper, B. F., Dibble, S. L., Dodd, M. J., Weiss, M. C., Slaughter, R. E., & Paul, S. M. (1998). The revised Piper Fatigue Scale, Psychometric evaluation in women with breast cancer. Oncology Nursing Forum, 25, 677-684.
Pippa, P. (2000). Brachial plexus block using a new subclavian perivascular technique, the proximal cranial needle approach. European Journal of Anaesthesiology, 17(2), 120-5.
Pires, L. A. S., Souza, A. C. A., Laitano, O., & Meyer, F. (2005). Densidade Mineral Ossea, Ingestão de Leite e Atividade Física de Meninos que Sofreram Fraturas no Antebraço. Jornal de Pediatria, Rio de Janeiro, 81, 4, 332-336.
Pluskiewicz, W., Adamczyk, P., Drozdzowska, B., Szprynger, K., Szczepanska, M., & Halaba, Z., et al. (2005). Skeletal status in adolescents with end-stage renal failure, a longitudinal study. Osteoporosis International, 16(3), 289-95.
Pluskiewicz, W., Adamczyk, P., Drozdzowska, B., Szprynger, K., Szczepanska, M., & Halaba, Z., et al. (2002). Skeletal status in children, adolescents and young adults with endstage renal failure with hemo- or peritoneal dialysis. Osteoporosis International, 13, 353–357.
Powell, K. E., & Paffenbarger, R. S. (1985). Workshop on epidemiologic and public health aspects of physical activity and exercise, Asummary. Public Health Reports, 100, 118-26.
Pocock, N. A. (1998). Quantitative diagnostic methods in osteoporosis, a review. Australasian Radiology, 42(4), 327-34.
Ream, E., & Richardson, A. (1997). Fatigue in patients with cancer and chronic obstructive airways disease, a phenomenological enquiry. International Journal of Nursing Studies, 34(1), 44-53.
Riggs, B. L., Seeman, E., Hodgson, S. F., Taves, D. R., & O'Fallon, W. M. (1982). Effect of the fluoride/calcium regimen on vertebral fracture occurrence in postmenopausal osteoporosis. Comparison with conventional therapy. New England Journal of Medicine, 306(8), 446-50.
Rikli, R. E., & Jones, C. J. (1998). The Reliabiltiy and Validity of a 6-Minute Walk Test as a. Measure of Physical Endurance in Older Adults. Journal of Aging and Physical Activity, 6(4), 1-1.
Sakkas, G. K., Ball, D., Mercer, T. H., Sargeant, A. J., Tolfrey, K., & Naish, P. F. (2003). Atrophy of non-locomotor muscle in patients with end-stage renal failure. Nephrology, Dialysis and Transplantation, 18, 2074-81.
Sakkas, G. K., Ball, D., Sargeant, A. J., Mercer, T. H., Koufaki, P., & Naish, P. F. (2004). Skeletal muscle morphology and capillarization of renal failure patients receiving different dialysis therapies. Clinical Science, 107(6), 617-23.
Sarna, L., & Conde, F. (2001). Physical activity and fatigue during radiation therapy, a pilot study using actigraph monitors. Oncology Nursing Forum, 28(6), 1043-1046.
Schaubert, K. L., & Bohannon, R. W. (2005). Reliability and validity of three strength measures obtained from community-dwelling elderly persons. Journal of Strength and Conditioning Research, 19(3), 717-20.
Shemesh, O., Golbetz, H., Kriss, J. P., & Myers, B. D. (1985). Limitations of creatinine as a filtration marker in glomerulopathic patients. Kidney International, 28(5), 830-8.
Sklar, A., Newman, N., Scott, R., Semenyuk, L., Schultz, J., & Fiacco, V. (1999). Identification of factors responsible for postdialysis fatigue. American Journal of Kidney Disease, 34(3), 464-70.
Sklar, A., Riesenberg, L. A., Silber, A. K., Ahmed, W., & Ali, A. (1996). Postdialysis fatigue. American Journal of Kidney Disease, 28, 732.
Starling, R. D., Toth, M. J., Carpenter, W. H., Matthews, D. E., & Poehlman, E. T. (1998). Energy requirements and physical activity in free-living older women and men, a doubly labeled water study. Journal of Applied Physiology, 85(3), 1063-9.
Stefanovic, V., & Milojkovic, M. (2005). Effects of physical exercise in patients with end stage renal failure, on dialysis and renal transplantation, current status and recommendations. The International Journal of Artificial Organs, 28(1), 8-15.
Stehman-Breen, C. O., Sherrard, D. J., Alem, A. M., Gillen, D. L., Heckbert, S. R., & Wong, C. S., et al. (2000). Risk factors for hip fracture among patients with end-stage renal disease. Kidney International, 58, 2200-5.
Storer, T. W., Casaburi, R., Sawelson, S., & Kopple, J. D. (2005). Endurance exercise training during haemodialysis improves strength, power, fatigability and physical performance in maintenance haemodialysis patients. Nephrology Dialysis Transplantation, 20(7), 1429-37.
Taal, M. W., Masud, T., Green, D., & Cassidy, M. J. (1999). Risk factors for reduced bone density in haemodialysis patients. Nephrol Dialysis Transplant, 14, 1922-8.
Takken, T., van der Net, J., Kuis, W., & Helders, P. J. (2003). Physical activity and health related physical fitness in children with juvenile idiopathic arthritis. Annals of the Rheumatic Diseases, 62, 885-889.
Terawaki, H., Kasai, K., Kawaguchi, Y., Kobayashi, H., Hirano, K., & Ohtsuka, Y., et al. (1998). The impact of low calcium dialysate (1.25 mmol/l; LCD) on bone metabolism in CAPD patients. Nippon Jinzo Gakkai Shi, 40(4), 252-7.
The North American Nursing Diagnosis Association, 1997-1998. (1996). Nursing Diagnosis, Definition and Classification. Philadelphia: Author.
Tokuda, N., Uozumi, J., Kumazawa, J., Yamasaki, T., & Kano, M. (1998). Bone mineral density (BMD) of the calcaneus bone in 72 dialysis patients measured by ultrasonic bone absorptiometry. Nippon Hiny Inverted Question Markkika Gakkai Zassh, 89(7), 629-34.
Trbojevic, J., Nesic, D., & Stojimirovic, B. (1998). Effect of various methods of treatment in chronic renal insufficiency on the quality of life in patients. Srpski Arhiv za Celokupno Lekarstvo, 126(9-10), 374-8.
Tuero, C., De Paz, J.A., & Marquez, S. (2001). Relationship of measures of leisure time physical activity to physical fitness indicators in Spanish adults. The Journal of Sports Medicine and Physical Fitness, 41(1), 62-7.
Tziviskou, E., Musso, C., Bellizzi, V., Khandelwal, M., Wang, T., & Savaj, S., et al. (2003). Prevalence and pathogenesis of hypokalemia in patients on chronic peritoneal dialysis, one center's experience and review of the literature. International Urology and Nephrology, 35(3), 429-34.
U.S. Department of Health and Human Service. (1996). Physical Activity and Health, A report of the Surgeon General. Atlanta: Author.
U.S. Renal Data System. (2002). Annual Data Report, Atlas of End-Stage Renal Disease in the United States. National Institutes of Health; National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD: Author.
Valdimarsson, O., Kristinsson, J. O., Stefansson, S. O., Valdimarsson, S., & Sigurdsson, G. (1999). Lean mass and physical activity as predictors of bone mineral density in 16–20-year old women. Journal of Internal Medicine, 245, 489–496.
van den Berg-Emons, H. J., Bussmann, J. B., Meyerink, H. J., Roebroeck, M. E., & Stam, H. J. (2003). Body fat, fitness and level of everyday physical activity in adolescents and young adults with meningomyelocele. Journal of Rehabilitation Medicine, 35(6), 271-5.
van den Ham, E. C., Kooman, J. P., Schols, A. M., Nieman, F. H., Does, J. D., Franssen, F. M., et al. (2005). Similarities in skeletal muscle strength and exercise capacity between renal transplant and hemodialysis patients. American Journal of Transplantation, 5(8), 1957-65.
Vercoulen, J. H., Bazelmans, E., Swanink, C. M., Fennis, J. F., Galama, J. M., Jongen, & P. J., et al. (1997). Physical activity in chronic fatigue syndrome, assessment and its role in fatigue. Journal of Psychiatric Research, 31, 661-673.
Visser, R., Dekker, F. W., Boeschoten, E. W., Stevens, P., & Krediet, R. T. (1999). Reliability of the 7-point subjective global assessment scale in assessing nutritional status of dialysis patients. Advances in Peritoneal Dialysis, 15, 222-5.
Wang, T., Tziviskou, E., Chu, M., Bargman, J., Jassal, V., & Vas, S., et al. (2003). Differences in survival on peritoneal dialysis between oriental Asians and Caucasians, one center's experience. International Urology and Nephrology, 35(2), 267-74.
Weinreich, T. (1998). Prevention of renal osteodystrophy in peritoneal dialysis. Kidney International, 54(6), 2226-33.
Weisbord, S. D., Fried, L. F., Arnold, R. M., Fine, M. J., Levenson, D. J., & Peterson, R. A., et al. (2005). Prevalence, severity, and importance of physical and emotional symptoms in chronic hemodialysis patients. Journal of the American Society of Nephrology, 16(8), 2487-94.
Winningham, M. L., Nail, L. M., Burke, M, B., Brophy, L., Cimprich, B., & Jones, L. S., et al. (1994). Fatigue and the cancer experience, The state of the knowledge. Oncology Nursing Forum, 21(1), 23-36.
World Health Organization. (1997). Physical activity. Retrieved March, 27, 2006, from http, //www.who.int/topics/physical_activity/en/
World Health Organization Study Group on assessment of fracture risk and its application to screening for postmenopausal osteoporosis. (1994). Assessment of fracture risk and its application to screening for postmenopausal osteoporosis, Report of a WHO Study Group. WHO Technical Report Series, 843, 1-129.
Xue, J. L., Chen, S. C., Ebben, J. P., Constantini, E. G., Everson, S. E., & Frazier, E. T., et al. (2002). Peritoneal and hemodialysis, I. Differences in patient characteristics at initiation. Kidney International, 61(2), 734-40.
Yucel, A. E., Kart-Koseoglu, H., Isiklar, I., Kuruinci, E., Ozdemir, F. N., & Arslan, H. (2004). Bone mineral density in patients on maintenance hemodialysis and effect of chronic hepatitis C virus infection. Renal Failure, 26(2), 159-64.
Zamojska, S., Szklarek, M., Niewodniczy, M., & Nowicki, M. (2006). Correlates of habitual physical activity in chronic haemodialysis patients. Nephrology Dialysis Transplantation, 21(5), 1323-7.
Znojova, M., & Sulkova, S. (2001). Evaluation of stress in dialyzed patients. Casopis Lekaru Ceskych, 140(4), 108-11.