THE RELATIONSHIP OF PATIENT EMPOWERMENT AND LIFE QUALITY

Yıl 2020, Cilt: 8 Sayı: 1, 97 - 114, 30.04.2020

Ali Yılmaz , Ahmet Kar , Mustafa Kaya

https://doi.org/10.22139/jobs.682555

Cited By: 4

Öz

Throughout human history, all societies have worked on protecting human life, extending life expectancy and life expectancy at birth. These studies have led to improvements in areas such as healthy lifestyle, environmental health, and the fight against harmful substances, which are closely related to the subject, especially health services. As a result of all this, the average life expectancy and life expectancy at birth have increased in many societies worldwide, especially in the last century. While it is an desired status that the average life expectancy is increasing, it also brought some problems. The proportion of elderly population formed by the increase in the average life expectancy made studies specific to this area necessary. The provision of health services for the elderly is at the top of these studies. Another field of study is the care needs of individuals with chronic diseases that appear with increasing old age. Increasing the lifes time has led to an increase in chronic disease rates. Long-term care and continuous use of medicines require large financial resources in the management of chronic diseases. Countries searched differently for the financial burden of chronic diseases in health systems. It is stated that the best solution for these studies, whose main purpose is to provide sustainability in healthcare services, is patient-centered care and empowerment of patients to participate in treatment.
Patient empowerment can be explained as informing individuals about their diseases and treatments and enabling them to participate in their treatment. In order for the patient to participate in the treatment, person must have general health information (health information literacy), which is called health literacy, to access the information needed about health, to understand, evaluate and use this information to improve health. The second thing that needs to be done to ensure that the individual with health literacy is included in the treatment is to increase the level of knowledge about the disease, treatment type and healthy lifestyle with this disease. The first step of this stage is to have information about the disease that the person has. The individual who knows about the disease will know what the symptoms of the disease are and will be able to interpret the state of health. The second step of this stage is to have information about the treatment of the disease it has. An individual who is knowledgeable about the treatment of his disease will be able to contribute individually to the treatment as soon as he feels the symptoms of the disease. The third step of this phase is to provide a healthy lifestyle. In this step, it is ensured that the person can continue his life with the highest possible quality with the disease person has. It is stated that individuals who have sufficient knowledge about the disease and who can participate individually in treatment lead a better life quality compared to individuals who do not have this competence. Therefore, patient empowerment is expressed as the solution of the density and economic burden on health systems in the world. With patient empowerment, individuals will have information about their diseases, treatment modalities and diseases, and continuing their lives and will apply to health institutions when they really need it.
n this study, it was aimed to determine the relationship between patient empowerment and life quality and the factors affecting patients' life quality. For this purpose, a group of patients with chronic disease was interviewed to include them in the study. These patients were selected from patients who applied to a university hospital in February and March 2018. While determining the patients, applying to the outpatient clinic in the internal medicine, chest diseases, cardiology and general surgery units and being chronic patients were used as the criterion to include in the research. Patients with chronic disease, asthma, diabetes, chronic obstructive pulmonary disease (copd), patients with thyroid and heart disease were included in the study. The data of the research were collected with a questionnaire form. The questionnaire form consisting of three parts was applied to the individuals included in the research. The first part of the questionnaire includes descriptive features, chronic diseases and questions about the outpatient clinic they apply to. In the second part of the survey, there is a patient empowerment scale developed by Small (2012) and whose validity and reliability in Turkish was performed by Kaya and Işık (2018). The scale, which was originally composed of 47 expressions, was reduced to 37 expressions whose goodness of fit was acceptable as a result of the confirmatory factor analysis conducted by Kaya and Işık (2018). In the second part of the questionnaire, a 37 item scale was used. In the third part of the survey, the Dutch model of the EQ-5D 5L scale developed by The Euro Qol Group was used to measure the life quality of patients. This model consists of five dimensions and 25 expressions. The patients to be included in the study were selected by random sampling method. The first of the analyzes made using the data obtained was made for the relationship between patient empowerment and life quality. The relationship between patient empowerment and life quality was examined by Pearson correlation analysis. In the second analysis, the evaluation of patient empowerment and life quality scores in terms of age groups and type of chronic disease were examined with the Duplex Manova analysis. In the third analysis, the relationship between patient empowerment and life quality scores and gender was examined with the independent sample T test. Linear regression analysis was used to evaluate the factors that affect the life quality of the final analysis patients.
In this study, which was conducted to examine the relationship between patient empowerment and life quality in individuals with chronic disease and to determine the factors affecting life quality, patients obtained an average score of 130.18 from the patient empowerment scale. As a result of the analysis, a negative relationship was found between age, life quality and patient empowerment. The highest life quality and patient empowerment score by age groups appeared in the youngest group. In another analysis in which patient empowerment and life quality scores were examined by gender, it was concluded that patient empowerment and life quality scores did not differ by gender. Significant differences were found between patient empowerment and life quality score averages according to the type of chronic disease. While the disease group with the highest life quality is thyroid, COPD patients constitute the lowest group. The same results were obtained between patient empowerment and chronic diseases as well as life quality. Thyroid patients had the highest average in the patient empowerment score, and COPD patients had the lowest average. The groups that make the difference in patient empowerment are thyroid and COPD, whereas life quality is COPD and diabetes patients. In the correlation analysis conducted to examine the relationship between patient empowerment and life quality, there was no multiple correlation between the variables included in the model and there was a moderately positive correlation between them (R = 0,505; R2 = 0,255; Adjusted R2 = 0,251 Durbin Watson = 1.592). In the regression model, it was concluded that patient empowerment, gender and age variables had a significant effect on life quality, and these three variables could explain 25% of the change in life quality together.
Considering the positive contributions of health literacy and patient active participation to the health status perceived by the person, these elements have important effects on patient empowerment and life quality. For this reason, it is recommended to strengthen individuals with a chronic disease over a certain age so that they can understand their own health status and express their complaints about their illnesses, and to implement educational practices and counseling that will contribute to their successful aging without reducing the life quality.

Anahtar Kelimeler

Chronic Illness, Patient Empowerment, Life Quality

HASTA GÜÇLENDİRME VE YAŞAM KALİTESİ İLİŞKİSİ

Öz

Amaç: Bu çalışmada hasta güçlendirme ve yaşam kalitesi arasındaki ilişkinin ve hastaların yaşam kalitesini etkileyen faktörlerin belirlenmesi amaçlanmıştır.
Yöntem: Araştırmaya bir üniversite hastanesinde 5 Şubat-25 Mayıs 2018 tarihleri arasında dâhiliye, göğüs hastalıkları, kardiyoloji ve genel cerrahi birimlerinde poliklinik başvurusu yapan kronik hastalar dâhil edilmiştir. Astım, diyabet, kronik obstrüktif akciğer hastalığı (koah), tiroid ve kalp rahatsızlığı bulunan hastaların dâhil edildiği bu çalışmada Small (2012) tarafından geliştirilen, Kaya ve Işık (2018) tarafından Türkçe geçerlilik ve güvenilirliği yapılan hasta güçlendirme ölçeği kullanılmıştır. Hastaların yaşam kalitesi ise The Euro Qol Group tarafından geliştirilmiş olan EQ-5D 5L ölçeğinin Hollanda ağırlıkları ile uygulanması ile değerlendirilmiştir. Rastgele örnekleme yöntemi kullanılmıştır ve 515 hasta araştırmaya dâhil edilmiştir. Araştırmanın verileri SPSS 23 programı ile analiz edilmiştir.
Bulgular: Uygulanan hasta güçlendirme ölçeğine ilişkin ortalama skor 130,18 olarak gerçekleşmiştir. Hasta güçlendirme ile yaşam kalitesi arasında orta düzeye yakın pozitif yönlü bir ilişki bulunmuştur. Ayrıca yaş grubu ve kronik hastalık türünün hasta güçlendirme ve yaşam kalitesi skoru üzerinde değişikliğe yol açtığı belirlenmiştir.
Sonuç: Bu çalışmada hasta güçlendirme ile yaşam kalitesi arasında ilişki olduğu ve hasta güçlendirmenin yaşam kalitesini artırdığı sonucuna ulaşılmıştır. Bu yüzden hastaların güçlendirilmesine yönelik uygulamalara önem verilmesi, hastanın tedavisine aktif katılımının sağlanması ve uygulanacak politikaların bu doğrultuda planlanması önerilmektedir. 

Anahtar Kelimeler

Kronik hastalık, Hasta Güçlendirme, Yaşam Kalitesi

Kaynakça

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