Gestasyonel diyabetli gebe kadınlarda dijital hikâye anlatımı müdahalesinin diyabet öz-yönetimine etkisi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Öz-yönetim, gestasyonel diyabet bakımının vazgeçilmez bir parçasıdır. Kendi kendine glikoz yönetimi ve izlemi, sağlıklı beslenme ve fiziksel aktivite gibi çeşitli sağlık davranışlarını değiştirmek ve gebelerin öz-yönetimi artırmak önemlidir. Bu çalışmanın birincil amacı, gestasyonel diyabetli kadınlarda dijital hikâye anlatımı müdahalesinin diyabet öz-yönetimine etkisini değerlendirmektir. Çalışmada deneysel araştırma desenlerinden "Eşitlenmemiş Kontrol Gruplu Öntest-Sontest Deseni" kullanılmıştır. Araştırma, Ege Üniversitesi Tıp Fakültesi Hastanesi Kadın Hastalıkları ve Doğum Polikliniğinde Mart-Kasım 2023 tarihleri arasında yürütülmüştür. Veri toplama süreci; kontrol grubunda 22, müdahale grubunda ise 23 kişi olacak şekilde toplam 45 kişiyle tamamlanmıştır. Veriler; Tanıtıcı Bilgi Formu, Diyabet Öz Etkililik Ölçeği, Diyabette Öz-Yönetim Algı Skalası, Uluslararası Fiziksel Aktivite Anketi (Kısa Formu) aracılığıyla yüz yüze toplanmıştır. Ön test verileri alındıktan sonra müdahale grubuna ilk hafta içerisinde gün aşırı olacak şekilde toplam dört video WhatsApp aracılığıyla gönderilmiştir. Dört haftalık izlem sürecinde haftada bir olmak üzere hatırlatıcı olarak dört ayrı kısa dijital hikaye videoları gönderilmiştir. Dördüncü haftanın sonunda son test verileri alınmıştır. Haftalık kan şekeri izlemleri her iki gruptaki gebelerden de WhatsApp aracılığıyla alınmıştır. Verilerin analizinde sayı, yüzde, aritmetik ortalama, standart sapma, medyan, ki-kare analizi, Anova testi, Mc Nemar testi, Friedman testi, bağımsız ve bağımlı örneklem t testi, Wilcoxon testi ve Mann Whitney U testi kullanılmıştır. Kontrol ve müdahale gruplarındaki gebelerin yaş, çalışma durumu, gelir durumu, eğitim durumu, aile tipi, gebelik hastasına göre uygun kilo alma durumu, gravida, parite, abortus ve küretaj öyküsü varlığı, yaşayan çocuk sayısı, gebeliği isteme durumu, sosyal destek varlığı, GDM tedavisi, önceki gebeliğinde GDM varlığı, birinci derece yakınında DM öyküsü varlığı, OGTT uygulama yaklaşımı, sağlıklı beslenme düşüncesi, düzenli fiziksel egzersiz varlığı ve düzenli egzersiz yapılan gün sayısı gibi özellikler açısından homojen bir dağılım gösterdiği ve grupların birbiriyle benzer olduğu bulunmuştur (p>0.05). Gruplar arasında Diyabet Öz Etkililik Ölçeği ön test toplam puan ortalamaları açısından istatistiksel olarak anlamlı bir farklılık olmadığı saptanmıştır (t=-0.645, p>0.05). Dijital hikaye anlatımı müdahalesi sonrası ise Diyabet Öz Etkililik Ölçeği son test puan ortalamasının kontrol grubuna göre daha yüksek olduğu ve aralarındaki farkın istatistiksel olarak anlamlı olduğu belirlenmiştir (t=-4.185, p<0.05). Müdahale grubunun Diyabette Öz-Yönetim Algı Skalasının hem ön test ve hem de son test puan ortalamalarının kontrol grubuna göre daha yüksek olduğu ve aralarındaki farkın istatistiksel olarak anlamlı olduğu belirlenmiştir (t=-2.697, p<0.05; t=-3.362, p<0.05). Açlık kan glukozu, öğle ve akşam birinci saat tokluk kan glukozu ortalamaları açısından gruplar arasında istatistiksel olarak anlamlı bir fark yoktur. Sabah tokluk kan glukozunun hem üçüncü hem de dördüncü ölçüm zamanları için müdahale grubu sabah tokluk kan glukoz ortalamaları kontrol grubuna göre daha düşüktür ve gruplar arasındaki fark istatistiksel olarak anlamlıdır. Kontrol grubundaki kişilerin %72.7'si minimal aktif iken; müdahale grubundaki kişilerin %26.1'inin minimal aktif olduğu belirlenmiştir. Dijital hikaye girişimi sonrası müdahale grubunun yarısından fazlası çok aktif kategorisindeyken kontrol grubunun yalnızca %9.1'i bu sınıftadır. Gruplar arasında tıbbi beslenme tedavisine uyma ve insülin tedavisine başlama açısından istatistiksel olarak anlamlı bir fark bulunmamıştır. Sonuç olarak, dijital hikaye anlatımı müdahalesinin gestasyonel diyabetli gebelerin diyabet öz yeterliliği ve diyabet öz-yönetim algısı üzerine etkili bir girişim olduğu belirlenmiştir. Anahtar Kelimeler; Gestasyonel diyabet; öz-yönetim; öz yeterlilik; dijital hikâye anlatımı; hemşirelik
Self-management is an essential part of gestational diabetes care. It is important to change various health behaviours such as glucose self-management and monitoring, healthy eating, and physical activity and to improve the self-management of pregnant women. The primary aim of this study was to evaluate the effect of digital storytelling intervention on diabetes self-management in women with gestational diabetes. In the study, "Unequalised Control Group Pretest-Posttest Design", one of the experimental research designs, was used. The study was conducted in Ege University Faculty of Medicine Hospital Gynaecology and Obstetrics Outpatient Clinic between March and November 2023. The data collection process was completed with a total of 45 people, 22 in the control group and 23 in the intervention group. Data were collected face-to-face through the Introductory Information Form, Diabetes Self-Efficacy Scale, Diabetes Self-Management Perception Scale, and International Physical Activity Questionnaire (Short Form). After the pre-test data were received, a total of four videos were sent to the intervention group via WhatsApp every other day in the first week. During the four-week follow-up period, four separate short digital story videos were sent once a week as a reminder. At the end of the fourth week, post-test data were collected. Weekly blood glucose monitoring was received from pregnant women in both groups via WhatsApp. Number, percentage, arithmetic mean, standard deviation, median, chi-square analysis, Anova test, Mc Nemar test, Friedman test, independent and dependent sample t-test, Wilcoxon test, and Mann Whitney U test were used in data analysis. It was found that the pregnant women in the control and intervention groups showed a homogeneous distribution in terms of characteristics such as age, employment status, income status, educational status, family type, appropriate weight gain according to the gestational age, gravida, parity, presence of abortion and curettage history, number of living children, desire for pregnancy, presence of social support, GDM treatment, presence of GDM in a previous pregnancy, presence of DM history in first-degree relatives, OGTT application approach, healthy eating idea, presence of regular physical exercise and number of days of regular exercise, and the groups were similar to each other (p>0.05). It was found that there was no statistically significant difference between the groups in terms of diabetes self-efficacy scale pretest total mean scores (t=-0.645, p>0.05). After the digital storytelling intervention, it was determined that the posttest mean score of the diabetes self-efficacy scale was higher than the control group and the difference between them was statistically significant (t=-4.185, p<0.05). It was determined that both pre-test and post-test mean scores of the self-management in diabetes perception scale of the intervention group were higher than the control group and the difference between them was statistically significant (t=-2.697, p<0.05; t=-3.362, p<0.05). There was no statistically significant difference between the groups in terms of mean fasting blood glucose, and mean midday and mean evening first-hour postprandial blood glucose. For both the third and fourth measurement times of morning postprandial blood glucose, the mean morning postprandial blood glucose in the intervention group was lower than in the control group and the difference between the groups was statistically significant. While 72.7% of the control group was minimally active, 26.1% of the intervention group was minimally active. After the digital story intervention, more than half of the intervention group was in the very active category, while only 9.1% of the control group was in. There was no statistically significant difference between the groups in terms of adherence to medical nutrition therapy and initiation of insulin therapy. In conclusion, digital storytelling intervention was found to be an effective intervention for diabetes self-efficacy and perception of self-management in diabetes in pregnant women with gestational diabetes. Keywords; Gestational diabetes; self-management; self-efficacy; digital storytelling; nursing
Self-management is an essential part of gestational diabetes care. It is important to change various health behaviours such as glucose self-management and monitoring, healthy eating, and physical activity and to improve the self-management of pregnant women. The primary aim of this study was to evaluate the effect of digital storytelling intervention on diabetes self-management in women with gestational diabetes. In the study, "Unequalised Control Group Pretest-Posttest Design", one of the experimental research designs, was used. The study was conducted in Ege University Faculty of Medicine Hospital Gynaecology and Obstetrics Outpatient Clinic between March and November 2023. The data collection process was completed with a total of 45 people, 22 in the control group and 23 in the intervention group. Data were collected face-to-face through the Introductory Information Form, Diabetes Self-Efficacy Scale, Diabetes Self-Management Perception Scale, and International Physical Activity Questionnaire (Short Form). After the pre-test data were received, a total of four videos were sent to the intervention group via WhatsApp every other day in the first week. During the four-week follow-up period, four separate short digital story videos were sent once a week as a reminder. At the end of the fourth week, post-test data were collected. Weekly blood glucose monitoring was received from pregnant women in both groups via WhatsApp. Number, percentage, arithmetic mean, standard deviation, median, chi-square analysis, Anova test, Mc Nemar test, Friedman test, independent and dependent sample t-test, Wilcoxon test, and Mann Whitney U test were used in data analysis. It was found that the pregnant women in the control and intervention groups showed a homogeneous distribution in terms of characteristics such as age, employment status, income status, educational status, family type, appropriate weight gain according to the gestational age, gravida, parity, presence of abortion and curettage history, number of living children, desire for pregnancy, presence of social support, GDM treatment, presence of GDM in a previous pregnancy, presence of DM history in first-degree relatives, OGTT application approach, healthy eating idea, presence of regular physical exercise and number of days of regular exercise, and the groups were similar to each other (p>0.05). It was found that there was no statistically significant difference between the groups in terms of diabetes self-efficacy scale pretest total mean scores (t=-0.645, p>0.05). After the digital storytelling intervention, it was determined that the posttest mean score of the diabetes self-efficacy scale was higher than the control group and the difference between them was statistically significant (t=-4.185, p<0.05). It was determined that both pre-test and post-test mean scores of the self-management in diabetes perception scale of the intervention group were higher than the control group and the difference between them was statistically significant (t=-2.697, p<0.05; t=-3.362, p<0.05). There was no statistically significant difference between the groups in terms of mean fasting blood glucose, and mean midday and mean evening first-hour postprandial blood glucose. For both the third and fourth measurement times of morning postprandial blood glucose, the mean morning postprandial blood glucose in the intervention group was lower than in the control group and the difference between the groups was statistically significant. While 72.7% of the control group was minimally active, 26.1% of the intervention group was minimally active. After the digital story intervention, more than half of the intervention group was in the very active category, while only 9.1% of the control group was in. There was no statistically significant difference between the groups in terms of adherence to medical nutrition therapy and initiation of insulin therapy. In conclusion, digital storytelling intervention was found to be an effective intervention for diabetes self-efficacy and perception of self-management in diabetes in pregnant women with gestational diabetes. Keywords; Gestational diabetes; self-management; self-efficacy; digital storytelling; nursing
Açıklama
Anahtar Kelimeler
Hemşirelik, Nursing
