Diyabetli Bireyler ve Onlara Bakım Veren Hemşirelerin Hastalık Özyönetim Stratejilerine Bakışı: Kalitatif Bir Çalışma

Amaç: Bu araştırma, diyabetli bireyler ve onlara bakım veren hemşirelerin diyabet yönetimi sırasında özyönetim stratejilerini belirlemek ve diyabetlilerin özyönetim durumları hakkında bilgi sahibi olmak amacıyla yapıldı. Yöntem: Araştırma Ankara'da yapıldı. Araştırmaya katılmaya gönüllü olan Tip 2 diyabetli yedi hasta ve onlara bakım veren yedi hemşire araştımanın örneklemini oluşturdu. Veri toplamak için yarı yapılandırılmış derinlemesine görüşme yöntemi kullanıldı. Hasta ve hemşireler ile uygun bir ortamda yüz yüze görüşme ile veriler toplandı. Görüşmeler araştırmaya katılan kişilerden izin alındıktan sonra ses kayıt cihazına kaydedildi. Çalışma sonunda verilerin çözümü yapılıp analiz edildi ve temalar oluşturuldu. Bulgular: Diyabetli bireylerle yapılan görüşmeler sonunda yapılan kalitatif değerlendirme sonuçlarına göre alt temalar; diyete uyum, egzersiz yapma, stres yönetimi ve insülin yapma olarak saptandı. Bakım veren hemşirelerle yapılan görüşmelerde ortaya çıkan alt temalar ise diyet, eğitim ve insülin yapma oldu. Sonuç: Bu bulgulara göre hemşirelerin diyabetli hastalara verdikleri danışmanlıkları ve eğitimi yönlendirmeleri, hastalara tanı almadan başlayarak özyönetimde zorlandıkları konularda yaşam boyu rehberlik etmeleri önerilir

Review of Disease Self-Management Strategies among Diabetic Individuals and their Caretaker Nurses: A Qualitative Study

Aim: This aim of this study was to determine the difŞ culties experienced by indivuduals with diabetes and their caregiver nurses during diabetes management of the disease, and to obtain information about their self-management level. Methods: The study was conducted in Ankara. The study sample consisted of seven volunteer patients with type 2 diabetes, and seven nurses responsible for these patients’ care. Data were collected using the semi-structured, intensive interview method. All data were collected through the face-to-face interviews conducted with the patients and their nurses in a suitable environment. The interviews were recorded with a tape recorder, after obtaining the permission of the study participants. At the end of the study, the data analysis was performed and various themes were created. Results: Following the interviews conducted with the diabetic patients, and based on the results of qualitative assessment that were performed, the subthemes were determined as diet adherence, exercise, stress management, and administration of insulin. The subthemes identiŞ ed in the interviews conducted with the caregiver nurses were diet, training, and administration of insulin. Conclusion: According to these Ş ndings, nurses are advised to provide lifelong counseling and education guidance for patients with diabetes, beginning with the diagnosis of the disease and challenging them in self-management

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1 . http://www.idf.org/diabetesatlas (Erişim tarihi: 12.07.2015).
2 . Satman I, Omer B, Tutuncu Y, Kalaca S, Gedik S, Dinccag N. ve ark. TURDEP-II Study Group. Twelve-year trends in the prevalence and risk factors of diabetes and prediabetes in Turkish adults. Eur J Epidemiol 2013; 28(2):169-80.
3 . http://www.health.vic.gov.au/pch/downloads/dhs_diabetes_guidelines. pdf. Diabetes self-management: Guidelines for providing services to people newly diagnosed with Type 2 diabetes, 2007. (Erişim tarihi: 12.07.2015).
4 . Cooper H, Booth K, Gill G. Patients perspectives on diabetes health care education. Health Educ Res 2003; 18(2):191-206. https://doi. org/10.1093/her/18.2.191.
5 . Glasgow RE, Strycker LA. Preventive care practices for diabetes management in two primary care samples. Am J Prev Med 2000; 19(1):9-14. http://dx.doi.org/10.1016/S0749-3797(00)00157-4.
6 . American Association of Diabetes Educators (AADE). Guidelines for the Practice of Diabetes Self- Management Education and Training (DSME/ T). 2011. http://www.diabeteseducator.org/export/sites/aade/_ resources/pdf/research/Guidelines_Final_2_1_11.pdf. (Erişim tarihi: 12.07.2015).
7 . ADA. Standarts of medical care ın diabetes, Diabetes Care 2015; V: 38 (Suppl 1).
8 . Norris SL, Nichols PJ, Caspersen CJ, Glaskow RE, Engelgau MM, Jack L. et al. Increasing diabetes self-management education in community settings. A systematic review. Am J. Prev. Med 2002; 22:29-66. http:// dx.doi.org/10.1016/S0749-3797(02)00424-5.
9 . Kargar M, Ramezanli S, Taheri L. Effectiveness of diabetes selfmanagement education on quality of life in diabetic elderly females. Glob J. Health Science 2014; Jul 29;7(1):10-5.
10 . Kirby S, Moore M, McCarron T, Perkins D, Lyle D. Nurse-led diabetes management in remote locations. Can J Rural Med 2015; 20(2):51-5.
11 . Guest G, Bunce A, Johnson L. How many ınterviews are enough? An experiment with data saturation and variability. Family Health International 2006; 18 (1):59-82. https://doi. org/10.1177/1525822X05279903.
12 . Guba EG, Lincoln YS. Epistemological and methodological bases of naturalistic inquiry. Educational Communication and Technology Journal. 1982; 30(4):233-52.
13 . Streubert HJ, Carpenter DR. Qualitative research in nursing. (5th ed.). Philadelphia: Lippincott Williams ve Wilkins 2011.
14 . Kümbetoğlu B. Sosyolojide ve antropolojide niteliksel yöntem ve araştırma. 2. baskı. Istanbul: Bağlam Yayıncılık; 2008. s: 96-102.
15 . Topp M. Nurse perceptions of the challenges of providing self management education primary health care to people with newly diagnosed type 2 diabetes. 2013. Eastern Instıtute Technology.
16 . Goetz K, Szecsenyi J, Campbell S, Rosemann T, Rueter G, Raum E. et al. The importance of social support for people with type 2diabetes – a qualitative study with general practitioners, practice nurses and patients. Psycho-Social-Medicine 2012; V:9, p:1-9. http://dx.doi.org/10.3205/ psm000080.
17 . Hung S, Fu S, Lau P, Wong SA. Qualitative study on why did the poorly educated Chinese elderly fail to attend nurse-led case manager clinic and how to facilitate their attendance. International Journal for Equity in Health 2015; 14(10). https://doi.org/10.1186/s12939-015-0137-3.
18 . ADA. Standarts of medical care ın diabetes, Diabetes Care 2014; January, V:37 (Supplement 1). p:14-80. https://doi.org/10.2337/dc14- S014.
19 . Rostami S, Yekta Z, Ghezeljeh T, Vanaki Z, Zarea K. Self-perception in Iranian adolescents with diabetes: a qualitative study. Journal of Diabetes & Metabolic Disorders 2015; 14(36):1-9 https://dx.doi.org/1 0.1186%2Fs40200-015-0163-0.
20 . Tekin O, Erarslan E, Işık B, Özkara A. Diyabetik hastalarda tedavi bariyerleri ve glisemik kontroldeki önemleri: Ankara-Pursaklar Bölgesinde Kesitsel bir çalışma. Yeni Tıp Dergisi 2007; 24(2): 105-9.
21 . Karadağ E, Karatay G, Parlar Kılıç S. Türkiye’nin doğusunda Tip 2 diyabetlilerde sosyal destek ve öz yeterliliğinin özbakım aktivitlerine etkisi. Hemşirelik Formu (Diyabet, Obezite ve Hipertansiyon Özel Sayısı) 2014; 6(1):1-12.
22 . Tan MY, Magarey J. Self-care practices of Malaysian adults with diabetes and sub-opitmal glycaemic control. Patient Education and Counseling 2008; 72(2):252-67. https://doi.org/10.1016/j.pec.2008.03.017.
23 . Surwit RS, Van Tilburg MAL, Zucker N, McCaskill CM, Parekh P, Feinglos MN, et al. Stress management improves long-term glycemic control in Type 2 diabetes. Diabetes Care 2002; 25:30-4, https://doi. org/10.2337/diacare.25.1.30.
24 . IDF. International standards for diabetes education. http://www.msc. es/organizacion/sns/planCalidadSNS/pdf/excelencia/cuidadospaliativosdiabetes/DIABETES/opsc_est12.pdf.pdf 2009; (Erişim Tarihi: 18 Kasım 2012).
25 . Mattila E, Leino K, Paavilainen Estedt-Kurki P. Nursing intervention studies on patients and family members: a systematic literature review. Scand J Caring Sci. 2009; 23(3):611-22. https://doi. org/10.1111/j.1471-6712.2008.00652.x.
26 . Van Dam HA, Van Der Horst F, Van Den Borne B, Ryckman R, Crebolder H. Provider-patient interaction in diabetes care: effects on patient selfcare and outcomes. A systematic review. Patient Educ Couns. 2003; Sep; 51(1):17-28.
27 . Boström E, Isaksson U, Lundman B, Graneheim UH, Hörnsten Å. Interaction between diabetes specialist nurses and patients during group sessions about self-management in type 2 diabetes. Patient Educ Couns. 2014; 94(2):187-92. https://doi.org/10.1016/j.pec.2013.10.010.
28 . Protheroe J, Brooks H, Chew-Graham C, Gardner C, Rogers A. Permission to participate. A qualitative study of participation in patients from differing socio-economic backgrounds. J Health Psychol 2013; 18:1046-55. https://doi.org/10.1177/1359105312459876.
29 . Nguyen AT. Self-Management of Type 2 Diabetes: Perspectives of Vietnamese Americans. J Transcult Nurs. 2014; Feb 26. https://doi. org/10.1177.