HEMODİYALİZ TEDAVİSİ ALAN HASTALARDA SAĞLIK OKURYAZARLIĞI VE TEDAVİYE UYUMLARI ARASINDAKİ İLİŞKİ

Yıl 2023, Cilt: 4 Sayı: 1, 1 - 5, 30.04.2023

Elif Bülbül , Songül Demiroglu

https://doi.org/10.52831/kjhs.1166286

Öz

Amaç: Bu araştırmanın amacı kronik hemodiyaliz tedavisi alan hastalarda sağlık okuryazarlığı ve tedaviye uyumları arasındaki ilişkinin incelenmesidir.
Yöntem: Tanımlayıcı ve ilişki arayıcı tipte olan bu araştırmanın verileri İstanbul ilinde bulunan özel bir diyaliz merkezinde tedavi alan ve araştırmaya dahil olma kriterlerini karşılayan 163 kronik hemodiyaliz tedavisi alan hastalardan Ekim-Kasım 2021 tarihleri arasında toplandı. Araştırma verilerinin toplanmasında, hasta tanıtım formu, Sağlık Okuryazarlığı Ölçeği ve Son Dönem Böbrek Yetmezliği-Uyum Ölçeği kullanıldı.
Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 62.21±12.97 ve hemodiyaliz tedavi süresi 5.26±5.39 yıldı. Erkek hastaların eğitim düzeyi yüksek olanların, çalışanların, yaş aralığı düşük olanların sağlık okuryazarlığı düzeyinin anlamlı olarak yüksek olduğu bulundu (p<0.01). Hemodiyaliz tedavisi alan hastaların yaşı ile Sağlık Okuryazarlığı Ölçeği toplam puanı arasında negatif yöndeki korelasyon istatistiksel olarak anlamlı bulundu (p<0.01). Son Dönem Böbrek Yetersizliği Uyum Ölçeği toplam puanı ile Sağlık Okuryazarlığı Ölçeği toplam puanı (r=0.371; p<0.01) ve Kt/V (K: Üre diyalizör klerensi t: Diyaliz zamanı V: Vücut üre dağılım hacmi) değeri (r=0.307; p<0.01) arasında pozitif yönde istatistiksel olarak anlamlı korelasyon olduğu belirlendi.
Sonuç: Sağlık okuryazarlığı düzeyi yüksek olan hastaların tedaviye uyumlarının daha iyi olduğu saptandı. Uyum düzeyleri iyi olan hastaların ise hemodiyaliz yeterliliğinin daha iyi olduğu belirlendi.

Anahtar Kelimeler

Hemodiyaliz, Hemşire, Sağlık Okuryazarlığı, Son-Dönem Böbrek Hastalığı, Uyum

Teşekkür

Çalışma ortamının hazırlanmasında ve verilerin toplanmasında değerli katkılarından dolayı Dr. Faruk Kaplan’a teşekkür ederiz.

THE RELATIONSHIP BETWEEN HEALTH LITERACY AND ADHERENCE TO TREATMENT IN PATIENTS RECEIVING HEMODIALYSIS TREATMENT

Öz

Objective: This study was conducted to examine the relationship between health literacy and adherence to treatment in patients receiving chronic hemodialysis treatment.
Method: The data of this descriptive and correlational study were collected from 163 chronic hemodialysis patients who met the inclusion criteria and received treatment in a private dialysis center in Istanbul between October and November 2021. Patient sociodemographic form, Health Literacy Scale and End Stage Renal Disease Adherence Questionnaire were used to collect the data.
Results: The mean age of the patients included in the study was 62.21±12.97 years and the duration of hemodialysis treatment was 5.26±5.39 years. It was found that the health literacy level of male patients, those with a high education level, those who were employed, and those with a younger age were significantly higher (p<0.01). There was a statistically significant negative correlation between the age of the patients receiving hemodialysis treatment and the Health Literacy Scale total score (p<0.01). It was determined that there was a statistically significant positive correlation between the End Stage Renal Disease Adherence Questionnaire total score with the Health Literacy Scale total score (r=0.371; p<0.01) and Kt/V (K: Dialyzer clearance of urea t: Dialysis time V: volume of distribution of urea) value (r=0.307; p<0.01).
Conclusion: It was determined that patients with high health literacy level had better adherence to treatment. However, it was determined that patients with good compliance levels had better hemodialysis adequacy.

Anahtar Kelimeler

Hemodialysis, Nurse, Health Literacy, End-Stage Kidney Disease, Compliance

Kaynakça

• Cockwell P, Fisher LA. The global burden of chronic kidney disease. Lancet. 2020;395(10225):662-664.
• Süleymanlar G, Utaş C, Arınsoy T, et al. A population-based survey of chronic renal disease in Turkey- The CREDIT study. Nephrol Dial Transplant. 2011;(26):1862-1871.
• Süleymanlar G, Ateş K, Seyahi N. Türkiye’de nefroloji, diyaliz ve transplantasyon registry-2020. Ankara: BAYT Bilimsel Arş. Basın Yayın Tanıtım Ltd. Şti.; 2021.
• Barnett T, Li Yoong T, Pinikahana J, Si-Yen T. Fluid compliance among patients having haemodialysis: can an educational program make a difference?. Journal of Advanced Nursing. 2008;61(3):300-306.
• Kutlu FY, Ok E. Son dönem böbrek yetmezliği uyum ölçeği Türkçe uyarlamasının psikometrik özellikleri. Acıbadem Univ Sağlık Bilim Derg. 2020;(3):427-437.
• Alikari V, Tsironi M, Matziou V, et al. The impact of education on knowledge, adherence and quality of life among patients on haemodialysis. Qual Life Res. 2019;28(1):73-83.
• Green JA, Mor MK, Shields AM, et al. Prevalence and demographic and clinical associations of health literacy in patients on maintenance hemodialysis. Clin J Am Soc Nephrol. 2011;6(6):1354-1360.
• Dantas LG, Cruz C, Rocha M, et al. Prevalence and predictors of nonadherence to hemodialysis. Nephron Clin Pract. 2013;124(1-2):67-71.
• Jain D, Green JA. Health literacy in kidney disease: Review of the literature and implications for clinical practice. World J Nephrol. 2016;5(2):147-151.
• Sørensen K, Van den Broucke S, Fullam J, et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health. 2012;12(1):80.
• Taylor DM, Fraser SDS, Bradley JA, et al. A Systematic review of the prevalence and associations of limited health literacy in CKD. Clin J Am Soc Nephrol. 2017;12(7):1070-1084.
• Mukakarangwa MC, Chironda G, Bhengu B, Katende G. Adherence to hemodialysis and associated factors among end-stage renal disease patients at selected nephrology units in Rwanda: A Descriptive Cross-Sectional Study. Nurs Res Pract. 2018;2018:4372716.
• Cervantes L, Hasnain-Wynia R, Steiner JF, Chonchol M, Fischer S. Patient navigation: Addressing social challenges in dialysis patients. Am J Kidney Dis. 2020;76(1):121-129.
• Alemayehu YH, Seylania K, Bahramnezhad F. The relationship between health literacy and quality of life among hemodialysis patients: An integrative review. Hum Antibodies. 2020;28(1):75-81.
• Lai AY, Ishikawa H, Kiuchi T, Mooppil N, Griva K. Communicative and critical health literacy, and self-management behaviors in end-stage renal disease patients with diabetes on hemodialysis. Patient Educ Couns. 2013;91(2):221-227.
• Green JA, Mor MK, Shields AM, et al. Associations of health literacy with dialysis adherence and health resource utilization in patients receiving maintenance hemodialysis. Am J Kidney Dis. 2013;62(1):73-80.
• Green JA, Cavanaugh KL. Understanding the influence of educational attainment on kidney health and opportunities for improved care. Adv Chronic Kidney Dis. 2015;22(1):24-30.
• Tripathy S, Cai X, Adhikari A, et al. Association of educational attainment with incidence of CKD in young adults. Kidney Int Rep. 2020;5(12):2256-2263.
• Lopez-Vargas PA, Tong A, Howell M, Craig JC. Educational interventions for patients with CKD: A systematic review. Am J Kidney Dis. 2016;68(3):353-370.
• Aras Z, Bayık Temel A. Sağlık okuryazarlığı ölçeği’nin Türkçe formunun geçerlik ve güvenirliğinin değerlendirilmesi. Florence Nightingale J Nurs. 2017;25(2):85-94.
• Kim Y, Evangelista LS, Phillips LR, Pavlish C, Kopple JD. The end-stage renal disease adherence questionnaire (ESRD-AQ): Testing the psychometric properties in patients receiving in-center hemodialysis. Nephrol Nurs J J Am Nephrol Nurses’ Assoc. 2010;37(4):377-393.
• Health literacy. The solid facts [Internet]. World Health Organization. 2013. https://apps.who.int/iris/bitstream/handle/10665/128703/e96854.pdf
• Levey AS, Coresh J. Chronic kidney disease. Lancet (London, England). 2012;379(9811):165-180.
• Lambert K, Mullan J, Mansfield K, Lonergan M. A Cross-sectional comparison of health literacy deficits among patients with chronic kidney disease. J Health Commun. 2015;20(Suppl 2):16-23.
• Liu MW-C, Syukri M, Abdullah A, Chien L-Y. Missing in-center hemodialysis sessions among patients with end-stage renal disease in Banda Aceh, Indonesia. Int J Environ Res Public Health. 2021;18(17):9215.
• Demir G, Efil S. Hemodiyaliz tedavisi olan bireylerde tedaviye uyum ve hemşirelik. 2. International Antalya Scientific Research and Innovative Studies Congress. Antalya, 17-21 Mart 2022.
• Cho YI, Lee S-YD, Arozullah AM, Crittenden KS. Effects of health literacy on health status and health service utilization amongst the elderly. Soc Sci Med. 2008;66(8):1809-1816.
• Yavuz N. Hemodiyaliz hastaları için geliştirilen Sağlık Okuryazarlığı Ölçeği kullanılarak sağlık okuryazarlığının yaşam kalitesi ve tedavi etkinliği ile ilişkisinin değerlendirilmesi. Gazi Üniversitesi; 2021.
• Taylor DM, Fraser S, Dudley C, et al. Health literacy and patient outcomes in chronic kidney disease: a systematic review. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc-Eur Ren Assoc. 2018;33(9):1545-1558.
• Schmidli J, Widmer MK, Basile C, et al. Editor’s choice- vascular access: 2018 clinical practice guidelines of the european society for vascular surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55(6):757-818.
• Flythe JE, Curhan GC, Brunelli SM. Shorter length dialysis sessions are associated with increased mortality, independent of body weight. Kidney Int. 2013;83(1):104-113.
• Stømer EU, Klopstad Wahl A, Gunnar Gøransson L, Hjorthaug Urstad K. Health literacy in kidney disease: Associations with quality of life and adherence. J Ren Care. 2020;46(2):85-94.