Kronik Hastalığa Sahip Hastaların İlaç Kullanmaya İlişkin Sağlık İnançları ile Tedaviye Uyumları Arasındaki İlişki

Öz

Amaç: Bu çalışma, aile sağlığı merkezine başvuran ve hipertansiyon, diyabet veya KOAH hastalıklarından birine sahip bireylerin ilaç kullanımına yönelik sağlık inançları ile tedaviye uyumları arasındaki ilişkiyi değerlendirmek amacıyla gerçekleştirildi Yöntem: Araştırmanın örneklemini 210 hasta oluşturdu. Veriler Tanıtıcı Bilgi Formu, İlaç Kullanmaya İlişkin Sağlık İnanç Ölçeği ve İlaca Uyum ve Reçete Yazdırma Ölçeği kullanılarak toplandı. Verilerin analizinde sıklık, yüzde, ortalama, standart sapma, Pearson korelasyon testi ve One-way ANOVA kullanıldı. Bulgular: Kronik hastalık türüne göre ilaç kullanımına ilişkin sağlık inançları karşılaştırıldığında gruplar arasında fark bulunmadı. Tedaviye uyumları karşılaştırıldığında; hipertansiyon ve KOAH hastaları arasında çok yüksek düzeyde (p<0,001), diyabet ve KOAH hastaları arasında ise yüksek düzeyde (p<0,01) istatistiksel olarak anlamlı farklar bulundu. Hastaların sağlık inanç algıları ile tedaviye uyumları arasında diyabet hastaları için iyi, hipertansiyon hastaları için orta, KOAH hastaları için zayıf düzeyde negatif yönde anlamlı ilişki saptandı. Sonuç: Hastaların sağlık inanç algılarının iyileşmesiyle tedaviye uyumlarının arttığı belirlendi. KOAH hastalarının tedaviye uyum düzeyi diğer gruplardan yüksekti. Hastaların sağlık inanç algılarını olumlu yönde geliştirmeye ve tedaviye uyumu artırmaya yönelik eğitim ve danışmanlık girişimlerinin etkisini inceleyen ileri çalışmaların yapılması önerilmektedir.

Anahtar Kelimeler

• Hipertansiyon
• KOAH
• diyabet
• hasta uyumu
• ilaç

The Relationship between Health Beliefs and their Adaptation to Drug Use in Patients with Chronic Disease

Öz

Aim: This study was conducted to evaluate the relationship between health beliefs about medication use and treatment adherence of individuals who applied to the family health center and had hypertension, diabetes, or COPD. Method: The study sample consisted of 210 patients. Data were collected using the Introductory Information Form, the Drugs Use Health Belief Scale, and the Medication Adherence and Prescription Renewal Scale. Frequency, percentage, mean, standard deviation, Pearson correlation test, and one-way ANOVA were used to analyze the data. Results: When health beliefs regarding medication use were compared according to the type of chronic disease, no difference was found between the groups. When treatment adherence was compared, statistically significant differences were found between hypertension and COPD patients at very high level (p<0.001) and between diabetes and COPD patients at a high level (p<0.01). There was a significant negative correlation between patients' perceptions of health beliefs and their compliance with treatment at a good level for diabetes patients, a moderate level for hypertension patients, and a weak level for COPD patients. Conclusions: It was determined that patients' adherence to treatment increased with improvement in their perception of health beliefs. The level of treatment adherence of COPD patients was higher than the other groups. Further studies examining the effect of education and counseling interventions to improve patients' health belief perceptions positively and to increase adherence to treatment are recommended.

Anahtar Kelimeler

• Hypertension
• COPD
• diabetes
• patient compliance
• drug

Kaynakça

1. 1. World Health Organization. The top 10 causes of death. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. Published 2020. Accessed March 8, 2025.
2. 2. Williams B, Mancia G, Spiering W, et al. ESC/ESH task force for the management of arterial hypertension. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021-3104. doi: 10.1093/eurheartj/ehy339.
3. 3. Virani SS, Alonso A, Aparicio HJ, et al. Heart disease and stroke statistics—2020 update. Circulation. 2020;141(9):e139-e596. doi: 10.1161/CIR.0000000000000757.
4. 4. Yurekli AA, Bilir N, Husain MJ. Türkiye'de hipertansiyon yükünün tahmini ve yönetimi, 2015-2030. PLoS One. 2019;14(9):e0221556. doi: 10.1371/journal.pone.0221556.
5. 5. International Diabetes Federation. IDF Diabetes Atlas. 10th ed. International Diabetes Federation; 2021. https://diabetesatlas.org/atlas/tenth-edition/. Accessed February 20, 2024.
6. 6. Saeedi P, Petersohn I, Salpea P, et al. IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045. Diabetes Res Clin Pract. 2019;157:107843. doi: 10.1016/j.diabres.2019.107843.
7. 7. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease—2021 report. GOLD. https://goldcopd.org/2021-gold-report/. Published 2021. Accessed March 8, 2025.
8. 8. GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017. Lancet. 2018;392(10159):1923-1994. doi: 10.1016/S0140-6736(18)32225-6.

9. 9. Glanz K, Rimer BK, Viswanath K, eds. Health Behavior: Theory, Research, and Practice. 6th ed. New York: Jossey-Bass/Wiley; 2020.
10. 10. Erci B, Çiçek Z. Reliability and validity of drugs use health belief scale in adult women. Int Arch Nurs Health Care. 2017;3:064. doi: 10.23937/2469-5823/1510064.
11. 11. Doğan MD, Tosun E, Tek AD. Kronik hastalıklarda hastalık algısı, yaşam kalitesi, öz-bakım yönetimi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2018;7(3):33-40.
12. 12. Kripalani S, Risser J, Gatti ME, Jacobson TA. Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low-literacy patients with chronic disease. Value Health. 2009;12(1):118-123.
13. 13. Gökdoğan F, Kes D. Validity and reliability of the Turkish Adherence to Refills and Medications Scale. Int J Nurs Pract. 2017;e12566. doi: 10.1111/ijn.12566.
14. 14. Peng Y, Zhong GC, Wang L, et al. Chronic obstructive pulmonary disease, lung function and risk of type 2 diabetes: A systematic review and meta-analysis of cohort studies. BMC Pulm Med. 2020;20:137. doi: 10.1186/s12890-020-1178-y.
15. 15. World Health Organization. Hypertension. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/hypertension. Published 2021. Accessed February 20, 2024.
16. 16. Chimezie RO. Health awareness: A significant factor in chronic diseases prevention and access to care. J Biosci Med. 2023;11(2):64-79. doi: 10.4236/jbm.2023.112006.
17. 17. Mustapa A, Justine M, Manaf H. Effects of patient education on the quality of life of patients with type 2 diabetes mellitus: A scoping review. Malays Fam Physician. 2022;17(3):22.
18. 18. Poletti V, Pagnini F, Banfi P, Volpato E. Illness perceptions, cognitions, and beliefs on COPD patients’ adherence to treatment–a systematic review. Patient Prefer Adherence. 2023;17:1845-1866. doi: 10.2147/PPA.S418437.
19. 19. Flaubert JL, Le Menestrel S, Williams DR, Wakefield MK, eds; National Academies of Sciences, Engineering, and Medicine. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. National Academies Press; 2021.
20. 20. Tian L, Weng Y, Xu A, Chen Y, Tang J. Effect of behavior modification combined with health belief model education on adherence to skin moisturizing care in patients with psoriasis vulgaris. Sci Rep. 2024;14(1):31997. doi: 10.1038/s41598-024-31997-4.