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Kronik Obstrüktif Akciğer Hastalığı olan Bireylerin Kronik Hastalık Yönetimine İlişkin Değerlendirmeleri ve İlişkili Faktörler

Year 2015, Volume: 23 Issue: 1, 11 - 22, 22.05.2015

Abstract

Amaç: Bu araştırmanın amacı, Kronik Obstrüktif Akciğer Hastalığı (KOAH) olan bireylerin kronik bakım yönetimlerini nasıl değerlendirdiklerini belirlemek ve kronik bakım yönetimlerinde ilişkili olan faktörleri incelemektir.

Yöntem: Tanımlayıcı-kesitsel tipteki araştırmanın örneklemini, İstanbul’da üç Aile Sağlığı Merkezi ve iki hastaneden hastalığı nedeniyle hizmet alan 300 KOAH hastası oluşturdu. Veriler Hasta Tanılama Formu ve Kronik Hastalık Bakımını Değerlendirme Ölçeği-Hasta Formu kullanılarak toplandı. Verilerin analizinde sayı, yüzde, ortalama, standart sapma, medyan, t-testi, ANOVA ve korelasyon analizi kullanıldı.

Bulgular: Yaş ortalaması 63.89 ± 11.14 (min-max= 38-87) olan örneklemin çoğunluğu erkek (%70.3), evli (%83), ilkokul mezunu (%41.7) ve çalışmamaktadır (%81). Kronik Hastalık Bakımını Değerlendirme Ölçeği toplam puan ortalaması 1.69±0.37’dir (min-max=1-5). Alt ölçeklerin ortalamaları ise; hasta katılımı 1.86±0.72; karar verme 2.34±0.63; amaç belirleme 1.56±0.39; problem çözme 1.81±0.51; izlem/koordinasyon 1.24±0.50’dir. Yaş, cinsiyet, medeni durum, çalışma durumu, eşlik eden hastalık, sağlık hizmeti alınan süre, son altı ayda acile baş- vurma ve hastanede yatma durumu ile kronik hastalık yönetimine ilişkin memnuniyet puan ortalamaları arasındaki fark anlamlı bulunmazken; eğitim durumuna göre ve hastaneden hizmet alan ile hastalığına ilişkin bilgi alan hastalarda kronik hastalık yönetimi memnuniyet puan ortalamaları arasındaki fark anlamlı bulundu. Ayrıca hastalarda hastalık süresi arttıkça, memnuniyet puan ortalamaları da artmaktadır.

Sonuç: KOAH’lı hastaların kronik bakım yönetimine ilişkin memnuniyetleri oldukça düşüktür. Hastalık yönetimini kapsayan hizmet süreçlerinde, “hasta katılımı, karar verme, amaç belirleme, problem çözme ve izlem/koordinasyon” alanlarındaki yetersizlikler hasta memnuniyetini azaltan başlıca nedenlerdir. KOAH’lı hastalara sunulan hastalık yönetimi hizmetlerinin planlanmasında kronik bakım modeli bileşenlerinin dikkate alınması hasta memnuniyetini artırabilir. Bu konuda KOAH’lı hastaları temsil eden örneklemlerde çalı- şılmasına ve ileri araştırmalar yapılmasına gereksim vardır.

Anahtar Kelimeler: Kronik Obstrüktif Akciğer Hastalığı (KOAH), kronik bakım yönetimi, PACIC, hemşirelik.

References

  • Adams, S., G. ve ark. (2007). Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management. Arch Intern Med, 167: 551-561.
  • Aragones, A. ve ark. (2008). Validation of the Spanish translation of the patient assessment of chronic illness care (PACIC) survey.
  • Preventing Chronic Disease, 5(4): 1-10. Aşti, T., Kara, M. (2002). Kronik obstrüktif akciğer hastalığının evde bakımı. AÜTD, 34: 75-81.
  • Aydın, T. H., Yıldız, T. F., Karagözoğlu, Ş., Özden, D. (2012). Has- taların bakış açısıyla kronik obstrüktif akciğer hastalığı ile yaşa- mak: Fenomenolojik çalışma. İ.Ü.F.N. Hem. Derg., 20(3): 177-183.
  • Bodenheimer, T., Wagner, E. H., Grumbach, K. (2002). Improving primary care for patients with chronic illness: The chronic care mo- del, Part 2. JAMA, 288(15): 1909-1914.
  • Boult, C., Karm, L., Groves, C. (2008). Improving chronic care:
  • “Guided Care” model. The Permanente Journal, 12(1): 50-54. Reduction of hospital utilization in patients with chronic obstructi- ve pulmonary disease. Arch Intern Med,163(5): 585-591. Bourbeau, J., Palen, J. van der (2009). Promoting effective self- management programmes to improve COPD. European Respira- tory Journal, 33(3): 461-463.
  • Briggs, H. A. (2003). Problem solving in diabetes self-management:
  • A model of chronic illness self-management behavior. Annals of Behavioral Medicine, 25(3): 182-193. Casas, A. ve ark. (2006). Integrated care prevents hospitalisations for exacerbations in COPD patients. European Respiratory Jour- nal, 28: 123-130.
  • Escarrabill, J. (2009). Discharge planning and home care for end- stage COPD patients. European Respiratory Journal, 34(2): 507- 5
  • Fernandes, A., Pache, S., Bird, W., Bryden, C. (2006). Measures to improve knowledge of self-care among patients with COPD: A
  • UK general practice audit. Primary Care Respiratory Journal, 15: 307-30
  • Global Initiative for Chronic Obstructive Lung Disea- se (GOLD) (2006). Global strategy for the diagnosis, ma- nagement and prevention of chronic obstructive pulmonary disease, http://www.goldcopd.org/guidelines-global-strategy-for- diagnosis-management.html (21.05.2013).
  • Glasgow, R. E., Nelson, C. C., Whitesides, H., King, D. K. (2005a).
  • Use of the patient assessment of chronic illness care (PACIC) with diabetic patients. Diabetes Care, 28: 2655-2661.
  • Glasgow, R. E. ve ark. (2005b). Development and validation of the patient assessment of chronic illness care (PACIC). Medical Care, 43(5): 436-444.
  • Haskett, T. (2006). Chronic illness management: Changing the system. Home Health Care Management Practice, 18: 492-494.
  • Hermiz,O., ve ark. (2002). Randomized controlled trial of home based care of patients with chronic obstructive pulmonary disease.
  • British Medical Journal, 325: 938-942. International Council of Nurses (ICN) (2010). International Nur- ses Day, Delivering Quality, Serving Communities: Nurses Lea- ding Chronic Care. ICN - International Council of Nurses, Gene- va, Switzerland.
  • İncirkuş, K. (2010). Kronik Hastalık Bakımını Değerlendirme
  • Aracı’nın geçerlik ve güvenirliği. Yayınlanmamış Yüksek Lisans Tezi, İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul. İncirkuş, K., Nahcivan, N. (2011). Kronik Hastalık Bakımını De- ğerlendirme Ölçeği-Hasta Formu’nun Türkçe versiyonunun geçer- lik ve güvenirliği. Dokuz Eylül Üniversitesi Hemşirelik Yüksekoku- lu Elektronik Dergisi, 4(1): 102-109.
  • Jonsdottir, H. (2008). Nursing care in the chronic phase of COPD:
  • A call for innovative disciplinary research. Journal of Clinical Nur- sing, 17: 272-290. Rosemann, T., Laux, M. D., Droesemeyer, S., Gensichen, J., Szec- senyi, J. (2007). Evaluation of a culturally adapted German version of the patient assessment of chronic illness care (PACIC) question- naire in a sample of osteoarthritis patients. Journal of Evaluation in Clinical Practice, 13: 806-813.
  • Sayıner, A. ve ark. (2012). Attitudes and beliefs about COPD:
  • Data from the BREATHE study. Respiratory Medicine, 106(S2): S60-S Tatlıcıoğlu, T. (2007). Kronik obstrüktif akciğer hastalığı (KOAH) ve geleceği. Tüberküloz ve Toraks Dergisi, 55(3): 303-318.
  • Taylor, S. J. C. ve ark. (2005). Effectiveness of innovations in nur- se led chronic disease management for patients with chronic obs- tructive pulmonary disease: Systematic review of evidence. BJM, 331(7515): 485.
  • T.C. Sağlık Bakanlığı (2009). Temel Sağlık Hizmetleri Genel
  • Müdürlüğü, “Türkiye Kronik Hava Yolu Hastalıklarını (Astım- KOAH) Önleme ve Kontrol Programı (2009-2013) Eylem Planı”,
  • Anıl Matbaacılık, Ankara. Ünsal, A.,Yetkin, A. (2005). Kronik obstrüktif akciğer hastalığı olan bireylerin günlük yaşam aktivitelerinin etkilenme durumunun incelenmesi. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergi- si, 8(1): 42-53.
  • Ünüvar, N., Mollahaliloğlu, S.,Yardım, N. (Ed.) (2006). Türkiye
  • Hastalık Yükü Çalışması 2004. Aydoğdu Ofset Matbaacılık San. ve Tic. Ltd. Şti., Ankara.
  • Wagner, E. H. ve ark. (2001). Improving chronic illness care:
  • Translating evidence into action. Health Affairs, 20(6): 64-78. Wensing, M., Lieshoud, J. V., Jung, H. P., Hermsen, J., Rosemann, T. (2008). The patient assessment chronic illness care (PACIC) qu- estionnaire in the Netherlands: A validation study in rural general practice. BMC Health Services Research, 8: 182-188.
  • World Health Organization (WHO) (2012). Chronic Obstructi- ve Pulmonary Disease (COPD), http//:www.who.int/mediacentre/ facrsheets/fs315/en/index.html (06.05.2013).
  • Yaman, H. ve Akdeniz, M. (2010). Kronik obstrüktif akciğer has- talığı (KOAH) ve birinci basamakta tedavi rehberlerinin kullanımı.
  • Sendrom Aktüel Tıp Dergisi, 22(1): 17-20.

Related Factors and Patient Assessment of Chronic Illness Care in Patients with Chronic Obstructive Pulmonary Disease

Year 2015, Volume: 23 Issue: 1, 11 - 22, 22.05.2015

Abstract

Aim: The purpose of this to determine perceive chronic care management and related factors of the people with Chronic Obstructive Pulmonary Disease (COPD).

Method: Sample of study which designed descriptive and cross-sectional consisted of 300 patients who treated in health care centers or hospitals in Istanbul. The data has been collected with Patient Identifi cation Form and Patient Assessment of Chronic Illness CarePatient Form. Analysis of the data; number, percent, mean, standart deviation, median, t test, ANOVA, correlation were used.

Results: Average age of sample group were 63.89±11.14 (min-max=1-5), most of them were male (%70.3), married (%83), primary school graduated (%41.7) and does not work (%81). Average score of Patient Assessment of Chronic Illness Care is 1.69±0.37 (min-max=1-5). Average scores of subscales were; patient activation 1.86±0.72, decision support 2.34±0.63, goal setting 1.56±0.39, problem-solving 1.81±0.51, follow-up 1.24±0.50. No statiscally signifi cant difference was found with age, sex, marital status, operating state, chronic conditions, duration of treatment, status of visit emergency and duration of hospitalization. The satisfaction with chronic care management was higger in patients with educated, treated in hospital and informed about illness. Also average score of satisfaction increases if duration of disease increases.

Conclusion: Findings revealed that patients with Chronic Obstructive Pulmonary Disease have low satisfaction about chronic care management. Defi ciencies according to “patient activation, decision support, goal setting, problem solving and follow up” are mean reasons to reduce patient satisfaction. Results of the study is recommended in health programme and quality improvement study in patients with Chronic Obstructive Pulmonary Disease.

Key Words: Chronic Obstructive Pulmonary Disease (COPD), chronic care management, PACIC, nursing.

References

  • Adams, S., G. ve ark. (2007). Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management. Arch Intern Med, 167: 551-561.
  • Aragones, A. ve ark. (2008). Validation of the Spanish translation of the patient assessment of chronic illness care (PACIC) survey.
  • Preventing Chronic Disease, 5(4): 1-10. Aşti, T., Kara, M. (2002). Kronik obstrüktif akciğer hastalığının evde bakımı. AÜTD, 34: 75-81.
  • Aydın, T. H., Yıldız, T. F., Karagözoğlu, Ş., Özden, D. (2012). Has- taların bakış açısıyla kronik obstrüktif akciğer hastalığı ile yaşa- mak: Fenomenolojik çalışma. İ.Ü.F.N. Hem. Derg., 20(3): 177-183.
  • Bodenheimer, T., Wagner, E. H., Grumbach, K. (2002). Improving primary care for patients with chronic illness: The chronic care mo- del, Part 2. JAMA, 288(15): 1909-1914.
  • Boult, C., Karm, L., Groves, C. (2008). Improving chronic care:
  • “Guided Care” model. The Permanente Journal, 12(1): 50-54. Reduction of hospital utilization in patients with chronic obstructi- ve pulmonary disease. Arch Intern Med,163(5): 585-591. Bourbeau, J., Palen, J. van der (2009). Promoting effective self- management programmes to improve COPD. European Respira- tory Journal, 33(3): 461-463.
  • Briggs, H. A. (2003). Problem solving in diabetes self-management:
  • A model of chronic illness self-management behavior. Annals of Behavioral Medicine, 25(3): 182-193. Casas, A. ve ark. (2006). Integrated care prevents hospitalisations for exacerbations in COPD patients. European Respiratory Jour- nal, 28: 123-130.
  • Escarrabill, J. (2009). Discharge planning and home care for end- stage COPD patients. European Respiratory Journal, 34(2): 507- 5
  • Fernandes, A., Pache, S., Bird, W., Bryden, C. (2006). Measures to improve knowledge of self-care among patients with COPD: A
  • UK general practice audit. Primary Care Respiratory Journal, 15: 307-30
  • Global Initiative for Chronic Obstructive Lung Disea- se (GOLD) (2006). Global strategy for the diagnosis, ma- nagement and prevention of chronic obstructive pulmonary disease, http://www.goldcopd.org/guidelines-global-strategy-for- diagnosis-management.html (21.05.2013).
  • Glasgow, R. E., Nelson, C. C., Whitesides, H., King, D. K. (2005a).
  • Use of the patient assessment of chronic illness care (PACIC) with diabetic patients. Diabetes Care, 28: 2655-2661.
  • Glasgow, R. E. ve ark. (2005b). Development and validation of the patient assessment of chronic illness care (PACIC). Medical Care, 43(5): 436-444.
  • Haskett, T. (2006). Chronic illness management: Changing the system. Home Health Care Management Practice, 18: 492-494.
  • Hermiz,O., ve ark. (2002). Randomized controlled trial of home based care of patients with chronic obstructive pulmonary disease.
  • British Medical Journal, 325: 938-942. International Council of Nurses (ICN) (2010). International Nur- ses Day, Delivering Quality, Serving Communities: Nurses Lea- ding Chronic Care. ICN - International Council of Nurses, Gene- va, Switzerland.
  • İncirkuş, K. (2010). Kronik Hastalık Bakımını Değerlendirme
  • Aracı’nın geçerlik ve güvenirliği. Yayınlanmamış Yüksek Lisans Tezi, İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul. İncirkuş, K., Nahcivan, N. (2011). Kronik Hastalık Bakımını De- ğerlendirme Ölçeği-Hasta Formu’nun Türkçe versiyonunun geçer- lik ve güvenirliği. Dokuz Eylül Üniversitesi Hemşirelik Yüksekoku- lu Elektronik Dergisi, 4(1): 102-109.
  • Jonsdottir, H. (2008). Nursing care in the chronic phase of COPD:
  • A call for innovative disciplinary research. Journal of Clinical Nur- sing, 17: 272-290. Rosemann, T., Laux, M. D., Droesemeyer, S., Gensichen, J., Szec- senyi, J. (2007). Evaluation of a culturally adapted German version of the patient assessment of chronic illness care (PACIC) question- naire in a sample of osteoarthritis patients. Journal of Evaluation in Clinical Practice, 13: 806-813.
  • Sayıner, A. ve ark. (2012). Attitudes and beliefs about COPD:
  • Data from the BREATHE study. Respiratory Medicine, 106(S2): S60-S Tatlıcıoğlu, T. (2007). Kronik obstrüktif akciğer hastalığı (KOAH) ve geleceği. Tüberküloz ve Toraks Dergisi, 55(3): 303-318.
  • Taylor, S. J. C. ve ark. (2005). Effectiveness of innovations in nur- se led chronic disease management for patients with chronic obs- tructive pulmonary disease: Systematic review of evidence. BJM, 331(7515): 485.
  • T.C. Sağlık Bakanlığı (2009). Temel Sağlık Hizmetleri Genel
  • Müdürlüğü, “Türkiye Kronik Hava Yolu Hastalıklarını (Astım- KOAH) Önleme ve Kontrol Programı (2009-2013) Eylem Planı”,
  • Anıl Matbaacılık, Ankara. Ünsal, A.,Yetkin, A. (2005). Kronik obstrüktif akciğer hastalığı olan bireylerin günlük yaşam aktivitelerinin etkilenme durumunun incelenmesi. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergi- si, 8(1): 42-53.
  • Ünüvar, N., Mollahaliloğlu, S.,Yardım, N. (Ed.) (2006). Türkiye
  • Hastalık Yükü Çalışması 2004. Aydoğdu Ofset Matbaacılık San. ve Tic. Ltd. Şti., Ankara.
  • Wagner, E. H. ve ark. (2001). Improving chronic illness care:
  • Translating evidence into action. Health Affairs, 20(6): 64-78. Wensing, M., Lieshoud, J. V., Jung, H. P., Hermsen, J., Rosemann, T. (2008). The patient assessment chronic illness care (PACIC) qu- estionnaire in the Netherlands: A validation study in rural general practice. BMC Health Services Research, 8: 182-188.
  • World Health Organization (WHO) (2012). Chronic Obstructi- ve Pulmonary Disease (COPD), http//:www.who.int/mediacentre/ facrsheets/fs315/en/index.html (06.05.2013).
  • Yaman, H. ve Akdeniz, M. (2010). Kronik obstrüktif akciğer has- talığı (KOAH) ve birinci basamakta tedavi rehberlerinin kullanımı.
  • Sendrom Aktüel Tıp Dergisi, 22(1): 17-20.
There are 36 citations in total.

Details

Journal Section Reserch Papers
Authors

Emine Üstünova

Nursen Nahcivan

Publication Date May 22, 2015
Published in Issue Year 2015 Volume: 23 Issue: 1

Cite

APA Üstünova, E., & Nahcivan, N. (2015). Related Factors and Patient Assessment of Chronic Illness Care in Patients with Chronic Obstructive Pulmonary Disease. Florence Nightingale Journal of Nursing, 23(1), 11-22. https://doi.org/10.17672/fnhd.44449
AMA Üstünova E, Nahcivan N. Related Factors and Patient Assessment of Chronic Illness Care in Patients with Chronic Obstructive Pulmonary Disease. Florence Nightingale Journal of Nursing. May 2015;23(1):11-22. doi:10.17672/fnhd.44449
Chicago Üstünova, Emine, and Nursen Nahcivan. “Related Factors and Patient Assessment of Chronic Illness Care in Patients With Chronic Obstructive Pulmonary Disease”. Florence Nightingale Journal of Nursing 23, no. 1 (May 2015): 11-22. https://doi.org/10.17672/fnhd.44449.
EndNote Üstünova E, Nahcivan N (May 1, 2015) Related Factors and Patient Assessment of Chronic Illness Care in Patients with Chronic Obstructive Pulmonary Disease. Florence Nightingale Journal of Nursing 23 1 11–22.
IEEE E. Üstünova and N. Nahcivan, “Related Factors and Patient Assessment of Chronic Illness Care in Patients with Chronic Obstructive Pulmonary Disease”, Florence Nightingale Journal of Nursing, vol. 23, no. 1, pp. 11–22, 2015, doi: 10.17672/fnhd.44449.
ISNAD Üstünova, Emine - Nahcivan, Nursen. “Related Factors and Patient Assessment of Chronic Illness Care in Patients With Chronic Obstructive Pulmonary Disease”. Florence Nightingale Journal of Nursing 23/1 (May 2015), 11-22. https://doi.org/10.17672/fnhd.44449.
JAMA Üstünova E, Nahcivan N. Related Factors and Patient Assessment of Chronic Illness Care in Patients with Chronic Obstructive Pulmonary Disease. Florence Nightingale Journal of Nursing. 2015;23:11–22.
MLA Üstünova, Emine and Nursen Nahcivan. “Related Factors and Patient Assessment of Chronic Illness Care in Patients With Chronic Obstructive Pulmonary Disease”. Florence Nightingale Journal of Nursing, vol. 23, no. 1, 2015, pp. 11-22, doi:10.17672/fnhd.44449.
Vancouver Üstünova E, Nahcivan N. Related Factors and Patient Assessment of Chronic Illness Care in Patients with Chronic Obstructive Pulmonary Disease. Florence Nightingale Journal of Nursing. 2015;23(1):11-22.