İnsülin kullanan tip 2 diyabet hastalarında,insülin tedavisine bakışın ve insülin tedavisi öz-yönetiminin tedavi yeterliliği ve komplikasyonlar ile ilişkisi
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Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnsülin kullanan tip 2 diyabet hastalarında, insülin tedavisine bakışın ve insülin tedavisi öz-yönetiminin tedavi yeterliliği ve komplikasyonlar ile ilişkisi Giriş ve Amaç: Diabetes Mellitus (DM) hastalarında tedavi başarısı medikal tedavi seçeneklerinin etkili yönetimine olduğu kadar hastanın tedaviye uyumuna, tedaviye bakış açısına ve hastalık hakkındaki bilgi düzeyine de bağımlıdır. Bu sebeple pek çok otorite DM tedavisinde hasta eğitimine dikkat çekmektedir. Hastaların DM tedavilerine bakış açısının ve uyumunun değerlendirilmesini mümkün kılacak araçlara ve bu parametrelerin hastalık açısından öneminin ortaya çıkarılmasına ihtiyaç vardır. Bu çalışma herhangi subkutan insülin rejimi ile takipli tip 2 DM hastalarında; hastaların DM tedavisine bakış açısını ve İnsülin Tedavisi Öz Yönetim Ölçeği (ITOY) ile İnsülin Tedavisi Değerlendirme Ölçeği (ITD)'nin klinik açıdan önemini araştırmayı hedeflemiştir. Gereç ve Yöntem: Çalışma Aralık 2023-Mart 2024 tarihleri arasında kliniğimize başvuran; 18 yaşından büyük, tip 2 DM tanısına sahip, herhangi subkutan insülin rejimi ile takip edilen, nörokognitif ve psikiyatrik hastalığı bulunmayan hastalar ile yürütüldü. Yüzyüze anket yöntemi ile ITOY ve ITD ölçekleri uygulandı. Ek olarak hastaların yaş, cinsiyet, HbA1c değerleri, ek hastalıkları ve son 1 yıl içerisindeki tıbbı özgeçmişleri incelendi. Çalışma 150 katılımcı ile yürütülmüştür. Bulgular: Olguların toplam ITOY skoru ortalama 124,31±18,13(Min-maks:75-156). Olguların toplam ITOY skoru ortalama 124,31±18,13(Min-maks:75-156) olarak saptandı ve Cronbach Alpha güvenilirlik katsayısı 0,840 olarak tespit edildi. Toplam ITD skoru ortalama 50,41±14,25 (Min-Maks: 26-84) olarak saptandı ve Cronbach Alpha güvenilirlik katsayısı 0,779 olarak tespit edildi. ITOY skorları ile yaş arasında pozitif korelasyon saptandı (R=-0,581, p=<0,001), ITD skorları ile yaş arasında doğrusal korelasyon saptandı (R=0,171 p=0,036).ITOY skorları eğitim düzeyine göre gruplar arasında farklılık gösterdi (p=<0,001), ITD skorları değişim göstermedi. ITOY skorları bağımlı değişken ve katılımcıların yaş, eğitim düzeyi, DM süresi ve İnsülin kullanım süresi bağımsız değişken olarak tanımlanarak kurulan regresyon modelinde R=0,662, düzeltilmiş R2=0,423, F(4-145)=28,308, p=<0,001 olarak saptandı. Aynı model ITD skorları açısından anlamlı değildi (p=0,136).HbA1c bağımlı değişken ve ITOY bağımsız değişken olarak kurgulanan regresyon modelinde R=0,301, düzeltilmiş R2=0,90, F(1-148)=14,709,p=<0,001). ITD ile yapılan modelde ise R=0,263, düzeltilmiş R2=0,63, F(1-148)=10,957, p=<0,001 olarak saptandı. Sonuç: DM hastalarında yapılan diyabet öz yönetiminin geliştirilmesi ve özyönetimin ölçümü DM tedavisinin izleminde önemlidir. ITOY ve ITD anketleri bu konuda yardımcı bir klinik araç olabilir. Anahtar Kelimeler: Diabetes Mellitus, Özyönetim, Ölçek, diyabet eğitimi, insülin
The relationship between patients' perspectives on insulin therapy and insulin therapy self-management with treatment adequacy and complications in type 2 diabetes patients using insulin. Introduction and Objective: Treatment success in Diabetes Mellitus (DM) patients depends on the effective management of medical treatment options as well as the patient's compliance with the treatment, his perspective on the treatment, and his level of knowledge about the disease. For this reason, many authorities draw attention to patient education in the treatment of DM. There is a need for tools that will enable the evaluation of patients' perspectives and compliance with DM treatments and reveal the importance of these parameters in terms of the disease. This study was conducted in type 2 DM patients with any subcutaneous insulin regimen; It aimed to investigate patients' perspectives on DM treatment and the clinical importance of the Insulin Therapy Self-Management Scale (ITSS) and the Insulin Therapy Evaluation Scale (ITE). Materials and Methods: The study included patients who applied to our clinic between December 2023 and March 2024; It was conducted with patients who were older than 18 years of age, diagnosed with type 2 DM, with any subcutaneous insulin regimen, and did not have neurocognitive or psychiatric diseases. ITSS and ITE questionnaires were applied by face-to-face survey method. In addition, the patients' age, gender, HbA1c values, comorbidities, and medical history within the last year were examined. The study was conducted with 150 participants. Results: The average total ITSS score of the cases was 124.31±18.13 (Min-max: 75- 156). The average total ITE score of the cases was determined as 124.31±18.13 (Min-max: 75-156) and the Cronbach Alpha reliability coefficient was determined as 0.840. The average total ITE score was determined as 50.41±14.25 (Min-Max: 26- 84) and the Cronbach Alpha reliability coefficient was determined as 0.779. A positive correlation was detected between ITSS scores and age (R=-0.581, p=<0.001), and a linear correlation was detected between ITE scores and age (R=0.171 p=0.036). ITE scores differed between groups according to education level (p=< 0.001), ITE scores did not change.In the regression model established by defining ITSS scores as dependent variables and participants' age, education level, DM duration, and insulin use duration as independent variables, R=0.662, adjusted R2=0.423, F(4-145)=28.308, p=<0.001. The same model was not significant for ITE scores (p=0.136). In the regression model designed with HbA1c as the dependent variable and ITSS as the independent variable, R=0.301, adjusted R2=0.90, F(1-148)=14.709, p=<0.001). In the model made with ITE, R=0.263, corrected R2=0.63, F(1-148)=10.957, p=<0.001. Conclusion: Improving diabetes self-management and measuring self-management in DM patients are important in monitoring DM treatment. ITSS and ITE questionnaires can be helpful clinical tools in this regard. Key Words: Diabetes Mellitus, Self-Management, questionnaires, diabetes education, insulin
The relationship between patients' perspectives on insulin therapy and insulin therapy self-management with treatment adequacy and complications in type 2 diabetes patients using insulin. Introduction and Objective: Treatment success in Diabetes Mellitus (DM) patients depends on the effective management of medical treatment options as well as the patient's compliance with the treatment, his perspective on the treatment, and his level of knowledge about the disease. For this reason, many authorities draw attention to patient education in the treatment of DM. There is a need for tools that will enable the evaluation of patients' perspectives and compliance with DM treatments and reveal the importance of these parameters in terms of the disease. This study was conducted in type 2 DM patients with any subcutaneous insulin regimen; It aimed to investigate patients' perspectives on DM treatment and the clinical importance of the Insulin Therapy Self-Management Scale (ITSS) and the Insulin Therapy Evaluation Scale (ITE). Materials and Methods: The study included patients who applied to our clinic between December 2023 and March 2024; It was conducted with patients who were older than 18 years of age, diagnosed with type 2 DM, with any subcutaneous insulin regimen, and did not have neurocognitive or psychiatric diseases. ITSS and ITE questionnaires were applied by face-to-face survey method. In addition, the patients' age, gender, HbA1c values, comorbidities, and medical history within the last year were examined. The study was conducted with 150 participants. Results: The average total ITSS score of the cases was 124.31±18.13 (Min-max: 75- 156). The average total ITE score of the cases was determined as 124.31±18.13 (Min-max: 75-156) and the Cronbach Alpha reliability coefficient was determined as 0.840. The average total ITE score was determined as 50.41±14.25 (Min-Max: 26- 84) and the Cronbach Alpha reliability coefficient was determined as 0.779. A positive correlation was detected between ITSS scores and age (R=-0.581, p=<0.001), and a linear correlation was detected between ITE scores and age (R=0.171 p=0.036). ITE scores differed between groups according to education level (p=< 0.001), ITE scores did not change.In the regression model established by defining ITSS scores as dependent variables and participants' age, education level, DM duration, and insulin use duration as independent variables, R=0.662, adjusted R2=0.423, F(4-145)=28.308, p=<0.001. The same model was not significant for ITE scores (p=0.136). In the regression model designed with HbA1c as the dependent variable and ITSS as the independent variable, R=0.301, adjusted R2=0.90, F(1-148)=14.709, p=<0.001). In the model made with ITE, R=0.263, corrected R2=0.63, F(1-148)=10.957, p=<0.001. Conclusion: Improving diabetes self-management and measuring self-management in DM patients are important in monitoring DM treatment. ITSS and ITE questionnaires can be helpful clinical tools in this regard. Key Words: Diabetes Mellitus, Self-Management, questionnaires, diabetes education, insulin
Açıklama
Tıp Fakültesi, İç Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
İç Hastalıkları, Internal diseases
