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Hemodiyaliz Tedavisi Alan Hastaların Sıvı Kısıtlamasına Uyumları ve Hasta Aktifliği Arasındaki İlişkinin Değerlendirilmesi

Year 2018, Volume: 2 Issue: 3, 126 - 137, 09.10.2018

Abstract

Amaç:
Araştırmanın
amacı; hemodiyaliz tedavisi alan hastaların sıvı
kısıtlamasına uyumları ve hasta aktifliği arasındaki ilişkiyi değerlendirmektir.

Gereç
ve Yöntemler:
Araştırmanın örneklemini, iki devlet
hastanesi ve bir özel diyaliz merkezinde hemodiyaliz tedavisi alan ve çalışmaya
katılmayı kabul eden 132 hasta oluşturdu. Veriler, Hasta
Tanıtım Formu, Hemodiyaliz Hastalarında
Sıvı Kontrol Ölçeği (HHSKÖ)ve
Hasta Aktiflik Düzeyi Ölçüm Aracı kullanılarak
elde edildi.

Bulgular:
HHSKÖ puan ortalaması 52,93±6,07
iken, ölçeğin alt boyutlarının puan ortalamaları sırası ile; bilgi alt boyutu
18,56±1,97, davranış alt boyutu 21,75±3,71 ve tutum alt boyutu için 12,62±2,88
olarak saptandı. Hasta aktiflik düzeyi
ölçüm aracı puan ortalaması 40,63±8,44 idi. HHSKÖ puanları ile hasta aktiflik düzeyi ölçüm aracı puanları arasında pozitif yönde istatistiksel olarak
anlamlı korelasyon saptandı. Buna ilaveten, hasta aktiflik düzeyi ölçüm
aracı ile HHSKÖ alt boyutlarından bilgi
ve davranış alt boyut puanları arasında pozitif yönde
istatistiksel olarak anlamlı korelasyon olduğu belirlendi. İnterdiyalitik sıvı
alımı ve ultrafiltrasyon miktarı ile HHSKÖ puanları arasında negatif yönde anlamlı korelasyonlar
bulundu.







Sonuç:
Hemodiyaliz tedavisi alan hastaların sıvı
kontrolüne yönelik bilgilerinin iyi olmasına rağmen davranış ve tutumları daha
zayıftır. Hastaların büyük çoğunluğunda interdiyalitik sıvı alımının fazladır
ve hasta aktiflik düzeyi 1’dir.Hasta aktiflik düzeyi arttıkça sıvı kontrolüne
uyum da artmaktadır. Bu bulgular doğrultusunda; hemodiyaliz tedavisi alan
hastalarda sıvı kontrolünün sağlanmasına yönelik uygulanabilecek girişimlerin;
bilgi vermenin yanı sıra, bireyin tutum ve davranış değişikliği yapmasını
sağlamaya ve aktiflik düzeyini artırmaya yönelik planlanması önerilebilir. 

References

  • 1. Süleymanlar, G., Utaş, C., Arınsoy, T., Ateş, K., Altun, B., Altıparmak, M.R. ve ark. (2011). A population-based survey of chronic renal disease in Turkey-the CREDIT study. Nephrol Dial Transplant, 26(6): 1862–1871.2. Seyahi, N., Ateş, K., Süleymanlar, G. (2015). Türkiye’de renal replasman tedavilerinin güncel durumu: Türk Nefroloji Derneği Kayıt Sistemi 2015 Yılı Özet Raporu. Turk Neph Dial Transpl, 26(2): 155-160.3. Richard, C.J. (2006). Self-care management in adults undergoing hemodialysis. Nephrology Nursing Journal, 33(4): 387-394.4. Welch, J.L., Perkins, S.M., Evans, J.D., Bajpai, S. (2003). Differences in perceptions by stage of fluid adherence. J Ren Nutr,13(4): 275-281.5. Pace, R.C. (2007). Fluid management in patients on hemodialysis. Nephrology Nursing Jounal, 34(5): 557-559. 6. Barnett, T., Yoong, T.L., Pinikahana, J., Yen T.S. (2008). Fluid compliance among patients having haemodialysis: can an educational programme make a difference, J. Adv. Nurs., 61(3): 300–306.7. Balım, S., Çınar Pakyüz, S. (2016). Hemodiyaliz hastalarının sıvı kısıtlamasına uyumlarının değerlendirilmesi. Nefroloji Hemşireliği Dergisi, 1: 35-43.8. Chironda, G.G., Bhengu, B., Manwere, A. (2017). Adherence of adult chronic kidney disease patients with regard to their dialysis, medication, dietary and fluid restriction. Res. J. of Health Sci, 5(1): 3-17.9. Naalweh, K.S., Barakat, M.A., Sweileh, M.W., Al-Jabi, S.W., Sweileh, W.M., Zyoud, S.H. (2017). Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine. BMC Nephrology, 18(178): 2-9.10. Günalay, S., Taşkıran, E., Mergen, H. (2017). Hemodiyaliz hastalarında diyet ve sıvı kısıtlamasına uyumsuzluğunun değerlendirilmesi. FNG & Bilim Tıp Dergisi, 3(1):9-14.11. Hecking, M., Karaboyas, A., Saran, R., Sen, A., Inaba, M. Rayner, H. ve ark. (2012). Dialysate sodium concentration and the associationwith ınterdialytic weight gain, hospitalization and mortality. Clinical Journal of the American Society of Nephrology, 7(1):92- 100.12. Zadeh, K.K., Regidor, D.L., Kovesdy, C.P., Wyck, D.V., Bunnapradist, S., Horwich, T.B. ve ark. (2009). Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation, 119(5):671-679.13. Welch, J.L., Perkins, S.M., Johnson, C.S., Kraus, M.A. (2006). Patterns of interdialytic weight gain during the first year of hemodialysis. Nephrol Nurs Journal, 33(5); 493-499.14. Welch, J.L., Davis, J. (2000). Self-care strategies to reduce fluid intake and control thirst in hemodialysis patients. Nephrology Nursing Journal, 27(4): 393-395.15. Deen, D., Lu, W., Rothstein, D., Santana, L., Gold, M. (2011). Asking questions: The effect of a brief intervention in community health centers on patient activation. Patient Education and Counseling, 84(2): 257–260.16. Hibbard, J.H., Mahoney, E.R., Stock, R., Tusler, M. (2004). Development of the Patient Activation Measure (PAM): Conceptualizing and measuring activation in patients and consumers. HSR: Health Services Research, 39(4): 1005-1026.17. Hibbard, J.H., Greene, J.. Tusler, M. (2009). Improving the outcomes of disease management by tailoring care to the patient’s level of activation. American Journal of Managed Care, 15(6): 353-360.18. Rask, K., Ziemer, D., Kohler, S., Hawley, J.N., Arinde, F., Barnes, C.S. (2009). Patient activation is associated with healthy behaviors and ease in managing diabetes in an Indigent population. The Diabetes Educator, 35(4): 622-630. 19. Hibbard, J.H., Mahoney, E.R., Stock, R., Tusler, M. (2007). Do increases in patient activation result in ımproved self-management behaviors, health research and educational trust. Health Serv Res., 42(4): 1443-1463.20. Albayrak Cosar, A., Cinar Pakyuz, S. (2016). Scale development study: The Fluid control in hemodialysis patients. Jpn J Nurs Sci, 13(1):174-82.21. Koşar, C. Büyükkaya Besen, D. (2015). Hasta aktiflik düzeyi ölçüm aracı ‘nın (pam) türkçe’ye uyarlanması: geçerlik güvenirlik çalışması. (Yayınlanmamış yüksek lisans tezi). DEÜ Sağlık Bilimleri Fakültesi, İzmir. 22. Rambod, M., Peyravi, H., Shokrpour, N., Sareban, M.T. (2010). Dietary and fluid adherence in Iranian hemodialysis patients. Health Care Manag, 29(4):359-64.23. Turgut Kurt, Y., Erdem, E., Kaya, C., Karataş, A., Arık, N. (2012). Hemodiyaliz hastalarına verilen eğitimin kan basıncı ve kilo alımına etkisi. Turk Neph Dial Transpl, 21 (1): 39-44.24. Kugler, C., Maeding, I., Russell, C.L. (2011). Non-adherence in patients on chronic hemodialysis: an international comparison study. J Nephrol, 24(3):366-75.25. Denhaerynck, K., Manhaeve, D., Dobbels, F., Garzoni, D., Nolte, C., De Geest, S. (2007). Prevalence and consequences of nonadherence to hemodialysis regimens. American Journal of Critical Care, 16(3): 222-235.26. Christensen, A.J., Moran, P.J., Wiebe, J.S., Ehlers, S.L., Lawton, W.J. (2002). Effect of a behavioral self-regulationintervention on patientadherence in hemodialysis. Health Psychology, 21(4): 393-397.27. Schmaderer, M.S., Zimmerman, L., Hertzog, M., Pozehl, B., Paulman, A. (2016). Correlates of patient activation and acute care utilization among multimorbid patients. Western Journal of Nursing Research, 38(10): 1335–1353. 28. Hendrics, M., Rademakers, J. (2014). Relationships between patient activation, disease-specificknowledgeandhealthoutcomesamongpeoplewithdiabetes; a survey study. BMC Health Services Research, 14: 393: 1-9.29. Heui, Y., Kim, B.J., Ham, O.K., Kim, S.H. (2015), Factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. J Korean Acad Community Health Nurs, 26(3); 303-311.30. Smith, S.G., Pandit, A., Rush, S.R., Wolf, M.S., Simon, C.J. (2016). The role of patient activation in preferences for shared decision making: Results from a national survey of US. Adults. Journal of Health Communication, 21(1):67–75. 31. Bos-Touwen, I.B., Schuurmans, M., Monninkhof, E.M., Korpershoek, Y. (2015). Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: A Cross-Sectional Survey Study. PLOS ONE, 10(5): 1-15. 32. Goodworth, M.R., Stepleman, L, Hibbard, J., Johns, L. (2016). Variables associated with patient activation in persons with multiple sclerosis. Journal of Health Psychology, 21(1): 82–92.33. Ryvicker, M., Feldman, P.H., Chiu, Y., Gerber, L.M. (2013). The Role of patient activation in ımproving blood pressure outcomes in black patients receiving home care. Medical Care Research and Review, 70(6): 636-652. 34. Mayberry, R., Willock, R.J., Boone, L., Lopez, P., Qin, H., Nicewander, D. A. (2010). High level of patient activation is observed but unrelated to glycemic control among adults with Type 2 Diabetes. Diabetes Spectr, 23(3): 171-176. 35. Hibbard, J.H., Greene, J. (2013). What the evidence shows about patient activation: beter health outcomes and care experiences; Fewerdata on costs. Health Affairs, 32(2): 207-214.
Year 2018, Volume: 2 Issue: 3, 126 - 137, 09.10.2018

Abstract

References

  • 1. Süleymanlar, G., Utaş, C., Arınsoy, T., Ateş, K., Altun, B., Altıparmak, M.R. ve ark. (2011). A population-based survey of chronic renal disease in Turkey-the CREDIT study. Nephrol Dial Transplant, 26(6): 1862–1871.2. Seyahi, N., Ateş, K., Süleymanlar, G. (2015). Türkiye’de renal replasman tedavilerinin güncel durumu: Türk Nefroloji Derneği Kayıt Sistemi 2015 Yılı Özet Raporu. Turk Neph Dial Transpl, 26(2): 155-160.3. Richard, C.J. (2006). Self-care management in adults undergoing hemodialysis. Nephrology Nursing Journal, 33(4): 387-394.4. Welch, J.L., Perkins, S.M., Evans, J.D., Bajpai, S. (2003). Differences in perceptions by stage of fluid adherence. J Ren Nutr,13(4): 275-281.5. Pace, R.C. (2007). Fluid management in patients on hemodialysis. Nephrology Nursing Jounal, 34(5): 557-559. 6. Barnett, T., Yoong, T.L., Pinikahana, J., Yen T.S. (2008). Fluid compliance among patients having haemodialysis: can an educational programme make a difference, J. Adv. Nurs., 61(3): 300–306.7. Balım, S., Çınar Pakyüz, S. (2016). Hemodiyaliz hastalarının sıvı kısıtlamasına uyumlarının değerlendirilmesi. Nefroloji Hemşireliği Dergisi, 1: 35-43.8. Chironda, G.G., Bhengu, B., Manwere, A. (2017). Adherence of adult chronic kidney disease patients with regard to their dialysis, medication, dietary and fluid restriction. Res. J. of Health Sci, 5(1): 3-17.9. Naalweh, K.S., Barakat, M.A., Sweileh, M.W., Al-Jabi, S.W., Sweileh, W.M., Zyoud, S.H. (2017). Treatment adherence and perception in patients on maintenance hemodialysis: a cross – sectional study from Palestine. BMC Nephrology, 18(178): 2-9.10. Günalay, S., Taşkıran, E., Mergen, H. (2017). Hemodiyaliz hastalarında diyet ve sıvı kısıtlamasına uyumsuzluğunun değerlendirilmesi. FNG & Bilim Tıp Dergisi, 3(1):9-14.11. Hecking, M., Karaboyas, A., Saran, R., Sen, A., Inaba, M. Rayner, H. ve ark. (2012). Dialysate sodium concentration and the associationwith ınterdialytic weight gain, hospitalization and mortality. Clinical Journal of the American Society of Nephrology, 7(1):92- 100.12. Zadeh, K.K., Regidor, D.L., Kovesdy, C.P., Wyck, D.V., Bunnapradist, S., Horwich, T.B. ve ark. (2009). Fluid retention is associated with cardiovascular mortality in patients undergoing long-term hemodialysis. Circulation, 119(5):671-679.13. Welch, J.L., Perkins, S.M., Johnson, C.S., Kraus, M.A. (2006). Patterns of interdialytic weight gain during the first year of hemodialysis. Nephrol Nurs Journal, 33(5); 493-499.14. Welch, J.L., Davis, J. (2000). Self-care strategies to reduce fluid intake and control thirst in hemodialysis patients. Nephrology Nursing Journal, 27(4): 393-395.15. Deen, D., Lu, W., Rothstein, D., Santana, L., Gold, M. (2011). Asking questions: The effect of a brief intervention in community health centers on patient activation. Patient Education and Counseling, 84(2): 257–260.16. Hibbard, J.H., Mahoney, E.R., Stock, R., Tusler, M. (2004). Development of the Patient Activation Measure (PAM): Conceptualizing and measuring activation in patients and consumers. HSR: Health Services Research, 39(4): 1005-1026.17. Hibbard, J.H., Greene, J.. Tusler, M. (2009). Improving the outcomes of disease management by tailoring care to the patient’s level of activation. American Journal of Managed Care, 15(6): 353-360.18. Rask, K., Ziemer, D., Kohler, S., Hawley, J.N., Arinde, F., Barnes, C.S. (2009). Patient activation is associated with healthy behaviors and ease in managing diabetes in an Indigent population. The Diabetes Educator, 35(4): 622-630. 19. Hibbard, J.H., Mahoney, E.R., Stock, R., Tusler, M. (2007). Do increases in patient activation result in ımproved self-management behaviors, health research and educational trust. Health Serv Res., 42(4): 1443-1463.20. Albayrak Cosar, A., Cinar Pakyuz, S. (2016). Scale development study: The Fluid control in hemodialysis patients. Jpn J Nurs Sci, 13(1):174-82.21. Koşar, C. Büyükkaya Besen, D. (2015). Hasta aktiflik düzeyi ölçüm aracı ‘nın (pam) türkçe’ye uyarlanması: geçerlik güvenirlik çalışması. (Yayınlanmamış yüksek lisans tezi). DEÜ Sağlık Bilimleri Fakültesi, İzmir. 22. Rambod, M., Peyravi, H., Shokrpour, N., Sareban, M.T. (2010). Dietary and fluid adherence in Iranian hemodialysis patients. Health Care Manag, 29(4):359-64.23. Turgut Kurt, Y., Erdem, E., Kaya, C., Karataş, A., Arık, N. (2012). Hemodiyaliz hastalarına verilen eğitimin kan basıncı ve kilo alımına etkisi. Turk Neph Dial Transpl, 21 (1): 39-44.24. Kugler, C., Maeding, I., Russell, C.L. (2011). Non-adherence in patients on chronic hemodialysis: an international comparison study. J Nephrol, 24(3):366-75.25. Denhaerynck, K., Manhaeve, D., Dobbels, F., Garzoni, D., Nolte, C., De Geest, S. (2007). Prevalence and consequences of nonadherence to hemodialysis regimens. American Journal of Critical Care, 16(3): 222-235.26. Christensen, A.J., Moran, P.J., Wiebe, J.S., Ehlers, S.L., Lawton, W.J. (2002). Effect of a behavioral self-regulationintervention on patientadherence in hemodialysis. Health Psychology, 21(4): 393-397.27. Schmaderer, M.S., Zimmerman, L., Hertzog, M., Pozehl, B., Paulman, A. (2016). Correlates of patient activation and acute care utilization among multimorbid patients. Western Journal of Nursing Research, 38(10): 1335–1353. 28. Hendrics, M., Rademakers, J. (2014). Relationships between patient activation, disease-specificknowledgeandhealthoutcomesamongpeoplewithdiabetes; a survey study. BMC Health Services Research, 14: 393: 1-9.29. Heui, Y., Kim, B.J., Ham, O.K., Kim, S.H. (2015), Factors associated with patient activation for self-management among community residents with osteoarthritis in Korea. J Korean Acad Community Health Nurs, 26(3); 303-311.30. Smith, S.G., Pandit, A., Rush, S.R., Wolf, M.S., Simon, C.J. (2016). The role of patient activation in preferences for shared decision making: Results from a national survey of US. Adults. Journal of Health Communication, 21(1):67–75. 31. Bos-Touwen, I.B., Schuurmans, M., Monninkhof, E.M., Korpershoek, Y. (2015). Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: A Cross-Sectional Survey Study. PLOS ONE, 10(5): 1-15. 32. Goodworth, M.R., Stepleman, L, Hibbard, J., Johns, L. (2016). Variables associated with patient activation in persons with multiple sclerosis. Journal of Health Psychology, 21(1): 82–92.33. Ryvicker, M., Feldman, P.H., Chiu, Y., Gerber, L.M. (2013). The Role of patient activation in ımproving blood pressure outcomes in black patients receiving home care. Medical Care Research and Review, 70(6): 636-652. 34. Mayberry, R., Willock, R.J., Boone, L., Lopez, P., Qin, H., Nicewander, D. A. (2010). High level of patient activation is observed but unrelated to glycemic control among adults with Type 2 Diabetes. Diabetes Spectr, 23(3): 171-176. 35. Hibbard, J.H., Greene, J. (2013). What the evidence shows about patient activation: beter health outcomes and care experiences; Fewerdata on costs. Health Affairs, 32(2): 207-214.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Cansu Koşar Şahin 0000-0003-2366-3977

Sezgi Çınar Pakyüz

Özden Dedeli Çaydam

Publication Date October 9, 2018
Published in Issue Year 2018 Volume: 2 Issue: 3

Cite

APA Koşar Şahin, C., Çınar Pakyüz, S., & Dedeli Çaydam, Ö. (2018). Hemodiyaliz Tedavisi Alan Hastaların Sıvı Kısıtlamasına Uyumları ve Hasta Aktifliği Arasındaki İlişkinin Değerlendirilmesi. Adnan Menderes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 2(3), 126-137.