Diyaliz Tedavisi Alan Hastaların Sağlık Hizmeti Kullanımını ve Yaşam Kalitesini Etkileyen Faktörlerin Belirlenmesi

Abstract

The aim of this study is to determine the treatment adherence, quality of life and health service utilization of patients with chronic kidney disease and receiving dialysis treatment and the factors affecting these levels. In this context, dependent variables are tried to be explained with demographic characteristics of the patients, disease specific characteristics, organizational characteristics, patient physician relationship and patient activity level variables. The population of the study consisted of chronic kidney patients, who received service from the dialysis unit of two university hospitals and two special dialysis centers. Within this study, 328 patients were reached. In order to measure the patients' quality of life, KDQOL (Kidney Disease Quality of Life) Scale developed by Hays et al. (1994) was used. In order to evaluate the activity level, Patient Activation Measure (PAM) developed by Hibbard et al. (2005) was used. To determine the relationship between patients and physicians, The Patient Doctor Relationship Questionnare (PDRQ) was developed by Van der Feltz-Cornelis et al. (2004) was used. In order to determine treatment adherence and the utilization of health services, a questionnaire was formed by taking into consideration the most frequently used indicators in the literature. Multivariate and logistic regression analyzes were used to analyze the variables. As a result of the analyzes, it was determined that the patients 'relationships with the physician and their activity levels were important variables affecting the patients' adherence to the treatment. Patients' adherence to medication and fluid restriction positively affects their physical and mental quality of life. The variables that have the greatest impact on the quality of life of patients with renal disease, the patients' level of activity and adherence to treatment were found. In addition, the low quality of life of patients and non-compliance with treatment affect the increase the utilization of health services. It is important to adopt a disease management model that focuses on improving the quality of life and more effective use of health care resources with patients who are more active by establishing positive relationships with physicians and who are better treatment adherence. These findings obtained as a result of the research, it is expected to provide evidence-based information about the management of treatment and disease control to health managers, health professionals and individually patients.