Tip 1 Diyabet ve Tip 2 Diyabeti Olan Bireylerin Diyabet Algısı: Karma Yöntemli Karşılaştırmalı Bir Çalışma

Öz

Amaç: Tip 1 ve tip 2 diyabet, tedavi yöntemleri ve yönetim süreçleri açısından önemli farklılıklar göstermektedir. Bu karma yöntem çalışması, tip 1 ve tip 2 diyabetli bireylerin hastalık algılarını araştırmış ve karşılaştırmıştır. Gereç ve Yöntemler: Çalışma, nicel ve nitel yöntemleri birleştiren eşzamanlı bir karma yöntem yaklaşımı kullanmıştır. Örnekleme, 15 tip 1 diyabetli ve 15 tip 2 diyabetli katılımcı dahil edilmiştir. Veriler, Nisan-Ağustos 2023 arasında sosyodemografik anketler, Hastalık Kabul Ölçeği ve yarı yapılandırılmış mülakatlar kullanılarak toplanmıştır. Nicel veriler SPSS 27.0 ile, nitel veriler ise Nvivo 12 ile analiz edilmiştir. Bulgular: Nicel bulgular, hastalık kabulü ile diyabet yönetimi arasında anlamlı bir ilişki olduğunu ortaya koymuş ve katılımcıların %76,7'sinin diyabet kabul seviyelerinin orta ila yüksek düzeyde olduğunu göstermiştir. Katılımcıların ortalama diyabet kabul puanı 22.50 ± 5.63 olarak belirlenmiştir. Nitel analiz, diyabet algılarıyla ilgili yedi tema ortaya koymuştur: diyabetin nedeni, yönetim öncelikleri, kolaylaştırıcılar, zorluklar, diyabet öncesi ve sonrası deneyimler ve duygusal yönler. Tip 1 diyabetli katılımcılar, diyabetlerini genellikle stresle ve belirsizlikle ilişkilendirirken, tip 2 diyabetli katılımcılar daha sık olarak yaşam tarzı alışkanlıklarını ve kaderi katkı sağlayan faktörler olarak belirtmişlerdir. Ayrıca, her iki grup da diyabet yönetiminde beslenme, ilaç uyumu ve fiziksel aktivitenin önemine vurgu yapmış, tip 1 diyabetli katılımcılar ise buna ek olarak öz farkındalık ve dengeye de odaklanmışlardır. Sonuç: Bulgular, tip 1 ve tip 2 diyabetli bireyler arasında diyabet algılarındaki farklılıkları vurgulayarak, diyabet yönetimi ve eğitimi için kişiye özel yaklaşımların gerekliliğine işaret etmektedir.

Anahtar Kelimeler

• Algı
• Kabul süreci
• Nitel araştırma Tip 1 diyabet
• tip 2 diyabet.

Perceptions of Diabet in Type 1 Diabetes and Type 2 Diabetes: A Mixed-Methods Comparative Insight

Öz

Aim: Type 1 and type 2 diabetes exhibit significant differences in terms of treatment methods, and management processes. This mixed-method study explored and compared the illness perceptions of individuals with type 1 and type 2 diabetes. Material and Methods: The study employed a simultaneous mixed-method approach, combining quantitative and qualitative methodologies. Fifteen participants with type 1 diabetes and fifteen with type 2 diabetes were included in the sample. Data were collected from April to August 2023 using sociodemographic surveys, the Acceptance of Illness Scale, and semi-structured interviews. The quantitative data were analyzed using SPSS 27.0, while the qualitative data were analyzed using the Nvivo 12. Results: Quantitative findings revealed a significant association between illness acceptance and diabetes management, with 76.7% of participants demonstrating moderate to high levels of diabetes acceptance. The mean diabetes acceptance score for the participants was 22.50 ± 5.63. Qualitative analysis revealed seven themes regarding diabetes perceptions, including the cause of diabetes, management priorities, facilitators, challenges, pre- and post-diabetes experiences, and emotional aspects. Participants with type 1 diabetes often linked their condition to stress and uncertain, whereas type 2 diabetes participants more frequently cited lifestyle habits and fate as contributing factors. Furthermore, both groups emphasized the importance of nutrition, medication adherence, and physical activity in managing diabetes, with type 1 diabetes participants additionally focusing on self-awareness and balance. Conclusion: The findings highlight differences in diabetes perceptions between individuals with type 1 and type 2 diabetes, indicating the need for tailored approaches to diabetes management and education.

Anahtar Kelimeler

• Acceptance Process
• Perception
• Type 1 diabetes
• Type 2 diabetes
• qualitative research.

Kaynakça

1. 1. Turkish Diabetes Foundation (TURKDIAB). (2021). Diabetes Diagnosis and Treatment Guide 2021. https://www.turkdiab. org/admin/PICS/webfiles/Diyabet_Tani_ve_Tedavi_Rehberi_ 2021.pdf Access Date: March 17, 2022.
2. 2. Türkiye Endokrinoloji ve Metabolizma Derneği. Diabetes Mellitus ve Komplikasyonlarının Tanı, Tedavi ve İzlem Kılavuzu. 16. Baskı, Ankara, TEMD Yayınları, 2024.
3. 3. International Diabetes Federation (IDF). (2019). Diabetes Atlas 9th Edition. (Erişim Tarihi:26.01.2025)
4. 4. IDF Diabetes Atlas-10th Edition.2021 (Erişim Tarihi: 26.01.2025 https://diabetesatlas.org/atlas/tenth-edition/)
5. 5. Ustaalioğlu S, Tan M. Examination Of Type 2 Diabetics Attitudes and Behaviours Against Care and Treatment. Gümüşhane University Journal of Health Sciences, 2017;6(4):12-20.
6. 6. Aytemur, M., & İnkaya, B. (2022). Diabetes mellituslu bireylerde diyabet komplikasyon risk algısının ve diyabet öz yönetim becerilerinin incelenmesi. Turkish Journal of Diabetes and Obesity, 6(2), 121-130.
7. 7. Armay Z, Özkan M, Kocaman N, Özkan S. The Turkish Reliability and Validity Study in Cancer Patients of Illness Perception Questionnaire. Turkish Journal of Clinical Psychiatry, 2007;10(4):192-200.
8. 8. Kocaman N, Özkan M, Armay Z, Özkan S. The reliability and the validity study of Turkish adaptation of the revised Illness Perception Questionnaire. Anatolian Journal of Psychiatry, 2007;8(4):271-280.

9. 9. Yorulmaz H, Tatar A, Saltukoğlu G, Soylu G. Analysis of the Factors Influencing Illness Perception in Patients with Diabetes. FSM Scientific Research Journal of Humanities and Social Sciences, 2013;(2):367-87.
10. 10. Kim S, Kim E, Ryu E. Illness Perceptions, Self-Care Management, and Clinical Outcomes According to Age-Group in Korean Hemodialysis Patients. International Journal of Environmental Research and Public Health, 2019;16(22):4459.
11. 11. Karagülle Ç, Çiçek S. The Effect of Disease Perception on Quality of Life of Individuals with Chronic Obstructive Pulmonary Disease. Turkish Journal of Science and Health, 2020;1(2):36- 49.
12. 12. Al-Amer R, Ramjan L, Glew P, Randall S, Salamonson Y. Self-efficacy, depression, and self-care activities in adult Jordanians with type 2 diabetes: The role of illness perception. Issues in Mental Health Nursing, 2016;37(10):744-55.
13. 13. Özgür H, Doğan N. Determination of Illness Perception and Social Relationships of Geriatric Individuals with Type 2 Diabetes Mellitus. Online Turkish Journal of Health Sciences, 2022;7(4):574-85.
14. 14. Kavak F, Aktürk Ü. The Effect of Disease Perception on Anxiety and Depression Symptoms in Diabetics. ACU Journal of Health Sciences, 2019;10(4):740-47.
15. 15. Bilgehan, T., Uludasdemir, D., Kacar, M. E., & Kiliçoğlu, Ö. (2024). Tip 1 Diyabeti Olan Çocuğun Bakım Vericilerinin Ekonomik Yükü Ölçeğinin Geliştirilmesi ve Psikometrik Özelliklerinin İncelenmesi. Turkish Journal of Diabetes and Obesity, 8(3), 215-224.
16. 16. Gündüz F, Yılmaz KE. The Assess of Illness Perception, Psychosocial Adjustment, and Glycemic Control in Type II Diabetic Mellitus Patients. Journal of Anatolia Nursing and Hewalkeralth Sciences, 2016;19:106-15.
17. 17. Teddlie C, Tashakkor A. Foundations of Mixed Methods Research. Ankara: Anı Publishing.2020
18. 18. Creswell J. W.,Plano Clark, V. L. Designing and conducting mixed methods research (3rd ed.). SAGE Publications, 2018.
19. 19. Baki A, Gökçek T. A General Overview of Mixed Method Research. Electronic Journal of Social Sciences, 2012;11(42):1-21.
20. 20. Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, Burroughs H, Jinks C. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant, 2018;52(4):1893-907.
21. 21. Manen M, Higgins I, Van Riet PA. Conversation With Max Van Manen on Phenomenology İn İts Original Sense. Nurs Health Sci, 2016;18(1):4-7.
22. 22. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 2007;19(6):349-57.
23. 23. Uysal Y, Akpınar E. Illness Perception and Depression of Type 2 Diabetic Patients. Çukurova Medical Journal, 2013;38(1):31- 40.
24. 24. Felton BJ, Revenson TS. Coping with chronic illness: A study of illness controllability and the influence of coping strategies on psychological adjustment. Journal of Consulting and Clinical Psychology, 1984;52:343-53.
25. 25. Besen DB, Esen A. The Adaptation of the Acceptance of Illness Scale to the Diabetic Patients in Turkish Society. TAF Preventive Medicine Bulletin, 2011;10:155-64.
26. 26. Walker RJ, Smalls BL, Hernandez-Tejada MA, Campbell JA, Davis KS, Egede LE. Effect of diabetes fatalism on medication adherence and self-care behaviors in adults with diabetes. General hospital psychiatry, 2012;34(6):598-603.
27. 27. Yıldırım A, Şimşek H. Qualitative Research Methods in Social Sciences (6th ed.). Ankara: Seçkin Printing.2008.
28. 28. Morrow R, Rodriguez A, King N. Colaizzi’s Descriptive Phenomenological Method. The Psychologist, 2015;28:643-44.
29. 29. Nowell LS, Norris JM, White DE, Moules NJ. Thematic analysis: Striving to meet the trustworthiness criteria. Int J Qual Methods. 2017;16(1):1609406917733847. doi:10.1177/1609406917733847
30. 30. Bertolin DC, Pace AE, Cesarino CB, Ribeiro RC, Ribeiro RM. Psychological adaptation to and acceptance of type 2 diabetes mellitus. Acta Paulista de Enfermagem, 2015;28:440-46.
31. 31. Şireci E, Yılmaz Karabulutlu E. Diabetes Mellitus Type II Patients’ Acceptance of Illness and Determination of Self-Efficacy Levels for Their Care. Journal of Anatolia Nursing and Health Sciences, 2017;20(1):48-55.
32. 32. Morse ZJ, Horwitz MS. Virus Infection Is an Instigator of Intestinal Dysbiosis Leading to Type 1 Diabetes. Frontiers in Immunology, 2021;12:751337.
33. 33. Robertson CC, Rich SS. Genetics of type 1 diabetes. Current Opinion in Genetics & Development, 2018;50:7-16.
34. 34. Rewers M, Ludvigsson J. Environmental risk factors for type 1 diabetes. The Lancet, 2016;387(10035):2340-2348.
35. 35. Morin JL, Cohen B, Harder N, Thompson S. Nurse Educators’ Perceptions of Ecoliteracy in Undergraduate Nursing Education. Quality Advancement in Nursing Education- Avancées en formation infirmière, 2022;8(1):5.
36. 36. Conti C, Mennitto C, Di Francesco G, Fraticelli F, Vitacolonna E, Fulcheri M. Clinical Characteristics of Diabetes Mellitus and Suicide Risk. Frontiers in Psychiatry, 2017;8:1-7.
37. 37. American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes. Diabetes Care, 2021;44(1):5-33.
38. 38. Adu MD, Malabu UH, Malau-Aduli AEO, Malau-Aduli BS. Enablers and barriers to effective diabetes self-management: A multi-national investigation. PLoS One, 2019;14(6):e0217771.
39. 39. Muslu L, Öncel S. The Importance of Self-Management and Monitoring of Diabetes Patients. R HA, editor. Ankara: Türkiye Klinikleri, 2019
40. 40. Polonsky WH, Fisher LF, Guzman S, Villa-Caballero L, Edelman SV. Psychological insulin resistance in type 2 diabetes: The scope of the problem. Diabetes Care, 2005;28: 2543-45.
41. 41. Al Hayek AA, Robert AA, Babli S, Almonea K, Al Dawish MA. Fear of self-injecting and self-testing and the related risk factors in adolescents with type 1 diabetes: A cross-sectional study. Diabetes Therapy, 2017;8:75-83.
42. 42. Çakır S, Sağlam H, Özgür T, Eren E, Tarım Ö. Factors Influencing Glycemic Control inChildren with Type 1 Diabetes. The Journal of Current Pediatrics, 2010;8(2):7-19.
43. 43. Üren Y, Yılmaz K. Investigating the Factors that Complicate Diabetes Control in Patients with Type 2 Diabetes. Journal of Health Science and Profession, 2018;5(3):376-386.
44. 44. Kara K, Çınar S. The Relation Between Diabetes Care Profile and Metabolic Control Variables. Kafkas Journal of Medical Sciences, 2011;1(2):57-63.
45. 45. Al-Haddad M, Mi MI, Hassali M, Sulaiman SS, Maarup N. Social and psychological evaluations of diabetic patients towards disease management: A cross-sectional study at a university health center in Malaysia. Journal of Clinical and Diagnostic Research, 2010;4(4):2798-803.
46. 46. Gupta S, Nayak MT, Sunitha JD, Dawar G, Sinha N, Rallan NS. Correlation of salivary glucose level with blood glucose level in diabetes mellitus. Journal of Oral and Maxillofacial Pathology, 2017;21(3):334-39.