Abstract
Amaç: Bu çalışma tip 1 diyabetli genç yetişkinlerin hastalığa psikososyal uyumları ve stresle baş etme tarzlarını incelemek amacıyla
yapıldı.
Yöntem: Kesitsel ve tanımlayıcı tipte planlanan araştırmanın örneklemini Ağustos 2012-Ocak 2013 tarihleri arasında diyabet polikliniğine başvuran 128
hasta oluştudu. Veriler öz-bildirim yöntemi ile toplandı. Veri toplama aracı olarak Tanıtıcı Bilgi Formu, Hastalığa Psikososyal Uyum-Öz Bildirim Ölçeği
(PAIS-SR) ve Stresle Başa Çıkma Tarzları Ölçeği (SBTÖ) kullanıdı. Verilerin istatistiksel değerlendirmesi tanımlayıcı ve çıkarımsal testler t testi, Mann
Whitney U testi, tek yönlü varyans analizi ve korelasyon analizi ile yapıdı.
Bulgular: Hastaların %73’ü kadın, %51.6’sı bekâr, %51.6’sı üniversite mezunu, yaş ortalaması 28.39±7.25, hastalık süresi 11.81±7.65
yıl ve %92.2’sinde HbA1c ≥ %6.5’dır. Hastalığa Psikososyal Uyum-Öz Bildirim Ölçeği sonuçlarına göre hastaların %99.2’nin hastalığa
uyumu “kötü” sınırları arasındadır. Hastalığa psikososyal uyum alt boyutlarında kadınlar çaresiz yaklaşımı (t=4.06, p=0.001), erkekler
(t=1.98, p=0.04), bekârlar (t= -1.98; p= 0.04) ve BKI’i normal olanlar (t= 2.54; p= 0.01) kendine güvenli yaklaşımı, üniversite
mezunları (F=3.79,p=0.02) ve BKI’i normal olanlar (t=2.48, p=0.01) sosyal destek arama yaklaşımını daha fazla kullanmıştır. Hastalığa
psikososyal uyum ölçeği toplam puanı ile stresle başa çıkma tarzları ölçeğinin çaresiz yaklaşım ve boyun eğici yaklaşım alt boyutları
arasında pozitif yönde anlamlı zayıf bir ilişki olduğu belirlenmiştir (p<0.05).
Sonuç: Çalışmada hastaların tamamına yakının psikososyal uyumlarının zayıf olduğu, kadın, bekar ve eğitim düzeyi düşük olanların
kötü uyum ve etkisiz baş etme açısından daha fazla risk taşıdıkları belirlendi.
Anahtar Kelimeler: Tip 1 diyabet, psikososyal uyum, stresle başa çıkma, hemşirelik.
References
- Adaylar, A. M. (1995). Kronik hastalığı olan bireylerin hastalıktaki tutum, adaptasyon, algı ve öz-bakım yönelimleri. Doktora Tezi,
- İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul. American Diabetes Association (ADA) (2014). Standarts of Medi- cal Care in Diabetes-2014. Diabetes Care, 37(1): 14-80.
- Buckloh, L. M. ve ark. (2008). Diabetes complications in youth. Diabetes Care, 31: 1516-1520.
- Buzlu, S. (2002). Diyabetin psikososyal yönü. Erdoğan, E. (Ed.).
- Diyabet Hemşireliği Temel Bilgiler. Yüce Yayım Dağıtım, İstanbul, 195-20
- Chang, R. (2009). The Effects of Stress and Coping Styles on Blo- od Glucose and Mood in Adolescents with Type 1 Diabetes Ho- nors Theses, Carnegie Melon University, Paper 3, http://reposi- tory.cmu.edu/cgi/viewcontent.cgi?article=1005&context=hsshono rs (04.2014)
- Collins, M. M., Corcoran, P., Perry, I. J. (2009). Anxiety and depression symptoms in patients with diabetes. Diabetic Medicine, 26: 153-161.
- Nathan ve ark. (2009). Modern-day clinical course of type 1 diabe- tes mellitus after 30 years’ duration: The diabetes control and comp- lication trial/epidemiology of diabetes interventions and complica- tions and Pittsburg epidemiology of diabetes complications expe- rience (1983-2005). Archives Internal Medicine, 169: 1307-1316.
- Derogatis, L. R. (1986). The psychosocial adjustment to illness sca- le (PAIS). Journal of Psychosomatic Research, 30: 77-91.
- Duangdao, K. M., Roesch, S. C. (2008). Coping with diabetes in adulthood: A meta-analysis. Journal of Behaverial Medicine, 31: 291-300.
- Gafvels, C., Wandell, P. E. (2006). Coping strategies in men and women with type 2 diabetes in Swedish primary care. Diabetes
- Research and Clinical Practice, 71: 280-289. Gendelman, N. ve ark. (2009). Prevalence and correlates of depression in individuals with and without type 1 diabetes. Diabetes Care, 32: 575-579.
- Graue, M., Wentzel-Larsen, T., Bru, E., Hanestad, B. R., Sİvik, O. (2004). The coping styles of adolescents with type 1 diabetes are associated with degree of metabolic control. Diabetes Care, 27: 1313–1317.
- Grey, M., Davidson, M., Boland, E. A., Tamborlane, W. V. (2004).
- Clinical and psychosocial factors associated with achievement of treatment goals in adolescents with diabetes mellitus. Journal of Adolescent Health, 28: 377-385. International Diabetes Federation (IDF) (2013). Diabetes At- las. basım, IDF Publication, Bruxelles, http://www.idf.org/ diabetesatlas/6e/the-global-burden (23.05.2014).
- Kara, K., Çınar, S. (2011). Diyabet bakım profi li ile metabolik kont- rol değişkenleri arasındaki ilişki. Kafkas J Med Sci, 1(2): 57–63.
- Özdemir, Ü., Taşcı, S. (2013). Kronik hastalıklarda psikososyal sorunlar ve bakım. Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 1(1): 57-72.
- Rasussen, B., Ward, G., Jenkins, A., King, S. J., Dunning, T. (2011).
- Young adults’ management type 1 diabetes during life transitions. Journal of Clinical Nursing, 20: 1981-1992.
- Salamon, K. S. ve ark. (2012). Experiencing type 2 diabetes melli- tus: Qualitative analysis of adolescents’ concept of illness, adjust- ment, and motivation to engage in self-care behaviours. Diabetes Educator, 38(4): 543-551.
- Serlachius, A., Northam, E., Frydenberg, E., Cameron, F. (2011).
- Adapting a generic coping skills programme for adolescents with type 1 diabetes: A qualitative study. Journal of Health Psychology, 17: 313-332. Shiu, A. T. Y., Wong, R. Y. M. (2002). Fears and worries associ- ated with hypoglycemia and diabetes complications: Perceptions and experience of Hong Kong Chinese clients. Journal of Advan- ced Nursing, 39: 155–163.
- Skocić, M., Rudan, V., Brajković, L., Marcinko, D. (2010). Relationship among psychopathological dimensions, coping mechanisms, and glycemic control in a Croatian sample of adolescents with diabetes mellitus type 1. European Child& Adolescent Psychiatry, 19(6): 525-533.
- Spencer, J., Cooper, H., Milton, B. (2009). Qualitative studies of type 1 diabetes in adolescence: A systematic literature review. Pe- diatr Diabetes, 11(5): 364-375.
- Spencer, J., Cooper, H., Milton, B. (2013). Educational and psycho- logical issues the lived experiences of young people (13-16 years) with type 1 diabetes mellitus and their parents- a qualitative pheno- menological study. Diabetic Medicine, 30: 17-24.
- Şahin, N. H., Durak, A. (1995). Stresle Başa Çıkma Tarzları Ölçeği:
- Üniversite öğrencileri için uyarlanması. Türk Psikoloji Dergisi, 10(34): 57-70. Roesch, S. C., Weiner, B., Vaughn, A. A. (2002). Cognitive approaches to stress and coping. Current Opinions in Psychiatry, 15: 627-632.
- Watkins K.W. ve ark. (2000). Effect of adults’ self-regulation of di- abetes on quality-of-life outcomes. Diabetes Care, 23: 1511–1515.
Abstract
Aim: The present study was performed to evaluate the psychosocial adjustment to illness and methods of coping with stress among young adults with type 1 diabetes.Method: One hundred twenty-eight patients admitted to the diabetes clinic between August 2012 and January 2013c omprised the sample of this study designed as a cross-sectional and descriptive one. The Descriptive Information Form, Psychosocial Adjustment to Illness Scale-Self Report version (PAIS-SR), and Methods of Coping with Stress Scale were used as data collection tools. Statistical evaluation of the data was performed using descriptive and inferential tests such as the t test, Mann-Whitney U test, one-way analysis of variance and correlation analysis.Results: Of the patients, 73 % were female, 51.6% were single, 51.6% were university graduates. Their mean age was 28.39±7.25 years. The mean disease duration was 11.81±7.65 years and in 92.2% of the patients the level of HbA1c was ≥6.5%. The results of Psychosocial Adjustment to Illness Scale-Self Report version were related with poor disease adjustment in 99.2 % of the patients. Of the subscales of psychosocial adjustment to illness, the helpless approach was utilized by the females (t = 4:06, p = 0.001), males (t = 1.98, p = 0.04) and singles (t = -1.98; p = 0.04), the self-confi dent approach was utilized by those whose BMI was normal (t = 2.54; p = 0.01), and the social support seeking approach was utilized by the university graduates (F = 3.79, p = 0.02) and those whose BMI was normal (t = 2.48, p = 0.01) more. A signifi cant positive weak correlation was determined between the total score obtained from the Psychosocial Adjustment to Illness Scale and the scores obtained from the helpless approach and submissive approach subscales of the Methods of Coping with Stress Scale (p <0.05).Conclusion: This study demonstrated that nearly all of the patients who were diagnosed with type 1 diabetes had poor psychosocial adjustment to their conditions. Especially single women with low education levels were at a greater risk of poor adjustment levels and insuffi cient coping with their diseases
References
- Adaylar, A. M. (1995). Kronik hastalığı olan bireylerin hastalıktaki tutum, adaptasyon, algı ve öz-bakım yönelimleri. Doktora Tezi,
- İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, İstanbul. American Diabetes Association (ADA) (2014). Standarts of Medi- cal Care in Diabetes-2014. Diabetes Care, 37(1): 14-80.
- Buckloh, L. M. ve ark. (2008). Diabetes complications in youth. Diabetes Care, 31: 1516-1520.
- Buzlu, S. (2002). Diyabetin psikososyal yönü. Erdoğan, E. (Ed.).
- Diyabet Hemşireliği Temel Bilgiler. Yüce Yayım Dağıtım, İstanbul, 195-20
- Chang, R. (2009). The Effects of Stress and Coping Styles on Blo- od Glucose and Mood in Adolescents with Type 1 Diabetes Ho- nors Theses, Carnegie Melon University, Paper 3, http://reposi- tory.cmu.edu/cgi/viewcontent.cgi?article=1005&context=hsshono rs (04.2014)
- Collins, M. M., Corcoran, P., Perry, I. J. (2009). Anxiety and depression symptoms in patients with diabetes. Diabetic Medicine, 26: 153-161.
- Nathan ve ark. (2009). Modern-day clinical course of type 1 diabe- tes mellitus after 30 years’ duration: The diabetes control and comp- lication trial/epidemiology of diabetes interventions and complica- tions and Pittsburg epidemiology of diabetes complications expe- rience (1983-2005). Archives Internal Medicine, 169: 1307-1316.
- Derogatis, L. R. (1986). The psychosocial adjustment to illness sca- le (PAIS). Journal of Psychosomatic Research, 30: 77-91.
- Duangdao, K. M., Roesch, S. C. (2008). Coping with diabetes in adulthood: A meta-analysis. Journal of Behaverial Medicine, 31: 291-300.
- Gafvels, C., Wandell, P. E. (2006). Coping strategies in men and women with type 2 diabetes in Swedish primary care. Diabetes
- Research and Clinical Practice, 71: 280-289. Gendelman, N. ve ark. (2009). Prevalence and correlates of depression in individuals with and without type 1 diabetes. Diabetes Care, 32: 575-579.
- Graue, M., Wentzel-Larsen, T., Bru, E., Hanestad, B. R., Sİvik, O. (2004). The coping styles of adolescents with type 1 diabetes are associated with degree of metabolic control. Diabetes Care, 27: 1313–1317.
- Grey, M., Davidson, M., Boland, E. A., Tamborlane, W. V. (2004).
- Clinical and psychosocial factors associated with achievement of treatment goals in adolescents with diabetes mellitus. Journal of Adolescent Health, 28: 377-385. International Diabetes Federation (IDF) (2013). Diabetes At- las. basım, IDF Publication, Bruxelles, http://www.idf.org/ diabetesatlas/6e/the-global-burden (23.05.2014).
- Kara, K., Çınar, S. (2011). Diyabet bakım profi li ile metabolik kont- rol değişkenleri arasındaki ilişki. Kafkas J Med Sci, 1(2): 57–63.
- Özdemir, Ü., Taşcı, S. (2013). Kronik hastalıklarda psikososyal sorunlar ve bakım. Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 1(1): 57-72.
- Rasussen, B., Ward, G., Jenkins, A., King, S. J., Dunning, T. (2011).
- Young adults’ management type 1 diabetes during life transitions. Journal of Clinical Nursing, 20: 1981-1992.
- Salamon, K. S. ve ark. (2012). Experiencing type 2 diabetes melli- tus: Qualitative analysis of adolescents’ concept of illness, adjust- ment, and motivation to engage in self-care behaviours. Diabetes Educator, 38(4): 543-551.
- Serlachius, A., Northam, E., Frydenberg, E., Cameron, F. (2011).
- Adapting a generic coping skills programme for adolescents with type 1 diabetes: A qualitative study. Journal of Health Psychology, 17: 313-332. Shiu, A. T. Y., Wong, R. Y. M. (2002). Fears and worries associ- ated with hypoglycemia and diabetes complications: Perceptions and experience of Hong Kong Chinese clients. Journal of Advan- ced Nursing, 39: 155–163.
- Skocić, M., Rudan, V., Brajković, L., Marcinko, D. (2010). Relationship among psychopathological dimensions, coping mechanisms, and glycemic control in a Croatian sample of adolescents with diabetes mellitus type 1. European Child& Adolescent Psychiatry, 19(6): 525-533.
- Spencer, J., Cooper, H., Milton, B. (2009). Qualitative studies of type 1 diabetes in adolescence: A systematic literature review. Pe- diatr Diabetes, 11(5): 364-375.
- Spencer, J., Cooper, H., Milton, B. (2013). Educational and psycho- logical issues the lived experiences of young people (13-16 years) with type 1 diabetes mellitus and their parents- a qualitative pheno- menological study. Diabetic Medicine, 30: 17-24.
- Şahin, N. H., Durak, A. (1995). Stresle Başa Çıkma Tarzları Ölçeği:
- Üniversite öğrencileri için uyarlanması. Türk Psikoloji Dergisi, 10(34): 57-70. Roesch, S. C., Weiner, B., Vaughn, A. A. (2002). Cognitive approaches to stress and coping. Current Opinions in Psychiatry, 15: 627-632.
- Watkins K.W. ve ark. (2000). Effect of adults’ self-regulation of di- abetes on quality-of-life outcomes. Diabetes Care, 23: 1511–1515.
Details
| Journal Section | Reserch Papers |
|---|---|
| Authors | |
| Publication Date | September 28, 2015 |
| Published in Issue | Year 2015 Volume: 23 Issue: 2 |