YOĞUN BAKIMA YATAN TİP 2 DİYABETLİ HASTALARIN İNSÜLİNE KARŞI ALGILARI İLE DİYABET ÖZ YÖNETİMLERİ ARASINDAKİ İLİŞKİNİN İNCELENMESİ

Yıl 2022, Cilt: 12 Sayı: 2, 396 - 402, 15.03.2022

Elif Günay İsmailoğlu Serkan Timuçin

https://doi.org/10.16899/jcm.899924

Öz

Amaç: Bu çalışma ile yoğun bakımda yatarak tedavi gören Tip 2 diyabet hastalarının insüline karşı algıları ve diyabet semptom yönetim düzeyinin belirlenmesi sağlanacaktır.
Gereç ve Yöntem: Bu çalışma 1 Aralık 2020 ve 31 Mart 2021 tarihleri arasında bir devlet hastanesinin Dahiliye ve Anestezi Yoğun Bakım ünitelerinde gerçekleştirilmiştir. Çalışmanın örneklemini insülin kullanan 100 gönüllü hasta oluşturmuştur. Araştırma verileri Hasta Tanıtım Formu, İnsülin Tedavisi Değerlendirme Ölçeği ve Diyabet Öz Yönetim Skalası ile toplandı. Araştırmanın etik kurul izni ve hastalardan yazılı izin alındı.
Bulgular: Hastaların yaş ortalaması 44,57±14,8 olup, %52’si kadın, %72’si bekar, %47’si ilköğretim mezunu, %52’si T2DM’e bağlı kronik bir komplikasyona sahiptir. Hastaların T2DM tanısı aldıkları yıl ortalaması 20,59 ± 12,87 yıl, insülin kullanma yıl ortalaması ise 2,8 ± 1,17 yıldır. Hastaların Diyabet Öz Yönetim Skalasından aldıkları toplam puan ortalamaları 4,07±1,74’tür (0,62-8,75). Hastaların İnsülin Tedavisi Değerlendirme Ölçeği pozitif ve negatif madde alt boyutu puan ortalamaları sırasıyla 11,44±3,43; 48,18±12,09’dur.
Sonuç: İnsülin kullanan Tip 2 diyabetli hastaların insülin kullanımına karşı negatif algısının fazla olduğu ve diyabet öz yönetimlerinin ortalamanın altında olduğu bulunmuştur. Hastaların negatif insülin algısı ile diyabet öz yönetiminin glikoz yönetimi ve diyet kontrolü alt boyutları arasında yüksek düzeyde negatif ilişki bulunmuştur.

Anahtar Kelimeler

İnsülin algısı, Öz yönetim, Tip 2 Diyabet

INVESTIGATING THE RELATIONSHIP BETWEEN INSULIN PERCEPTIONS AND DIABETES SELF-MANAGEMENT OF INTENSIVE CARE PATIENTS WITH TYPE 2 DIABETES

Öz

Aim: This study aimed to determine the level of perception of insulin and diabetes symptom management of patients with Type 2 diabetes who received inpatient treatment in intensive care.
Materials and Methods: This study was conducted in the Internal Medicine and Anesthesia Intensive Care units of a state hospital during the period of December 01, 2020 and March 31, 2021. The sample of the study was composed of 100 voluntary patients who used insulin. Research data were collected via the Patient Introduction Form, Diabetes Self-Management Questionnaire and the Insulin Treatment Appraisal Scale. Written permission was obtained from ethics committee and patients.
Results: The average age of the patients was 44.57 ± 14.8, 52% were female, 72% were single, 47% were primary school graduates, and 52% had a chronic complication related to diabetes. The mean time duration for being diagnosed with diabetes was 20.59 ± 12.87 years (3-52) while the mean duration of insulin use was 2.8 ± 1.17 years. Patients’ ITAS positive and negative item subscale mean scores were 11.44 ± 3.43 and 48.18 ± 12.09, respectively. Patients’ mean Diabetes Self-Management Questionnaire total score was 4.07 ± 1.74 (range: 0.62-8.75).
Conclusion: Patients have a high negative perception towards insulin use and their diabetes self-management is below the average. There was a high level of negative correlation between patients’ negative insulin perception and glucose management and diet control sub-dimensions of their diabetes self-management.

Anahtar Kelimeler

insulin perceptions, self-management, type 2 diabetes mellitus

Kaynakça

• 1. Koç E. Evaluation of Disease Self-Management in People with Type 2 Diabetes and Development of Type 2 Diabetes Self-Management Scale. T.C. Gazi University Faculty of Medicine. Doctoral Thesis. 2020, Ankara.
• 2. Diabetesatlas.org [homepage on the Internet]. International Diabetes Federation. [updated 16 April 2018; cited 01 March 2021]. Available from: http://www.diabetesatlas.org
• 3. American Diabetes Association. ADA Classification And Diagnosis Of Diabetes. Diabetes Care, 40(1):S11-24, 2017.
• 4. Meral DK. The Effect of Motivational Interviewing on Self-Management and Hba1c in Patients with Type 2 Diabetes. T.C. Istanbul University Institute of Health Sciences. Doctoral Thesis. 2018, Istanbul.
• 5. Diagnosis, Treatment and Follow-up Guide of Diabetes Mellitus and Its Complications. Turkey Endocrinology and Metabolism Society. 2018, Ankara.
• 6. Bulguroğlu M. The Effects of Pilates Exercises and Awareness Training on Health Related Physical Fitness Parameters in People with Type 2 Diabetes. T.C. Hacettepe University Institute of Health Sciences. Doctoral Thesis. 2020, Ankara.
• 7. Mumcu CD, Inkaya BV. Diabetes Self Care Management with Web Based Education. Acta Medica Nicomedia. 2020; 3 (2): 88-91.
• 8. Oecd.org [homepage on the Internet]. Revenue statistics - classification of taxes, ınterpretative guide and methodology. [updated 01 March 2021]. Available from: http://www.oecd.org/ctp/tax-policy/revenue-statistics-methodology-guide-andclassification-system.htm
• 9. Surucu HA, Baksi A, Samancioğlu S. Validity and Reliability of the Turkish Version of Insulin Treatment Appraisal Scale for Type 2 Diabetes Patients. 2017;10(3):1187-1200.
• 10. Sofulu F, Avdal EÜ. The Effect of Family Support and Family Conflict on the Self-Management Process in Type 2 Diabetes. Journal of Nursing Forum on Diabetes, Obesity, and Hypertension. 2016; 8 (2): 15-18.
• 11. American Diabetes Association. ADA. Standards of Medical Care in Diabetes . Diabetes Care. 37(1):S14-80, 2014.
• 12. Sürücü HA, Samancıoğlu S. Predictors of Negative Insulin Treatment Perception in Type 2 Diabetes Individuals. Journal of Clinical Nursing Sciences in Turkey. 2018; 10 (2): 130-7.
• 13. Celik S, Pınar R. Fear of Insulin Injection and Finger Piercing in People with Diabetes. Journal of Psychiatric Nursing. 2014;5(2):104-108.
• 14. Polat HB, Çeliker M, Özyurt S, Terzi S, Özgür A. Insulin resistance and affecting factors in patients with obstructive sleep apnea syndrome. Int J Otorhinolaryngol Head Neck Surg 2017;3(4):986-989.
• 15. Petrak F, Strıdde E, Leverkus F, Crıspın AA, Forst T, Pfützner A. Development and Validation of a New Measure to Evaluate Psychological Resistance to Insulin Treatment. Dıabetes Care 2007;30(9):2199-2204.
• 16. Polonsky WH, Fısher L, Guzman S, Caballero LV, Edelman SV. Psychological Insulin Resistance in Patients With Type 2 Diabetes. Diabetes Care. 2005;28(10):2543-2545.
• 17. Eroğlu N, Sabuncu N. Adaptation of Diabetes Self-Management Scale (DÖYS) to Turkish Society: Validity and Reliability Study. Journal of Nursing Science 2018;1(3):01-06.
• 18. He X, Li J, Wang B, et al. Diabetes self-management education reduces risk of all-cause mortality in type 2 diabetes patients: a systematic review and meta-analysis. Endocrine 2017;55(3): 712-731.
• 19. Powers MA, Bardsley J, Cypress M, et al. 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. The Science Diabetes Self-Manag Care 2017; 43(1): 40-53.
• 20. Snoek FJ, Skovlund SE, Pouwer F. Development and validation of the insulin treatment appraisal scale (ITAS) in patients with type 2 diabetes. Health Quality Life Outcomes 2007; 5(5): 69-75.
• 21. Schmitt A, Hermanns N, Kulzer B. The Diabetes Self-Management Questionnaire (DSMQ): Development and evaluation of an instrument to assess diabetes self-care activities associated with glycaemic control. Health Quality Life Outcomes 2013; 11(1): 138-151.
• 22. T. C. Ministry of Health General Directorate of Primary Health Care, Turkey Diabetes Prevention and Control Program Action Plan (2011-2014), Ankara; 2011. 23. Karadakovan A, Aslan FE. Care in Internal and Surgical Diseases. Academician Bookstore: Ankara; 2020.
• 24. Rashıdı M, Genç A. Evaluation of Diabetes Attitudes of Patients with Type 1 and Type 2 Diabetes. 2020; 10: 34-49.
• 25. Holmes-Truscott E, Browne JL, Ventura AL, Pouwer F, Speight J. Short Report: Educational and Psychological Aspects Diabetes stigma is associated with negative treatment appraisals among adults with insulin-treated Type 2 diabetes: results from the second Diabetes MILES – Australia (MILES-2) survey. Dıabetıc Medicine. 2018; 35(5): 658-662.
• 26. Chen CC, Li TC, Huang CY, Chang MP. Validation of the Chinese version of the insülin treatment appraisal scale. Diabetes Research and Clinical Practice. 2020; 170: 1-7.
• 27. Lee KP. Validity and reliability of the Chinese version ofthe Insulin Treatment Appraisal Scale among primary care patients in Hong Kong. Hong Kong Med J 2016; 22: 306–13.
• 28. Lee KP. Translation and validation of the Insulin Treatment Appraisal Scale in Hong Kong primary care patients. J Diabetes Investig 2018; 9: 311–320.
• 29. Pouwer F, Makine C, Snoek FJ. Negative Evaluation of Insulin Therapy and Depression in Insulin-Naive Patients with Type 2 Diabates Mellitus. Diabetes Jun 2007; 56: 504.
• 30. T.C. Turkey Ministry of Health Public Health Agency of Turkey Diabetes Program (2015-2020), Ankara; 2014.
• 31. Chen CC, Chang MP, Hsieh MH, Huang CY, Liao LN, Li TC. Evaluation of perception of insulin therapy among Chinese patients with type 2 diabetes mellitus. Diabetes & Metabolism. 2011; 37: 389–394.
• 32. Gündoğdu, AS. (2013) Guidelines for diagnosis, treatment and follow-up of diabetes mellitus and its complications. Turkey Endocrinology and Metabolism Association (TEMD), 6th Edition, Graphic Design and Publication Services, Ankara, 2016.
• 33. Yanık YT, Erol Ö. Evaluation of Self-Efficacy Levels of Individuals with Type 2 Diabetes. Anatolian Journal of Nursing and Health Sciences. 2016; 19 (3): 166-174.
• 34. Kartal A, Çağırgan G, Tığlı H, Güngör Y, Karakuş N, Gelen M. The attitudes and attitudes of patients with type 2 diabetes towards care and treatment, and the factors affecting the attitude. TSK Preventive Medicine Bulletin. 2008; 7 (3): 223-230.
• 35. Çalık A, Kapucu S. Developing Healthy Lifestyle Behaviors in Diabetic Patients: Pender's Health Promotion Model. Hacettepe University Nursing Faculty Journal. 2017; 4 (2): 62-75.
• 36. Beyazıt E, Mollaoğlu M. Investigation of Effect on Glycosylated Hemoglobin, Blood Pressure, and Body Mass Index of Diabetes Intensive Education Program in Patients With Type 2 Diabetes Mellitus. American Journal of Men’s Health. 2011; 5(4): 351-357.
• 37. Kartal A. Investigation of the Effects of Planned Education Program on Health Beliefs and Diabetes Management in Diabetic Patients. T. C. Ege University Health Sciences Institute. Doctoral Thesis. 2006, İzmir.
• 38. Turan E, Kulaksızoğlu M. Current Approaches in the Treatment of Type 2 Diabetes. Okmeydanı Medical Journal. 2015; 31: 86-94.
• 39. Brod M, Kongso JH, Lessard S, Christensen TL. Psychological insulin resistance: patient beliefs and implications for diabetes management. Quality of Life Research Journal 2009; 32: 18-23.
• 40. Özden G, Çevik S, Sarıtaş SÇ. Discomfort Endurance Capacity in DM Patients and Perspective on Insulin Therapy. Iı International Battalgazi Multidisciplinary Studies Congress: Malatya; 2019.
• 41. Ustaalioğlu S, Tan M. Investigation of Type 2 Diabetes Patients' Attitudes and Behaviors Towards Care and Treatment. Gümüşhane University Journal of Health Sciences. 2017; 6 (4): 12-20.