Edirne il merkezinde 46 yaş ve üzeri tip2 diyabetes mellitus hastalarının öz yönetim ve tedavi uyumunun değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Diyabetes Mellitus (DM), tüm dünyada mortalite ve morbiditede artışına sebep olan kronik bir metabolizma bozukluğu olup, ömür boyu düzenli tıbbi bakım gerektirir. Bu durum göz önüne alındığında, özellikle birinci basamak sağlık hizmetlerinde hastaların bilgilendirilmesi ve yönetimi önem arz etmektedir. Bu çalışmada, 46 yaş üzeri Tip 2 DM hastalarının, diyabet öz yönetimi ve tedavi uyumuna ilişkin bilgi düzeyini, davranış kalıplarını değerlendirmek ve buna etki eden sosyodemografik özellikler, alınan tedavi, diyabet süresinin öz yönetim ve tedavi uyumuna etkisini değerlendirmek amaçlanmıştır. Çalışmaya, Edirne il merkezindeki Aile Sağlığı Merkezleri'ne başvuran, tip 2 DM hastalığı olan 46 yaş ve üstü 318 kişi dahil edilmiştir. Veriler, 57 sorudan oluşan anket yardımı ile toplanmıştır. Anket formunda tarafımızca oluşturulan, hastaların sosyodemografik özellikleri ve tıbbi durumları ile ilgili 30 soru bulunmaktadır. Ek olarak 8 soru içeren Morisky Tedavi Uyum Ölçeği (MTUÖ-8) ve 19 sorudan oluşan Tip 2 Diyabet Öz Yönetim Ölçeği katılımcılara uygulanmıştır. Elde edilen verilerin istatistiksel analizi SPSS 19 paket istatistik programı (seri no:10240642) kullanılarak yapılmıştır. İstatistiksel anlamlılık düzeyi p<0,05 olarak alınmıştır. Araştırmaya dahil edilen hastaların yaş ortalamaları 63,32±9,12 saptanmış ve %52,5'inin kadın, %82,1'inin evli, %48,4'ünün emekli olduğu belirlenmiştir. Katılımcıların eğitim durumu incelendiğinde %48,1 ile büyük kısmının ilkokul mezunu olduğu belirlenmiştir. Katılımcıların %49,1'inin hiç sigara kullanmadığı, %80,5'inin hiç alkol kullanmadığı saptanmıştır. Katılımcıların hastalıklarına ait sorular sorulduğunda, çoğunluğunun şeker hastalığı tanısı aldıktan sonra diyabet eğitimi aldığı (%89,9), şeker hastası tanısı aldıktan sonra diyetisyene yönlendirildiği (%91,2), evde düzenli olarak kan şekeri takibi yaptığı (%72,0) ve 50 diyabet takibi için kontrol amaçlı aile hekimliğine gittikleri (%76,4) belirlenmiştir. Ayrıca çalışmamıza katılan bireylerin %34'ü hafif kilolu, %27'si hafif obez, %13,2'si orta derecede obez, %1,9'u süper obez, %6,3 ü morbid obez olarak bulunmuş olup, zayıf kimse bulunmamaktadır. Katılımcıların tedavi uyum düzeyleri puan ortalaması 6,016±2,10 ile yüksek düzeyde olduğu saptanmıştır. Çalışmamıza katılan bireylerin, diyabet öz yönetim ölçeğinden aldığı toplam ölçek puan ortalaması ise 60,51±14,39 bulunmuş ve orta düzey olarak belirlenmiştir. Erişkin aşılarını olanların, diyabet eğitimi alanların, diyetisyene yönlendirilenlerin, hastane yatışı olanların, hipoglisemi atağı olanların ve haftalık toplam egzersiz süresi 150 dakikadan fazla olanların diyabet öz yönetim puanları daha yüksek ve istatistiksel olarak anlamlı bulunmuştur. Katılımcıların yaşları ile tedavi uyum ve diyabet öz yönetim düzeyleri arasında pozitif anlamlı ilişki saptanmıştır. Ayrıca diyabet tanısı konulma yılı ile diyabet öz yönetimi arasında pozitif anlamlı ilişki saptanmıştır. Diyabet kronik bir hastalıktır. Diyabet hastasının takibinde amaç glisemik hedeflere ulaşarak komplikasyonları önlemek veya ötelemektir. Diyabet tedavisinde hangi ajan kullanılırsa kullanılsın tedavinin ilk basamağı her zaman yaşam tarzı değişikliği olmalıdır. Glisemik kontrolün sağlanması için hasta yaşam tarzı değişikliği önerilerine uymalı, reçete edilen ilaçları önerildiği şekilde kullanmalı, düzenli kontrole gitmeli, evde kan basıncı ve kan şekeri takibini yapmalı ve hastalığı hakkında bilgi sahibi olmalıdır. Tedavi başarısı ancak hekim ve hastanın karşılıklı uyum içinde sürecin yönetimine katılmalarıyla sağlanabilir. Anahtar Kelimeler: Diyabetes mellitus, tip 2, tedavi uyumu, öz yönetim
Diabetes Mellitus is a chronic metabolic disorder that causes an increase in mortality and morbidity all over the world and requires lifelong regular medical care. Considering this situation, it is very important to inform and manage patients, especially in primary health care services. In this study, it was aimed to evaluate the knowledge level and behavioral patterns of Type 2 diabetes mellitus patients over the age of 46 regarding diabetes self-management and adherence to treatment, and to evaluate the effects of sociodemographic characteristics, treatment received, duration of diabetes on self-management and treatment compliance. The study included 318 people aged 46 and over, who applied to Family Health Centers in Edirne city center and had type 2 diabetes mellitus. The data were collected with the help of a questionnaire consisting of 57 questions. In the questionnaire form, there are 30 questions about the sociodemographic characteristics and medical conditions of the patients. In addition, Morisky Treatment Adherence Scale containing 8 questions and Type 2 Diabetes SelfManagement Scale consisting of 19 questions were applied to the participants. Statistical analysis of the obtained data was made using SPSS 19 package statistics program (serial no:10240642). Statistical significance level was taken as p<0.05. The mean age of the patients included in the study was 63.32±9.12, and 52.5% were female, 82.1% were married, 48.4% were retired. When the educational status of the participants was examined, it was determined that 48.1% of the participants were primary 52 school graduates. It was determined that 49.1% of the participants never smoked and 80.5% never used alcohol. When the questions about the diseases of the participants were asked, it was found that the majority of them received diabetes education after being diagnosed with diabetes (89.9%), they were referred to a dietitian after being diagnosed with diabetes (91.2%), they regularly followed their blood sugar at home (72.0%), and it was determined that they went to family medicine for control purposes (76.4%) for diabetes follow-up. In addition, 34% of the individuals participating in our study were found to be slightly overweight, 27% mildly obese, 13.2% moderately obese, 1.9% super obese, 6.3% morbidly obese, and there was no thin person. The treatment adherence levels of the participants were found to be high, with a mean score of 6,016±2,10. The total scale score average of the individuals participating in our study from the diabetes self-management scale was found to be 60.51±14.39 and was determined as moderate. The diabetes self-management scores of those who received adult vaccinations, received diabetes education, were referred to a dietitian, were hospitalized, had hypoglycemia attacks, and had a weekly total exercise time of more than 150 minutes were found to be higher and statistically significant. A positive and significant relationship was found between the age of the participants and their level of adherence to treatment and diabetes self-management. In addition, a positive significant relationship was found between the year of diagnosis of diabetes and diabetes self-management. Diabetes is a chronic disease. The aim of the follow-up of the diabetic patient is to reach glycemic targets and to prevent or delay complications. No matter which agent is used in the treatment of diabetes, the first step of treatment should always be lifestyle changes. In order to provide glycemic control, the patient; should follow lifestyle change recommendations, use prescribed medications as recommended, go to regular checkups, monitor blood pressure and blood sugar at home, and have information about the disease. Treatment success can only be achieved by the physician and the patient's participation in the management of the process in mutual harmony. Keywords: Diabetes mellitus, Type 2, medication adherence, self-management
Diabetes Mellitus is a chronic metabolic disorder that causes an increase in mortality and morbidity all over the world and requires lifelong regular medical care. Considering this situation, it is very important to inform and manage patients, especially in primary health care services. In this study, it was aimed to evaluate the knowledge level and behavioral patterns of Type 2 diabetes mellitus patients over the age of 46 regarding diabetes self-management and adherence to treatment, and to evaluate the effects of sociodemographic characteristics, treatment received, duration of diabetes on self-management and treatment compliance. The study included 318 people aged 46 and over, who applied to Family Health Centers in Edirne city center and had type 2 diabetes mellitus. The data were collected with the help of a questionnaire consisting of 57 questions. In the questionnaire form, there are 30 questions about the sociodemographic characteristics and medical conditions of the patients. In addition, Morisky Treatment Adherence Scale containing 8 questions and Type 2 Diabetes SelfManagement Scale consisting of 19 questions were applied to the participants. Statistical analysis of the obtained data was made using SPSS 19 package statistics program (serial no:10240642). Statistical significance level was taken as p<0.05. The mean age of the patients included in the study was 63.32±9.12, and 52.5% were female, 82.1% were married, 48.4% were retired. When the educational status of the participants was examined, it was determined that 48.1% of the participants were primary 52 school graduates. It was determined that 49.1% of the participants never smoked and 80.5% never used alcohol. When the questions about the diseases of the participants were asked, it was found that the majority of them received diabetes education after being diagnosed with diabetes (89.9%), they were referred to a dietitian after being diagnosed with diabetes (91.2%), they regularly followed their blood sugar at home (72.0%), and it was determined that they went to family medicine for control purposes (76.4%) for diabetes follow-up. In addition, 34% of the individuals participating in our study were found to be slightly overweight, 27% mildly obese, 13.2% moderately obese, 1.9% super obese, 6.3% morbidly obese, and there was no thin person. The treatment adherence levels of the participants were found to be high, with a mean score of 6,016±2,10. The total scale score average of the individuals participating in our study from the diabetes self-management scale was found to be 60.51±14.39 and was determined as moderate. The diabetes self-management scores of those who received adult vaccinations, received diabetes education, were referred to a dietitian, were hospitalized, had hypoglycemia attacks, and had a weekly total exercise time of more than 150 minutes were found to be higher and statistically significant. A positive and significant relationship was found between the age of the participants and their level of adherence to treatment and diabetes self-management. In addition, a positive significant relationship was found between the year of diagnosis of diabetes and diabetes self-management. Diabetes is a chronic disease. The aim of the follow-up of the diabetic patient is to reach glycemic targets and to prevent or delay complications. No matter which agent is used in the treatment of diabetes, the first step of treatment should always be lifestyle changes. In order to provide glycemic control, the patient; should follow lifestyle change recommendations, use prescribed medications as recommended, go to regular checkups, monitor blood pressure and blood sugar at home, and have information about the disease. Treatment success can only be achieved by the physician and the patient's participation in the management of the process in mutual harmony. Keywords: Diabetes mellitus, Type 2, medication adherence, self-management
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Aile Hekimliği, Family Medicine
