Betül TOSUN, Canan PÖRÜCÜ, Nuri KARADURMUŞ, Nursemin ÜNAL

İmmünoterapi Alan Kanser Hastalarında İlaç Tedavisine İnancı Etkileyen Faktörlerin Belirlenmesi

Amaç:Bu çalışmanın amacı immünoterapi tedavisi alan kanser hastalarında ilaç inancı ve etkileyen faktörlerin belirlenmesiydi. Hastalar ve Yöntem:Tanımlayıcı tipteki bu çalışmanın örneklemini Aralık 2018-Mayıs 2019 tarihleri arasında bir eğitim ve araştırma hastanesinin tıbbi onkoloji kliniğine ayaktan başvuran, immünoterapi tedavisi alan ve araştırmaya katılmayı kabul eden hastalar (N=85) oluşturdu. Verilerin toplanmasında hasta tanıtıcı bilgi formu ve İlaçlar Hakkında İnançlar Anketi kullanıldı. Veriler bilgisayar ortamında SPSS for Windows 22.00 paket programında değerlendirildi. Verilerin normal dağılıma uygunluğu Shapiro-Wilk Testi ile değerlendirildi. p ≤ 0.05 istatistiksel olarak anlamlı kabul edildi. Bulgular:Katılımcıların yaş ortalaması 58.80±14.23 yıl, %50.6’sı kadın, %56.5’i evre IV kanser hastasıydı ve %74.1’inin metastazı vardı. İmmünoterapinin yan etkilerinden etkilenen hastalar katılımcıların %54.1’ini oluşturdu. Yaşa göre İlaç İnanç Anketinin alt ölçek puan ortalamaları karşılaştırıldığında 65 yaş üzeri hastaların “Spesifik Endişe” puan ortalamalarının genç hastalara göre daha düşük olduğu saptandı (t=2.175, p=0.032). Metastaz varlığına göre alt ölçek puan ortalamaları karşılaştırıldığında, metastazı olan hastaların “spesifik gereklilik” alt ölçeğinden aldıkları puan ortalamalarının metastazı olmayanlara göre daha yüksek olduğu bulundu (z=-2.185, p=0.029). İlaçların yan etki oluşturmasına göre ilaç yan etkisi olan hastaların “Genel Aşırı Kullanım” ve “Genel Zarar” alt ölçeklerinden aldıkları puan ortalamalarının yan etki yaşamayan hastalara göre daha yüksek olduğu saptandı (sırasıyla; z=-2.599, p=0.009; z=-1.966, p=0.049). Sonuç:Sonuç olarak yaşlı kanser hastalarının immünoterapi ilaçları konusunda daha az endişe duyduğu, metastazı olan hastaların kullandıkları ilaçların gerekli olduğuna daha fazla inandığı, yan etki yaşayan hastaların yaşamayanlara göre genel zarar ve genel aşırı kullanım inançlarının daha yüksek olduğu değerlendirildi.

Determining the Factors Affecting the Beliefs of Patients with Cancer on Immunotherapy Medications

Purpose:The aim of this study was to determine the beliefs about medications and the affecting factors in patients with cancer having immunotherapy treatment. Patients and Methods:The sample of this descriptive study consisted of patients (n = 85) who were admitted to the outpatient medical oncology clinic of an education and research hospital between December 2018-May 2019. Data were collected using the patient information form and the Beliefs about Medications Questionnaire. Data were analysed by SPSS for Windows 22.00 package program. p ≤ 0.05 was considered statistically significant. Results:The mean age of the participants was 58.80±14.23 years, 50.6% were female, 56.5% had stage IV cancer and 74.1% had metastasis. More than half of the patients (54.1%) experienced adverse effects of immunotherapy. It was found that the “Specific Concern” subscale scores of the patients over 65 years were lower than the younger patients (t = 2.175, p = 0.032). The mean “Specific Necessity” subscale scores of the patients with metastasis were higher than those without metastasis (z = -2.185, p = 0.029). It was found that the mean “General Harm” and “General Overuse” subscale scores of the patients who had adverse effects were higher than the patients who did not experience adverse effects (z = -1.966, p = 0.049; z = -2.599, p = 0.009, respectively). Conclusion:Elderly patients with cancer were less concerned about immunotherapy, patients with metastasis believed that immunotherapy medications were necessary, and patients who had adverse effects during immunotherapy treatment believed that medications were harmful and overused.

Keywords:

Immunotherapy, treatment, medication belief, cancer,

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