BÖBREK NAKLİ HASTALARINDA DEPRESYON ANKSİYETE STRES SEVİYELERİ İLE İMMÜNOSUPRESİF TEDAVİYE UYUM ARASINDAKİ İLİŞKİ

Yıl 2022, , 539 - 553, 20.06.2022

Runida Doğan , Erman Yıldız , Nazlıcan Bağcı

https://doi.org/10.33715/inonusaglik.1056285

Cited By: 1

Öz

Bu araştırma böbrek nakli olmuş hastalarda depresyon, anksiyete, stres seviyeleri ile immünsupresif tedaviye uyum arasındaki ilişkiyi belirlemek amacı ile tanımlayıcı ve ilişki arayıcı türde yapıldı. Araştırma verileri 20 Kasım ile 10 Aralık 2021 tarihleri arasında toplandı. Araştırma sonunda 95 hastaya ulaşıldı. Verilerin analizi SPSS 25 programı kullanılarak yapıldı ve gerekli tüm yasal ve etik izinler alındı. Araştırma sonunda hastaların depresyon, anksiyete, stres, DASS-21 ve İTUÖ toplam puanları sırasıyla; 5.15±3.61, 5.16±3.78, 9.62±4.93, 19.94±10.37 ve 11.42±3.29 olarak belirlendi. Kadın hastaların depresyon puan ortalamalarının erkek hastalara göre daha yüksek olduğu tespit edildi. Serbest mesleği olan hastaların memur olarak çalışan hastalara göre daha yüksek bir depresyon puan ortalamasına sahip olduğu sonucuna ulaşıldı. Geniş aile yapısına sahip hastaların İTUÖ sıra ortalamalarının çekirdek aile yapısına sahip hastalara göre daha yüksek olduğu saptandı. Bu araştırmada hastaların İTUÖ puanları ile depresyon, anksiyete ve stres puanları arasında istatistiksel açıdan önemli bir ilişki tespit edilemedi. Böbrek nakli olmuş hastaların depresyon, anksiyete, stres seviyeleri ile immünsupresif tedaviye uyumları arasında ilişki bulunmadı. Daha büyük örneklem gruplarıyla benzer nitelikte araştırmalar yapılması önerilebilir.

Anahtar Kelimeler

Anksiyete, Böbrek nakli, Depresyon, İmmünsupresif tedaviye uyum, Stres

The Relationship between Depression, Anxiety, Stress Levels and Compliance with Immunosuppressive Therapy in Renal Transplant Patients

Öz

This study was conducted in a descriptive and correlational type to determine the relationship between depression, anxiety, stress levels and compliance with immunosuppressive therapy in kidney transplant patients. Research data were collected between November 20 and December 10, 2021. At the end of the study, 95 patients were reached. Data analysis was performed by using SPSS 25 and all legal and ethical permissions were obtained. At the end of the study, the depression, anxiety, stress, DASS-21, and SAITTP total scores of the patients were determined as; 5.15±3.61, 5.16±3.78, 9.62±4.93, 19.94±10.37, and 11.42±3.29, respectively. It was determined that the mean depression scores of female patients were higher than that of male patients. It was concluded that self-employed patients had a higher depression score average than patients working as civil servants. It was determined that the mean SAITTP rank of patients with extended family structure was higher than patients with nuclear family structure. In this study, no statistically significant relationship could be found between the SAITTP scores of the patients and their depression, anxiety, and stress scores. No correlation was found between depression, anxiety, stress levels and compliance with immunosuppressive therapy in kidney transplant patients. It may be recommended to conduct similar studies with larger sample groups.

Anahtar Kelimeler

Anxiety, Compliance with immunosuppressive therapy, Depression, Kidney transplantation, Stress

Kaynakça

• Alavi, N. M., Aliakbarzadeh, Z. ve Sharifi, K. (2009). Depression, anxiety, activities of daily living, and quality of life scores in patients undergoing renal replacement therapies. Transplantation Proceedings, 41(9), 3693–3696. https://doi.org/10.1016/J.TRANSPROCEED.2009.06.217
• Antony, M. M., Cox, B. J., Enns, M. W., Bieling, P. J. ve Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181. https://doi.org/10.1037/1040-3590.10.2.176
• Barutcu-Atas, D., Aydin-Sunbul, E., Velioglu, A. ve Tuglular, S. (2021). The association between perceived stress with sleep quality, insomnia, anxiety and depression in kidney transplant recipients during Covid-19 pandemic. Plos One, 16(3), e0248117. https://doi.org/10.1371/JOURNAL.PONE.0248117
• Chilcot, J., Spencer, B. W. J., Maple, H. ve Mamode, N. (2014). Depression and kidney transplantation. Transplantation, 97(7), 717–721. https://doi.org/10.1097/01.TP.0000438212.72960.AE
• Chisholm, M. A., Lance, C. E., Williamson, G. M. ve Mulloy, L. L. (2005). Development and validation of the immunosuppressant therapy adherence instrument (ITAS). Patient Education and Counseling, 59(1), 13–20. https://doi.org/10.1016/J.PEC.2004.09.003
• Cukor, D., Newville, H. ve Jindal, R. (2008). Depression and immunosuppressive medication adherence in kidney transplant patients. General Hospital Psychiatry, 30(4), 386–387. https://doi.org/10.1016/J.GENHOSPPSYCH.2007.12.003
• Czyżewski, Frelik, P., Wyzgał, J. ve Szarpak. (2018). Evaluation of quality of life and severity of depression, anxiety, and stress in patients after kidney transplantation. Transplantation Proceedings, 50(6), 1733–1737. https://doi.org/10.1016/J.TRANSPROCEED.2018.04.026
• De Brito, D. C. S., Machado, E. L., Reis, I. A., de Freitas do Carmo, L. P. ve Cherchiglia, M. L. (2019). Depression and anxiety among patients undergoing dialysis and kidney transplantation: a cross-sectional study. Sao Paulo Medical Journal, 137(2), 137–147. https://doi.org/10.1590/1516-3180.2018.0272280119
• De Pasquale, C., Luisa Pistorio, M., Veroux, M., Indelicato, L., Biffa, G., Bennardi, N., ...Veroux, P. (2020). Psychological and psychopathological aspects of kidney transplantation: A systematic review. Frontiers in Psychiatry, 11, 106. https://doi.org/10.3389/FPSYT.2020.00106/BIBTEX
• Dew, M. A., DiMartini, A. F., De Vito Dabbs, A., Myaskovsky, L., Steel, J., Unruh, M., ...Greenhouse, J. B. (2007). Rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation, 83(7), 858–873. https://doi.org/10.1097/01.TP.0000258599.65257.A6
• Diniz, G., Tugmen, C. ve Sert, İ. (2019). Türkiye ve Dünyada organ transplantasyonu. Tepecik Eğitim ve Araştırma Hastanesi Dergisi, 29(1), 1-10. https://doi.org/10.5222/terh.2019.40412
• Ganjali, R., Sabbagh, M. G., Nazemiyan, F., Mamdouhi, F., Aval, S. B., Taherzadeh, Z., ...Eslami, S. (2019). Factors associated with adherence to immunosuppressive therapy and barriers in Asian kidney transplant recipients. ImmunoTargets and Therapy, 8, 62. https://doi.org/10.2147/ITT.S212760
• Gorevski, E., Succop, P., Sachdeva, J., Cavanaugh, T. M., Volek, P., Heaton, P., ...Martin-Boone, J. E. (2013). Is there an association between immunosuppressant therapy medication adherence and depression, quality of life, and personality traits in the kidney and liver transplant population? Patient Preference and Adherence, 7, 301. https://doi.org/10.2147/PPA.S34945
• Haberal, M., Moray, G., Soy, E. H. A. ve Arslan, G. (2020). Transplantation and legislation history in Turkey. Experimental and clinical transplantation: Official Journal of the Middle East Society for Organ Transplantation, 18(Suppl 2), 6-15. https://doi.org/10.6002/ect.rlgnsymp2020.L2
• Jana, A. K., Sircar, D., Waikhom, R., Praharaj, S. K., Pandey, R., Ray Chaudhury, A. ve Dasgupta, S. (2014). Depression and anxiety as potential correlates of post-transplantation renal function and quality of life. Indian Journal of Nephrology, 24(5), 286. https://doi.org/10.4103/0971-4065.132996
• Karaman, A., Özhanli, Y., Seyhan-Ak, E., Öztekin, S. D., Göksoy, E., Seyahi, N. ve Şengül, E. (2021). Immunosuppressant therapy adherence after kidney transplantation. International Archives of Nursing and Health Care, 7(157), 1–6. https://doi.org/10.23937/2469-5823/1510157
• Lovibond, P. F. ve Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U
• Madran, B., Karayurt, Ö., Spivey, C. A. ve Chisholm-Bruns, M. A. (2016). Organ nakli alıcıları için immünosupresif tedaviye uyum ölçeği Türkçe geçerlik ve güvenirlik çalışması. Türkiye Klinikleri J Nurs Sci, 8(4), 325–334.
• Morisky, D. E., Green, L. W. ve Levine, D. M. (1986). Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care, 24(1), 67–74.
• Nerini, E., Bruno, F., Citterio, F. ve Schena, F. P. (2016). Nonadherence to immunosuppressive therapy in kidney transplant recipients: can technology help? Journal of Nephrology, 29(5), 627–636. https://doi.org/10.1007/S40620-016-0273-X/TABLES/4
• Oren, E. ve Dag, G. S. (2020). Determination of Adherence to Immunosuppressive Drugs in Renal Transplant Recipients in Turkish Republic of Northern Cyprus. Journal of Education and Research in Nursing, 17(1), 1–10.
• Özdemir, Z. ve Talas, M. S. (2017). Solid organ transplantasyonu sonrası immünsupresif ilaç kullanımına uyum. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 20(4), 304–309. https://doi.org/10.11.2017
• Perveen, N., Batool, I., Asghar, M. ve Malik, G. (2019). Quality of life, psychological stress and death anxiety among liver and renal transplant recipients. Isra Medical Journal, 11(2), 106–109.
• Pisanti, R., Poli, L., Lombardo, C., Bennardi, L., Giordanengo, L., Berloco, P. B. ve Violani, C. (2014). The role of transplant-related stressors and social support in the development of anxiety among renal transplant recipients: The Direct and Buffering Effects. 19(6), 650–655. https://doi.org/10.1080/13548506.2014.882514
• Sarigöl-Ordin, Y., Karayurt, Ö., Ertan, N. ve Yildiz, S. (2018). Böbrek nakli alıcılarında immünosupresif tedaviye uyumun farklı yöntemler ile değerlendirilmesi. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi, 27(3), 254–261. https://doi.org/10.5262/tndt.2018.3147
• Szeifert, L., Molnar, M. Z., Ambrus, C., Koczy, A. B., Kovacs, A. Z., Vamos, E. P., ...Novak, M. (2010). Symptoms of depression in kidney transplant recipients: A cross-sectional study. American Journal of Kidney Diseases, 55(1), 132–140. https://doi.org/10.1053/J.AJKD.2009.09.022
• Yılmaz, Ö., Boz, H. ve Arslan, A. (2017). Depresyon Anksiyete Stres Ölçeğinin (DASS 21 Türkçe kısa formunun geçerlilik-güvenirlik çalışması. Finans Ekonomi ve Sosyal Araştırmalar Dergisi, 2(2), 78–91.
• Zelle, D. M., Dorland, H. F., Rosmalen, J. G. M., Corpeleijn, E., Gans, R. O. B., Homan Van Der Heide, J. J., ...Bakker, S. J. L. (2012). Impact of depression on long-term outcome after renal transplantation: A prospective cohort study. Transplantation, 94(10), 1033–1040. https://doi.org/10.1097/TP.0B013E31826BC3C8.