Tip 2 Diyabeti Olan Yaşlı Bireylerde Kırılganlığın Belirleyicileri: Diyabet Yönetimi, Uyku Kalitesi, Bilişsel Düzey
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Tarih
2023
Yazarlar
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Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu araştırma tip 2 diyabeti olan yaşlı bireylerde kırılganlık, diyabet yönetimi, uyku kalitesi ve bilişsel düzeyi belirlemek; kırılganlık düzeyi ile diyabet yönetimi, uyku kalitesi ve bilişsel düzey arasındaki ilişkiyi değerlendirmek; kırılganlık düzeyini etkileyen faktörleri incelemek amacıyla yapılmıştır. Bu araştırma tanımlayıcı ve ilişkisel türdedir. Bu çalışmanın evrenini Hüyük Devlet Hastanesi dahiliye polikliniğine başvuran tip 2 diyabeti olan 65 yaş ve üzeri bireyler oluşturmaktadır. Örneklem büyüklüğü toplam 246 yaşlı bireyden oluşmaktadır. Araştırma verileri Kişisel Bilgi Formu, Edmonton Kırılganlık Ölçeği, Diyabet Öz Yönetim Ölçeği, Pittsburg Uyku Kalite İndeksi (PUKİ), Standardize Mini Mental Test (SMMT) ile toplanmıştır. Çalışmanın verilerinin analizinde bağımsız gruplarda t testi, tek yönlü varyans analizi, korelasyon analizi ve çoklu regresyon analizi kullanılmıştır. Araştırmaya katılan yaşlı bireylerin yaş ortalamasının 73,22±8,02, %52,4'ünün kadın, %68,3'ünün evli, %41,5'inin ilkokul mezunu, diyabet hastalık süresinin 10,91±8,77, %49,2'sinin insülin tedavisi aldığı saptanmıştır. Bireylerin kırılganlık toplam puan ortalaması 7,10±3,71, mini mental test puan ortalaması 25,04±1,77 ve uyku kalitesi puan ortalamasının 7,10±3,77 olduğu görülmüştür. Tip 2 diyabeti olan yaşlı bireylerin yaş, HbA1c, diyabet süresi, kullanılan ilaç sayısı ile kırılganlık düzeyi puan ortalaması ilişkisi incelendiğinde, kırılganlık düzeyi ile yaş ve hastalık süresi arasında pozitif yönlü yüksek bir ilişki (p<0,05), kırılganlık düzeyi ile HbA1c ve ilaç sayısı düzeyi arasında pozitif yönlü orta düzeyde ilişki (p<0,05) saptanmıştır. Yaşlı bireylerin eğitim durumu (β=0,643), ekonomik durum (β=0,621), birlikte yaşadığı kişiler (β=0,745), kullandıkları ilaç sayısı (β=0,785) diyabet hastalık süresi (β=0,881), diyabete bağlı komplikasyon varlığı (β=0,691), başka bir kronik hastalık varlığının (β=0,551), diaybet öz yönetim toplam (β=0,769), mini mental test toplam (β=0,678) ve uyku kalitesi toplam puanının (0,776) kırılganlık düzeyi üzerinde etkili olduğu saptanmıştır (p<0,001). Etkili olan belirleyici faktörlerin kırılganlık düzeyi üzerindeki değişimin % 71,3'ünü (Adjusted R2= 0,713) açıkladığı belirlenmiştir. Sonuç olarak tip 2 diyabeti olan yaşlı bireyler hafif düzeyde kırılgandır. Diyabet öz yönetimi, uyku kalitesi ve bilişsel düzey kırılganlığın bir yordayıcısıdır. Bu sonuçlar doğrultusunda tip 2 diyabeti olan yaşlı bireylerin kırılganlık açısından kapsamlı bir ön değerlendirmesi hem klinik hem de birinci basamak sağlık hizmetlerinin rutinlerine eklenmeli ve kişilerin bakım ihtiyaçları multidisipliner ekip tarafından değerlendirilerek bireyselleştirilmiş girişimler planlanmalıdır.
This research aimed to determine frailty, diabetes management, sleep quality and cognitive level; to evaluate the relationship between frailty level and diabetes management, sleep quality and cognitive level; it was conducted to examine the factors affecting the level of frailty. purposes I mentioned are for older people with type 2 diabetes. This research is descriptive and relational type.The population of this study consists of individuals aged 65 and over with type 2 diabetes who applied to the Hüyük State Hospital internal medicine outpatient clinic. The sample size consists of a total of 246 older people individuals. Research data were collected with Personal Information Form, Edmonton Frailty Scale, Diabetes Self-Management Scale, Pittsburg Sleep Quality Index (PSQI), Standardized Mini Mental Test (SMMT). In the analysis of the data of the study, t-test, one-way analysis of variance, correlation analysis and multiple regression analysis were used in independent groups. It was found that the average age of the older people participating in the study was 73.22±8.02, 52.4% were women, 68.3% were married, 41.5% were primary school graduates, 10.91±8.77 diabetes duration of illness, 49.2% were receiving insulin therapy.It was observed that the mean frailty total score of the individuals was 7,10±3,71 the mean mini-mental test score was 25.04±1.77, and the mean sleep quality score was 7,10±3,77 When the relationship between age, HbA1c, duration of diabetes, number of drugs used and frailty level mean score of older people individuals with type 2 diabetes was examined, there was a high positive correlation between frailty level and age and disease duration (p<0.05), frailty level and HbA1c and a moderate positive correlation (p<0.05) was found between the number of drugs and the level of the drug. Educational status (β=0.643), economic status (β=0.621), cohabitants (β=0.745), number of medications they use (β=0.785), duration of diabetes (β=0.881), presence of diabetes-related complications (β) =0.691), presence of another chronic disease (β=0.551), diabetes self-management total (β=0.769), mini mental test total (β=0.678) and sleep quality total score (0.776) were found to be effective on frailty level (p<0.001). It was determined that the effective determinants explained 71.3% (Adjusted R2= 0.713) of the change on the frailty level. As a result, older people with type 2 diabetes are slightly fraile. Diabetes self-management, sleep quality and cognitive level are predictors of frailty. In line with these results, a comprehensive preliminary assessment of older people with type 2 diabetes in terms of frailty should be added to the routines of both clinical and primary health care services, and individualized initiatives should be planned by evaluating the care needs of people by a multidisciplinary team.
This research aimed to determine frailty, diabetes management, sleep quality and cognitive level; to evaluate the relationship between frailty level and diabetes management, sleep quality and cognitive level; it was conducted to examine the factors affecting the level of frailty. purposes I mentioned are for older people with type 2 diabetes. This research is descriptive and relational type.The population of this study consists of individuals aged 65 and over with type 2 diabetes who applied to the Hüyük State Hospital internal medicine outpatient clinic. The sample size consists of a total of 246 older people individuals. Research data were collected with Personal Information Form, Edmonton Frailty Scale, Diabetes Self-Management Scale, Pittsburg Sleep Quality Index (PSQI), Standardized Mini Mental Test (SMMT). In the analysis of the data of the study, t-test, one-way analysis of variance, correlation analysis and multiple regression analysis were used in independent groups. It was found that the average age of the older people participating in the study was 73.22±8.02, 52.4% were women, 68.3% were married, 41.5% were primary school graduates, 10.91±8.77 diabetes duration of illness, 49.2% were receiving insulin therapy.It was observed that the mean frailty total score of the individuals was 7,10±3,71 the mean mini-mental test score was 25.04±1.77, and the mean sleep quality score was 7,10±3,77 When the relationship between age, HbA1c, duration of diabetes, number of drugs used and frailty level mean score of older people individuals with type 2 diabetes was examined, there was a high positive correlation between frailty level and age and disease duration (p<0.05), frailty level and HbA1c and a moderate positive correlation (p<0.05) was found between the number of drugs and the level of the drug. Educational status (β=0.643), economic status (β=0.621), cohabitants (β=0.745), number of medications they use (β=0.785), duration of diabetes (β=0.881), presence of diabetes-related complications (β) =0.691), presence of another chronic disease (β=0.551), diabetes self-management total (β=0.769), mini mental test total (β=0.678) and sleep quality total score (0.776) were found to be effective on frailty level (p<0.001). It was determined that the effective determinants explained 71.3% (Adjusted R2= 0.713) of the change on the frailty level. As a result, older people with type 2 diabetes are slightly fraile. Diabetes self-management, sleep quality and cognitive level are predictors of frailty. In line with these results, a comprehensive preliminary assessment of older people with type 2 diabetes in terms of frailty should be added to the routines of both clinical and primary health care services, and individualized initiatives should be planned by evaluating the care needs of people by a multidisciplinary team.
Açıklama
Anahtar Kelimeler
Kırılganlık, diyabet yönetimi, uyku kalitesi, bilişsel düzey, tip 2 diyabet, yaşlı birey, Frailty, diabetes management, sleep quality, cognitive level, type 2 diabetes, older people
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Künye
Anlar, M., (2023). Tip 2 Diyabeti Olan Yaşlı Bireylerde Kırılganlığın Belirleyicileri: Diyabet Yönetimi, Uyku Kalitesi, Bilişsel Düzey. (Yüksek Lisans Tezi). Selçuk Üniversitesi, Sağlık Bilimler Enstitüsü, Konya.
