DETERMINATION OF FACTORS ASSOCIATED WITH FEAR OF HYPOGLYCEMIA AND PERCEPTION OF SELF-EFFICACY IN DIABETES PATIENTS USING INSULIN

Öz

Objective The aim of this study is to determine the factors associated with fear of hypoglycemia and perception of self-efficacy and related factors in diabetic patients using insulin. Material and Method This descriptive and correlational study was conducted with a total of 136 patients followed by a diabetes education nurse in a State Hospital between December 2016 and February 2017. "Patient Information Form", "Self-Efficacy Perception Sub-Scale of Multidimensional Diabetes Questionnaire" and "Hypoglycemia Fear Scale (HFS)" were used to collect data. In order to determine whether the data showed a normal distribution, Kolmogorov-Smirnov test, kurtosis and skewness values were calculated and the tests to be used for the analysis of the data were determined. The t test was used to compare the data between two independent groups, and the one-way analysis of variance was used to compare the data between more than two groups. Pearson Correlation analysis was performed to determine the relationship between scale scores. Multiple Linear Regression analysis was performed to determine whether the independent variables significantly predicted the Self-Efficacy Perception Scale and HFS scores. Results The mean age of the individuals participating in the research is 58.12 ± 12.4. In addition, 66.9% of the participants are women and 75% of them are fifty years old and over. The total mean score of the participants on the HFS was 52.5 ± 11.2; Behavior sub-dimension mean score was 28.12 ± 4.76 and Worry sub-dimension mean score was 24.46 ± 8.11. The mean score of the Self-Efficacy Perception Scale of the patients was 364.2 ± 18.46. It was determined that there was a statistically significant difference between the patients' DM duration, DM type, DM drug treatment type, regular follow-up visits, hypoglycemia experience and knowing the symptoms of hypoglycemia, and the scores of HFS and Self-Efficacy Perception Scale (p < 0.05). A negative and moderate correlation was found between the Self-Efficacy Perception Scale score and the total score of HFS, the Behavior sub-dimension score and the Worry sub-dimension score (r=- 0.578, p<0.001; r= - 0.588, p<0.001 ve r= - 0.548, p<0.001 respectively). According to the multiple regression analysis carried out to determine whether the duration of DM, type of DM, DM medication, regular follow-up visits, hypoglycemia, and knowing the symptoms of hypoglycemia significantly predicted the total score of the HFS and Self-Efficacy Scale, the model was found to be significant and the variance explained 42% and 53% of them respectively. (F= 16.71; p<0.001; F= 19.47; p<0.001, respectively). Conclusion Fear of hypoglycemia and self-efficacy perception of diabetic patients using insulin are affected by some characteristics of the disease. In addition, the self-efficacy perception level of the patients is effective on the fear of hypoglycemia. In this context, improving the perception of self-efficacy in individuals with diabetes may be effective in reducing fears of hypoglycemia.

Anahtar Kelimeler

• Diabetes Mellitus
• Hypoglycemia
• Fear
• Self-efficacy

İNSÜLİN KULLANAN DİYABETLİ HASTALARDA HİPOGLİSEMİ KORKUSU VE ÖZ-YETERLİLİK ALGISI İLE İLİŞKİLİ FAKTÖRLERİN BELİRLENMESİ

Öz

Amaç Bu çalışmanın amacı insülin kullanan diyabetli hastalarda hipoglisemi korkusu ve öz-yeterlilik algısını ve bunlarla ilişkili faktörleri belirlemektir. Gereç ve Yöntem Tanımlayıcı ve ilişki arayıcı tipteki bu araştırma Aralık 2016-Şubat 2017 tarihleri arasında bir Devlet Hastanesi’nde diyabet eğitim hemşiresi tarafından takip edilen toplam 136 hasta ile yapılmıştır. Verilerin toplanmasında literatür doğrultusunda hazırlanan “Hasta Tanıtım Formu”, “Çok Boyutlu Diyabet Anketi’nin Öz-yeterlilik Algısı Alt Ölçeği” ve “Hipoglisemi Korku Ölçeği (HKÖ)” kullanılmıştır. Verilerin normal dağılım gösterip göstermediğini belirlemek için Kolmogorov- Smirnov testi, basıklık ve çarpıklık değerleri hesaplanarak verilerin analizi için kullanılacak testler belirlenmiştir. Bağımsız iki grup arasındaki verilerin karşılaştırılmasında t testi, ikiden fazla grup arasındaki verilerin karşılaştırılmasında Tek Yönlü Varyans analizi kullanılmıştır. Ölçek puanları arasındaki ilişkiyi belirlemek için Pearson Korelasyon analizi yapılmıştır. Bağımsız değişkenlerin Öz-yeterlilik Algı Ölçeği ile HKÖ puanlarını anlamlı düzeyde yordama durumunu belirlemek amacıyla Çoklu Doğrusal Regresyon analizi yapılmıştır. Bulgular Araştırmaya katılan bireylerin yaş ortalaması 58,12 ± 12,45’dir. Ayrıca katılımcıların %66,9’u kadın olup %75’i elli yaş ve üzerindedir. Katılımcıların HKÖ toplam puan ortalaması 52,58 ± 11,21; Davranış alt boyutu puan ortalaması 28,12 ± 4,76 ve Kaygı alt boyutu puan ortalaması 24,46 ± 8,11’dir. Hastaların Öz-yeterlilik Algısı Ölçeği puan ortalaması 364,24 ± 18,46’dır. Hastaların DM süresi, DM tipi, DM ilaç tedavi türü, düzenli kontrollere gitme durumu, hipoglisemi yaşama durumu ve hipoglisemi belirtilerini bilme durumu ile HKÖ ve Öz-yeterlilik Algısı Ölçeği puanları arasında istatistiksel olarak anlamlı bir fark olduğu belirlenmiştir (p < 0,05). Öz-yeterlilik Algı Ölçeği puanı ile HKÖ toplam puanı, Davranış ve Kaygı alt boyutu puanı arasında negatif yönde ve orta düzeyde bir korelasyon (sırasıyla r= - 0,578, p<0,001; r= - 0,588, p<0,001 ve r= - 0,548, p<0,001) bulunmuştur. DM süresi, DM tipi, DM ilaç tedavisi, düzenli kontrollere gitme durumu, hipoglisemi yaşama durumu ve hipoglisemi belirtilerini bilme durumunun HKÖ ve Öz-yeterlilik Algısı Ölçeği toplam puanını anlamlı düzeyde yordama durumunu belirlemek amacıyla yapılan çoklu regresyon analizi- ne göre modelin anlamlı olduğu ve sırasıyla varyansın %42’sini ve %53’ünü açıkladığı bulunmuştur (sırasıyla F= 16,71; p<0,001; F= 19,47; p<0,001). Sonuç İnsülin kullanan diyabetli hastaların hipoglisemi korkusu ve öz-yeterlilik algısı hastalığa ilişkin bazı özelliklerden etkilenmektedir. Ayrıca hastaların öz-yeterlilik algı düzeyi hipoglisemi korkusu üzerinde etkilidir. Bu bağlamda diyabetli bireylerde öz-yeterlik algısının geliştirilmesi hipoglisemi korkularının azaltılmasında etkili olabilir.

Anahtar Kelimeler

• Diyabetes Mellitus
• Hipoglisemi
• Korku
• Öz-yeterlilik

Kaynakça

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