AKROMEGALİK HASTANIN NİTEL VERİLERİNİN ROY ADAPTASYON MODELİNE GÖRE DEĞERLENDİRİLMESİ

Öz

Akromegali, büyüme hormonunun genelde altta yatan bir nedene bağlı olarak aşırı salgılanması durumunda gelişen ve karaciğerden insülin benzeri olan, büyüme faktörünün aşırı salgılanması durumudur. Akromegali, başta diyabetes mellitus olmak üzere, kalp hastalığı, servrovasküler hastalık, böbrek yetmezliği, şiddetli baş ağrısı ve kanser gibi hastalıklarla yaşam kalitesini kötü etkileyen ve hatta ölümle sonuçlanmasına neden olan bir hastalıktır(Ben-Shlomo,2011;Adelman,2013). Akromegali hastaları, hayatları boyunca çok çeşitli zorluklarla karşı karşıya kalmaktadır. Hastalığın başlangıcı yavaş ve sinsi geliştiği için tanı genellikle gecikmektedir. Hastalar, tanı aşamasına kadar uzun yıllar açıklanamayan komplikasyonlara ve kötü yaşam koşullarına maruz kalabilmektedir. Tanının gecikmesi, duygu durum bozukluklarına neden olarak, hasta ile birlikte ailesinin de çeşitli sorunlar yaşamasına neden olabilmektedir. Yapılan birçok çalışma, geciken tanı nedeniyle hastaların, hayal kırıklığı yaşadığını ve öfke kontrolünü sağlamada zorlandığını ortaya koymaktadır. ilaveten, hastanın yıllarca anlaşılamayan semptomlar karşısında yorgun düştüğünü ve giderek artan hastalık yüküyle baş etmede zorlandıklarını ve benlik saygılarının ağır şekilde hasar alması nedeniyle hastalığa ve yaşama uyumlarının zorlaştığını göstermektedir(Carmichael,2014;Gurel,2014). Akromegali hastalarının uzun ve zorlu tedavi sürecinde, uyumun sağlanmasına engel olan faktörlerin belirlenmesi, önceliklerin ele alınması ve tedavi sürecinde profesyonel hemşirelik bakımının sağlanabilmesi için Roy’un Adaptasyon Modeli hemşirelere rehberlik sağlayabilir.

Anahtar Kelimeler

• Akromegali
• hemşire
• hemşirelik kuramı
• roy adaptasyon modeli

EVALUATİON OF QUALİTATİVE DATA OF ACROMEGALİC PATİENT ACCORDİNG TO ROY ADAPTATİON MODEL

Öz

Acromegaly is a rare disease characterized by an increase in growth hormone, which usually occurs as a result of pituitary adenomas of benign character. In addition to causing excessive development of bodily tissue, acromegaly can also lead to a variety of ailments, including those that manifest gradually over time and include cardiovascular, metabolic, and osteoarticular disorders. In addition to the significant disease burden in acromegaly, a wide range of issues can be observed in acceptance and adaption of the disease. The nurse is crucial in ensuring the patient adapts to the disease since she is in a position to evaluate how well acromegaly patients have adapted. However, the patient's assessment of the condition may not often be easy. Therefore, a guide may be needed to evaluate the patient's condition and to adapt to the disease. At this stage, Roy's Adaptation Model can guide the nurse. Material and Methods: The study was conducted using the technique using face-to-face on the 13th day of hospitalization and online interview 3 months after discharge with 57-year-old N.A, who was hospitalized in an endocrinology clinic of a hospital in Ankara between 06.06.2022 and 10.06.2022. Before both interviews, written and verbal consent was obtained by explaining to the patient and Beck Depression Scale was applied. Data were gathered from the patient file, nursing observation forms, and the hospital information system in addition to the information gained from the patient. Results: In addition to the diagnosis of acromegaly, the diagnosis of an eye nerve tumor that causes hypertension, anemia, osteoporosis, cholelithiasis and sudden loss of vision. Less talking, avoiding communication, spending most of his/her time in bed. Beck Depression Scale Score applied in the first interview is in the range of 17-29 points and there are symptoms that the patient may be moderately depressed. Conclusion: In theinterview conducted 3 months after the nursing care applied according to Roy Adaptation Model in N.A, in whom the disease burden is very heavy, Beck Depression Scale Score was measured in the range of 10-16. It was observed that there were mild depression symptoms.

Anahtar Kelimeler

• Acromegaly
• nurse
• nursıng theory
• roy adaptation model

Kaynakça

1. Adelman DT, Liebert KJ, Nachtigall LB, Lamerson M, Bakker B. Acromegaly: the disease, its impact on patients, and managing the burden of long-term treatment. Int J Gen Med. 2013;6:31–38.
2. Alligood, M.R., Tomey, A.M. (2006). Nursing theory: Ultilization & application. (3rd ed, p:307–333). America: Mosby Company.
3. Ben-Shlomo A, Sheppard MC, Stephens JM, Pulgar S, Melmed S. Clinical, quality of life, and economic value of acromegaly disease control. Pituitary. 2011;14(3):284–294. Carmichael JD, Bonert VS, Nuno M, Ly D, Melmed S. Acromegaly clinical trial methodology impact on reported biochemical efficacy rates of somatostatin receptor ligand treatments – a meta-analysis. J Clin Endocrinol Metab. 2014;99(5):1825–1833
4. Dixon, E.L. (1999). Community health nursing practice and the roy adaptataion model. Public Health Nursing, 16: 90-98.
5. Gurel MH, Bruening PR, Rhodes C, Lomax KG. Patient perspectives on the impact of acromegaly: results from individual and group interviews. Patient Prefer Adherence. 2014;8:53–62
6. Malicki A, Malicka J, Potembska E, Zwolak A, Malicki D, Rogowska P. Depressive symptoms in acromegaly: factors that affect their incidence and severity? JMS 2020 Sep 28;89(3):e453. doi:10.20883/medical.e453
7. Roy, C. (2009). The Roy adaptation model. Upper saddle river: Pearson prentice hall health, (3rd ed., p:35–50). New Jersey.
8. Roy, S.C. (2011). Extending the roy adaptation model to meet changing global needs. Nursing Science Quarterly, 24(4), 345-351.

9. Roy, C., Andrews, H. (1991). The Roy adaptation model: The definitive statement. Norwalk: Appleton & Lange.
10. Smrtka J, Caon C, Saunders C, Becker BL, Baxter N. Enhancing adherence through education. J Neurosci Nurs. 2010;42(5 suppl):S19–S29.