Hemşirelerin Psikiyatri Kliniklerinde Tedavi Gören Hastaların Metabolik Sendrom Risklerini Değerlendirmeye Yönelik Bilgi ve Uygulamalarının İncelenmesi

Öz

Amaç: Bu çalışma, psikiyatri kliniklerinde çalışan hemşirelerin metabolik sendrom risklerini değerlendirmeye yönelik bilgi ve klinik uygulamalarını incelemek amacıyla tanımlayıcı, kesitsel olarak olarak yapılmıştır. Yöntem: Çalışma İstanbul’ da kamuya bağlı bir psikiyatri hastanesinde yetişkin kliniklerinde görev yapan ve araştırmaya katılmayı kabul eden 164 hemşire ile gerçekleştirilmiştir. Veriler, araştırmacılar tarafından literatür taranarak oluşturulmuş tanımlayıcı özellikler, metabolik risk değerlendirme bilgi ve uygulama formları ile toplanmıştır. Formların iç geçerlilik çalışmaları için konu ile ilgili 4 uzmanın önerileri alınmıştır. Öneriler sonrasında tekrar düzenlenen formların iç güvenirlik çalışmaları için psikiyatri servisinde çalışan 10 hemşire ile ön uygulama gerçekleştirilmiştir. Formun iç güvenirlik çalışması için cronbach alfa değeri 0,87 ve 0,77 olarak hesaplanmıştır. Çalışmada non-parametrik testlerden üç veya daha fazla değişkenli olan karşılaştırmalarda Kruskal Wallis testi kullanılmıştır. İkişerli gruplar arasında ise Mann Whitney U testi uygulanmıştır. Tüm istatistiksel hesaplamalarda anlamlılık düzeyi p<0,05 olarak kabul edilmiştir. Bulgular: Metabolik sendrom riski değerlendirmeye ilişkin en fazla 30 puan alınan Metabolik Sendrom Bilgi Formu’da hemşirelerin puan ortalaması 17,83 ± 6,36; en fazla 28 puan alınan Metabolik Sendrom Klinik Uygulama Formunda ise puan ortalaması 18,70±5,67 olarak bulunmuştur. Hemşirelerin yaş, medeni durum, eğitim durumu, mesleki deneyim süresi, psikiyatri kliniği deneyimi süresi, çalıştığı klinik türü ve bakım verdiği hasta sayısı açısından bilgi puan ortalamalarında anlamlı farklılıklar olduğu belirlenmiştir (p<0,05). Eğitim durumu açısından metabolik sendroma ilişkin klinik uygulamalarında farklılıklar olduğu belirlenmiştir (p<0,05). Sonuç: Psikiyatri kliniklerinde çalışan hemşirelerin hastaların metabolik sendrom risk değerlendirmelerine yönelik bilgi düzeylerinin ve klinik uygulamalarının arttırılması önerilmektedir. Özellikle psikiyatrik tedavi gören hastaların metabolik sağlığını geliştirmeye yönelik eğitimler düzenlenmesi ve metabolik risk değerlendirmesinin önündeki engellerin araştırılması için araştımaların düzenlenmesi önerilmektedir.

Anahtar Kelimeler

• Metabolic syndrome
• Metabolic syndrome risk assesment
• Nursing
• Psychiatric patients
• Psychtrop treatments.

Investigation Of Nurse's Knowledge and Practices To Assess The Metabolic Syndrome Risks Of Patients Treated In Psychiatry Clinics

Öz

Objectives: This descriptive, cross-sectional study was conducted to examine the knowledge and clinical practices of nurses working in psychiatry clinics to assess metabolic syndrome risks. Methods: The study carried out with 164 nurses working in adult clinics in a public psychiatric hospital in Istanbul and agreeing to participate in the research. Data were collected with descriptive features, metabolic risk assessment information and implication forms created by the researchers by scanning the literature. For the internal validity studies of the forms, suggestions of 4 experts on the subject were received. Pre-application was carried out with 10 nurses working in the psychiatry service for the internal reliability studies of the reorganized forms after the suggestions. For the internal reliability study of the form, the cronbach's alpha values were calculated as 0.87 and 0.77. In the study, Kruskal Wallis test was used for comparisons with three or more variables, one of the non-parametric tests. Mann Whitney U test was applied between groups of two. The significance level was accepted as p<0.05 in all statistical calculations. Results: The mean score of the nurses in the Metabolic Syndrome Information Form, with a maximum score of 30 for metabolic syndrome risk assessment, was 17.83 ± 6.36; In the Metabolic Syndrome Clinical Practices Form with a maximum score of 28, the mean score was found to be 18.70±5.67. It was determined that there were significant differences in the mean information scores of the nurses in terms of age, marital status, education level, professional experience, psychiatry clinic experience, the type of clinic they worked in, and the number of patients they care for (p<0.05). It was determined that there were differences in clinical practices related to metabolic syndrome in terms of educational status (p<0.05). Conclusion: It is recommended to increase the information and clinical practices of nurses working in psychiatry clinics on metabolic syndrome risk assessments of patients. It is recommended to organize trainings to improve the metabolic health of patients receiving psychiatric treatment and to organize research to investigate the obstacles to metabolic risk assessment.

Anahtar Kelimeler

• Metabolic syndrome
• Metabolic syndrome risk assesment
• Nursing
• Psychiatric patients
• Psychtrop treatments.

Kaynakça

1. Aksu, H (2009). Bipolar Bozukluk Tanısı ile İzlenen Hastalarda Görülebilen Metabolik Sendroma İlişkin Ruh Sağlığı Çalışanlarının Farkındalığı ve Diğer Etmenlerle İlişkisi. Sağlık Bakanlığı Bakırköy Prof. Dr. Mazhar Osman Ruh Sağlığı ve Sinir Hastalıkları Hastanesi, Yayımlanmamış Uzmanlık Tezi, İstanbul.
2. Aktay M., Sayar HG (2021). Psikiyatrik bozuklukların psikososyal yönü. Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi, 3(1):48-55.
3. Asharani PV, Ling Seet VA, Abdin E, Siva Kumar FD, Wang P, Roystonn K, et al. (2020) Smoking and Mental Illness: Prevalence, Patterns and Correlates of Smoking and Smoking Cessation among Psychiatric Patients. Int J Environ Res Public Health. Aug;17(15):5571.
4. Aşık E, Albayrak S, Erdogan N (2016). Hemşirelerin Antipsikotik İlaç Kullanan Hastalarda Metabolik Sendrom Riskine Yönelik Uyguamalar. Clinical And Experimental Health Sciences, 6:4:161-165.
5. Bolton PS, Knight M, Kopeski LM (2016) Psychiatric–Mental Health Nurses’ Knowledge of Risks and Care Practices. Journal Of Psychosocial Nursing, 54.11.
6. Curtis J, Watkins A, Rosenbaum S, Teasdale S, Kalucy M, Samaras K, ve ark (2016) Keeping the Body in Mind: an individualised lifestyle and life-skills intervention to prevent antipsychotic-induced weight gain in first episode psychosis. Early Interv Psychiatry10:267
7. Çam O, Arabaci LB, Yildirim S, Beşer NG (2010) Psikiyatri Hemşireliği Eğitiminin Hemşirelerin Bilgi Düzeyine Etkisi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 13:
8. Çelik S, Hisar F (2012) The Influence of the Professionalism Behaviour of Nurses Working in Health Instutions on Job Satisfaction. International Journal of Nurses Practice,18:180-187.

9. Daumit GL, Goff DC, Meyer JM, Davis VG, Nasrallah HA, McEvoy JP, et al. (2008) Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study. Schizophr Res. Oct;105(1-3):175–87
10. De-Hert M, Correll CU, Bobes J, Cetkovich-Bakmas MA, Cohen DA, Asai I, Detraux J, Gautam S, Moller HJ, Ndetei DM. et al. (2011) Physical illness in patients with severe mental disorders. I. Prevalence, impact of medications and disparities in health care. World Psychiatry
11. Gray R, Hardy S, Anderson KH. (2009) Physical health and severe mental illness: If we don’t do something about it, who will? Int. J. Ment. Health Nurs. 18, 299–300.
12. Happell B, Platania-Phung C, Scott D. (2014) What Determines Whether Nurses Provide Physical Health Care to Consumers with Serious Mental İllness? Arch Psychiatry Nurs,28:2:87
13. Harmancı H. (2019) Psikiyatri kliniğine başvuran yaşlı hastaların klinik ve sosyodemografik özellikleri: Bir özell tıp fakültesi hastanesi deneyimi. Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi, 1(3):152-157.
14. Hardy S, White J, Deane K, Gray R. (2011) Educating Healthcare Professionals to Act on The Physical Health Needs of People with Serious Mental Illness: A Systematic Search for Evidence. Journal of Psychiatric and Mental Health Nursing, 18:8:721-727.
15. Hoang U, Goldacre MJ, Stewart R. (2013) Avoidable mortality in people with schizophrenia or bipolar disorder in England. Acta Psychiatr Scand. Mar;127(3):195–201.
16. Holt R, Peveler R. (2010) Diabetes and cardiovascular risk in severe mental illness: A missed opportunity and challenge for the future. Practice Diabetes International,27:2:79-84
17. Howard L, Gamble C. (2011) Supporting Mental Health Nurses to Address the Physical Health Needs of People With Serious Mental Illness In Acute Inpatient Care Settings. Journal of Psychiatric and Mental Health Nursing,18:105-112.
18. Jin H, Meyer JM, Jeste DV. (2004) Atypical antipsychotics and glucose dysregulation: a systematic review. Schizophr Res.
19. Meyer JM, Koro CE. (2004) The effects of antipsychotic therapy on serum lipids: a comprehensive review. Schizophr Res. Sep;70(1)
20. Morgan V, Mcgrath J, Jablensky A, Badcock J, Waterreus A, Bush R. (2014) Psychosis Prevelance and Physical, Metabolic and Cognitive Co-morbidity: Data from the Second Australian National Survey of Psychosis. Psychol Med,44:10:2163-2176.
21. Muir-Cochrane C.E. (2006) Medical Comorbidity Risk Factors and Barriers to Care for People with Schizophrenia. Psychiatric and Mental Health Nursing,13:4:447-452.
22. Nash M, Bracken-Scally M, Smith V, Higgins A, Eustace-Cook J, Monahan M, Callaghan P, Romanos MT (2015) Literature Review using systematic approaches to explore physical illness co-Morbidity Among People with Serious Mental İllness and Related Healthcare İnterventions. Dublin: Health Services Executives.
23. Naslund JA, Aschbrenner KA, Scherer EA, Pratt SI, Wolfe RS, Bartels SJ. (2016)Lifestyle intervention for people with severe obesity and serious mental illness. Am J Prev Med
24. Organ B, Nicholson E, Castle D. (2010) Implementing A Physical Health Strategy in a Mental Health Service. Australias Psychiatry,18:5:456-459.
25. Reininghaus U, Dutta R, Dazzan P, Doody GA, Fearon P, Lappin J, et al. (2015) Mortality in schizophrenia and other psychoses: a 10-year follow- up of the ӔSOP first-episode cohort. Schizophr Bull. May; 41(3): 66473. http://dx.doi.org/10.1093/schbul/sbu138. PubMed. 1745
26. Robson D, Gray R (2007) Serious Mental Illness and Physical Health Problems: A Discussion Paper. International Journal of Nursing Studies, 44:457-466.
27. Rosenbaum S, Morell R, Abdel-Baki A, Ahmadpanah M, Anilkumar TV, Baie L, et al.(2020) Assessing physical activity in people with mental illness: 23-country reliability and validity of the simple physical activity questionnaire (SIMPAQ). BMC Psychiatry. Mar;20(1):108
28. Vancampfort D, Stubbs B, Mitchell AJ, De Hert M, Wampers M, Ward PB, Rosenbaum S, Correll CU. (2015) Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: A systematic review and meta-analysis. World Psychiatry, 14, 339
29. Ward T, Wynaden D, Heslop K. (2018) Who is Responsible for Metabolic Screening for Mental Health Clients Taking Antipsychotic Medication? International Journal of Mental Health Nursing,27:1:196-203.