Türkiye'de Hemşirelik Alanında Hasta Güçlendirmesine Dayalı Çalışmalar: Lisansüstü Tezlerin Bir İçerik Analizi

Öz

Amaç Sağlık hizmetlerinde hasta merkezli bakım hastaların karar verme süreçlerine daha fazla dahil edilmesini ve kendi sağlıkları üzerinde daha fazla kontrol sahibi olmalarını gerektirir. Bu, hasta güçlendirmesi çalışmalarını teşvik eder. Bu çalışmanın amacı, Türkiye’de hemşirelik alanında yapılan hasta güçlendirmesine dayalı lisansüstü tezlerin incelenmesidir. Yöntem Çalışma lisansüstü tezlerden elde edilen verilerin betimsel içerik analizi yoluyla çözümlenmesine dayalı olarak yapılmıştır. Yükseköğretim Kurulu Ulusal Tez Merkezi veri tabanı 01.07.2023–23.07.2024 tarihleri arasında taranmış, hemşireler tarafından yürütülen hasta güçlendirmesine ilişkin yüksek lisans ve doktora tezleri incelenmiştir. Veriler içerik analizi yöntemi ile değerlendirilmiştir. Verilerin analizi sayısal değerlendirmeler yapılarak tezlerin yayınlanma yılı, amacı, tezin türü, araştırma deseni, örneklem grubu ve sayısı, deneysel müdahale türü açısından raporlanmıştır. Bulgular Araştırmaya dahil edilen lisansüstü tezlerin çoğunluğunun son beş yıl içerisinde yürütülen doktora tezlerinden oluştuğu belirlenmiştir. Yüksek lisans tezlerinin kesitsel tasarım ve metodolojik inceleme ile gerçekleştirildiği, doktora tezlerinin ise deneysel müdahale yöntemleriyle hasta güçlendirmesini geliştirmeyi amaçladığı saptanmıştır. Örneklem grubunu kronik hastalığı olan bireyler oluştururken, hasta güçlendirme müdahaleleri arasında güçlendirme eğitimi, egzersiz müdahalesi, yaratıcı drama, tele-hemşirelik ve yenilikçi giysiler yer almıştır. Sonuç Hemşirelikte hasta güçlendirme çalışmaları son yıllarda, özellikle doktora düzeyinde artış göstermiş ve müdahale temelli yaklaşımlara yönelik ilgi giderek artmıştır. Hasta güçlendirme uygulamalarının yaygınlaştırılması ve daha fazla deneysel çalışmanın yürütülmesi, özellikle kronik hastalığı olan bireylerde sağlık sonuçlarının iyileştirilmesine katkı sağlayabilir.

Anahtar Kelimeler

• Akademik tez
• Güçlendirme
• Hemşirelik
• Yetkilendirme

Destekleyen Kurum

Çalışma herhangi bir kurum ya da kuruluş tarafından desteklenmemektedir.

Etik Beyan

Bu çalışma için etik kurul onayı gerekmemektedir

Teşekkür

Yazarlar, hasta güçlendirmesine dayalı tez çalışmalarıyla alana katkıda bulunan tüm yazarlara teşekkür eder.

Studies on Patient Empowerment in Nursing in Türkiye: A Content Analysis of Postgraduate Theses

Öz

Aim Patient-centered care in healthcare requires patients to be more involved in decision-making processes and to have more control over their own health. This promotes patient empowerment initiatives. The purpose of this study is to examine postgraduate theses based on patient empowerment conducted in the field of nursing in Türkiye. Methods The study was conducted based on the descriptive content analysis of data obtained from postgraduate theses. The National Thesis Center database of the Council of Higher Education was searched between 01.07.2023 and 23.07.2024, and master’s and doctoral theses addressing patient empowerment by nurses were examined. Data analysis was reported in terms of publication year, purpose, type of thesis, research design, sample group and size, and type of experimental intervention. Results It was found that the majority of the postgraduate theses included in the research were doctoral theses conducted within the last five years. The master’s theses were conducted with cross-sectional design and methodological review, while the doctoral theses aimed to improve patient empowerment with an experimental intervention tool. The sample group consisted of individuals with chronic diseases, and the types of patient empowerment interventions included empowerment education, exercise intervention, creative drama, tele-nursing, and innovative clothing. Conclusion Patient empowerment studies in nursing have increased in recent years, particularly at the doctoral level, with a growing emphasis on intervention-based approaches. Expanding patient empowerment practices and conducting further experimental studies may contribute to improving health outcomes, especially among individuals with chronic diseases.

Anahtar Kelimeler

• Academic dissertation
• Empowerment
• Nursing
• strengthening

Destekleyen Kurum

The study was not supported by any institution or organization.

Etik Beyan

Ethics approval was not required for this study, as it was based on the analysis of publicly accessible postgraduate theses obtained from the National Thesis Center database.

Teşekkür

The authors thank all authors who contributed to the field through their thesis studies based on patient empowerment.

Kaynakça

1. Lukewich J, Martin-Misener R, Norful AA, Poitras ME, Bryant-Lukosius D, Asghari S, et al. Effectiveness of registered nurses on patient outcomes in primary care: a systematic review. BMC Health Serv Res. 2022 Dec;22(1):740.
2. Coster S, Watkins M, Norman IanJ. What is the impact of professional nursing on patients’ outcomes globally? An overview of research evidence. International Journal of Nursing Stud¬ies. 2018;78:76–83.
3. King ML. The role of nurses in improving health care access and quality. In: Flaubert JL, Le Menestrel S, Williams DR, Wakefield MK, editors. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington (DC): National Academies Press (US); 2021. p. 99–126.
4. Kara ÖGB, Akdeni̇z AGC, Kavaslar AGİ. Hemşirelik 2.0: Türkiye’de hemşirelik bakımı ve eğitiminde paradigma değişimi önerisi [Nursing 2.0: suggestion of a paradigm change in nursing care and education in Turkey]. Sağlık ve Sosyal Refah Araştırmaları Dergisi. 2022;4(1):136–43.
5. Abu-Qamar MZ, Vafeas C, Ewens B, Ghosh M, Sundin D. Postgraduate nurse education and the implications for nurse and patient outcomes: A systematic review. Nurse Education Today. 2020;92:104489.
6. Doughty L, Sinnema C, McKillop A, Dixon R. The impact of postgraduate education in transition to practice programmes on new graduate nurses’ knowledge and skills: A pre- post survey design. Nurse Education Today. 2021;102:104888.
7. McKenna L, Sommers CL, Rachmawaty R, Efendi F, Malik G, Davis J, et al. Postgraduate nurse education in Indonesia and Australia: A comparative analysis. Nurse Education Today. 2023;131:105954.
8. Cleary M, West S, Hungerford C. The post-graduate: How and why to take mental health nurses to the next level. Issues in Mental Health Nursing. 2024;45(3):352–5.

9. Bozkurt ÖD, Kazankaya F, Demrkol A, Karakaş G, Pekşen H. Hemşirelik öğrencilerinin lisansüstü eğitime yönelik düşünce ve tutumları [Nursing students’ thoughts and attitudes towards post¬graduate education]. Kadın Sağlığı Hemşireliği Dergisi. 2022;8(2):72–82.
10. Weisbeck S, Lind C, Ginn C. Patient empowerment: An evolutionary concept analysis. International Journal of Caring Sciences. 2019;12(2):1148–55.
11. Navarro Martínez O, Igual García J, Traver Salcedo V. Estimating patient empowerment and nurses’ use of digital strategies: eSurvey study. International Journal of Environmental Research and Public Health. 2021 Sep 18;18(18):9844.
12. World Health Organization. Global Status Report on Noncommunicable Diseases 2010 [Internet]. 2011 Available from: https://apps.who. int/iris/handle/10665/44579 [Accessed 1st August 2014].
13. Wang R, Zhou C, Wu Y, Sun M, Yang L, Ye X, et al. Patient empowerment and self‐management behaviour of chronic disease patients: A moderated mediation model of self‐efficacy and health locus of control. Journal of Advanced Nursing. 2022;78(4):1055–65.
14. Yilmaz A, Kar A, Kaya M. Hasta güçlendirme ve yaşam kalitesi ilişkisi [The relationship of patient empowerment and life quality]. İşletme Bilimi Dergisi. 2020;8(1):97–114.
15. Cheng L, Sit JWH, Choi K chow, Chair S ying, Li X, Wu Y, et al. The effects of an empowerment-based self-management intervention on empowerment level, psychological distress, and quality of life in patients with poorly controlled type 2 diabetes: A randomized controlled trial. International Journal of Nursing Studies. 2021;116:103407.
16. Zhao J, Hu Y, Zhang X, Zhang G, Lin M, Chen X, et al. Efficacy of empowerment strategies for patients with hypertension: A systematic review and meta-analysis. Patient Education and Counseling. 2020;103(5):898–907.
17. Erdoğan M, Kirilmaz H. Hasta merkezlilik ve hasta merkezli bakım [Patient-centered approach and patient-centered care]. İnsan ve İnsan Dergisi. 2020;7(24):97–126.
18. Kontsevaya A, Farrington J, Balcılar M, Ergüder T. Türkiye’de bulaşıcı olmayan (kronik) hastalıkların önlenmesi ve kontrolü için Yatırım Gerekçeleri Raporu [Report on the rationale for investment in the prevention and control of noncommunicable (chronic) diseases in Turkey]. Dünya Sağlık Örgütü; 2018. Erişim adresi: https://hsgm.saglik.gov.tr/depo/birimler/ kronik-hastaliklar-ve-yasli-sagligi-db/Dokuman¬lar/Raporlar/BizzCaseTrSS.pdf [Erişim Tarihi: 01.08.2024].
19. Connor L, Dean J, McNett M, Tydings DM, Shrout A, Gorsuch PF, et al. Evidence‐based practice improves patient outcomes and healthcare system return on investment: Findings from a scoping review. Worldviews on Evidence-Based Nursing. 2023;20(1):6–15.
20. Karaman E. Kalp yetersizliği olan yaşlı bireylerde ev temelli egzersiz programının düşme durumu ve yaşam kalitesine etkisinin incelenmesi: güçlendirme modeli [Effects of home-based exercise programs on the quality of life and falling for older individuals with heart failure: an empowerment model] [Yayımlanmamış tez]. Ege Üniversitesi; 2015.
21. Jahanpeyma P. Yaşlı bireylerde Otago egzersizlerinin fiziksel performans, denge, düşme, kırılganlık ve güçlendirme üzerindeki etkisinin incelenmesi [Effects of the Otago exercise program on physical performance, balance, falls, frailty and empowerment in the elderly] [Yayımlanmamış tez]. Ege Üniversitesi; 2018.
22. Uslu N. İnsan bakım modeli’ne göre yaratıcı drama ile verilen problem çözme ve stresle baş etme eğitiminin Tip 1 diabetes mellitus’lu adölesanların güçlendirilmesine etkisi [The effect of education for problem solving and coping with stress with creative drama based on human caring model on empowerment the adolescents with type 1 diabetes mellitus] [Yayınlanmamış tez]. Erciyes Üniversitesi; 2016.
23. Üzar Özçetin YS. Hastalığı aktif dönemde olmayan kanser hastalarına uygulanan güçlendirme programının travma sonrası büyüme ve psikolojik sağlamlık düzeylerine etkisi [The effects of an empowerment program on resilience and posttraumatic growth of cancer patients in remission period] [Yayınlanmamış tez]. Hacettepe Üniversitesi; 2016.
24. Dobrowolska B, Chruściel P, Markiewicz R, Palese A. The role of doctoral‐educated nurses in the clinical setting: Findings from a scoping review. Journal of Clinical Nursing. 2021;30(19–20):2808–21.
25. Weaver TE, Lott S, McMullen P, Leaver CA, Zangaro G, Rosseter R. Research focused doctoral nursing education in the 21st century: Curriculum, evaluation, and postdoctoral considerations. Journal of Professional Nursing. 2023;44:38–53.
26. Bahall M, Bailey H. The impact of chronic disease and accompanying bio-psychosocial factors on health-related quality of life. Journal of Family Medicine and Primary Care. 2022;11(8):4694–704.
27. Yi JY, Kim Y, Cho YM, Kim H. Self-management of chronic conditions using mhealth interventions in Korea: A Systematic Review. Health¬care Informatics Research. 2018;24(3):187– 97.
28. Koşar Şahi̇n C, Sevgi̇ Doğan E, Deni̇z Akan D, Dedeli̇ Caydam O, Çinar Pakyüz S. Kronik hastalık yönetiminde bireyin aktif olmasını etkileyen faktörlerin incelenmesi [Investigation of factors affecting the activation of the individual in the management of chronic disease]. Izmir Democracy University Health Sciences Journal. 2023;6(1):35–51.
29. Mogueo A, Oga‐Omenka C, Hatem M, Kuate Defo B. Effectiveness of interventions based on patient empowerment in the control of type 2 diabetes in sub‐Saharan Africa: A review of randomized controlled trials. Endocrinology, Diabetes & Metabolism. 2021;4(1):e00174.
30. MacDonald C, Ilie G, Kephart G, Rendon R, Mason R, Bailly G, et al. Mediating effects of self-efficacy and illness perceptions on mental health in men with localized prostate cancer: A secondary analysis of the prostate cancer patient empowerment program (PC-PEP) randomized controlled trial. Cancers. 2024;16(13):2352.
31. Gençer Şendur E, Yıldırım Usta Y. Kronik hastalık yönetiminde güncel kavramlar [Current concepts in the management of chronic diseases]. In: Akman Yılmaz A, Kav S (eds). İç Hastalıkları Hemşireliğinde Güncel Konular [Current Topics in Internal Medicine Nursing]. 1st ed. Antalya: Antalya Nobel Kitabevi; 2023. p. 141–58.
32. Gürdap Z, Cengiz Z. Sağlık bakım sisteminde hastayı güçlendirme: Fırsatlar ve zorluklar [Patient empowerment in health care system: opportunities and challenges]. Artuklu International Journal of Health Sciences. 2023;3(1):74–81.
33. Yavuzer Bayrak N. Meme kanseri hastalarında teknolojik yeterlilik teorisine temellendirilen tele hemşirelik uygulamalarının güçlenme durumu ve semptom yönetimine etkisi [The effect of telenursing practices based on technological competence theory on empowerment and symptom management in breast cancer patients] [Yayımlanmamış tez]. [Atatürk Üniversitesi; 2024.
34. Sharma A, Harrington RA, McClellan MB, Turakhia MP, Eapen ZJ, Steinhubl S, et al. Using digital health technology to better generate evidence and deliver evidence-based care. Journal of the American College of Cardiology. 2018;71(23):2680–90.
35. Azhdari Mamaghani H, Jabbarzadeh Tabrizi F, Seyedrasooli A, Sarbakhsh P, Badri Gargari R, Zamanzadeh V, et al. Effect of empowerment program with and without telenursing on self-efficacy and glycosylated hemoglobin index of patients with type-2 diabetes: A randomized clinical trial. Journal of Caring Sciences: Home. 2021;10(1):22–8.
36. Shahabi N, Kolivand M, Salari N, Abbasi P. The effect of telenursing training based on family-centered empowerment pattern on compliance with diet regimen in patients with diabetes mellitus type 2: a randomized clinical trial. BMC Endocrine Disorders. 2022;22(1):36.
37. Lin LW, Lu YH, Chang TH, Yeh SH. Effects of drama therapy on depressive symptoms, attention, and quality of life in patients with dementia. Journal of Nursing Research. 2022;30(1):e188.
38. Abu-Odah H, Sheffield D, Hogan S, Yorke J, Molassiotis A. Effectiveness of creative arts therapy for adult patients with cancer: a systematic review and meta-analysis. Supportive Care in Cancer. 2024 Jul;32(7):430.
39. Bhattad PB, Pacifico L. Empowering patients: Promoting patient education and health literacy. Cureus. 2022;14(7):e27336.
40. Finbråten HS, Guttersrud Ø, Nordström G, Pettersen KS, Trollvik A, Wilde-Larsson B. Explaining variance in health literacy among people with type 2 diabetes: the association between health literacy and health behaviour and empowerment. BMC Public Health. 2020;20(1):161.
41. Janchai N, Deoisres W, Chaimongkol N. Improving health Literacy using the health education and health empowerment program in Thai adults with uncontrolled hypertension: A randomized controlled trial. Pacific Rim International Journal of Nursing Research. 2021;25(4):600–13.