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Determination of Cardiovascular Risk Awareness and Related Factors in Patients with Diabetes Mellitus: A Mixed-Method Study

Year 2026, Volume: 11 Issue: 1, 71 - 79, 15.03.2026
https://doi.org/10.26453/otjhs.1839963
https://izlik.org/JA45JW67CW

Abstract

Objective: The study aimed to determine cardiovascular risk awareness and related factors in patients with diabetes mellitus. Materials and Methods: The study was conducted between March 15, 2025, and December 2, 2025, using a mixed-methods design (descriptive, correlational, and phenomenological). A total of 154 patients participated in the quantitative phase, and 12 patients participated in the qualitative phase. The “Patient Information Form, Cardiovascular Risk Awareness Scale, and Semi-Structured Interview Form” were used for data collection. The study was conducted in two parts: a questionnaire was administered in the first, and interviews were conducted in the second. Data were collected through face-to-face interviews. SPSS 25 was used for the analysis of quantitative data, and MAXQDA 24 was used for the study of qualitative findings. Results: The average cardiovascular risk awareness of the patients was 29.88±7.03. According to regression analysis, the independent variables predicted cardiovascular risk awareness with 21.5 percent accuracy (F = 6.982, p < 0.001). Cardiovascular risk awareness was directly affected by gender, occupation, marital status, treatment compliance, smoking, and exercise or walking (p < 0.005). The qualitative findings consisted of the main theme “disease management” and the subthemes “awareness, lack of knowledge, and fatalism.” Conclusion: The cardiovascular risk awareness of the patients was low. Individual factors significantly affected awareness. Eliminating patients’ lack of knowledge may increase their understanding and prevent fatalistic tendencies.

Ethical Statement

Approval for the study was obtained from the ethics committee of a Kahramanmaraş Sütçü İmam University (Date: 03.03.2025, decision no: 2025/08-10). Permission was obtained from the institution where the study was conducted. Informed consent was obtained from all participants in the study. Permission was obtained from the scale developers via e-mail. The study was conducted in accordance with the Helsinki Declaration.

References

  • 1. Haile KE, Asgedom YS, Azeze GA, Amsalu AA, Kassie GA, Gebrekidan AY. Burden of peripheral artery disease and risk factors among patients with diabetes mellitus in sub-saharan Africa: a systematic review and meta-analysis. BMC Endocrine Disorders. 2025;25(1):42. doi:10.1186/s12902-025-01866-8
  • 2. International Diabetes Federation (IDF). Diabetes Atlas 2025. https://diabetesatlas.org/resources/idf-diabetes-atlas-2025/ Accessed December 3, 2025.
  • 3. Zehirlioglu L, Mert H, Sezgin D, Özpelit E. Cardiovascular risk, risk knowledge, and related factors in patients with type 2 diabetes. Clinical Nursing Research. 2020;29(5):322-330. doi:10.1177/1054773819844070
  • 4. Saeedi P, Karuranga S, Hammond L, et al. Cardiovascular disease and risk factor knowledge and awareness among people with type 2 diabetes mellitus: a global evaluation. Diabetes Research and Clinical Practice. 2020;165:108194. doi:10.1016/j.diabres.2020.108194
  • 5. World Health Organization (WHO). The top 10 causes of death 2025. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death Accessed December 3, 2025.
  • 6. Alemu F, Beza L, Jiru T, Endale D. Assessment of knowledge on cardiovascular disease risk factors among diabetes mellitus patients in tikur anbessa specialized hospital, Ethiopia 2021: a cross‐sectional study. Nursing Research and Practice. 2025;1:7737392. doi:10.1155/nrp/7737392
  • 7. Fetters MD, Molina-Azorin JF. A checklist of mixed methods elements in a submission for advancing the methodology of mixed methods research. J Mix Methods Res. 2019;13(4):414-423. doi:10.1177/1558689819875832
  • 8. Karataş G. Evaluation of happiness levels according to disease awareness and acceptance in patients with type 2 diabetes mellitus. Turk J Diab Obes. 2024;8(2):180–90. doi:10.25048/tudod.1411309
  • 9. Tekindal M, Uğuz Arsu Ş. A review on the scope and process of phenomenological approach as a qualitative research method. Ufkun Ötesi Bilim Derg. 2020;20(1):153–82.
  • 10. Nanayakkara N, Ranasinha S, Gadowski A, et al. Age, age at diagnosis and diabetes duration are all associated with vascular complications in type 2 diabetes. J Diabetes Complication. 2018;32(3):279–90. doi:10.1016/j.jdiacomp.2017.11.009
  • 11. Woringer M, Nielsen JJ, Zibarras L, et al. Development of a questionnaire to evaluate patients’ awareness of cardiovascular disease risk in England’s national health service health check preventive cardiovascular programme. BMJ Open. 2017;7(9): e01441. doi:10.1136/bmjopen-2016-014413
  • 12. Vural DB, Utli H, Karaman E. Cardiovascular disease risk awareness assessment questionnaire: psychometric properties of the Turkish version. J Cardiovasc Nurs. 2021;12(27):18–25. doi:10.5543/khd.2021.05914
  • 13. Peñafiel BDG. Factores de riesgo asociados a diabetes mellitus tipo 2. Revista Científica De Salud Y Desarrollo Humano. 2024;5(2):101–15. doi:10.61368/r.s.d.h.v5i2.123
  • 14. Yüce Özcan U, Kırtıloğlu HD, Bektaş NA, Atik D. Diabetes mellitus hastalarının diyete uyumları, kişilik özellikleri ve hedonistik yeme davranışları arasındaki ilişki: Tanımlayıcı çalışma. Turkiye Klin J Heal Sci. 2025;10(1):1–9. doi:10.5336/healthsci.2024-105405
  • 15. Özel CB, Arikan H, Dağdelen S, et al. Tip 2 diyabetli bireylerde kardiyovasküler hastalıklar risk faktörleri bilgi düzeyi ve fiziksel aktivite seviyelerinin incelenmesi. JETR. 2021;8(1):99–105.
  • 16. Amaravadi SK, Maiya GA, Vaishali K, Shastry BA. Effectiveness of structured exercise program on insulin resistance and quality of life in type 2 diabetes mellitus – a randomized controlled trial. PLoS One. 2024;19(5):1–18. doi:10.1371/journal.pone.0302831
  • 17. Tricò D, Masoni MC, Baldi S, et al. Early time ‑ restricted carbohydrate consumption vs conventional dieting in type 2 diabetes : a randomised controlled trial. Diabetologia. 2024;67(2):263–74. doi:10.1007/s00125-023-06045-9
  • 18. Yuan S, Larsson SC. A causal relationship between cigarette smoking and type 2 diabetes mellitus : a mendelian randomization study. Sci Rep. 2019;9(1):19342. doi:10.1038/s41598-019-56014-9
  • 19. Huang J, Xiao L, Zhao H, Liu F, Du L. Primary Care Diabetes Living alone increases the risk of developing type 2 diabetes mellitus : a systematic review and meta-analysis based on longitudinal studies. Prim Care Diabetes. 2024;18(1):1–6. doi:10.1016/j.pcd.2023.11.011
  • 20. Soylu A, Soylu D, Korkmaz M. Diabetes mellitus risk and awareness of young population: a descriptive study. Firat University Medical Journal of Health Sciences. 2024;38(3):206–212.
  • 21. İlaslan E, Dalkıran Ş, Özer ZC, Balcı MK. Level of acceptance of illness by persons with type 2 diabetes and burden on caregivers. STED. 2021;30(2):84–95. doi:10.17942/sted.803667
  • 22. Alp SŞ, Özer Z. The relationship between glycemic control, diabetes distress and understanding of fatalism in patients diagnosed with type 2 diabetes. Turkish Journal of Diabetes Nursing. 2024;3(2):46-52. doi:10.29228/tjdn.71107
  • 23. Durak E, Yilmaz M. The Relationship between nutritional literacy and self effectiveness and diabetes self-care activities in individuals diagnosed with type 2 diabetes mellitus. Journal of Hacettepe University Faculty of Nursing. 2022;9(1):57–63. doi:10.31125/hunhemsire.1102077
  • 24. Çam HH, Güleç HY, Karasu F, Öztürk, E. Health literacy and diabetes mellitus. Turkish Journal of Diabetes and Obesity. 2021;5(1):68-74. doi:10.25048/tudod.794597

Diabetes Mellitus Hastalarında Kardiyovasküler Risk Farkındalığı ve Ilişkili Faktörlerin Belirlenmesi: Karma Yöntem Araştırması

Year 2026, Volume: 11 Issue: 1, 71 - 79, 15.03.2026
https://doi.org/10.26453/otjhs.1839963
https://izlik.org/JA45JW67CW

Abstract

Amaç: Çalışma Diyabetes Mellitus’lu hastaların kardiyovasküler risk farkındalıklarının ve ilişkili faktörlerin belirlenmesi amacıyla yapıldı. Materyal ve Metot: Çalışma 15 Mart 2025 ve 2 Aralık 2025 tarihleri arasında karma desen türünde (tanımlayıcı, ilişki arayıcı ve fenomenolojik tür) yapıldı. Nicel kısma 154 nitel kısma 12 hasta katıldı. Verilerin toplanmasında “Hasta tanıtım formu, kardiyovasküler risk farkındalığı ölçeği ve yarı yapılandırılmış soru formu” kullanıldı. Çalışma iki kısımda yürütüldü birinci kısımda anket yapıldı ikinci kısımda röportaj yapıldı. Veriler yüz yüze görüşme tekniği ile toplandı. Nicel verilerin analizinde SPSS 25, Nitel bulguların analizinde MAXQDA 24 programı kullanıldı. Bulgular: Hastaların kardiyovasküler risk farkındalığı ortalamaları 29,88±7,03’tür. Regresyon analizine göre kardiyovasküler risk farkındalığını bağımsız değişkenler %21,5 oranında yordamaktadır (F=6,982, p<0.001). Kardiyovasküler risk farkındalığını, cinsiyet, meslek, medeni durum, tedavi uyumu, sigara kullanımı, egzersiz ya da yürüyüş yapma doğrudan etkilemektedir (p<0.005). Nitel bulgular ise “hastalık yönetimi” ana teması, “farkındalık, bilgi eksikliği ve kadercilik” alt temalarından oluşmuştur. Sonuç: Hastaların kardiyovasküler risk farkındalığı düşüktür. Farkındalığı bireysel faktörler önemli oranda etkilemektedir. Hastaların bilgi eksikliğinin giderilmesi onların farkındalığını artırabilir ve kaderci yaklaşımlarını önleyebilir.

Ethical Statement

Çalışma için Kahramanmaraş Sütçü İmam Üniversitesi Etik Kurulu'ndan onay alınmıştır (Tarih: 03.03.2025, karar no: 2025/08-10). Çalışmanın yürütüldüğü kurumdan izin alınmıştır. Çalışmaya katılan tüm katılımcılardan bilgilendirilmiş onam alınmıştır. Ölçek geliştiricilerinden e-posta yoluyla izin alınmıştır. Çalışma Helsinki Deklarasyonu'na uygun olarak yürütülmüştür.

References

  • 1. Haile KE, Asgedom YS, Azeze GA, Amsalu AA, Kassie GA, Gebrekidan AY. Burden of peripheral artery disease and risk factors among patients with diabetes mellitus in sub-saharan Africa: a systematic review and meta-analysis. BMC Endocrine Disorders. 2025;25(1):42. doi:10.1186/s12902-025-01866-8
  • 2. International Diabetes Federation (IDF). Diabetes Atlas 2025. https://diabetesatlas.org/resources/idf-diabetes-atlas-2025/ Accessed December 3, 2025.
  • 3. Zehirlioglu L, Mert H, Sezgin D, Özpelit E. Cardiovascular risk, risk knowledge, and related factors in patients with type 2 diabetes. Clinical Nursing Research. 2020;29(5):322-330. doi:10.1177/1054773819844070
  • 4. Saeedi P, Karuranga S, Hammond L, et al. Cardiovascular disease and risk factor knowledge and awareness among people with type 2 diabetes mellitus: a global evaluation. Diabetes Research and Clinical Practice. 2020;165:108194. doi:10.1016/j.diabres.2020.108194
  • 5. World Health Organization (WHO). The top 10 causes of death 2025. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death Accessed December 3, 2025.
  • 6. Alemu F, Beza L, Jiru T, Endale D. Assessment of knowledge on cardiovascular disease risk factors among diabetes mellitus patients in tikur anbessa specialized hospital, Ethiopia 2021: a cross‐sectional study. Nursing Research and Practice. 2025;1:7737392. doi:10.1155/nrp/7737392
  • 7. Fetters MD, Molina-Azorin JF. A checklist of mixed methods elements in a submission for advancing the methodology of mixed methods research. J Mix Methods Res. 2019;13(4):414-423. doi:10.1177/1558689819875832
  • 8. Karataş G. Evaluation of happiness levels according to disease awareness and acceptance in patients with type 2 diabetes mellitus. Turk J Diab Obes. 2024;8(2):180–90. doi:10.25048/tudod.1411309
  • 9. Tekindal M, Uğuz Arsu Ş. A review on the scope and process of phenomenological approach as a qualitative research method. Ufkun Ötesi Bilim Derg. 2020;20(1):153–82.
  • 10. Nanayakkara N, Ranasinha S, Gadowski A, et al. Age, age at diagnosis and diabetes duration are all associated with vascular complications in type 2 diabetes. J Diabetes Complication. 2018;32(3):279–90. doi:10.1016/j.jdiacomp.2017.11.009
  • 11. Woringer M, Nielsen JJ, Zibarras L, et al. Development of a questionnaire to evaluate patients’ awareness of cardiovascular disease risk in England’s national health service health check preventive cardiovascular programme. BMJ Open. 2017;7(9): e01441. doi:10.1136/bmjopen-2016-014413
  • 12. Vural DB, Utli H, Karaman E. Cardiovascular disease risk awareness assessment questionnaire: psychometric properties of the Turkish version. J Cardiovasc Nurs. 2021;12(27):18–25. doi:10.5543/khd.2021.05914
  • 13. Peñafiel BDG. Factores de riesgo asociados a diabetes mellitus tipo 2. Revista Científica De Salud Y Desarrollo Humano. 2024;5(2):101–15. doi:10.61368/r.s.d.h.v5i2.123
  • 14. Yüce Özcan U, Kırtıloğlu HD, Bektaş NA, Atik D. Diabetes mellitus hastalarının diyete uyumları, kişilik özellikleri ve hedonistik yeme davranışları arasındaki ilişki: Tanımlayıcı çalışma. Turkiye Klin J Heal Sci. 2025;10(1):1–9. doi:10.5336/healthsci.2024-105405
  • 15. Özel CB, Arikan H, Dağdelen S, et al. Tip 2 diyabetli bireylerde kardiyovasküler hastalıklar risk faktörleri bilgi düzeyi ve fiziksel aktivite seviyelerinin incelenmesi. JETR. 2021;8(1):99–105.
  • 16. Amaravadi SK, Maiya GA, Vaishali K, Shastry BA. Effectiveness of structured exercise program on insulin resistance and quality of life in type 2 diabetes mellitus – a randomized controlled trial. PLoS One. 2024;19(5):1–18. doi:10.1371/journal.pone.0302831
  • 17. Tricò D, Masoni MC, Baldi S, et al. Early time ‑ restricted carbohydrate consumption vs conventional dieting in type 2 diabetes : a randomised controlled trial. Diabetologia. 2024;67(2):263–74. doi:10.1007/s00125-023-06045-9
  • 18. Yuan S, Larsson SC. A causal relationship between cigarette smoking and type 2 diabetes mellitus : a mendelian randomization study. Sci Rep. 2019;9(1):19342. doi:10.1038/s41598-019-56014-9
  • 19. Huang J, Xiao L, Zhao H, Liu F, Du L. Primary Care Diabetes Living alone increases the risk of developing type 2 diabetes mellitus : a systematic review and meta-analysis based on longitudinal studies. Prim Care Diabetes. 2024;18(1):1–6. doi:10.1016/j.pcd.2023.11.011
  • 20. Soylu A, Soylu D, Korkmaz M. Diabetes mellitus risk and awareness of young population: a descriptive study. Firat University Medical Journal of Health Sciences. 2024;38(3):206–212.
  • 21. İlaslan E, Dalkıran Ş, Özer ZC, Balcı MK. Level of acceptance of illness by persons with type 2 diabetes and burden on caregivers. STED. 2021;30(2):84–95. doi:10.17942/sted.803667
  • 22. Alp SŞ, Özer Z. The relationship between glycemic control, diabetes distress and understanding of fatalism in patients diagnosed with type 2 diabetes. Turkish Journal of Diabetes Nursing. 2024;3(2):46-52. doi:10.29228/tjdn.71107
  • 23. Durak E, Yilmaz M. The Relationship between nutritional literacy and self effectiveness and diabetes self-care activities in individuals diagnosed with type 2 diabetes mellitus. Journal of Hacettepe University Faculty of Nursing. 2022;9(1):57–63. doi:10.31125/hunhemsire.1102077
  • 24. Çam HH, Güleç HY, Karasu F, Öztürk, E. Health literacy and diabetes mellitus. Turkish Journal of Diabetes and Obesity. 2021;5(1):68-74. doi:10.25048/tudod.794597
There are 24 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases Nursing​
Journal Section Research Article
Authors

Ayse Soylu 0000-0001-9800-2108

Ahmet Seven 0000-0002-2599-1918

Submission Date December 10, 2025
Acceptance Date February 2, 2026
Publication Date March 15, 2026
DOI https://doi.org/10.26453/otjhs.1839963
IZ https://izlik.org/JA45JW67CW
Published in Issue Year 2026 Volume: 11 Issue: 1

Cite

AMA 1.Soylu A, Seven A. Determination of Cardiovascular Risk Awareness and Related Factors in Patients with Diabetes Mellitus: A Mixed-Method Study. OTJHS. 2026;11(1):71-79. doi:10.26453/otjhs.1839963

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