SLEEP QUALITY AND PERCEIVED SELF-MANAGEMENT IN PATIENTS WITH DIABETIC FOOT ULCERS: CORUM/TURKEY

Öz

Abstract: This study was conducted in order to evaluate sleep quality and perception of diabetes self-management in Turkish patients with diabetic foot ulcers (DFU).

This study was conducted as a descriptive and cross-sectional study in patients with diabetic foot ulcers. This study was conducted with 61 people in the Diabetic Foot Clinic of the university hospital in Çorum. Patient Introduction Form, Pittsburgh Sleep Quality Index (PSQI) and Perceived Diabetes Self-Management Scale (PDSMS) were used as data collection tools.

Of the patients included, 82% had a PSQI score 5≥ and the sleep quality was found to be poor. The mean PSQI score was significantly higher and poorer in smokers and those with other diseases/comorbidities (p<0.05). The mean PDSMS score of the patients was found as 22.75± 2.03.  The mean PDSMS score was found to be statistically significantly higher in patienst with longer duration of diabetes than in patients with shorter duration of diabetes (p<0.05).

The poor sleep quality of individuals with diabetic foot ulcers leads to the failure of diabetes management. It is therefore important that health professionals focus on determining the conditions that affect sleep quality in patients with diabetic foot problems.

Anahtar Kelimeler

• Diyabetik ayak ülseri

DİYABETİK AYAK ÜLSERİ OLAN HASTALARDA UYKU KALİTESİ VE ÖZ-YÖNETİM ALGISI: ÇORUM/TÜRKİYE

Öz

Özet: Bu çalışma, diyabetik ayak ülseri olan Türk hastalarda uyku kalitesini ve diyabette öz-yönetim algısını değerlendirmek amacıyla yürütülmüştür.

Tanımlayıcı ve kesitsel tipteki çalışma, Çorum'da üniversite hastanesinde yürütülmüştür. Bu çalışma, üniversite hastanesinin Diyabetik Ayak Kliniği'nde yatan 61 kişi ile yapılmıştır. Veri Toplama Araçları olarak Hasta Bilgi Formu, Pittsburgh Uyku Kalitesi İndeksi (PSQI) ve Algılanan Diyabet Öz Yönetim Ölçeği (PDSMS) kullanılmıştır.

Çalışmaya dahil olan hastaların% 82'sinde PSQI puanı ≥ 5 ve uyku kalitesi kötü bulunmuştur. Ortalama PSQI skoru, sigara içenlerde ve diğer hastalık/komorbiditesi olan bireylerde PSQI puanı anlamlı olarak daha yüksekti (p<0.05). Hastaların ortalama PDSMS skoru 22.75±2.03 bulunmuştur. Ortalama PDSMS skorunun, diyabet süresi daha uzun olan diyabetli hastalarda, diyabet süresi daha kısa olanlara göre istatistiksel olarak anlamlı derecede yüksek olduğu bulunmuştur (p <0.05).

Diyabetik ayak ülseri olan bireylerin uyku kalitesinin kötü olması, diyabet yönetiminin başarısızlığına neden olmaktadır. Bu nedenle sağlık çalışanlarının diyabetik ayak sorunları olan hastalarda uyku kalitesini etkileyen koşulların belirlenmesine de odaklanması önem arz etmektedir.

Anahtar Kelimeler

• Diabetic foot ulcers,Sleep quality

Kaynakça

1. Abubakari, A.R., Cousins, R., Thomas, C., Sharma, D., & Naderali, E. K. (2016). Sociodemographic and clinical predictors of self-management among people with poorly controlled type 1 and type 2 diabetes: The role of illness perceptions and self-efficacy. Journal of Diabetes Research, 6708164. doi: 10.1155/2016/6708164.
2. Adwan, M. A., & Najjar, Y. W. (2013). The relationship between demographic variables and diabetes self-management in diabetic patients in Amman City/Jordan. Global Journal of Health Science, 5, 213–220.
3. Ağargün, M. Y, Kara, H., & Anlar, Ö. (1996). Pittsburgh uyku kalitesi indeksi’nin geçerliliği ve güvenirliliği. Türk Psikiyatri Dergisi, 7, 107-15.
4. Akça, D. (2016). Effect of diabetes symptoms on sleep quality of patients with TYPE 2 diabetes. Nursing Department Master Thesis, İnönü Univerty Institute of Health Sciences, Malatya, Turkey.
5. Alexiadou, K., & Doupis, J. (2012). Management of diabetic foot ulcers. Diabetes Ther, 3 (4), 1-15. doi:10.1007/s13300-012-0004-9.
6. Alrahbi, H. (2014). Diabetes self-management (DSM) in Omani with type-2 diabetes. International Journal of Nursing Science, 1, 352–9. https://doi.org/10.1016/j.ijnss.2014.09.002.
7. American Diabetes Association Diabetes Care. (2014). Diagnosis and Classification of Diabetes Mellitus Jan; 37(Supplement 1): 81-90. https://doi.org/10.2337/ dc14-S081.
8. Arora, T., & Taheri, S. (2015). Sleep optimization and diabetes control: A review of the literature. Diabetes Therapy, 6, 425–68.

9. Brod, M., Christensen, T., & Bushnell, D. M. (2011). Impact of nocturnal hypoglycemic events on diabetes management, sleep quality, and next-day function: results from a four-country survey. Journal of Medical Economics, 15, 77-86. https://doi.org/10.3111/13696998.2011.624144.
10. Buysse, D. J., Reynolds, C.F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The pittsburg sleep quality index: A new intrument for psychiatric practice and research. Psychiatry Research, 28 (2), 193-213.
11. Cappuccio, F. P., D'Elia, L., Strazzullo, P., & Miller, M. A. (2010). Quantity and quality of sleep and ıncidence of type 2 diabetes: A systematic review and meta-analysis. Diabetes Care, 33 (2), 414-420. https://doi.org/10.2337/dc09-1124.
12. Çevik, A., & Özcan Ş. (2014). Diyabette Öz-Yönetim Algısı Skalası’nın (DÖYAS) Türkçe Versiyonu: Geçerlik ve Güvenirlik Değerlendirme. http://www.tdhd.org/pdf/16_UDHS_sunumlari/HSB-03.pdf [accessed on 23 March 2017].
13. Chasens, E. R., Korytkowski, M., Sereika, S.M., & Burke, L.E. (2013). Effect of poor sleep qualityand excessive daytime sleepiness on factors associated with diabetes self-management. The Diabetes Educator Journal, 39, 74-82.
14. Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Education and Counseling, 99 (6), 926-943. https://doi.org/10.1016/j.pec.2015.11.003.
15. Demirci, H., Sarı, I. K., Kevlekçi, C., Küçüködük, İ., Özdemir, K., & Öztürk, Y. B. (2016). Frequency of skin lesions accompanied by diabetic foot ulcers and relation with wagner classification. Gazi Medical Journal, 27, 104-6.
16. Depner, C. M., Stothard, E. R., & Wright, K. P. (2014). Metabolic consequences of sleep and circadian disorders. Current Diabetes Reports, 14, 507-22. doi: 10.1007/s11892-014-0507-z.
17. Ekpo, C. F., Duff, E. M., Bailey, E. Y., & Lindo, J. L. M. (2016). Lived experiences of Jamaican hospital patients with delayed wound healing. International Journal of Healthcare, 2, 21-8.
18. Griva, K., Lee, Y. W. V., Kalyanasundram, P., Lee, Y. S., Tan, L. S. M., Amir, M., et al. (2016). Sleep problems in patients with type 2 diabetes mellitus in Singapore. The European Health Psychologist, 18, 64-72.
19. Güçlü, Y.A., Çıbık, İ., Görgün, M., Helvacı, M., & Can, H. (2016). Investigating the effects of education on diabetic foot: An interventional study from Turkey. Familiy Practice & Palliative Care, 1, 13­8.
20. Güneş, Z., Körükcü, Ö., & Özdemir, G. (2009). Diyabetli hastalarda uyku kalitesinin belirlenmesi. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 12 (2), 10-17.
21. Hu, J., Amirehsani, K., Wallace, D. C., & Letvak, S. (2013). Perceptions of barriers in managing diabetes: Perspectives of Hispanic immigrant patient and family members. The Diabetes Educator Journal, 39, 494-503. doi: 10.1177/0145721713486200.
22. Knutson, K. L., Ryden, A. M., Mander, B. A., & Cauter, E. V. (2006). Role of sleep duration and quality in the risk and severity of type 2 diabetes mellitus. Arch Intern Med, 166, 1768-1774.
23. Lawless, M. E., Kanuch, S. W., Martin, S., Kaiser, D., Blixen, C., Fuentes-Casiano, E., & et al. (2016). A nursing approach to self-management education for ındividuals with mental ıllness and diabetes. Diabetes Spectrum, 29 (1), 24-31. https://doi.org/10.2337/diaspect.29.1.24.
24. Luyster, F. S., & Dunbar-Jacob, J. (2011). Sleep quality and quality of life in adults with type 2 diabetes. The Diabetes Educator Journal, 37, 347-55. doi: 10.1177/0145721711400663.
25. McDaniel, J. C., & Browning, K. K. (2014). Smoking, chronic wound healing, and implications for evidencebased practice. Journal of Wound Ostomy & Continence Nursing, 41, 415–23. doi: 10.1097/WON.0000000000000057.
26. Obilor, H. N., & Adejumo, P. O. (2015). Assessment of diabetic foot ulcer-related pain and its relationship to quality of life. Wound Practice & Research, 23, 124-31. ISSN: 1837-6304.
27. Ogurtsova, K., Rocha Fernandes, J. D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H., et al. (2017). IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40-50. doi: http://dx.doi.org/10.1016/j.diabres.2017.03.024.
28. Pedras, S., Carvalho, R., & Pereira, M. G. (2016). Sociodemographic and clinical characteristics of patients with diabetic foot ulcer. Revista Da Associacao Medica Brasileira, 62, 171-78.
29. Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A.H., & et al. (2015). Diabetes self-management education and support in type 2 diabetes: A joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics. Diabetes Care, 38, 1372–1382. doi: 10.2337/dc15-0730.
30. Salomé, G. M., Pellegrino, D. M. S., Blanes, L., & Ferreira, L. M. (2013). Sleep quality in patients with diabetic foot ulcers. Wounds, 25, 20–7.
31. Satman, I., Omer, B., Tutuncu, Y., Kalaca, S., Gedik, S., Dinççağ, N., et al. (2013). Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. European Journal of Epidemiology, 28, 169-80.
32. Smith, M. S., Wallston, K. A., & Smith, C. A. (1995). The development and validation of the perceived health competence scale. Health Education Research, 10, 51-64.
33. Surani, S., Brito, V., Surani, A., & Ghamande, S. (2015). Effect of diabetes mellitus on sleep quality. World J Diabetes, 25; 6(6), 868-873. doi: 10.4239/wjd.v6.i6.868.
34. Talaz, D., & Kızılcı, S. (2015). Tip 2 diyabet riski ve hastalık sürecinde uykunun rolü. DEUHFED,8 (3), 203-208.
35. Wallston, K. A., Rothman, R. L., & Cherrington, A. (2007). Psychometric properties of the perceived diabetes self-management scale (PDSMS). Journal of Behavioral Medicine, 30, 395-401. doi:10.1007/s10865-007-9110-y.
36. Xu, Y., Pan, W., & Liu, H. (2010). Self-management practices of Chinese Americans with type 2 diabetes. Nursing & Health Sciences, 12, 228-34.
37. Yazdanpanah, L., Nasiri, M., & Adarvishi, S. (2015). Literature review on the management of diabetic foot ulcer. World Journal of Diabetes, 6, 37-53. doi: 10.4239/wjd.v6.i1.37.
38. Yücel, F., & Sunay, D. (2016). Assessment of knowledge, attitudes and behaviours of diabetic patients about diabetic foot and foot care. Ankara Medical Journal, 16, 270‐84.
39. Zhu, B. Q., Li, X. M., Wang, D., & Yu, X. F. (2014). Sleep quality and its impact on glycaemic control in patients with type 2 diabetes mellitus. International Journal of Nursing Sciences, 1, 260-65. https://doi.org/10.1016/j.ijnss.2014.05.020.