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THE RELATIONSHIP OF PATIENT EMPOWERMENT AND LIFE QUALITY

Yıl 2020, Cilt: 8 Sayı: 1, 97 - 114, 30.04.2020
https://doi.org/10.22139/jobs.682555

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.

Kaynakça

  • Alden, D. (2014). Associated with Patient Empowerment Prior to Cancer Treatment Decision Making”, Medical DecisionMaking, 34(7):884-98.
  • All Party Parliamentary Groups on Global Health; HIV/AIDS; Population Development and Reproductive Health; Global Tuberculosis; and Patientand Public Involvement in Health and Social Care. (2014). Patient Empowerment: for Better Quality, More Sustainable Health Services Globally.
  • Barr PJ, Scholl I, Bravo P, Faber MJ, Elwyn, G, McAllister M (2015). Assessment of Patient Empowerment-A Systematic Review of Measures, PLoS ONE 10(5): e0126553. doi:10.1371/journal.pone.0126553
  • Boylu, A.A. ve Paçacıoğlu, B. (2016). Yaşam Kalitesi Göstergeleri, Journal of Academic Researches and Studies, 8(15):137-150.
  • Bravo, P., Edwars, A., Barr, P.J., Scholl, I., Elwyn, G. ve McAllister, M. (2015). Cochrane Health Care Quality Research Group, Conseptualising Patient Empowerment: A Mixed Methods Study, BMC Health Services Research, 15:252.
  • Camerini L., Schulz P. ve Nakamoto K. (2012). Differential Effects of Health Knowledge and Health Empowerment Over Patients’ Self-Management and Health Outcomes: A Cross-Sectional Evaluation, Patient Education and Counseling 89:337–344.
  • Çimen, Z. ve Temel, A. B. (2017). Kronik Hastalığı Olan Yaşlı Bireylerde Sağlık Okuryazarlığı ve Sağlık Algısı İlişkisi ve Sağlık Okuryazarlığını Etkileyen Faktörlerin İncelenmesi, Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 33(3):105-125.
  • Delespaul, P., Milo, M., Schalken, F., Boevink, W., Van Os, J., Goede, G.G.Z. (2016). Nieuwe Concepten, Aangepaste Taal, Verbeterde Organisatie. Diagnosis Uitgevers, Amsterdam.
  • Feste, C. ve Anderson, R.M. (1995). Empowerment: From Philosophy to Practice. Patient Educ Couns. 26(1–3):139–44.
  • Forlani, G., Zannoni, C., Tarrini, G., Melchionda, N. ve Marchesini, G. (2006). An Empowerment-Based Educational Program İmproves Psychological Well-Being and Health-Related Quality of Life in Type 1 Diabets, Journal of Endocrinological Investigation, 29:405-412.
  • Kaya, N. ve Işık, O. (2018). Hasta Güçlendirme Ölçeğinin Geçerlilik ve Güvenilirliği, İşletme Bilimi Dergisi (JOBS), 6(1):21-42. doi: 10.22139/jobs.403021.
  • McAllister, M., Dunn, G., Payne, K., Davies, L. ve Todd, C. (2012). Patient Empowerment: The Need to Consider It as A Measurable Patient-Reported Outcome for Chronic Conditions. BMC Health Services Research, 12:157.
  • Megari, K. (2013). Quality of Life in Chronic Disease Patients. Health Psychology Research, 1(3):1-20.
  • Náfrádi, L., Nkamoto, K., Csabai, M. ve Papp-Zipernovszky, O. An Empirical Test of the Health Empowerment Model: Does Patient Empowerment Moderate the Effect of Health Literacy on Health Status?, Patient Education and Counseling, 101:511–517.
  • Russo, G.,Tartaglione, A.M., Cavacece, Y. (2019). “Empowering Patients to Co-Create A Sustainable Healthcare Value, Sustainability 2019, 11, 1315; doi:10.3390/su11051315. www.mdpi.com/journal/sustainability.
  • Raheb, G., Kazemi, S.V., Alipour, F., Hosseinzadeh, S. ve Teymouri, R. (2018). Effectiveness of Self-Care Training Program Based on Empowerment Model on Quality of Life among Hemodialysis Patients in the City of Sari, Iran. Middle East Journal of Family Medicine, 1;7(10):16.
  • Perkins, D. ve Zimmerman, M. (1995). Empowerment Theory, Research and Application, AmJ Community Psychol, 23(5):69–79.
  • Schulz, P.J. ve Nakamoto, K. (2011). ‘‘Bad’’ Literacy, The Internet, and The Limits of Patient Empowerment. In: AAAI Spring Symposium Series: Artificial Intelligence & Health Communication, 65-69.
  • Small, N., Bower, P., Chew-Graham, C.A., Whalley, D. ve Protheroe, j. (2013). Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Serv Res 13, 263.https://doi.org/10.1186/1472-6963-13-263
  • Soyyiğit, Ş., Erk, M., Güler, N., ve Kılınç, G. (2006). Kronik Obstrüktif Akciğer Hastalığında Yaşam Kalitesinin Belirlenmesinde SF-36 Sağlık Taramasının Değeri, Tüberküloz ve Toraks Dergisi, 54(3):259-266.
  • Tabari, F., Pedram Razi, S.H., Asadi Gharabaghi, M., Torabi, S., Mehran, A., Mohamadinejad, F., Amini, F., Abbaszadeh, R. ve Rezaie Zivlaei, M. (2018). Effect of Education Based on Family-Centered Empowerment Model on The Quality of Life of Elderly Patients With Chronic Obstructive Pulmonary Disease (COPD). Medical Science, 22(91):301-311.
  • Teymori, F., Alhani, F. ve Kazemnejad, A. (2017). The Effect of Family-Centered Empowerment Model on Self-Efficacy and Self-Esteem of The Children Eith Asthma, Preventive Care in Nursing & Midwifery Journal, 7(1): 18-26.
  • Tol, A.,Alhani, F., Shojaeazadeh, D., Sharifirad, G., ve Moazam, N. (2015). An Empowering Approach to Promote the Quality of Life and Self-Management among Type 2 Diabetic Patients. Journal of Education and Health Promotion, 4(13):1-27.
  • Wilson, I.B. ve Cleary, P.D. (1995). Linking Clinical Variables with Health-Related Quality of Life: A Conceptual Model of Patient Outcomes. J AmMedAssoc, 273:59-65.
  • World Health Organization, Regional Office for Europe. (2013) Health 2020 Policy Framework and Strategy Document; WHO: Geneva, Switzerland.
  • Yeh, M.Y., Wu. S.C. ve Tung, T.H. (2018). The Relation Between Patient Education, Patient Empowerment and Patient Satisfaction: A Cross-Sectional-Comparison Study, Applied Nursing Research, 39:11-17.

HASTA GÜÇLENDİRME VE YAŞAM KALİTESİ İLİŞKİSİ

Yıl 2020, Cilt: 8 Sayı: 1, 97 - 114, 30.04.2020
https://doi.org/10.22139/jobs.682555

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. 

Kaynakça

  • Alden, D. (2014). Associated with Patient Empowerment Prior to Cancer Treatment Decision Making”, Medical DecisionMaking, 34(7):884-98.
  • All Party Parliamentary Groups on Global Health; HIV/AIDS; Population Development and Reproductive Health; Global Tuberculosis; and Patientand Public Involvement in Health and Social Care. (2014). Patient Empowerment: for Better Quality, More Sustainable Health Services Globally.
  • Barr PJ, Scholl I, Bravo P, Faber MJ, Elwyn, G, McAllister M (2015). Assessment of Patient Empowerment-A Systematic Review of Measures, PLoS ONE 10(5): e0126553. doi:10.1371/journal.pone.0126553
  • Boylu, A.A. ve Paçacıoğlu, B. (2016). Yaşam Kalitesi Göstergeleri, Journal of Academic Researches and Studies, 8(15):137-150.
  • Bravo, P., Edwars, A., Barr, P.J., Scholl, I., Elwyn, G. ve McAllister, M. (2015). Cochrane Health Care Quality Research Group, Conseptualising Patient Empowerment: A Mixed Methods Study, BMC Health Services Research, 15:252.
  • Camerini L., Schulz P. ve Nakamoto K. (2012). Differential Effects of Health Knowledge and Health Empowerment Over Patients’ Self-Management and Health Outcomes: A Cross-Sectional Evaluation, Patient Education and Counseling 89:337–344.
  • Çimen, Z. ve Temel, A. B. (2017). Kronik Hastalığı Olan Yaşlı Bireylerde Sağlık Okuryazarlığı ve Sağlık Algısı İlişkisi ve Sağlık Okuryazarlığını Etkileyen Faktörlerin İncelenmesi, Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 33(3):105-125.
  • Delespaul, P., Milo, M., Schalken, F., Boevink, W., Van Os, J., Goede, G.G.Z. (2016). Nieuwe Concepten, Aangepaste Taal, Verbeterde Organisatie. Diagnosis Uitgevers, Amsterdam.
  • Feste, C. ve Anderson, R.M. (1995). Empowerment: From Philosophy to Practice. Patient Educ Couns. 26(1–3):139–44.
  • Forlani, G., Zannoni, C., Tarrini, G., Melchionda, N. ve Marchesini, G. (2006). An Empowerment-Based Educational Program İmproves Psychological Well-Being and Health-Related Quality of Life in Type 1 Diabets, Journal of Endocrinological Investigation, 29:405-412.
  • Kaya, N. ve Işık, O. (2018). Hasta Güçlendirme Ölçeğinin Geçerlilik ve Güvenilirliği, İşletme Bilimi Dergisi (JOBS), 6(1):21-42. doi: 10.22139/jobs.403021.
  • McAllister, M., Dunn, G., Payne, K., Davies, L. ve Todd, C. (2012). Patient Empowerment: The Need to Consider It as A Measurable Patient-Reported Outcome for Chronic Conditions. BMC Health Services Research, 12:157.
  • Megari, K. (2013). Quality of Life in Chronic Disease Patients. Health Psychology Research, 1(3):1-20.
  • Náfrádi, L., Nkamoto, K., Csabai, M. ve Papp-Zipernovszky, O. An Empirical Test of the Health Empowerment Model: Does Patient Empowerment Moderate the Effect of Health Literacy on Health Status?, Patient Education and Counseling, 101:511–517.
  • Russo, G.,Tartaglione, A.M., Cavacece, Y. (2019). “Empowering Patients to Co-Create A Sustainable Healthcare Value, Sustainability 2019, 11, 1315; doi:10.3390/su11051315. www.mdpi.com/journal/sustainability.
  • Raheb, G., Kazemi, S.V., Alipour, F., Hosseinzadeh, S. ve Teymouri, R. (2018). Effectiveness of Self-Care Training Program Based on Empowerment Model on Quality of Life among Hemodialysis Patients in the City of Sari, Iran. Middle East Journal of Family Medicine, 1;7(10):16.
  • Perkins, D. ve Zimmerman, M. (1995). Empowerment Theory, Research and Application, AmJ Community Psychol, 23(5):69–79.
  • Schulz, P.J. ve Nakamoto, K. (2011). ‘‘Bad’’ Literacy, The Internet, and The Limits of Patient Empowerment. In: AAAI Spring Symposium Series: Artificial Intelligence & Health Communication, 65-69.
  • Small, N., Bower, P., Chew-Graham, C.A., Whalley, D. ve Protheroe, j. (2013). Patient empowerment in long-term conditions: development and preliminary testing of a new measure. BMC Health Serv Res 13, 263.https://doi.org/10.1186/1472-6963-13-263
  • Soyyiğit, Ş., Erk, M., Güler, N., ve Kılınç, G. (2006). Kronik Obstrüktif Akciğer Hastalığında Yaşam Kalitesinin Belirlenmesinde SF-36 Sağlık Taramasının Değeri, Tüberküloz ve Toraks Dergisi, 54(3):259-266.
  • Tabari, F., Pedram Razi, S.H., Asadi Gharabaghi, M., Torabi, S., Mehran, A., Mohamadinejad, F., Amini, F., Abbaszadeh, R. ve Rezaie Zivlaei, M. (2018). Effect of Education Based on Family-Centered Empowerment Model on The Quality of Life of Elderly Patients With Chronic Obstructive Pulmonary Disease (COPD). Medical Science, 22(91):301-311.
  • Teymori, F., Alhani, F. ve Kazemnejad, A. (2017). The Effect of Family-Centered Empowerment Model on Self-Efficacy and Self-Esteem of The Children Eith Asthma, Preventive Care in Nursing & Midwifery Journal, 7(1): 18-26.
  • Tol, A.,Alhani, F., Shojaeazadeh, D., Sharifirad, G., ve Moazam, N. (2015). An Empowering Approach to Promote the Quality of Life and Self-Management among Type 2 Diabetic Patients. Journal of Education and Health Promotion, 4(13):1-27.
  • Wilson, I.B. ve Cleary, P.D. (1995). Linking Clinical Variables with Health-Related Quality of Life: A Conceptual Model of Patient Outcomes. J AmMedAssoc, 273:59-65.
  • World Health Organization, Regional Office for Europe. (2013) Health 2020 Policy Framework and Strategy Document; WHO: Geneva, Switzerland.
  • Yeh, M.Y., Wu. S.C. ve Tung, T.H. (2018). The Relation Between Patient Education, Patient Empowerment and Patient Satisfaction: A Cross-Sectional-Comparison Study, Applied Nursing Research, 39:11-17.
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular İşletme
Bölüm Özgün Makaleler
Yazarlar

Ali Yılmaz 0000-0002-7482-1712

Ahmet Kar 0000-0002-3734-497X

Mustafa Kaya 0000-0002-2005-5370

Yayımlanma Tarihi 30 Nisan 2020
Gönderilme Tarihi 31 Ocak 2020
Kabul Tarihi 24 Nisan 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 8 Sayı: 1

Kaynak Göster

APA Yılmaz, A., Kar, A., & Kaya, M. (2020). HASTA GÜÇLENDİRME VE YAŞAM KALİTESİ İLİŞKİSİ. İşletme Bilimi Dergisi, 8(1), 97-114. https://doi.org/10.22139/jobs.682555