M.murat ÇELİK, Umut KALYONCU, Hakan GÜZELSAĞALTICI

Hatay bölgesindeki romatoid artritli hastaların tedavi sürecini etkileyen motivasyon faktörlerinin araştırılması

Bu çalışmada romatoid artrit (RA) hastalarının romatoloji polikliniğine başvurmalarıyla ilgili motivasyon faktörlerinin araştırılması amaçlanmıştır. Ağustos 2012 ile Ekim 2012 tarihleri arasında Hatay Devlet Hastanesi Romatoloji Polikliniğine başvuran ardışık 95 RA hastası çalışmaya alındı. Son 6 ay içerisinde 1 veya daha fazla poliklinik kontrolüne gelen hastalar “düzenli takibe gelen hastalar” olarak kabul edildi. Çalışma tarihleri arasında başvuran ve son kontrolü 6 aydan önce olan hastalar ise “düzenli takibe gelmeyen hastalar” olarak kabul edildi. Hastalardan alınan bilgiler ışığında tedavi sürecinde sağlık kontrollerini düzenli yaptırma ve yaptırmama nedenlerini içeren iki ayrı form oluşturuldu. Düzenli tedavi olan hastalar için hazırlanan formda ifade sayısı 42, düzensiz tedavi olan hastalar için hazırlanan formda ise ifade sayısı 56 idi. Bu çalışmaya 95 RA hastası (63'ü kadın) alındı. Hastaların yaş ortalamaları sırasıyla 46.4±13.0 ve 40.6±12.6 idi. Bu hastaların 81'i (%85.3) tedavi sürecinde kontrollerini düzenli yaptıran hastalar olup, 14'ü (%14.7) ise kontrollerini aksatan hastalardan oluşmaktaydı. Düzenli olarak kontrole gelen 81 hastanın 47'sinin (%58.0) ilkokul düzeyi veya altında eğitim aldığı, kontrollerini aksatan 14 hatanın ise tümünün (%100) ilkokul düzeyi veya altında eğitim aldığı görülmüştür (p=0.002). Kontrollerini düzenli yaptıran hastaların 37'si (%45.6) steroid kullanıyorken, düzenli kontrollerini yaptırmayan hastaların 12'si (%85.7) steroid kullanmaktaydı ve aradaki fark anlamlıydı (p=0.006). RA hastalarını motive eden asıl faktörler sırasıyla doktor ve sağlık çalışanlarıyla, hastanın kendi düşünce, inanç ve beklentileriyle, hastane koşullarıyla, hastanın çalışma koşulları ve maddi gerekçelerle en sonunda da toplumsal etkilerle ilgili bulundu. RA hastalarının düzenli takip edilmeleri hasta ve doktor kaynaklı birçok nedenden etkilenmektedir. Hastaların sosyo-kültürel düzeyi düzenli takip edilmeyi doğrudan etkiliyor gibi görülmektedir.

Anahtar Kelimeler:

Motivasyon faktörleri; romatoid artrit; tedavi süreci.

An investigation of motivational factors affecting treatment process of patients with rheumatoid arthritis in Hatay province

In the present study, it was aimed to investigate factors of motivation concerning referral of the patient with rheumatoid arthritis (RA) to rheumatology department. Ninety-five consecutive patients with RA presented to Rheumatology Department of Hatay State Hospital between August, 2012 and October, 2012 were included to the study. The patients attended to one or more control visit within prior 6 months were considered as “patients regularly attending control visits”. Those attended to a control visit during study period but not within prior 6 months were considered as “patients not regularly attending control visits”. In the light of information obtained from patients, two distinct forms were designed including reasons for attending regularly or not regularly to control visits. The form designed for “patients regularly attending control visits” included 42 items, whereas the form designed for “patients not regularly attending control visits” included 56 items. Ninety-five patients (63 women) with RA were included to the study. Mean ages were 46.4±13.0 and 40.6±12.6 years. Of these patients, 81 (85.3%) were “patients regularly attending control visits”, whereas 14 (14.7%) were “patients not regularly attending control visits”. It was seen that, the educational levels was primary school or below in 47 (58%) of the 81 “patients attending regularly to control visits” vs. all 14 “patients attending not regularly to control visits” (p=0.002).While 37 (45.6%) of the “patients attending regularly to control visits” were on steroid therapy, 12 (85.7%) of the “patients attending not regularly to control visits” were on steroid therapy. The difference was statistically significant (p=0.006).The main factors motivating patient with RA are found to be related to clinicians and healthcare providers; thoughts, beliefs and expectations of the patients; conditions of hospital; working condition of the patients; economic arguments; and social interactions. Regular follow-up of the patients with rheumatoid arthritis can be affected by several factor originating from patient or clinician. It seems that socio-cultural level of the patients directly affect regular follow-up of these patients.

Keywords:

Factors of motivation; rheumatoid arthritis; treatment process.,

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