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Yıl:2017; Cilt: 4; Sayı: 2>> Özet
TAM METİN
The Journal of Neurobehavioral Sciences; 2017;4(2):53-62
Tip 2 diabetes mellituslu hastalarda insülin kullanımına psikolojik direnç oluşturabilecek algı ve düşüncelerin saptanması
E Kirli,TD Berkol, HM Aytaç, H Yumrukçal, H Erensoy, G Özgen
İstanbul S.B.Ü Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, İstanbul
DiyabetesMellitus (DM), hiperglisemi ile karakterize, kronik, metabolik bir hastalıktır. Hastaların büyük bir bölümünün insülin tedavisine başlamaya psikolojik anlamda direnç gösterdiği yaygın olarak gözlemlenmekte, bu nedenle de diyabetin birçok komplikasyonuna maruz kaldıkları görülmektedir. Tip 2 DM tanısı almış hastalar arasındaki psikolojik insülin direncine neden olan algı ve inançları saptamak, bu düşünce ve algıların sosyodemografik verilerle ilişkisini belirlemek amaçlanmıştır. Araştırmaya, Bursa Şevket Yılmaz Devlet Hastanesi Dâhiliye Birimi Diyabet Polikliniğinden takip edilen Tip 2 DM tanılı 120 hasta dâhil edilmiştir. Hastalar; sosyodemografik bilgi formu, diyabetle ilgili sorunlu alanlar ölçeği (DİSA), insülin tedavisini değerlendirme ölçeği (İTAS) ile değerlendirilmiştir. Olguların %65’i (n=78) kadın, %35’i (n=42) erkektir. Olguların DİSA puanları ortalama 63.75±13.88, BDO puanları 15.16±8.25, DKÖ puanları 41.96±3.74, SKÖ puanları ise 46.80±5.52’dir. ITAS’ın bazı maddeleri ile yaş, diyabet süresi, cinsiyet, medeni durum, eğitim düzeyi, çalışma durumu, tedavi çeşidi, kan şekeri ayarlamanın önem düzeyi, kan şekerini ayarlamada güçlük çekme düzeyleri, komplikasyon gelişme durumu, şuan depresyon tedavisi alma durumu arasında ilişki olduğu saptanmıştır. Benzer şekilde bazı ITAS maddeleri ile DISA toplam puanı, DKÖ puanı ve SKÖ puanı arasında ilişki olduğu gözlenmiştir. Sonuç olarak hastaların insülin tedavisine başlamaya psikolojik direnç gösterdikleri, bu direncin çok sayıda olumsuz algı ve tutumlardan kaynaklandığı bulunmuştur. Algı ve düşüncelere yönelik kognitif müdahaleler insülin tedavisine olan psikolojik direnci azaltabilir.
Identification of perceptions and thoughts that can create psychological resistance to insulin use in type 2 diabetes mellitus patients
Diabetes Mellitus (DM) is chronic, metabolic disease characterized by hyperglycemia. It has been widely observed that large proportion of patients show psychological resistance to the initiation of insulin treatment, and as a result they are exposed to many complications of diabetes. It was aimed to identify the perceptions and beliefs that cause psychological insulin resistance among Type 2 DM diagnosed patients, to determine relationship between sociodemographic data and these perceptions & beliefs. In research, 120 patients diagnosed with type 2 DM were included followed by outpatient clinic of Bursa Sevket Yilmaz State Hospital Internal Medicine Unit. Patients were evaluated with socio-demographic information form, diabetes-related problem areas scale (PAID), insulin treatment assessment scale (ITAS), state and trait anxiety inventory (STAI), beck depression inventory (BDI). The average PAID score of patients is 63.75±13.88, BDI scores: 15.16±8.25, State Anxiety Inventory (SAI) subscale scores: 41.96±3.74, Trait Anxiety Inventory (TAI) subscale scores: 46.80±5.52. Correlation was found between age, duration of diabetes, sex, marital status, education level, employment status, type of treatment, the level of importance of blood sugar regulation, the difficulty level of blood glucose adjustment,complications, currently treatment for depression and certain items of ITAS. Similarly, relationship was found between certain items of ITAS and total PAID scores, SAI subscale scores, TAI subscalescores. As a result, it has been found that patients have psychological resistant to start insulin therapy and this is caused by large number of negative perceptions and thoughts. Cognitive interventions for perceptions and thoughts can reduce psychological resistance to insulin therapy.

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