Tip 2 Diyabetli Hastalarda Kronik Hastalıklarının Yönetimine Etki Eden Faktörlerin Değerlendirilmesi: Toplum Tabanlı Kesitsel Bir Çalışma

Year 2024, Volume: 11 Issue: 2, 114 - 124, 31.08.2024

Bahadır Dede , Erhan Eser

https://doi.org/10.47572/muskutd.1444546

Abstract

Çalışmamız Manisa merkez ilçede yaşayan tip 2 diyabetli hastalarda kronik hastalıklarının yönetimlerini etkileyen faktörleri değerlendirmek amaçlanmıştır. Kesitsel tipteki araştırmamıza çok aşamalı, tabakalı rastgele örnekleme yöntemiyle 505 tip 2 diyabetli hasta katılmıştır. Katılımcılara yüz yüze anket uygulanmıştır. Anket literatür taraması ile hazırlanmış yarı yapılandırılmış sorular ve hastaların kronik hastalık bakımlarını kendilerinin değerlendirdiği Patient Assessment of Chronic İllness Care (PACIC) Türkçe ölçeğinden oluşmaktadır. Çok değişkenli çözümlemelerde regresyon analizi uygulanmıştır. Katılımcıların HbA1c düzeyi ortalaması 6.9±1.7 mg/dl’dir. HbA1c’ye göre %61.7'sinin metabolik kontrolü iyi ve sadece %69.5'i evde kendi kendine kan şekeri takiplerini yapmaktadır. Katılımcıların toplam PACIC skor ortalaması 2.59±0.62'dir. Tek değişkenli analiz sonuçlarına göre; kent merkezinde yaşayanların, erkeklerin, 45 yaş altındakilerin, yüksek gelirlilerin, yüksek eğitimlilerin ve evde kendi kendine şeker takibi yapanların, HbA1c, kan lipid düzeyleri kontrol altında olanların, rutin izlemlerini düzenli yaptıranların ve diyabete bağlı sağlık problemi olmayanların toplam PACIC skorları anlamlı olarak daha yüksektir (p<0.05). Çok değişkenli modelde; karar verme becerisinin toplam PACIC skorlarındaki değişimin %52.5'ini, düzenli rutin izlemleri yaptıranların ise %19.0'ını açıkladığı bulunmuştur. Bu, hastaların kendi sağlık yönetimlerinde aktif roller alması ve düzenli sağlık kontrolü yaptırmasının, hasta merkezli bakımın kalitesini önemli ölçüde etkileyebileceğini gösterir. Diyabet eğitiminin nicel ve nitel kalitesinin artırılması, hastaların karar verme becerilerini geliştirmesi kronik hastalık yönetimini kolaylaştırabilir.

Keywords

HbA1c, Kronik Bakım Modeli, Kronik Hastalık Bakımının Hasta Değerlendirmesi Ölçeği (PACIC), Metabolik Kontrol, Tip 2 Diyabet

Ethical Statement

This research received ethical approval from Celal Bayar University Faculty of Medicine Non-Invasive Clinical Research Ethics Committee with the decision dated 14.03.2013 and numbered 20478486-64.

Supporting Institution

Celal Bayar University Scientific Research Projects Coordination Unit provided financial support with the approval of the project number 2013-057.Celal Bayar University Scientific Research Projects Coordination Unit provided financial support with the approval of the project number 2013-057.

Project Number

2013-057

Thanks

I would like to express my deepest gratitude to Dr. Erhan Eser for his invaluable mentorship, patience, and unwavering support throughout this research project. His profound expertise and insightful feedback have been pivotal to the success of our work, and for that, I am eternally grateful. Additionally, I extend my heartfelt thanks to Dr. Cemil Özcan, Dr. Pınar Erbay Dündar, and Dr. Beyhan Cengiz Özyurt for their guidance and encouragement. Their contributions have not only enriched my academic journey but have also played a crucial role in shaping my educational path.

Assessment of Factors Affecting the Management of Chronic Diseases in Patients with Type 2 Diabetes: A Community-Based Cross-Sectional Study

Abstract

Our study aimed to evaluate the factors affecting the management of chronic diseases in patients with type 2 diabetes living in Manisa central district. In our cross-sectional study, 505 type 2 diabetic patients participated in a multi-stage, stratified random sampling method. A face-to-face questionnaire was applied to the participants. The questionnaire consisted of semi-structured questions prepared with a literature review and the Patient Assessment of Chronic Illness Care (PACIC) Turkish scale in which patients self-assessed their chronic disease care. Regression analysis was applied in multivariate analysis. The mean HbA1c level of the participants was 6.9±1.7 mg/dl. According to HbA1c, 61.7% had good metabolic control and only 69.5% of the participants self-monitored their blood glucose at home. The mean total PACIC score of the participants was 2.59±0.62. According to the results of univariate analysis, the total PACIC scores of those living in urban centers, males, those under the age of 45, those with higher income, those with higher education, those who self-monitor glucose at home, those with controlled HbA1c and blood lipid levels, those who have regular routine follow-ups and those who do not have diabetes-related health problems are significantly higher (p<0.05). In the multivariate model; decision-making ability was found to explain 52.5% of the change in total PACIC scores and 19.0% of those who had regular routine follow-ups. This indicates that patients taking active roles in their own health management and having regular health check-ups can significantly impact the quality of patient-centered care. Increasing the quantitative and qualitative quality of diabetes education and improving patients' decision-making skills can facilitate chronic disease management.

Keywords

HbA1c, Chronic Care Model, Patient Assessment of Chronic Illness Care Scale (PACIC), Metabolic Control, Type 2 Diabetes

Project Number

2013-057

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