Kırsal Alanda Yaşayan Hipertansiyonlu Bireylerin İlaç Tedavisine Uyum Özetkililik Düzeyleri ve Etkileyen Faktörlerin Belirlenmesi

Year 2018, Volume: 11 Issue: 2, 120 - 128, 01.05.2018

Nur Teke Selda Arslan

Abstract

Giriş-Amaç: Bu çalışma; kırsal alanda hipertansiyon tanısı almış bireylerin ilaç tedavisine uyum özetkililik düzeylerinin ve bu düzeyin bazı sosyodemografik, sağlık ve hastalık özelliklerine göre değişip değişmediğinin belirlenmesi amacına yönelik olarak tanımlayıcı türde yapılmıştır. Yöntem: Araştırmanın çalışma grubunu kırsal bölgede Kardiyoloji Polikliniğine başvuran hipertansiyon tanısı alan 235 birey oluşturmuştur. Araştırmada araştırmacı tarafından hazırlanan “Anket Formu ”, ve “İlaca Bağlılık/Uyum Öz-Etkililik Ölçeği” kullanılmıştır. Bağımsız değişkenlerin analizinde t testi ve tek yönlü varyans analizi kullanılmıştır. Farklılığın tespit edilmesinde Tukey HSD testinden yararlanılmıştır. Anlamlılık p<0,05 düzeyinde değerlendirilmiştir. Bulgular: Katılımcıların; yaş ortalaması 63.2±9.9 olup, %64.3’ü kadın ve %78.7 si evli, %47.7’si ilkokul-ortaöğretim mezunu, %59.6’sı ev hanımıdır. Ölçeğin toplam puan ortalamasının sosyodemografik özelliklere göre puan dağılımı değerlendirildiğinde yaş, cinsiyet, medeni durum, eğitim durumu, çalışma durumu, gelir durumunun benzer olduğu (p>0.05), birlikte yaşadığı kişiler değişkeninde anlamlılık tespit edilmiştir (p<0,05). Sistolik kan basıncı, diyastolik kan basıncı, düzenli ilaç kullanma durumu, tansiyonun yan etkilerini bilme durumu, tansiyon ölçme/ölçtürme sıklığı değişkenlerinde ise ölçek puan ortalamasının farklılaştığı belirlenmiştir (p<0.05). Sonuç: Çalışma sonucunda; kırsal kesimde yaşayan hasta grubunun ilaç tedavisine uyum düzeylerinin yüksek olduğu ve bazı değişkenlerden etkilendiği bulunmuştur. Kırsal alanda yaşayan hipertansif hastaların; ilaç tedavisine uyum öz-etkililik düzeylerini geliştirmelerine yönelik iş birliği sağlanması, hemşirelerin; hastaların ihtiyaçlarına yönelik eğitim planı hazırlanması önerilebilir.Anahtar Sözcükler: Hipertansiyon; ilaç tedavisine uyum; kırsal alan.

Keywords

Hemşire, Hipertansiyon, İlaç Uyum, Kırsal Alan.

Hypertensive Individuals’s Medication Adherence Self Efficacy Level in Rural Population and Determination of the Affeting Factors

Abstract

Background: Compliance to drug therapy in hypertension are very important. Objectives: This study has been done in a in order to
determine if the compliance feature level to drug treatment of the individuals who were diagnosed with hypertension and living in rural
areas change according to some socio-demographic, health and illness features. Methods: The study descriptive, cross-sectional type group
consisted of 235 individuals diagnosed with hypertension who visited the cardiology polyclinic of a hospital in a rural area. The study used
“the Questionnaire” and “the Medication Commitment/Adherence Self-Efficacy Scale” prepared by the researcher. One-way ANOVA and ttest were used in the analysis of the independent variables. Tukey HSD test was utilized in determining the difference. “p<0.05” was
accepted as the statistically significant level. Results: While the mean age of the participants was 63.2±9.9, 64.3% were female, 78.8% were
married and 47.7% were graduates of primary-secondary education. When the socio-demographics based score distribution of the total
average score of the scale was analyzed, it was determined that age, sex, marital status, education level, working status and income level
were similar, while the variable regarding the people participants lived with showed differences. It was also found that the average score of
the scale varied in terms of the variables of systolic blood pressure, diastolic blood pressure, status of regular drug usage, status of awareness
of side effects of blood pressure, and measuring blood pressure / having blood pressure measured (p<0.05). Conclusion: As a result of the
study, it was found that medication adherence levels of the patient group living in the rural area were high, while being affected by some
variables. The following may be recommended for patients with hypertension living in rural areas: establishing cooperation towards
improving their medication adherence self-efficacy levels.

Keywords

Nursing, Hypertension, Drug Compliance, Rural Area

References

• Al-Ramahi, R. (2015). Adherence to medications and associated factors: A cross-sectional study among Palestinian hypertensive patients. Journal of Epidemiology and Global Health, 5(2), 125-32.
• Aypak, C., Önder, Ö., Dicle, M., Yıkılkan, H., Tekin, H., & Görpelioğlu, S. (2013). Evaluation of blood pressure control levels and treatment compliances of hypertensive patients. Cukurova Medical Journal, 38 (2), 224-32.
• Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd edition). Mahwah, NJ: Lawrence Earlbaum Associates.
• Dessie, A., Asres, G., Meseret, S., & Birhanu, Z. (2012). Adherence to antihypertensive treatment and associated factors among patients on follow up at University of Gondar Hospital, Northwest Ethiopia. BMC Public Health, 12 (4), 282.
• Goldilocks, N., & Lewis, J. (2007). Prevalence, awareness, treatment and control of hypertension in a rural Nicaraguan sample. Journal of Human Hypertension, 21, 815–17.
• Gözüm, S., & Hacıhasanoğlu, R. (2009). Reliability and validity of the turkish adaptation of medication adherence self-efficacy scale in hypertensive patients. European Journal of Cardiovascular Nursing, 8, 2.
• Gün, Y. (2014). Treatment adaptation and quality of life of hypertensive patients. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi, 7 (2), 98-108.
• Hacıhasanoğlu, R. (2009). Factors affecting compliance in hypertension. TAF Preventive Medicine Bulletin, 2, 167-72.
• Hacıhasanoğlu, R., Gözüm, S., & Çapık, C. (2012). Validity of the turkish version of the medication adherenceself-efficacy scale-short form in hypertensive patients Anadolu Kardiyoloji Dergisi, 12, 241-48.
• Hema, K., & Padmalatha, P. (2014). Adherence to medication among hypertensive patients attending a tertiary care hospital in Guntur, Andhra Pradesh. Indian Journal of Basic and Applied Medical Research, 4, 451- 56.
• Hyre, A. D., Krousel-Wood, M. A., Muntner, P., Kawasak,i L., & DeSalvo, K. B. (2007). Prevalence and predictors of poor antihypertensive medication adherence in an urban health clinic setting. The Journal of Clinical Hypertens (Greenwich), 9, 179-86.
• Kamran, A., Sadeghieh, A. S., Ahari, S., Biria, M., Malepour, A., & Heydari, H. (2015). Determinants of patient’s adherence to hypertension medications: application of health belief model among rural patients. Annals of Medical and Health Sciences Research, Nov-Dec, 4 (6), 922-7.
• Kang, D. C., Tsang, P. M., Li, W., Wang, H. X., Liu, K., Griffiths, S. M., et al. (2015). Determinants of medication adherence and blood pressure controlamong hypertensive patients in hong kong: a cross-sectional study. International Journal of Cardiology, 82, 250–57.
• Karadağ, E., Akkuş, Y., & Karatay, G. (2012). Medıcatıon adherence self effıcacy level of the hypertensıve patıents who applıed to a famıly health center. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 28 (3), 85-96.
• Koçoğlu, D., Gedik, S. (2016). Kırsal alanda yaşayan hipertansif bireylerin hastalık yönetimlerinin değerlendirilmesi. Akademik Sosyal Araştırmalar Dergisi, 4(36), 207-218.
• Kousalya, K., Vasantha, J., Ponnudura, R., Sumitkumar, G., Ramalakshmi, S., & Saranya, S. (2012). Study on non-adherence and the effect of counselling in the pharmacological management of psychiatric patients. International Journal of Pharma and Bio Sciences, 1, 102-09.
• Kumar, N., Unnikrishnan, B., Thapar, R., Mithra, P., Kulkarni, V., Holla, R., et al. (2014). Factors assocıated wıth adherence to antıhypertensıve treatment among patıents attendıng a tertıary care hospıtal ın mangalore, South Indıa. International Journal of Current Scientific Research, 06 (10).
• Lee, G. K., Wang, H. H., Liu, K. Q., Cheung, Y., Morisky, D. E., & Wong, M. C. ( 2013). Determinants of medication adherence to antihypertensive medications among a Chinese population using morisky medication adherence scale. Plos One, 8, 627- 75.
• Ma, C. (2015). A cross-sectional survey of medication adherence and associated factors for rural patients with hypertension. Applied Nursing Research. doi: 10.1016/j.apnr.2016.01.004
• Mancia, G., Fagard, R., Narkiewicz, K., Redon, J., Zanchetti, A., Böhm, M., et al. (2013). ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). European Heart Journal, 34, 2159–19.
• Mert, H., Özçakar, H., & Kuruoğlu, E. (2011). A multidisciplinary special study module research: treatment compliance of patients with hypertension. Turk Aile Hekimliği Dergisi, 15 (1), 7-12. www.turkailehekderg.org.
• Mohammad, Y., Amal, A., Sanaa, A., Samar, R., Salam, Z., Wafa, B., et al. (2015). Evaluation of edication adherence in lebanese hypertensive patients. J Epidemiol Global Health, Received 6 April 2015.
• Mukora F. N., & Chadambuka, E. M. (2013). Drug adherence behavior among hypertensive outpatients at a tertiary health institution in manicaland province, Zimbabwe, 2011. Patient Prefer Adherence, 7, 65-70.
• Odusola, A. O., Nelissen, H., Hendriks, M., Schultsz, C., Wit, F., Bolarinwa, O. A, et al. (2015). How group-based cardiovascular health education affects treatment adherence and blood pressure control among ınsured hypertensive nigerians: a pre-test, post-test study. World Journal of Cardiovascular Diseases, 5, 181-98.
• Ogedegbe, G., Mancuso, C. A., Allegrante, J. P., & Charlson, M. E. (2003). Development and evaluation of medication adherence self-efficacy scale in hypertensive african-american patients. Journal of Clinical Epidemiology, 56, 520–29.
• Okan, A. (2010). Bolu valiliği yaşlı merkezine kayıtlı 65 yaş ve üstü kişilerin hipertansiyon farkındalığı ve evde bakım uygulamaları. Yüksek Lisans Tezi, Abant İzzet Baysal Üniversitesi Sağlık Bilimleri Enstitüsü. Bolu.
• Oliveria, S. A., Chen, R.S., McCarthy, B. D., Davis, C. C., Pharma, D., & Hill, M. N. (2005). Hypertension knowledge, awareness, and attitudes in a hypertensive population. Journal of General Internal Medicine, 20, 219-25.
• Onat, A., Uğur, M., Tuncer, M., Ayhan, E., Kaya, Z., & Küçükdurmaz, Z. (2009). TEKHARF, Age at death in the Turkish Adult Risk Factor Study: temporal trend and regional distribution at 56,700 person-years’ follow-up. Article in Turkish, 37, 155- 60.
• Türk Hipertansiyon ve Böbrek Hastalıkları Derneği. (2012). Türk Hipertansiyon Prevalans Çalışması PatenT2. Erişim: . 07.06.2016. http://www.turkhipertansiyon.org/prevelans_calismasi_2.php.
• Ramli, A., Ahmad, N. S., & Paraidathathu, T. (2012). Medication adherence among hypertensive patients of primary health clinics in Malaysia. Patient Prefer Adherence, 6, 613-22.
• Rosendorf, C., Lackland, D.T., Allison, M., Aronow, W.S., Black, H.R., Blumenthal, R.S. et al. (2015). Treatment of hypertension in patients with coronary artery disease. Hypertension, 65, 1372-1407.
• Saounatsou, M., Patsi, O., Fasoi, G., Stylianou, M., Kavga, A., Economou, O., et al. (2001). The influence of the hypertensive patient_s education in compliance with their medication. Public Health Nursing, 18, 436–42.
• Türkiye İstatistik Kurumu (2012), Sağlık araştırması, Erişim: 05.05.2017 file:///C:/Users/User/Downloads/7926937269404380631.pdf
• Vatansever, Ö. (2014). Determination of medical treatment adherence, self-efficacy levels of patients with essential hypertension and affecting factors. Turk Soc Cardiol Turkish Journal of Cardiovascular Nursing, 5 (8), 66-74.
• Wang, W., Lau, Y., Loo, A., Chow, A., & Thompson, D. R. (2014). Medication adherence and its associated factors among Chinese community-dwelling older adults with hypertension. Heart & Lung, 43, 278-83.
• Wet, H., Ramulondi, M., & Ngcobo, Z. N. (2016). The use of indigenous medicine for the treatment of hypertension by a rural community in northern maputaland, south africa. South African Journal of Botany, 103, 78–88.
• World Health Organization. (2014). Global status report on alcohol and health 2014. Erişim: 15.01.2016. Geneva: http://www.who.int/substance_abuse/publications/global_alcohol_report/msb_gsr_2014_1.pdf?ua=1.
• World Health Organization. (2015). A global brief on hypertension. Silent killer, global public health crisis. 2013. Erişim:02.02.2016. Available at: http://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en. Accessed February 1].