Background Patient activation is a central concept in chronic illness care model. Activated patients have ability and willingness to manage their health. Objective Aim of this study was to test the reliability and validity of a Patient Activation Measure. Methods Research sample consisted of 130 patients who had diabetes, hypertension or rheumatoid arthritis. Data was collected through socio-demographic information form and a Patient Activation Measure (PAM). Reliability and validity of PAM were analyzed. Results Internal consistency reliability coefficient of the PAM was α: .81. Correlation coefficients between item and total scale scores varied from .38 to .66. Result of explanatory factor analysis Kaiser Meyer Olkin coefficient was .75 and Barlett test was x2: 646.870; p: 0. 000. Result of confirmatory factor analysis, model fit indexes were x2/df: 1.59, RMSEA: 0.071, CFI: 0.96, NNFI: 0.95. The result of Rasch analysis, reliability coefficient varied from 0.83 to 0.87 and in validity assesment, item fit statistics for INFIT varied from 0.68 to 1.53 and for OUTFIT varied from 0.65 to 1.54. Conclusion PAM has enough validy and reliability for use in determining activation scores and level of the patients in Turkey. It could be used in planing appropriate interventions for the activation level and help to improve self management.
ObjectivesHypoglycemia is a common side effect of insulin therapy in type 1 and type 2 diabetes. Limited data exist on the frequency of hypoglycemic events in type 2 diabetic patients in Turkey. Our study investigated self-reported hypoglycemic events and awareness of hypoglycemia in Turkish patients with type 2 diabetes.MethodsPeople with type 2 diabetes older than 18 years of age were recruited from the two university hospital diabetes clinics. The frequency and severity of hypoglycemia and awareness of hypoglycemia during the preceding year were determinated using questionnaires by the face-to-face interview method.ResultsIn this study of 187 patients with type 2 diabetes, 83.4% had impaired awareness of their hypoglycemia, and 62% reported that they had missed some of the symptoms of hypoglycemia. Of the patients reporting hypoglycemic symptoms and severity level, 84.1% experienced mild hypoglycemia, 60% moderate, and 15.5% severe hypoglycemia in the past year. No significant association was made between hypoglycemia awareness and age, body-mass index (BMI), years of diabetes, dose of insulin, duration of insulin use, number of meals, or amount of snacking. A significant correlation was found between A1c levels and hypoglycemia awareness and severity of hypoglycemia. A significant correlation was found between dose of insulin, amount of snacking, and severity of hypoglycemia. No significant association was made between severity of hypoglycemia and age, BMI, years of diabetes, duration of insulin use, or the number of meals. However, the group with severe hypoglycemia had diabetes longer, and the average daily dose of insulin use was higher than in other groups.ConclusionsAccording to the study results, the percentage of patients with impaired awareness of hypoglycemia is high, and 62% of patients reported that they had missed some of the symptoms of hypoglycemia in type 2 diabetes. In addition, the percentage of severe hypoglycemic events is not low. Impaired awareness of hypoglycemia is a major risk factor for severe hypoglycemic events. Patients should be educated about the danger of hypoglycemia. Education should be improved, and a determined attempt should be made to eradicate the problem.
BackgroundPrevious studies have examined the role of individuals’ personal characteristics in diabetes management and used the locus of control theory to assess adherence to a diabetes management regimen. These studies have emphasized that having internal locus of control may be a protective factor in diabetes management.ObjectiveThe purpose of this study is to determine the predictor effect of locus of control on self-care activities and A1c level.MethodThe study is descriptive and relational. Researchers used a Diabetes Self-Care Activities Scale and a Locus of Control Scale to collect data. The study sample consisted of 129 individuals with type 2 diabetes.ResultsThe average score of locus of control of individuals with diabetes was 10.26, and the frequency of self-care activities in the past week was 2.9 days. A weak but statistically significant negative relation was found between the locus of control level and self-care activities of individuals with diabetes, which had no effect on A1c. It was determined that locus of control predicts 19% of self-care activities.ConclusionAccording to the study results, having internal locus of control had positive effects on self-care activities. Training and planning activities to improve internal locus of control can improve diabetes management.
Giriş: Çatışma sağlıklı iletişimin sürdürülmesini engelleyen bir etken niteliğindedir. Hekim ve hemşireler arasında etkin iletişim, ekip işbirliğinin sürdürülerek çatışmanın önlenmesini sağlayabilecek temel bir faktördür. Literatürde yer almamakla birlikte hekim ve hemşirelerinhemşirelik imajına yönelik algılarının da çatışmaya götürebileceği düşünülmektedir. Buna bağlı olarak iki meslek grubunun çatışmanedenlerinin ve hemşirelik imajına yönelik algılarının saptanması önem taşımaktadır. Amaç: Bu araştırmanın amacı, tıp fakültesi ve hemşirelikbölümü intörn öğrencilerinin, hekim hemşire çatışma nedenlerine ve hemşirelik imajına yönelik algılarını karşılaştırarak değerlendirmektir.Yöntem: Tanımlayıcı ve kesitsel tipteki bu araştırmanın evrenini Mart – Mayıs 2019 tarihleri arasında bir kamu üniversitesinin Tıp Fakültesi(n = 200) ve Hemşirelik (n = 182) Bölümü’nde öğrenim görmekte olan toplam 382 intörn öğrenci oluşturmuştur. Örneklemi dahil edilmekriterlerini karşılayan toplam 158 öğrenci oluşturmuştur. Veriler tanıtıcı özellikler formu, Hekim-Hemşire Çatışma Nedenleri Ölçeği veHemşirelik Mesleğine Yönelik İmaj Ölçeği ile toplanmıştır. Bulgular: Örneklemde yer alan toplam 158 intörn öğrencinin %71,5’i (n = 113)hemşirelik, %28,5’i (n = 45) tıp fakültesi intörn öğrencilerinden oluşmuştur. Tıp intörnlerinin Hemşirelik Mesleğine Yönelik İmaj Ölçeği puanortalaması 106.55 ± 1.50 iken, hemşirelik intörnlerinin 105.42 ± 1.10 olarak saptanmıştır. Hem hemşirelik hem de tıp intörn öğrencileri içinhemşirelik mesleğine yönelik imajın zayıf düzeyde olduğu saptanmıştır. Tıp ve hemşirelik intörn grupları arasında Hekim-Hemşire ÇatışmaNedenleri Ölçeği’nin Meslek Algısı (p = .000) ve İletişim (p = .000) alt boyutu puanları ile Hemşirelik Mesleğine Yönelik İmaj Ölçeği’ninMesleki Nitelik (p = .000), Çalışma Koşulları (p = .000), Cinsiyet (p = .000), Eğitim (p = .000) ve Dış Görünüm (p = .000) puanları açısındananlamlı fark olduğu saptanmıştır. Hemşirelik bölümü intörnleri hekimin meslek algısı ve iletişime dayanan özelliklerini; tıp fakültesi intörnleriise işlerin çok yoğun olması, dengesiz nöbet dağılımı, yoğun çalışma saatleri ile yetki ve sorumluluk dengesizliğini daha fazla çatışma nedeniolarak göstermiştir. Sonuç: Hemşirelik ve tıp intörn öğrencilerinin hemşirelik mesleğine yönelik imaj algısı zayıf düzeydedir. Çatışma nedeniolarak tıp intörnleri daha çok çalışma koşullarına odaklanırken, hemşirelik intörnlerinin hekim hemşire arasındaki meslek algısı ve iletişimdenkaynaklanan problemleri çatışma nedeni olarak gördüğü saptanmıştır.
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