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Journals / Etkili Hemşirelik Dergisi / 2026 / Cilt: 19 Sayı: 4

The Effect of General Procrastination Behavior on Patient Activation and Self-Care Management in Patients with Chronic Diseases Treated in Surgical Clinics

Cerrahi Kliniklerinde Tedavi Gören Kronik Hastalığı Olan Hastalarda Genel Erteleme Davranışının Hasta Aktifliği ve Öz Bakım Yönetimine Etkisi

Zeynep Deveci Koçbilek(PAMUKKALE ÜNİVERSİTESİ)
Buket Çelik(DOKUZ EYLÜL ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ)0000-0003-3229-1845
Özlem Bilik(DOKUZ EYLÜL ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ)
Pages
534–551
Publication Date
2026-10-15
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AI Summary & Key Takeaways

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⚡ TL;DR(Too Long; Didn't Read)

Keywords: Procrastination; Patient Activation; Self-Care; Chronic Disease; Surgical Clinics

📌 3 Key Takeaways

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Objective & Hypothesis:Background: Chronic diseases impact the success of surgery, patient outcomes and the burden on nurses’ patient care.
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Key Findings & Data:The sampling included 213 patients aged 18 years and older, with at least one chronic disease and undergoing treatment in surgical clinics.
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Conclusion & Impact:Keywords: Procrastination; Patient Activation; Self-Care; Chronic Disease; Surgical Clinics
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:Erteleme · Hasta Aktifliği · Öz Bakım

Abstract

Background: Chronic diseases impact the success of surgery, patient outcomes and the burden on nurses’ patient care. Objectives: This study aimed to examine the effect of general procrastination behavior on patient activation and self-care management among individuals with chronic diseases undergoing surgical procedures. Methods: This descriptive and cross-sectional study was conducted in the surgical clinics of a university hospital. The sampling included 213 patients aged 18 years and older, with at least one chronic disease and undergoing treatment in surgical clinics. The data were collected during the preoperative period using the sociodemographic and clinical characteristics form, Self-Care Management Process Scale in Chronic Illnesses (SCMP-G), Patient Activation Measure (PAM) and General Procrastination Scale (GPS). Descriptive statistics, Student’s t-test, one-way ANOVA and multiple linear regression analyses were applied in the analysis of the data. Results: The Participants’ age mean was 63.76±9.26. The mean scores of the patients were as follows: SCMP-G score=110.7±5.1 (min:98-max:125), PAM score=59.6±15.6 (min:14-100), and GPS score=40.21±14.8 (min:18-max:88). Regression analysis (F=22.168, p<.001, R2=0.241, DW=.802) revealed that the patient’s activation level is related to general procrastination behavior, mean scores of SCMP-G, and educational status. Self-care management (R 2 :0.129, F:15.594, p<0.001, DW:2.052) was found to be associated with the mean score of the PAM and frequency of hospitalization, but not with general procrastination behavior. Conclusion: In this study, it was determined that patient activation and self-care management were above average, and general procrastination behavior was below average. Although the general procrastination behavior significantly affected patient activation, it did not impact on the level of self-care. Health professionals should consider the procrastinating behavior tendencies of patients when making attempts to improve patient self-care. Keywords: Procrastination; Patient Activation; Self-Care; Chronic Disease; Surgical Clinics

Özet

Giriş: Kronik hastalıklar yapılan cerrahinin başarısını, hasta sonuçlarını ve hemşirelerin hasta bakım yükünü etkilemektedir. Amaç: Bu çalışmada kronik hastalığı olan ve cerrahi girişim uygulanan hastalarda genel erteleme davranışının hasta aktifliği ve öz bakım yönetimine etkisini incelemek amaçlanmıştır. Yöntem: Tanımlayıcı ve kesitsel nitelikteki bu çalışma bir üniversite hastanesinin cerrahi kliniklerinde yürütülmüştür. Örnekleme, 18 yaş ve üzeri, en az bir öz bakım gerektiren kronik hastalığı olan ve cerrahi kliniklerde tedavi gören 213 hasta dahil edilmiştir. Veriler, preoperatif süreçte; Sosyodemografik ve Klinik Özellikler Formu, Kronik Hastalıklarda Öz Bakım Yönetimi Ölçeği (KHÖBYÖ), Hasta Aktiflik Düzeyi Ölçüm Aracı (HADÖA) ve Genel Erteleme Ölçeği (GEÖ) kullanılarak toplanmıştır. Verilerin analizinde tanımlayıcı istatistikler, Student t testi, tek yönlü ANOVA ve çoklu lineer regresyon analizleri uygulanmıştır. Bulgular: Katılımcıların ortalaması 63.76±9.26’dir. Hastaların KHÖBYÖ puan ortalaması 110.7±5.1 (min:98-max:125), HADÖA puan ortalaması 59.6±15.6 (min:14-100), GEÖ puan ortalaması 40.21±14.8 (18-88) olarak belirlenmiştir. Regresyon analizinde (F=22.168, p<.001, R 2 =0.241, DW:.802), hasta aktiflik düzeyinin genel erteleme davranışı, KHÖBYÖ puan ortalaması ve eğitim durumu ile ilişkili olduğu bulunmuştur. Öz bakım yönetiminin ise (R 2 :0.129, F:15.594, p<0.001, DW:2.052), HADÖA puan ortalaması ve hospitalizasyon sıklığı ile ilişkili olduğu, genel erteleme davranışı ile ilişkisinin bulunmadığı saptanmıştır. Sonuç: Bu çalışmada hasta aktifliği ve öz bakım yönetiminin ortalamanın üzerinde, genel erteleme davranışının ise ortalamanın altında olduğu belirlenmiştir. Genel erteleme davranışı hasta aktifliğini anlamlı şekilde etkilerken, öz bakım düzeyini etkilememiştir. Sağlık profesyonelleri, hasta öz bakımını geliştirmeye yönelik girişimlerde bulunurken, hastaların erteleme davranışı eğilimlerini dikkate almalıdır. Anahtar Sözcükler: Erteleme; Hasta Aktifliği; Öz Bakım; Kronik Hastalık; Cerrahi Klinikler

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Cite This Article

Koçbilek, Z. D., Çelik, B., Bilik, Ö. (2026). The Effect of General Procrastination Behavior on Patient Activation and Self-Care Management in Patients with Chronic Diseases Treated in Surgical Clinics. Etkili Hemşirelik Dergisi, Cilt: 19 Sayı: 4, 534–551. https://doi.org/10.46483/jnef.1709623

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References (51)

  1. Almutairi, N., Hosseinzadeh, H., & Gopaldasani, V. (2020). The effectiveness of patient activation intervention on type 2 diabetes mellitus glycemic control and self-management behaviors: A systematic review of RCTs. Primary care diabetes, 14(1), 12–20. https://doi.org/10.1016/j.pcd.2019.08.009
  2. Alvarez, P., Sianis, A., Brown, J., Ali, A., & Briasoulis, A. (2021). Chronic disease management in heart failure: focus on telemedicine and remote monitoring. Reviews in cardiovascular medicine, 22(2), 403-413.
  3. Andrawis, J., Akhavan, S., Chan, V., Lehil, M., Pong, D., & Bozic, K. J. (2015). Higher Preoperative Patient Activation Associated With Better Patient-reported Outcomes After Total Joint Arthroplasty. Clinical orthopaedics and related research, 473(8), 2688–2697. https://doi.org/10.1007/s11999-015-4247-4
  4. Atashzadeh‐Shoorideh, F., Bahramnezhad, F., Sanaie, N., Jackson, A., & Shariati, E. (2021). The of effect of partnership-based education on adherence to the treatment plans in open heart surgery. Journal of Education and Health Promotion, 10(1). https://doi.org/10.4103/jehp.jehp_1463_20
  5. Bergeron, C. D., Cisneros Franco, C. L., Sherman, L. D., Pullyblank, K., Brunner, W., Brandford, A. A., Kew, C. L., & Smith, M. L. (2024). Health Care Engagement in Disease Prevention and Management: Factors Influencing Chronic Disease Program Referral Adherence Among Non-Hispanic Black and Hispanic Men With Chronic Conditions. American journal of men’s health, 18(5), 15579883241288978. https://doi.org/10.1177/15579883241288978
  6. Brady, T. J., Murphy, L., O’Colmain, B. J., Beauchesne, D., Daniels, B., Greenberg, M., House, M., & Chervin, D. (2013). A meta-analysis of health status, health behaviors, and health care utilization outcomes of the Chronic Disease Self-Management Program. Preventing chronic disease, 10, 120112. https://doi.org/10.5888/pcd10.120112
  7. Endeshaw, A. S., Dejen, E. T., & Kumie, F. T. (2024). The effect of comorbidity on 28-day perioperative mortality rate among non-cardiac surgical patients in Northwest Ethiopia: a prospective cohort study using propensity score matching. BMC public health, 24(1), 3139. https://doi.org/10.1186/s12889-024-20678-4
  8. Gönen Şentürk, S. (2021) Kronik hastalıkların yönetiminde öz yönetim stratejilerinin önemi ve hemşirenin rolü. Avrasya Sağlık Bilimleri Dergisi, 4(1), 9-13.
  9. Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse education today, 24(2), 105–112. https://doi.org/10.1016/j.nedt.2003.10.001
  10. Greene, J., & Hibbard, J. H. (2012). Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes. Journal of general internal medicine, 27(5), 520–526. https://doi.org/10.1007/s11606-011-1931-2
  11. Greene, J., Hibbard, J. H., Sacks, R., Overton, V., & Parrotta, C. D. (2015). When patient activation levels change, health outcomes and costs change, too. Health affairs (Project Hope), 34(3), 431–437. https://doi.org/10.1377/hlthaff.2014.0452
  12. Gülebağlan, C. (2003). Öğretmenlerin işleri son ana erteleme eğilimlerinin, mesleki yeterlilik algıları, mesleki deneyimleri ve branşları bakımından karşılaştırılmasına yönelik bir araştırma. (Yüksek Lisans Tezi). Ankara Üniversitesi Eğitim Bilimleri Enstitüsü, Eğitimde Psikolojik Hizmetler Anabilim Dalı, Eğitimin psikolojik temelleri programı, Ankara.
  13. Haghbin, M., & Pychyl, T. A. (2016). Measurement of health-related procrastination: development and validation of the exercise and healthy diet procrastination scales. In, F. M. Sirois, & T. A. Pychly (Eds.), Procrastination and Well Being (pp. 121-42), Elsevier.
  14. Hançerlioğlu, S., & Şenuzun Aykar, F. (2018). Kronik Hastalıklarda Öz-Bakım Yönetimi Ölçeği’nin Türkçe’ye Uyarlanması, Geçerlik ve Güvenirliği. Gümüşhane üniversitesi sağlık bilimleri dergisi, 7(1), 175-183.
  15. Hibbard, J. H., & Greene, J. (2013). What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health affairs (Project Hope), 32(2), 207–214. https://doi.org/10.1377/hlthaff.2012.1061
  16. Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005). Development and testing of a short form of the patient activation measure. Health services research, 40(6 Pt 1), 1918–1930. https://doi.org/10.1111/j.1475-6773.2005.00438.x
  17. Janamian, T., Greco, M., Cosgriff, D., Baker, L., & Dawda, P. (2022). Activating people to partner in health and self-care: use of the Patient Activation Measure. The Medical journal of Australia, 216 Suppl 10(Suppl 10), S5–S8. https://doi.org/10.5694/mja2.51535
  18. Jones, L. C. (2003). Measuring guarding as a self-care management process in chronic illness: the SCMP-G. In, O. L. Strickland, & C. Dilorio (Eds.), Measurement of Nursing Outcomes (pp, 150). New York, Springer Publishing Company.
  19. Kassahun, W. T., Babel, J., & Mehdorn, M. (2024). The impact of chronic obstructive pulmonary disease on surgical outcomes after surgery for an acute abdominal diagnosis. European journal of trauma and emergency surgery: official publication of the European Trauma Society, 50(3), 799–808. https://doi.org/10.1007/s00068-023-02399-2
  20. Koşar, C., & Besen, D. B. (2015). Kronik hastalıklarda hasta aktifliği: kavram analizi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 8(1), 45-51.
  21. Koşar, C., & Besen, D. B. (2019). Adaptation of a patient activation measure (PAM) into Turkish: reliability and validity test. African health sciences, 19(1), 1811–1820. https://doi.org/10.4314/ahs.v19i1.58
  22. Lay, C. H., 1986. At last, my research article on procrastination. Journal of research in personality, 20, 474–495. https://doi.org/10.1016/0092-6566(86)90127-3
  23. Lee, K. S., Moser, D. K., & Dracup, K. (2023). The association between comorbidities and self-care of heart failure: a cross-sectional study. BMC cardiovascular disorders, 23(1). https://doi.org/10.1186/s12872-023-03166-2
  24. Lightfoot, C. J., Nair, D., Bennett, P. N., Smith, A. C., Griffin, A. D., Warren, M., & Wilkinson, T. J. (2022). Patient activation: the cornerstone of effective self-management in chronic kidney disease?. Kidney and dialysis, 2(1), 91–105. https://doi.org/10.3390/kidneydial2010012
  25. Ma, C. (2019). Rehospitalisation rates and associated factors within 6 months after hospital discharge for patients with chronic heart failure: a longitudinal observational study. Journal of clinical nursing, 28(13-14), 2526-2536. https://doi.org/10.1111/jocn.14830
  26. Mao, Y., Lin, W., Wen, J., & Chen, G. (2020). Impact and efficacy of mobile health intervention in the management of diabetes and hypertension: a systematic review and meta-analysis. BMJ Open Diabetes Research and Care, 8(1), e001225.
  27. Mayhew, D., Mendonca, V., & Murthy, B. V. S. (2019). A review of ASA physical status - historical perspectives and modern developments. Anaesthesia, 74(3), 373–379. https://doi.org/10.1111/anae.14569
  28. Meraz, R., Caldwell, E. P., & McGee, J. S. (2023). The relationships among health literacy, patient activation, and self-care behaviors in adults with heart failure: a cross sectional study. Sage Open, 13(1), 21582440231163779.
  29. Odom-Forren, J., & Wesmiller, S. (2017). Managing Symptoms: Enhancing Patients Self-Management Knowledge and Skills for Surgical Recovery. Seminars in oncology nursing, 33(1), 52–60. https://doi.org/10.1016/j.soncn.2016.11.005
  30. Paukkonen, L., Oikarinen, A., Kähkönen, O., & Kaakinen, P. (2022). Patient activation for self-management among adult patients with multimorbidity in primary healthcare settings. Health Science Reports, 5(4), e735. https://doi.org/10.1002/hsr2.735
  31. Podmore, B., Hutchings, A., van der Meulen, J., Aggarwal, A., & Konan, S. (2018). Impact of comorbid conditions on outcomes of hip and knee replacement surgery: a systematic review and meta-analysis. BMJ open, 8(7), e021784. https://doi.org/10.1136/bmjopen-2018-021784
  32. Resnick, B. (2008). Theory of self-efficacy. In: (Smith, M., J., Liehr, P., R., Carpenter, R., D. Eds.) Middle range theory for nursing, fifth editions, spinger publishing compony, USA, 183-204.
  33. Riegel, B., Westland, H., Iovino, P., Barelds, I., Bruins Slot, J., Stawnychy, M. A., Osokpo, O., Tarbi, E., Trappenburg, J. C. A., Vellone, E., Strömberg, A., & Jaarsma, T. (2021). Characteristics of self-care interventions for patients with a chronic condition: A scoping review. International journal of nursing studies, 116, 103713. https://doi.org/10.1016/j.ijnurstu.2020.103713
  34. Riveros, C., Ranganathan, S., Shah, Y. B., Huang, E., Xu, J., Hsu, E., Geng, M., Hu, S., Melchiode, Z., Miles, B. J., Esnaola, N., Klaassen, Z., Jerath, A., Wallis, C. J. D., & Satkunasivam, R. (2024). Association of chronic kidney disease with postoperative outcomes: a national surgical quality improvement program (NSQIP) multi-specialty surgical cohort analysis. BMC nephrology, 25(1), 305. https://doi.org/10.1186/s12882-024-03753-1
  35. Sahebi, A., Mohammad-Aliha, J., Ansari-Ramandi, M., & Naderi, N. (2015). Investigation the relationship between self-care and readmission in patients with chronic heart failure. Research in cardiovascular medicine, 4(1), e25472. https://doi.org/10.5812/cardiovascmed.25472
  36. Sartor, G., Fusco, M., Milana, M., Rigon, L., Arcara, G., Conte, P., & Buja, A. (2025). Risk factors for 30-day unplanned readmissions after surgical procedures in the elderly population. Patient safety in surgery, 19(1), 19. https://doi.org/10.1186/s13037-025-00442-2
  37. Shareinia, H., Ghiyasvandian, S., Rooddehghan, Z., & Esteghamati, A. (2024). The formation of health-related procrastination in patients with type-2 diabetes: a grounded theory research. Frontiers in psychology, 14, 1196717. https://doi.org/10.3389/fpsyg.2023.1196717
  38. Shively, M. J., Gardetto, N. J., Kodiath, M. F., Kelly, A., Smith, T. L., Stepnowsky, C., Maynard, C., & Larson, C. B. (2013). Effect of patient activation on self-management in patients with heart failure. The Journal of cardiovascular nursing, 28(1), 20–34. https://doi.org/10.1097/JCN.0b013e318239f9f9
  39. Sirois F. M. (2015). Is procrastination a vulnerability factor for hypertension and cardiovascular disease? Testing an extension of the procrastination-health model. Journal of behavioral medicine, 38(3), 578–589. https://doi.org/10.1007/s10865-015-9629-2
  40. Sirois, F. M., Stride, C. B., & Pychyl, T. A. (2023). Procrastination and health: A longitudinal test of the roles of stress and health behaviours. British journal of health psychology, 28(3), 860–875. https://doi.org/10.1111/bjhp.12658
  41. Son, Y. J., Lee, S. J., & Kim, S. H. (2023). The role of patient activation in self‐care behaviours of Korean older adults with heart failure. Nursing open, 10(8), 5202-5210. https://doi.org/10.1002/nop2.1756
  42. Steel, P. (2007). The nature of procrastination: A meta-analytic and theoretical review of quintessential self-regulatory failure. Psychological Bulletin, 133(1), 65–94. https://doi.org/10.1037/0033-2909.133.1.65
  43. Sümer Coşkun, A. (2020). Postoperatif yoğun bakıma kabul edilen hastaların 1 yıllık incelenmesi [A one-year examination of patients admitted to post-operative intensive care]. Acta Medica Nicomedia, 3(3), 105-108.
  44. Tabachnick, B. G., & Fidell, L. S. (2020). Çok değişkenli istatistiklerin kullanımı (M. Baloğlu, Çev.). Nobel Akademik Yayıncılık. (2013)
  45. Türkiye Halk Sağlığı ve Kronik Hastalıklar Enstitisü (TÜSEP-TÜHKE). (2021). Türkiye’de 2010-2020 yılları arasında diyabet, hipertansiyon, obezite, santral obezite ve türk toplumuna göre santral obezite sıklığının nüfusa göre değişiminin değerlendirilmesi çalışması. Retrieved from: https://www.tuseb.gov.tr/tuhke/uploads/genel/files/turkiye_2010-2021.pdf Accessed on 3 March 2025.
  46. Utli, H., & Vural Doğru, B. (2022). The relationship between patient activation level and self-care management in elderly patients with chronic illness in the southeastern anatolian region of Turkey. Progress in Health Science, 12(1), 14-21. https://doi.org/10.5604/01.3001.0015.8874.
  47. World Health Organization. (2022). WHO guideline on self-care interventions for health and well-being. Retrieved from: https://files.magicapp.org/guideline/411b5969-8716-4e88-99ae-7ee0be1416eb/published_guideline_5512-3_0.pdf Accessed on 3 March 2025.
  48. World Health Organization. (2024). Noncommunicable diseases. Retrieved from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases Accessed on 3 March 2025.
  49. Yagi, M., Fujita, N., Okada, E., Tsuji, O., Nagoshi, N., Tsuji, T., Asazuma, T., Nakamura, M., Matsumoto, M., & Watanabe, K. (2018). Impact of frailty and comorbidities on surgical outcomes and complications in adult spinal disorders. Spine, 43(18), 1259–1267. https://doi.org/10.1097/BRS.0000000000002596
  50. Yong, P. H., Weinberg, L., Torkamani, N., Churilov, L., Robbins, R. J., Ma, R., Bellomo, R., Lam, Q. T., Burns, J. D., Hart, G. K., Lew, J. F., Mårtensson, J., Story, D., Motley, A. N., Johnson, D., Zajac, J. D., & Ekinci, E. I. (2018). The presence of diabetes and higher HbA1c are independently associated with adverse outcomes after surgery. Diabetes Care, 41(6), 1172–1179. https://doi.org/10.2337/dc17-2304
  51. Kassahun, W. T., Babel, J., & Mehdorn, M. (2024). The impact of chronic obstructive pulmonary disease on surgical outcomes after surgery for an acute abdominal diagnosis. European journal of trauma and emergency surgery: official publication of the European Trauma Society, 50(3), 799–808. https://doi.org/10.1007/s00068-023-02399-2