Hemodiyaliz Hastalarının Hayat Kalitelerinin Ruh Sağlığı Bileşeni ile Bu Bileşen ile Algılanan Dışa Vuran Duygudurumu, Hastalığın Belirtilerine Yönelik Algılanan Başetme Öz-yeterliliği İyimserlik, Benlik Saygısı ve Sosyal Destek Arasındaki İlişkinin İncelenmesi

Examination of The Mental Health Componet of Quality of Life of Hemodialysis Patients and Its Relationship to Perceived Expressed Emotion, Coping Self Efficacy, Optimism, Self Esteem, and Social Support

Abstract

Objective: This study aimed to examine the mental health component of quality of life (MHC) of Hemodialysis patients and its relationship with personal characteristics and other resources within the Conservation of Resources (COR) model. Method: Demographic variables and Hemodialysis related information of patients, with the other resources classified as resources according to COR model, were also included in the study. One hundred and six Hemodialysis patients voluntarily participated in the study. For the study, perceived expressed emotion, optimism, self-esteem, perceived social support and perceived coping self efficacy were taken as resources and were also included as measures. After examining the correlational matrix among the variables of, in order to examine variables related to MHC and test the main hypothesis of the study, multiple regression analysis was conducted. Results: The results of the analysis showed that age, income, house ownerhip, presence of additional diagnosis, self esteem, perceived criticism/hostility and coping self efficacy were significantly related to MHC. Directions of the relationship between age, presence of additional diagnosis, and criticism/hostility were negative with the outcome variables, whereas, directions of the relationship between income, house ownerhip, self-esteem and coping self-efficacy were positive with the outcome variable, MHC. Conclusion: Patients' concerns about various aspects of demographic and illness related variables, perceived coping selfefficacy, self-esteem, and criticism-hostility were found to be predictive of their MHC.

Özet

Amaç: Bu çalışmada, hemodializ hastalarının hayat kalitesinin ruh sağlığı bileşeni (RSB) ile, kişisel karakteristikler ve diğer psikososyal değişkenler arasındaki ilişkinin, Kaynakların Korunumu Modeli (KKM) çerçevesinde araştırılması amaçlandı.Yöntem: KKM'ne göre kaynak olarak sınıflandırılan, demografik değişkenler ve hastaların hemodiyalizle ilgili bilgileri araştırmaya dahil edildi. Araştırmaya 106 gönüllü hemodiyaliz hastası katılmıştır. Çalışmaya, kaynak olarak kabul edilen, algılanan dışa vuran duygu durumu, iyimserlik, benlik saygısı, algılanan sosyal destek ve hastalığın belirtilerine yönelik algılanan başetme özyeterliliği ölçümleri de eklenmiştir. Korelasyon maktriksi incelendikten sonra, RSB ile ilişkili değişkenleri belirlemek ve araştırmanın temel hipotezini test etmek için çoklu regresyon analizi kullanılmıştır.Bulgular: Araştırmanın bulguları, hayat kalitesinin ruhsal sağlığı bileşenini, yaş, gelir düzeyi, ev sahibi olma, ikinci bir kronik hastalığın varlığı, benlik saygısı, dışa vuran duygu durumunun eleştirici/düşmanca tutum faktörü ve başetme özyeterliliği değişkenlerinin yordadığını göstermiştir. Yaş, gelir düzeyi, ev sahibi olma, ikinci bir kronik hastalığın varlığı, dışa vuran duygu durumunun eleştirici/düşmanca tutum değişkenleri sonuç değişkeni olan hastaların RSB'i ile negatif yönde ilişki gösterirken; benlik saygısı ve hastalığın belirtilerine yönelik algılanan başetme özyeterliliği değişkenleri sonuç değişkeni ile pozitif yönde ilişki göstermiştir.Sonuç: Hastaların RSB'ini, hastaların hemodiyalizin farklı yönlerine ilişkin endişeleri, hastalığın belirtilerine yönelik algılanan başetme özyeterliliği, benlik saygısı, dışa vuran duygu durumunun eleştirici/düşmanca tutum faktörü faktörü değişkenleri yordamıştır. ted that stress of chronic illness and handicap can severely tax the emotional resources of the most tolerant and optimistic person (DiMattew and Martin 2002). It was argued that the onset of severe and chronic illness represents one of the most traumatic events imaginable, especially when it occurs in earlier phases of the life span (Ferring and Filipp 2000). The life expectations of ESRD patients has increased because of the technological advances in the treatment of patients. Compared with other chronic illnesses, the length of time patients live with this disease are improving and dialysis units are presently reporting patients who have survived as long as 25 years while on dialysis (Symister and Friend 1996). Thus, this resulted in the increased attention to the psychological aspects of their adaptation to changed routines. Concerning the increasing number of patients and occurrence of the ESRD treatment, psychological interventions may have important contributions to the quality of life and rehabilitation of these patients. Although, Hobfoll's (1989) conservation of resources (COR) model offers a theoretical guide for comprehending illness-health literature, it has been rarely used in the field of chronic illness.COR theory's basic tenet is that people strive to retain, protect, and build resources, and that what is threatening to them is the potential or actual loss of these valued resources (Hobfoll 1989). The model defines psychological stress as a reaction to the environment in which there is (a) the threat of a net loss of resources, (b) the net loss of resources, or (c) a lack of resource gain following the investment of resources. Both perceived and actual loss and the lack of gain was seen as sufficient for producing stress. The COR model identifies four kinds of resources, whose loss and gain result in stres or eustress, respectively. Firstly object resources were valued because of the aspect of their physical nature or because of their acquiring secondary status value based on their rarity and expense. A home, mansion, and other objects linked to socioeconomic status were given as examples of object resources. Conditions were defined as a second group of resources to the extent that they are valued and sought after. Marriage, tenure, and seniority were given as examples of these. Moreover, it was suggested that measuring the extent to which conditions are valued by individuals or groups may provide insight into their stress-resistance potential. Personal characteristics were defined as the third group of resources to the extent that they generally aid stress resistance. Personal traits and skills were classified in this category of resources and suggested that many of them aid stres