Kronik Böbrek Yetmezliğine Sahip Ergen ve Ebeveynleri İçin Geliştirilen Özyönetim Programının Ergenlerin Sağlığına Etkisi

Abstract

The aim of this study was to investigate the effects of chronic kidney disease on adolescents between aged 12-21 years and evaluating the effect of self-management program developed based on The Individual and Family Self Management on adolescent self-management knowledge and behavior, quality of life, self-efficacy, social support, depression, anxiety and clinical parameters randomized controlled trial. The study was conducted between December 2018 and May 2019 in two hospitals in Ankara. The study was completed with 20 experiments and 20 control patients. The data included in the study were Demographic and Clinical Information Form Based on The Individual and Family Self Management”, “Self Management Evaluation Form for Chronic Kidney Disease”, “Self-Efficacy Scale for Children”,“Quality of Life Scale for Adolescent Form”, “Multidimensional Perceived Social Support Scale”, “Beck Depression Scale”, “Beck Anxiety Scale” and clinical parameters were collected from patient files. The training program prepared for chronic kidney disease was administered in three sessions as group training when the patients came to the outpatient clinic for control. Adolescents and parents in the experimental group were taken to separate sessions and educated. In the period following the end of the training program, home visits were made to the patients for 3 months in total, 6 times in 2 weeks and followed up. During the home visits, the patients were asked follow-up questions consisting of ten structured questions. Self-management knowledge and behavior of the adolescents in the experimental group after self-management training showed a significant change compared to the pre-test (p<0,05), only a significant decrease in the BUN level (pretest:41,87±17,85; posttest:35,23±16,86) was found in the clinical parameters (p<0,05) and quality of life scores (pretest:67,25±20,51;posttest:73,60±16,99) increased significantly (p<0,05). However, although there was an increase in self-efficacy (pretest:61,80±12,34; posttest:66,35±9,90) and perceived social support scores of the adolescents (pretest: 65,75±16,02;posttest:67,45±10,36) in the experimental group after training, it was not statistically significant. Among the psychosocial variables, there was a significant decrease in anxiety level (pretest: 14,60±10,94; posttest:7,05±6,52) , whereas a decrease in depression level (pretest: 11,55±8,16;posttest:8,15±6,47) was not statistically significant. As a result, self-management education program given to adolescents showed significant changes in quality of life and anxiety levels of adolescents although self-efficacy, perceived social support and depression levels were not significant. At the same time, self-management behaviors changed positively in cognitive and psychosocial domains. It is recommended that self-management training programs be implemented by nurses in clinics as an effective method for improving the health status of adolescents with chronic kidney disease.