Roy adaptasyon modeline göre hemodiyaliz hastalarına verilen eğitimin sıvı yöntemi, semptom kontrolü ve yaşam kalitesine etkisi
Yükleniyor...
Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu araştırma; Roy Adaptasyon Modeline göre hemodiyaliz hastalarına verilen eğitimin sıvı yönetimi, semptom kontrolü ve yaşam kalitesine etkisini değerlendirmek amacıyla yapıldı. Araştırma 9 Aralık 2019 ile 12 Ekim 2020 tarihleri arasında 107 hasta (53 deney, 54 kontrol) ile randomize kontrolü bir çalışma olarak gerçekleştirildi. Verilerin toplanmasında ‘‘Hasta Tanıtım Formu’’, ‘‘Hemodiyaliz Hastalarında Sıvı Kontrol Ölçeği’’(HHSKÖ), ‘‘Diyaliz Semptom İndeksi’(DSİ), ‘‘Nottingham Sağlık Profili’’(NHP) kullanıldı. Deney ve kontrol grubundaki hastalar ile 0. ay, 1. ve 3.ay da görüşmeler yapılarak formlar dolduruldu. Deney grubundaki hastalara Roy Adaptasyon Modeline dayalı eğitim verilerek eğitim kitapçığı dağıtıldı. Veriler NCSS (Number Cruncher Statistical System) 2007 programı ile tanımlayıcı istatiksel yöntemler, Student-t testi, Mann Witney U testi, Pearson Ki-Kare testi, FisherFreeman- Halton Exact testi, Repeated Measures testi, Bonferroni testi, Spearman’s korelasyon analizi ve Pearson Korelasyon analizi kulanılarak değerlendirildi. Anlamlılık en az p<0,05 olarak kabul edildi. Eğitim verilen deney grubunda Hemodiyaliz Hastaları Sıvı Kontrol Ölçeği bilgi alt boyutu (0. ay,1.ay ve 3.ay) (sırasıyla p<0,05; p<0,01; p<0,01), davranış alt boyutu (1.ay, 3. ay),(p<0,01) tutum alt boyutu (1.ay, 3.ay) (p<0,01) ve toplam ölçek puan ortalamaları (1.ay,3.ay) (p<0,01) kontrol grubuna göre istatiksel olarak anlamlı düzeyde arttı. Eğitim sonrasında hastaların sıvı kontrolünün arttığı bulundu. Eğitim verilen deney grubunun Nottingham Sağlık Profili ölçeği enerji alt boyutu (1.ay)(p<0,05), ağrı alt boyutu (1ay, 3.ay) (sırasıyla p<0,05; p<0,01), duygusal reaksiyonlar alt boyutu (1.ay) (p<0,05), uyku alt boyutu (3.ay) (p<0,01), sosyal izolasyon alt boyutu (1.ay),(p<0,01), fiziksel hareket alt boyutu (3.ay) (p<0,05) ve toplam ölçek puan ortalamaları (1.ay,3.ay), (p<0,01) kontrol grubuna göre istatiksel olarak anlamlı düzeyde azaldı. Eğitim sonrasında hastaların yaşam kalitesinin iyileştiği belirlendi. Eğitim verilen deney grubunun Diyaliz Semptom İndeksi toplam puan ortalaması (1.ay, 3.ay) (p<0,01) kontrol grubuna göre istatiksel olarak anlamlı olarak azaldığı, hastaların semptomlardan daha az etkilendiği bulundu. Deney grubunun interdiyalik kilo (1.ay) (p<0,01), ultrafiltasyon (UF) miktarı (1.ay) (p<0,05), ödem (1. ay,3.ay) (p<0,01), diyaliz öncesi diyastolik kan basıncı (3.ay) (p<0,05) kontrol grubuna göre istatiksel olarak azalırken, diyaliz öncesi, sonrası kilo, kuru ağırlık, diyaliz sonrası diyastolik kan basıncı, diyaliz öncesi sonrası sistolik kan basıncında (p>0,05) istatiksel olarak anlamlı bir fark bulunmadı. Eğitim verilen deney grubundaki hastaların kontrol grubuna göre albümin ve potasyum seviyelerinin arttığı diğer laboratuvar parametrelerinde ise istatiksel olarak anlamlı bir değişiklik olmadığı saptandı (p>0,05). Sonuç olarak; Roy Adaptasyon Modeline göre verilen eğitimin hemodiyaliz hastalarının sıvı kontrolüne uyumunu, yaşam kalitesini ve semptom kontrolünü iyileştirdiği belirlendi. Roy adaptasyon Modeline dayalı eğitimin hemodiyaliz hemşireleri tarafından hastalarda sistematik olarak kullanımı önerilmektedir.
The study was conducted in order to evaluate the effect of the training provided to hemodialysis patients according to Roy Adaptation Model on fluid management, symptom control, and quality of life. The study was carried out as a randomized controlled trial with the participation of 107 patients (53 experimental, 54 control) between December 9, 2019 and October 12, 2020. The data were collected by using “Patient Information From”, “Fluid Control in Hemodialysis Patients Scale” (FCHPS), “Dialysis Symptom Index” (DSI), and “Nottingham Health Profile” (NHP). The forms were filled out by having interviews with the patients in the experimental and control groups in the 0 th , 1 st , and 3 rd months. The patients in the experimental group were provided with training based on Roy Adaptation Model, and training booklets were handed out. The data were analyzed by using descriptive statistics methods with NCSS (Number Cruncher Statistical System) 2007 software, Student’s t-test, Mann-Whitney U Test, Pearson Chi-square test, Fisher-Freeman-Halton Exact test, Repeated Measures test, Bonferroni test, Spearman’s Correlation analysis, and Pearson Correlation analysis. Significance was accepted as p<0,05. Hemodialysis patients in the experimental group given training Hemodialysis Patients Fluid Control Scale knowledge sub-dimension (0. month, 1 91 st month and 3 month) (respectively p<0,05; p<0,01; p<0,01), behavioral sub-dimension (1 st month, 3 month), (p<0,01) attitude sub-dimension (1 st month, 3 rd rd rd month) (p<0,01) and total scale mean score (1 month, 3 rd month) ( p<0,01) increased statistically significantly compared to the control group. It was found that the fluid control of the patients increased after training. It was found in the experimental group provided with training that their scores obtained from the energy subscale of the Nottingham Health Profile Scale (1 st month) (p<0,05), pain subscale (1 month) (p<0,05 and p<0,01, respectively), emotional reactions subscale (1 st month) (p<0,05), from sleep subscale (3 rd month) (p<0,01), social isolation subscale (1 st month) (p<0,01), physical activity subscale (3 rd month) (p<0,05), and the total scale mean scores (1 month) (p<0,01) statistically significantly decreased in comparison to the control group. It was determined that the quality of life of the patients improved after training. As regards the Dialysis Symptom Index, it was found that the total scale of mean score obtained by the experimental group provided with training (1 st and 3 rd month) (p<0,01) statistically significantly decreased in comparison to the control group, and that the patients were affected less by the symptoms. While the experimental group’s interdialytic weight (1 month) (p<0.01), ultrafiltration (UF) amount (1 st st st and 3 and 3 month) (p<0,05), edema (fluid retention) (1 and 3 rd month) (p<0.01), pre-dialysis diastolic blood pressure (3 rd month) (p<0,05) statistically significantly decreased compared to the control group, no statistically significant difference was found in their pre- and post-dialysis weight, dry weight, post-dialysis diastolic blood pressure, pre- and post-dialysis systolic blood pressure (p>0,05). It was determined that the albumin and post-dialysis potassium levels of the patients in the experimental group provided with training increased in comparison to the control group, and that there was no statistically significant change in terms of other laboratory parameters (p>0,05). In conclusion; It was determined that the education given according to the Roy Adaptation Model improved the adaptation with fluid control, quality of life and symptom control of hemodialysis patients. It is recommended that education based on Roy Adaptation Model should be systematically used in patients by hemodialysis nurses.
The study was conducted in order to evaluate the effect of the training provided to hemodialysis patients according to Roy Adaptation Model on fluid management, symptom control, and quality of life. The study was carried out as a randomized controlled trial with the participation of 107 patients (53 experimental, 54 control) between December 9, 2019 and October 12, 2020. The data were collected by using “Patient Information From”, “Fluid Control in Hemodialysis Patients Scale” (FCHPS), “Dialysis Symptom Index” (DSI), and “Nottingham Health Profile” (NHP). The forms were filled out by having interviews with the patients in the experimental and control groups in the 0 th , 1 st , and 3 rd months. The patients in the experimental group were provided with training based on Roy Adaptation Model, and training booklets were handed out. The data were analyzed by using descriptive statistics methods with NCSS (Number Cruncher Statistical System) 2007 software, Student’s t-test, Mann-Whitney U Test, Pearson Chi-square test, Fisher-Freeman-Halton Exact test, Repeated Measures test, Bonferroni test, Spearman’s Correlation analysis, and Pearson Correlation analysis. Significance was accepted as p<0,05. Hemodialysis patients in the experimental group given training Hemodialysis Patients Fluid Control Scale knowledge sub-dimension (0. month, 1 91 st month and 3 month) (respectively p<0,05; p<0,01; p<0,01), behavioral sub-dimension (1 st month, 3 month), (p<0,01) attitude sub-dimension (1 st month, 3 rd rd rd month) (p<0,01) and total scale mean score (1 month, 3 rd month) ( p<0,01) increased statistically significantly compared to the control group. It was found that the fluid control of the patients increased after training. It was found in the experimental group provided with training that their scores obtained from the energy subscale of the Nottingham Health Profile Scale (1 st month) (p<0,05), pain subscale (1 month) (p<0,05 and p<0,01, respectively), emotional reactions subscale (1 st month) (p<0,05), from sleep subscale (3 rd month) (p<0,01), social isolation subscale (1 st month) (p<0,01), physical activity subscale (3 rd month) (p<0,05), and the total scale mean scores (1 month) (p<0,01) statistically significantly decreased in comparison to the control group. It was determined that the quality of life of the patients improved after training. As regards the Dialysis Symptom Index, it was found that the total scale of mean score obtained by the experimental group provided with training (1 st and 3 rd month) (p<0,01) statistically significantly decreased in comparison to the control group, and that the patients were affected less by the symptoms. While the experimental group’s interdialytic weight (1 month) (p<0.01), ultrafiltration (UF) amount (1 st st st and 3 and 3 month) (p<0,05), edema (fluid retention) (1 and 3 rd month) (p<0.01), pre-dialysis diastolic blood pressure (3 rd month) (p<0,05) statistically significantly decreased compared to the control group, no statistically significant difference was found in their pre- and post-dialysis weight, dry weight, post-dialysis diastolic blood pressure, pre- and post-dialysis systolic blood pressure (p>0,05). It was determined that the albumin and post-dialysis potassium levels of the patients in the experimental group provided with training increased in comparison to the control group, and that there was no statistically significant change in terms of other laboratory parameters (p>0,05). In conclusion; It was determined that the education given according to the Roy Adaptation Model improved the adaptation with fluid control, quality of life and symptom control of hemodialysis patients. It is recommended that education based on Roy Adaptation Model should be systematically used in patients by hemodialysis nurses.
Açıklama
Anahtar Kelimeler
Hemodiyaliz, Sıvı Yönetimi, Semptom Kontrolü, Yaşam Kalitesi, Roy Adaptasyon Modeli, Hemodialysis, Fluid Management, Symptom Control, Life Quality, Roy Adaptation Model
