İNSÜLİN KULLANAN DİYABETLİ HASTALARDA HİPOGLİSEMİ KORKUSU VE ÖZ-YETERLİLİK ALGISI İLE İLİŞKİLİ FAKTÖRLERİN BELİRLENMESİ
Amaç
Bu çalışmanın amacı insülin kullanan diyabetli hastalarda
hipoglisemi korkusu ve öz-yeterlilik algısını ve
bunlarla ilişkili faktörleri belirlemektir.
Gereç ve Yöntem
Tanımlayıcı ve ilişki arayıcı tipteki bu araştırma Aralık
2016-Şubat 2017 tarihleri arasında bir Devlet
Hastanesi’nde diyabet eğitim hemşiresi tarafından
takip edilen toplam 136 hasta ile yapılmıştır. Verilerin
toplanmasında literatür doğrultusunda hazırlanan
“Hasta Tanıtım Formu”, “Çok Boyutlu Diyabet Anketi’nin
Öz-yeterlilik Algısı Alt Ölçeği” ve “Hipoglisemi
Korku Ölçeği (HKÖ)” kullanılmıştır. Verilerin normal
dağılım gösterip göstermediğini belirlemek için Kolmogorov-
Smirnov testi, basıklık ve çarpıklık değerleri
hesaplanarak verilerin analizi için kullanılacak testler
belirlenmiştir. Bağımsız iki grup arasındaki verilerin
karşılaştırılmasında t testi, ikiden fazla grup arasındaki
verilerin karşılaştırılmasında Tek Yönlü Varyans
analizi kullanılmıştır. Ölçek puanları arasındaki ilişkiyi
belirlemek için Pearson Korelasyon analizi yapılmıştır.
Bağımsız değişkenlerin Öz-yeterlilik Algı Ölçeği ile
HKÖ puanlarını anlamlı düzeyde yordama durumunu
belirlemek amacıyla Çoklu Doğrusal Regresyon analizi
yapılmıştır.
Bulgular
Araştırmaya katılan bireylerin yaş ortalaması 58,12
± 12,45’dir. Ayrıca katılımcıların %66,9’u kadın olup
%75’i elli yaş ve üzerindedir. Katılımcıların HKÖ toplam
puan ortalaması 52,58 ± 11,21; Davranış alt boyutu
puan ortalaması 28,12 ± 4,76 ve Kaygı alt boyutu
puan ortalaması 24,46 ± 8,11’dir. Hastaların Öz-yeterlilik
Algısı Ölçeği puan ortalaması 364,24 ± 18,46’dır.
Hastaların DM süresi, DM tipi, DM ilaç tedavi türü, düzenli
kontrollere gitme durumu, hipoglisemi yaşama
durumu ve hipoglisemi belirtilerini bilme durumu ile
HKÖ ve Öz-yeterlilik Algısı Ölçeği puanları arasında
istatistiksel olarak anlamlı bir fark olduğu belirlenmiştir
(p < 0,05). Öz-yeterlilik Algı Ölçeği puanı ile HKÖ
toplam puanı, Davranış ve Kaygı alt boyutu puanı arasında
negatif yönde ve orta düzeyde bir korelasyon
(sırasıyla r= - 0,578, p<0,001; r= - 0,588, p<0,001 ve
r= - 0,548, p<0,001) bulunmuştur. DM süresi, DM tipi,
DM ilaç tedavisi, düzenli kontrollere gitme durumu, hipoglisemi
yaşama durumu ve hipoglisemi belirtilerini
bilme durumunun HKÖ ve Öz-yeterlilik Algısı Ölçeği
toplam puanını anlamlı düzeyde yordama durumunu
belirlemek amacıyla yapılan çoklu regresyon analizi-
ne göre modelin anlamlı olduğu ve sırasıyla varyansın
%42’sini ve %53’ünü açıkladığı bulunmuştur (sırasıyla
F= 16,71; p<0,001; F= 19,47; p<0,001).
Sonuç
İnsülin kullanan diyabetli hastaların hipoglisemi korkusu
ve öz-yeterlilik algısı hastalığa ilişkin bazı özelliklerden
etkilenmektedir. Ayrıca hastaların öz-yeterlilik
algı düzeyi hipoglisemi korkusu üzerinde etkilidir.
Bu bağlamda diyabetli bireylerde öz-yeterlik algısının
geliştirilmesi hipoglisemi korkularının azaltılmasında
etkili olabilir.
DETERMINATION OF FACTORS ASSOCIATED WITH FEAR OF HYPOGLYCEMIA AND PERCEPTION OF SELF-EFFICACY IN DIABETES PATIENTS USING INSULIN
Objective
The aim of this study is to determine the factors associated
with fear of hypoglycemia and perception of
self-efficacy and related factors in diabetic patients
using insulin.
Material and Method
This descriptive and correlational study was conducted
with a total of 136 patients followed by a diabetes
education nurse in a State Hospital between
December 2016 and February 2017. "Patient Information
Form", "Self-Efficacy Perception Sub-Scale of
Multidimensional Diabetes Questionnaire" and "Hypoglycemia
Fear Scale (HFS)" were used to collect
data. In order to determine whether the data showed
a normal distribution, Kolmogorov-Smirnov test, kurtosis
and skewness values were calculated and the
tests to be used for the analysis of the data were determined.
The t test was used to compare the data
between two independent groups, and the one-way
analysis of variance was used to compare the data
between more than two groups. Pearson Correlation
analysis was performed to determine the relationship
between scale scores. Multiple Linear Regression
analysis was performed to determine whether
the independent variables significantly predicted the
Self-Efficacy Perception Scale and HFS scores.
Results
The mean age of the individuals participating in the
research is 58.12 ± 12.4. In addition, 66.9% of the
participants are women and 75% of them are fifty
years old and over. The total mean score of the
participants on the HFS was 52.5 ± 11.2; Behavior
sub-dimension mean score was 28.12 ± 4.76 and
Worry sub-dimension mean score was 24.46 ± 8.11.
The mean score of the Self-Efficacy Perception Scale
of the patients was 364.2 ± 18.46. It was determined
that there was a statistically significant difference between
the patients' DM duration, DM type, DM drug
treatment type, regular follow-up visits, hypoglycemia
experience and knowing the symptoms of hypoglycemia,
and the scores of HFS and Self-Efficacy Perception
Scale (p < 0.05). A negative and moderate
correlation was found between the Self-Efficacy
Perception Scale score and the total score of HFS,
the Behavior sub-dimension score and the Worry
sub-dimension score (r=- 0.578, p<0.001; r= - 0.588,
p<0.001 ve r= - 0.548, p<0.001 respectively). According
to the multiple regression analysis carried out to
determine whether the duration of DM, type of DM,
DM medication, regular follow-up visits, hypoglycemia,
and knowing the symptoms of hypoglycemia
significantly predicted the total score of the HFS and
Self-Efficacy Scale, the model was found to be significant
and the variance explained 42% and 53%
of them respectively. (F= 16.71; p<0.001; F= 19.47;
p<0.001, respectively).
Conclusion
Fear of hypoglycemia and self-efficacy perception of
diabetic patients using insulin are affected by some
characteristics of the disease. In addition, the self-efficacy
perception level of the patients is effective on
the fear of hypoglycemia. In this context, improving
the perception of self-efficacy in individuals with diabetes
may be effective in reducing fears of hypoglycemia.
___
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