Sistemik lupus eritematozuslu hastalara verilen web tabanlı eğitim ve danışmanlığın bakım sonuçlarına etkisi
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Dosyalar
Tarih
2017
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Araştırma, web tabanlı eğitim ve danışmanlığın Sistemik Lupus Eritematozus (SLE)'li hastaların bakım sonuçlarına etkisini belirlemek amacıyla randomize kontrollü (öntest-sontest kontrol gruplu model) olarak yapılmıştır. Araştırmanın evrenini; Ağustos 2015-Ekim 2016 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Hastanesi, İç Hastalıkları Anabilim Dalı, Romatoloji Bilim Dalı Polikliniği'ne başvuran ve SLE tanısı alan 18 yaş üzeri bireyler, örneklemini; güç analizi ile belirlenen ve araştırma ölçütlerine uyan 40 uygulama, 40 kontrol grubu olmak üzere toplam 80 hasta oluşturmuştur. Randomizasyon basit rastgele düzen ile yapılmıştır. Çalışmanın ilk aşamasında, uygulama grubunun eğitimi, izlemi ve danışmanlık hizmetinin yürütüleceği SLE'li hastalara yönelik internet sitesi yapılandırılmıştır. Veri toplama sürecinde; uygulama grubuna; ilk poliklinik ziyaretinde (0. ay) araştırmada kullanılacak olan veri toplama formları yüz yüze görüşme tekniği ile uygulanmış, web üzerinden izlemlerinde ilk üç ay belirlenen eğitime ilişkin materyaller siteye yüklenmiş ve okumaları, sonrasında sormak istedikleri soruları belirlemeleri ve danışmana sormaları sağlanmıştır. Hastalara eğitimleri her okuduklarında mesaj kısmından iletişime geçerek bilgi vermeleri istenmiştir. Çalışmanın üçüncü ayından itibaren hastaların sordukları sorulara ve yapılan görüşmelere göre araştırmacı tarafından bireysel danışmanlık ve bilgi güncellemesi yapılmıştır. Telefon ya da internet sitesi üzerinden sorular yanıtlanmış, gerekli yönlendirmeler yapılmıştır. Danışmanlık sırasında; hastanın hekimi ile işbirliği esas alınmıştır. Hastanın tıbbi tedavisi ile ilgili hiçbir konuya girilmemiş, bu konular danışmanlık kapsamında yer almamıştır. Hastalara 6. aydaki kontrollerinde anket formları tekrar uygulanmıştır. Kontrol grubuna; ilk poliklinik ziyareti ve 6. aydaki poliklinik izlemlerinde araştırmada kullanılacak olan veri toplama formları yüz yüze görüşme tekniği ile uygulanmıştır. Araştırma sonunda; kontrol grubuna, uygulama grubuna verilen web tabanlı eğitimin basılı materyali (kitapçık) verilmiştir. Araştırma verilerinin toplanmasında; Birey Tanılama Formu, Kronik Hastalıklar Yönetiminde 6 Maddelik Öz Yeterlik Ölçeği, Yorgunluk Şiddeti Ölçeği, Kronik Hastalık Bakımını Değerlendirme Ölçeği-Hasta Formu, SLE Aktivite İndeksi, LupusQoLTürkçe–Lupus Yaşam Kalitesi Ölçeği Türkçe Versiyonu kullanılmıştır. Verilerin analizinde, Levene testi, ki-kare ve t testi, Wilcoxon, Mann Whitney U, Kruskal-Wallis, McNemar-Bowker Testi kullanılmıştır. Çalışma sonunda; uygulama grubundaki hastaların özyeterlik, yorgunluk, kronik hastalık bakımını değerlendirme puanları, hastalık aktivite indeksinde anlamlı düzeyde iyileşme görülürken (p>0.05), yaşam kalitesinin bazı alanlarında anlamlı değişimler belirlenmiştir. Sonuç olarak, SLE'li hastalara verilen web tabanlı eğitim ve danışmanlığın, hastaların özyeterlik algısı, yorgunluk, kronik hastalık bakımından memnuniyet, hastalık aktivitesi ve yaşam kalitesinin bazı alanlarına olumlu etkisinin olduğu saptanmıştır. Elde edilen sonuçlara göre; hastanelerde SLE'li bireylerin eğitim ve sürekli danışmanlığın sağlaması için web sitelerinin oluşturulması ve hemşireler tarafından yönetimi, diğer romatizmal hastalıklara yönelik eğitim ve danışmanlığı sağlayan benzer web sitelerinin oluşturulması önerilerinde bulunulmuştur.
The study was conducted as a randomized controlled (pretest-posttest control group) model to determine the effect of web-based education and counseling for patients with systemic lupus erythematosus (SLE) on care results. The universe of study included patients who are 18 years old who are admitted to the Rheumatology Policlinic of Ege University Medical Faculty Hospital and who are diagnosed with SLE between August 2015 and October 2016. The sample of the study consisted 80 patients "the experimental group (n=40), control group (n=40). For the sample selection, power analysis values were determined, and randomization was done with simple random order. In the first phase of the study, the website was configured for education, follow-up and counseling for SLE patients in the experimentel group. During the data collection process; in the first visit (0.month), the data collection forms were applied by face to face interview technique to experimental group. In the first three month, the educational materials were uploaded on the web, then they read it and they asked their questions the advisor. Every time they read the education materials, they are required to communicate through the message section to provide information. In the second three month, counseling and information updates were made by the researcher according to the questions asked by the patients and the interviews. The questions were answered via phone or web site and necessary directions were made. During counseling; cooperation with the patient's physician was taken as the basis. No topics related to the medical treatment of the patient were answered and these subjects were not included in the scope of counseling. At the 6th month, questionnaire forms were re-applied. Data collection forms were applied by face to face interview technique to control group in the first and 6th month. At the end of the study; the printed web-based education material (booklet) given to the experimental group was given to control group. In the data collection of the study; Patient Assessment Form, Self-Efficacy for Managing Chronic Disease 6-Item Scale, Fatigue Severity Scale, Patient Assessment of Chronic Illness Care, SLE Disease Activity Index and Lupus Quality of Life Turkish version were used. Chi-square and t test, Kruskal-Wallis, Wilcoxon, Mann Whitney U, McNemar-Bowker Test and Levene test were used in the analysis of the data. We found that there is significant improvement in self-efficacy, fatigue, assessment of chronic illness care and disease activity index of patients in the experimental group, but significant changes were found in a few subscales quality of life. In conclusion, web based education and counseling with SLE patients was found to have a positive effect on self-efficacy, fatigue, satisfaction with chronic illness, disease activity and a few subscales quality of life. According to the results, establishing web sites for education and continuing counseling of SLE patients in hospitals and suggesting the creation of similar websites that provide education and counseling for other rheumatic diseases by nurses.
The study was conducted as a randomized controlled (pretest-posttest control group) model to determine the effect of web-based education and counseling for patients with systemic lupus erythematosus (SLE) on care results. The universe of study included patients who are 18 years old who are admitted to the Rheumatology Policlinic of Ege University Medical Faculty Hospital and who are diagnosed with SLE between August 2015 and October 2016. The sample of the study consisted 80 patients "the experimental group (n=40), control group (n=40). For the sample selection, power analysis values were determined, and randomization was done with simple random order. In the first phase of the study, the website was configured for education, follow-up and counseling for SLE patients in the experimentel group. During the data collection process; in the first visit (0.month), the data collection forms were applied by face to face interview technique to experimental group. In the first three month, the educational materials were uploaded on the web, then they read it and they asked their questions the advisor. Every time they read the education materials, they are required to communicate through the message section to provide information. In the second three month, counseling and information updates were made by the researcher according to the questions asked by the patients and the interviews. The questions were answered via phone or web site and necessary directions were made. During counseling; cooperation with the patient's physician was taken as the basis. No topics related to the medical treatment of the patient were answered and these subjects were not included in the scope of counseling. At the 6th month, questionnaire forms were re-applied. Data collection forms were applied by face to face interview technique to control group in the first and 6th month. At the end of the study; the printed web-based education material (booklet) given to the experimental group was given to control group. In the data collection of the study; Patient Assessment Form, Self-Efficacy for Managing Chronic Disease 6-Item Scale, Fatigue Severity Scale, Patient Assessment of Chronic Illness Care, SLE Disease Activity Index and Lupus Quality of Life Turkish version were used. Chi-square and t test, Kruskal-Wallis, Wilcoxon, Mann Whitney U, McNemar-Bowker Test and Levene test were used in the analysis of the data. We found that there is significant improvement in self-efficacy, fatigue, assessment of chronic illness care and disease activity index of patients in the experimental group, but significant changes were found in a few subscales quality of life. In conclusion, web based education and counseling with SLE patients was found to have a positive effect on self-efficacy, fatigue, satisfaction with chronic illness, disease activity and a few subscales quality of life. According to the results, establishing web sites for education and continuing counseling of SLE patients in hospitals and suggesting the creation of similar websites that provide education and counseling for other rheumatic diseases by nurses.
Açıklama
Anahtar Kelimeler
Sistemik Lupus Eritematozus, Web, Eğitim, Hemşire Danışmanlık, Systemic Lupus Erythematosus, Education, Nurse, Counseling
