Multiple Skleroz Yönetiminde Hemşire Liderliğinde Öz Düzenlemeyi Destekleyen İnteraktif Web Tabanlı Programın Geliştirilmesi ve Etkisinin Değerlendirilmesi
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Dosyalar
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Araştırma Multiple Skleroz (MS) yönetiminde hemşire liderliğinde öz düzenlemeyi
destekleyen interaktif web tabanlı programın (Yönetebilirim) geliştirilmesi ve geliştirilen programın öz
yönetim, yorgunluk ve kaygıya olan etkisini inceleme amacıyla yürütülmüştür.
Web tabanlı program, öz yönetim stratejileri temelinde, dinleme, planlama, yapma, inceleme
ve eyleme geçme basamaklarından oluşan STAR modeli rehber alınarak eylem araştırması sonucunda
oluşturulmuştur. Web tabanlı programın öz yönetim, yorgunluk ve kaygıya olan etkisi, paralel grup
desende randomize kontrollü araştırma ile değerlendirilmiştir. Araştırma, Konya’da bir üniversite
hastanesi nöroloji kliniğinde yürütülmüştür. Çalışma grubunu, blok randomizasyonla 38 müdahale, 38
kontrol grubuna olmak üzere 76 MS’li birey oluşturmuştur. Araştırma verilerinin toplanmasında, Birey
Tanılama Formu, MS Öz-Yönetim Ölçeği, Yorgunluk Şiddet Ölçeği ve Durumluluk ve Sürekli Kaygı
Ölçeği kullanılmıştır. Araştırmada, müdahale grubu, sekiz hafta süreyle “Yönetebilirim”i kullanmış,
kontrol grubu herhangi bir girişim almamıştır. Araştırmanın yürütülmesi için etik kurul izni, kurum izni
ve hastalardan onam alınmış, protokol kaydı yapılmıştır (Clinical Trial No: NCT05393765). Verilerin
istatistiğinde SPSS 25.0 programı kullanılarak, ortalama, yüzde ve standart sapma hesaplamalarından
yararlanılmıştır. Grupların dağılımını inceleme için ki-kare, gruplar arası karşılaştırmalarda bağımsız
gruplar için t testi, zaman ve grup etkileşimini inceleme için karma ANOVA analizinden
yararlanılmıştır. Deney tasarımına uygun etki büyüklükleri hesaplanmıştır. Anlamlılık düzeyi p<0,05
olarak alınmıştır.
Yaş ortalamasının müdahale grubunda 35,89±10,94, kontrol grubunda 34,26±9,66 olduğu
bulunmuştur. Grupların, sosyodemografik ve hastalık özellikleri bakımından benzer dağılıma sahip
oldukları saptanmıştır (p>0,05). Müdahale grubunda uygulamadan sonra, öz yönetim puanının anlamlı
olarak arttığı ve orta düzeyde bir etki büyüklüğüne sahip olduğu belirlenmiştir (p<0,01, pη2=0,114).
Müdahale grubunda uygulamadan sonra, yorgunluk şiddeti, durumluluk ve süreklilik kaygı düzeyinde ise
anlamlı bir değişim olmamıştır (p>0,05). Müdahale grubundaki bireylerin tamamına yakını, web
programının bilgilendirici ve kullanışlı olduğunu ifade etmiştir. MS yönetiminde hemşire liderliğinde
öz düzenlemeyi destekleyen interaktif web tabanlı programın MS’li bireylerin öz yönetimlerini
iyileştiren uygulanabilir bir program olduğu belirlenmiştir. Bu bulgular sonucunda, geliştirilen web
tabanlı programın yaygınlaştırılması, MS’li bireylerin öz yönetimlerini güçlendirmek için yeni web
tabanlı programların geliştirilmesi ve etkisinin randomize kontrollü olarak değerlendirilmesi
önerilmektedir.
The research was conducted to develop an interactive web-based program, named "I Can Manage", in order to support nurse-led self-regulation in multiple sclerosis (MS) management, and to examine the program's impact on self-management, fatigue, and anxiety. The web-based program was developed through action research, guided by the STAR model, which consists of stages including listening, planning, doing, reviewing, and taking action, based on self-management strategies. The impact of the web-based program on self-management, fatigue, and anxiety was assessed through a parallel-group, randomized controlled trial design. The research was conducted between April and September 2022 at the neurology clinic of a university hospital in Konya. A total of 76 individuals with Multiple Sclerosis (MS) were included in the study through block randomization, with 38 individuals in the intervention group and 38 individuals in the control group. Data was collected using the Personal Information Form, Multiple Sclerosis Self-Management Scale, The Fatigue Severity Scale, and State-Trait Anxiety Inventory. In the study, the intervention group used "I Can Manage" for eight weeks, while the control group did not receive any intervention. Ethical approval, institutional permission, and informed consent from the patients were obtained to conduct the research, and protocol registration was completed (Clinical Trial No: NCT05393765). The SPSS 25.0 software was used in the statistical analysis of the data, and calculations for means, percentages, and standard deviations were employed. To examine the distribution of groups, the chi-square test was used, and independent samples t-tests were conducted for group comparisons. Furthermore, a mixed-design ANOVA was carried out to investigate the interaction between time and group. Effect sizes appropriate to the experimental design were also calculated. The significance level was taken as p<0.05. The mean age in the intervention group was found to be 35.89 ± 10.94, while in the control group, it was 34.26 ± 9.66. It was determined that the groups had a similar distribution in terms of sociodemographic and disease characteristics (p>0.05). After the intervention, a significant increase was observed in the self-management scores of the intervention group, with a medium effect size. (p<0.01, pη2=0.114). However, there was no significant change in the severity of fatigue, state anxiety, and trait anxiety levels in the intervention group after the intervention (p>0.05). Nearly all participants in the intervention group stated that the web-based program was informative and useful. It was found that the interactive web-based program supporting nurse-led self-regulation in MS management is a feasible program enhancing self-management in individuals with MS. Based on these findings, it is recommended to develop and extend web-based programs to enhance self-management in individuals with MS within the Turkish community, and to evaluate the effectiveness of these programs through randomized controlled trials.
The research was conducted to develop an interactive web-based program, named "I Can Manage", in order to support nurse-led self-regulation in multiple sclerosis (MS) management, and to examine the program's impact on self-management, fatigue, and anxiety. The web-based program was developed through action research, guided by the STAR model, which consists of stages including listening, planning, doing, reviewing, and taking action, based on self-management strategies. The impact of the web-based program on self-management, fatigue, and anxiety was assessed through a parallel-group, randomized controlled trial design. The research was conducted between April and September 2022 at the neurology clinic of a university hospital in Konya. A total of 76 individuals with Multiple Sclerosis (MS) were included in the study through block randomization, with 38 individuals in the intervention group and 38 individuals in the control group. Data was collected using the Personal Information Form, Multiple Sclerosis Self-Management Scale, The Fatigue Severity Scale, and State-Trait Anxiety Inventory. In the study, the intervention group used "I Can Manage" for eight weeks, while the control group did not receive any intervention. Ethical approval, institutional permission, and informed consent from the patients were obtained to conduct the research, and protocol registration was completed (Clinical Trial No: NCT05393765). The SPSS 25.0 software was used in the statistical analysis of the data, and calculations for means, percentages, and standard deviations were employed. To examine the distribution of groups, the chi-square test was used, and independent samples t-tests were conducted for group comparisons. Furthermore, a mixed-design ANOVA was carried out to investigate the interaction between time and group. Effect sizes appropriate to the experimental design were also calculated. The significance level was taken as p<0.05. The mean age in the intervention group was found to be 35.89 ± 10.94, while in the control group, it was 34.26 ± 9.66. It was determined that the groups had a similar distribution in terms of sociodemographic and disease characteristics (p>0.05). After the intervention, a significant increase was observed in the self-management scores of the intervention group, with a medium effect size. (p<0.01, pη2=0.114). However, there was no significant change in the severity of fatigue, state anxiety, and trait anxiety levels in the intervention group after the intervention (p>0.05). Nearly all participants in the intervention group stated that the web-based program was informative and useful. It was found that the interactive web-based program supporting nurse-led self-regulation in MS management is a feasible program enhancing self-management in individuals with MS. Based on these findings, it is recommended to develop and extend web-based programs to enhance self-management in individuals with MS within the Turkish community, and to evaluate the effectiveness of these programs through randomized controlled trials.
Açıklama
Anahtar Kelimeler
Multiple Skleroz, Öz Yönetim, Hemşirelik, Web Tabanlı Müdahale, Randomize Kontrollü Çalışma, Eylem Araştırması, Multiple Sclerosis, Self-Management, Nursing, Internet-Based Intervention, Randomized Controlled Trial, Action Research
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Koçak, A. T., (2023). Multiple Skleroz Yönetiminde Hemşire Liderliğinde Öz Düzenlemeyi Destekleyen İnteraktif Web Tabanlı Programın Geliştirilmesi ve Etkisinin Değerlendirilmesi. (Doktora Tezi). Selçuk Üniversitesi, Sağlık Bilimleri Enstitüsü, Konya.
