Dercan GENÇBAŞ, Zeynep Kübra DARICI, Hatice BEBİŞ

Yaşlı Yetişkinlere Yapılan NIC Müdahalelerinin İlaç Kullanımı ve İlaç Tepkilerine İlişkin Davranışlar Üzerindeki Etkisi: Yari Deneysel Çalışma

Amaç: Bu çalışmanın amacı, 'öğretme: reçete edilen ilaç' NIC'inin yaşlı yetikinlerin ilaç kullanımına ilişkin davranışlarına ve 'ilaca tepki' NOC çıktıları üzerindeki etkisini araştırmaktır. Gereç ve Yöntem: Bu çalışma yarı deneysel tasarımda olup, İç Hastalıkları Kliniği'ne başvuran ve araştırma kriterlerine uyan yaşlı erişkinlere Hasta Bilgi Formu, Yaşlı İlaç Kullanım Davranışları Ölçeği ve “İlaç Yanıt” NOC Ölçeği uygulandı. Formları uyguladıktan sonra, yaşlı yetişkinlerin her birine 'öğretme: reçeteli ilaç' NIC müdahaleleri uygulanmıştır. Bulgular: Yaşlı yetişkine uygulanan 'öğretme: reçete edilen ilaç' NIC girişimi sonrası ilaç uyum davranışları ve ilaç cevabı ile ilgili hasta çıktıları olumlu yönde değişmiştir (p<0.05). Sonuç: "Öğretme: reçete edilen ilaç'" NIC hemşirelik hemşirelik girişimleri sonrasında yaşlıların ilaç kullanımına yönelik davranışlarında ve ilaç kullanım sonrası beklenen değişimlerde iyileşmeler gerçekleşmiştir. Hemşireler, yaşlı yetişkinlere sağlık hizmeti sunan kuruluşlarda NOC ile sorunun ciddiyetini ölçerek ve NIC ile kapsamlı hemşirelik girişimleri uygulayarak yaşlı yetikinlere sağlık bakımı sunma konusunda doğru kararlar verebilir ve bu sağlık bakımını etkin ve objektif bir şekilde sağlayabilir.

Anahtar Kelimeler:

NOC Terminolojisi, NIC Terminolojisi, Yaşlı Yetişkin, İlaç Etkileşimi

Effect of NIC Interventions to Older Adults on Behaviour Regarding Drug Use and Drug Response: Quasi-Experimental Study

Aim: This study aims to investigate the effect of ‘teaching: prescribed medication’ NIC on drug use behaviors and ‘medication response’ NOC outputs of older people. Material and Methods: This study was designed with a quasi-experimental form. The Patient Information Form, Questionnaire of Elderly Drug Use Behaviours, and ‘Medication Response’ NOC Scale were applied to older adults who were admitted to Internal Medicine Clinic and complied with the research criteria. After applying the forms, ‘teaching: prescribed medication’ NIC interventions were applied to each of the older adults. Results: After the ‘teaching: prescribed medication’ NIC intervention was applied to the older adults, the drug adherence behavior and patient outputs after drug use changed positively (p<0.05). Conclusion: After the ‘teaching prescribed medication’ NIC nursing interventions, some improvements occurred in the behavior of older adults regarding drug use and the changes expected after drug use. Nurses can make accurate decisions about health care for older adults and provide this health care effectively and objectively by measuring the seriousness of the problem with NOC and applying comprehensive nursing interventions with NIC in organizations providing health services to older adults.

Keywords:

NOC terminology, NIC terminology, Older adult, Drug interaction,

PDF

___

AbdAllah, A. M., Nofal, H. A., Sharafeddin, M. A. (2021). Illness perceptions, beliefs about medication and blood pressure control among hypertensive Egyptian cohort. Egyptian Journal of Community Medicine, 39(1), 50-64.
Arain, M. A., Ahmad, A., Chiu, V., Kembel, L. (2021). Medication adherence support of an in-home electronic medication dispensing system for individuals living with chronic conditions: a pilot randomized controlled trial. BMC Geriatrics, 21(1), 56. doi: 10.1186/s12877-020-01979-w
Arpaci, F., Acikel, C. H., Simsek, I. (2008). Attitudes of drug use of an elderly population living in Ankara. TAF-Preventive Medicine Bulletin, 7(6), 515.
Bulechek, G., Butcher, H., Dochterman, J., M., Wagner, C., (2017). Nursing interventions classification (NIC). (6th ed.). Elsevier publishes.
CDC. (2018). Transparent Reporting of Evaluations with Nonrandomized Designs (TREND). Accessed date: 16.04.2023, https://www.cdc.gov/trendstatement/pdf/trendstatement_TREND_Checklist.pdf
Erdemir, F., Kav, S., Yılmaz, A. A. (2017). Nursing outcomes classification (NIC). Nobel Tıp Kitabevleri.
Gencbaş, D., Bebiş, H., Moorhead, S. (2020). Validation of the outcomes tools for urinary incontinence in Nursing Outcomes Classification system and their sensitivities on nursing interventions. Gülhane Tip Dergisi, 62(1), 21. DOI: 10.4274/gulhane.galenos.2019.757
Griffiths, R., Johnson, M., Piper, M., Langdon, R. (2004). A nursing intervention for the quality use of medicines by elderly community clients. International Journal of Nursing Practice, 10(4), 166–176. doi: 10.1111/j.1440-172X.2004.00476.x
Gungen, C., Ertan, T., Eker, E., Yaşar, R., Engin, F. (2002). Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population. Turkish Journal of Psychiatry, 13(4), 273–281.
Haugsdal, C. S., Scherb, C. A. (2003). Using NIC to describe the role of the nurse practitioner. International Journal of Nursing Terminologies and Classifications, 14, 43-43. doi: 10.1111/j.1744-618X.2003.040_5.x
Irmak, Y.D.D.Z., Düzöz, Ö.G.G.T., Bozyer, Ö.G.İ. (2007). Effect of an education programme on the lifestyle change and compliance to drug therapy of hypertensive patients. Journal of Hacettepe University School of Nursing, 14(2), 39-47.
Jankowska-Polańska, B., Świątoniowska-Lonc, N., Sławuta, A., Krówczyńska, D., Dudek, K., Mazur, G. (2020). Patient-Reported Compliance in older age patients with chronic heart failure. PloS one, 15(4), e0231076. doi: 10.1371/journal.pone.0231076
Laurant, M., van der Biezen, M., Wijers, N., Watananirun, K., Kontopantelis, E., van Vught, A. J. (2018). Nurses as substitutes for doctors in primary care. The Cochrane Database of Systematic Reviews, 7(7), CD001271. doi: 10.1002/14651858.CD001271.pub3
Mathes, T., Jaschinski, T., Pieper, D. (2014). Adherence influencing factors - a systematic review of systematic reviews. Archives of Public Health, 72(1), 37-46. doi: 10.1186/2049-3258-72-37
Moorhead, S., Swanson, E., Johnson, M., Maas, M. (2018). Nursing outcomes classification (NOC): Measurement of health outcomes. (6th ed.). Elsevier publishes.
Morin, L., Laroche, M. L., Texier, G., Johnell, K. (2016). Prevalence of potentially inappropriate medication use in older adults living in nursing homes: A systematic review. Journal of the American Medical Directors Association, 17(9), 862.e1–862.e8629. doi: 10.1016/j.jamda.2016.06.011
Patterson, S. M., Cadogan, C. A., Kerse, N., Cardwell, C. R., Bradley, M. C., … Hughes, C. (2014). Interventions to improve the appropriate use of polypharmacy for older people. The Cochrane Database of Systematic Reviews, (10), CD008165. doi: 10.1002/14651858.CD008165.pub3
Rodgers, J. E., Thudium, E. M., Beyhaghi, H., Sueta, C. A., Alburikan, K. A., … Stearns, S. C. (2018). Predictors of medication adherence in the elderly: The role of mental health. Medical Care Research and Review, 75(6), 746–761. doi: 10.1177/1077558717696992
Suhonen, R., Välimäki, M., Leino-Kilpi, H. (2008). A review of outcomes of individualised nursing interventions on adult patients. Journal of Clinical Nursing, 17(7), 843–860. doi: 10.1111/j.1365-2702.2007.01979.x
Teichert, M., Luijben, S. N., Wereldsma, A., Schalk, T., Janssen, J., Wensing, M. … de Smet, P. (2013). Implementation of medication reviews in community pharmacies and their effect on potentially inappropriate drug use in elderly patients. International Journal of Clinical Pharmacy, 35(5), 719–726. doi: 10.1007/s11096-013-9794-8
Van Camp, Y. P., Van Rompaey, B., Elseviers, M. M. (2013). Nurse-led interventions to enhance adherence to chronic medication: systematic review and meta-analysis of randomised controlled trials. European Journal of Clinical Pharmacology, 69(4), 761–770. doi: 10.1007/s00228-012-1419-y
van Loon-van Gaalen, M., van Winsen, B., van der Linden, M. C., Gussekloo, J., van der Mast, R. C. (2021). The effect of a telephone follow-up call for older patients, discharged home from the emergency department on health-related outcomes: a systematic review of controlled studies. International Journal of Emergency Medicine, 14(1), 13. doi: 10.1186/s12245-021-00336-x
Visco, V., Finelli, R., Pascale, A. V., Mazzeo, P., Ragosa, N., Trimarco, V., … Iaccarino, G. (2018). Difficult-to-control hypertension: identification of clinical predictors and use of ICT-based integrated care to facilitate blood pressure control. Journal of Human Hypertension, 32(7), 467–476. doi: 10.1038/s41371-018-0063-0
World Health Organization. (2011). Promoting rational use of medicines: Report of the Intercountry Meeting New Delhi, India, 13–15 July 2010. World Health Organization. World Health Organization Regional Office for South-East Asia. Accessed Date: 20.11.2023, https://apps.who.int/iris/bitstream/handle/10665/205688/B4676.pdf?sequence=1&isAllowed=y
World Health Organization. (2015). World report on ageing and health. World Health Organization. Accessed Date: 20.11.2023, https://www.who.int/ageing/events/world-report-2015-launch/healthy-ageing-infographic.jpg?ua=1