Hipertansiyon tedavisi alan hastaların tedavi uyumları ve ilişkili faktörlerin incelenmesi
Evaluation of treatment adaptation of hypertension patients with hill-bone hypertension adjustment scaleand depression anxiety stress scale
Yazar: ÖZGE ÖZSOY ZENGİN
Danışman: DR. ÖĞR. ÜYESİ HACER HİCRAN MUTLU
İstanbul Medeniyet Üniversitesi / Göztepe Eğitim ve Araştırma Hastanesi / Aile Hekimliği Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2021
Konu: Aile Hekimliği = Family Medicine
Dizin: Anksiyete = Anxiety ; Depresyon = Depression ; Hipertansiyon = Hypertension ; Stres = Stress ; Tedavi = Treatment ; Tedaviye bağlılık ve uyum = Treatment adherence and compliance ; Ölçekler = Scales

Özet:
AMAÇ: Hipertansiyon ciddi bir halk sağlığı sorunu olup, hipertansiyona
karşı birinci basamak sağlık hizmetinin verilmesi, erken tanı konulması ve
bilinçli hasta grubunun oluşması gelişebilecek komplikasyonları önlemek
adına çok önemlidir. Hipertansif bireylerin yaşam tarzı değişikliğini
benimsemesi ve medikal tedavi önerilerine uyum sağlaması tedavinin
temelidir. Bu çalışmada hipertansiyon hastalarının tedaviye uyum
düzeylerini araştırmak, tedaviyi etkileyen ilişkili faktörleri ortaya koymak
amaçlandı.
GEREÇ VE YÖNTEM: Prof. Dr. Süleyman Yalçın Şehir Hastanesi Aile
Hekimliği polikliniğine 15.02.2021-15.05.2021 tarihleri arasında herhangi
bir nedenle başvuran ve çalışmaya katılmayı kabul eden 18 yaş üstündeki
hipertansiyon tanılı tedavi alan bireyler çalışmaya katılımı sağlanmıştır. 18
yaş altı bireyler, iletişim engeli olan, psikiyatrik bir hastalık sebebiyle takip
edilen hastalar çalışma dışı bırakılmıştır. Hastaların sosyodemografik
özellikleri, hipertansiyon ile ilgili özellikleri ve diyet alışkanlıklarını ölçmek
için hazırlanan sorulardan oluşan anket formu ile Hill-Bone Hipertansiyon
Tedavisine Uyum Ölçeği ve hastaların tedavi uyumunu etkileyen duygu
durum özelliklerini saptamak için DASS-21 ölçeği hastalara yüz yüze
görüşme sırasında tarafımca uygulandı.
BULGULAR: Çalışmaya anketleri tam olarak dolduran 200 hasta dahil
edildi. Çalışmaya katılan hastaların %73,8'i kadın %26,2'si erkekti.
Çalışmaya katılanların yaş ortalaması 58,21±11,86 yıl olarak hesaplandı.
Çalışmamızda hipertansiyon hastaları tedavi uyumu oldukça yüksekti
(%86.5). HBHTUÖ beslenme alt grup puanları incelendiğinde yaş ilişkisi ile
tedavi uyumu ilişkisi istatiksel olarak anlamlı bulundu. Sigara veya alkol
alan hastaların HBHTUÖ görüşme alt puanının sigara veya alkol
kullanmayan hastalarda tedavi uyumunun güçlü derecede yüksek olduğu
görüldü. Depresyon şiddeti yüksek olan hastaların hipertansiyon tedavisine
uyum oranı da anlamlı derecede düşmekteydi. Anksiyete şiddeti azaldıkça hipertansiyon tedavi uyumu orta düzeyde artmaktadır. Stres şiddeti
azaldıkça hipertansiyon tedavi uyumu orta düzeyde artmaktadır.
SONUÇ: Hipertansiyon hastalarının tedaviye uyum oranları yüksek
saptanmış ve tedaviye uyumu etkileyen birçok faktör saptanmıştır.
Hipertansiyon ciddi bir halk sağlığı sorunu olup, hipertansiyon tedavisine
tam uyum sağlamak hastalığın yan etkilerine karşı bilinç oluşturmak ve
erken teşhis amacıyla toplumun bilgilendirilmesi ve hipertansiyonu kontrol
altına almak için hastaların tedaviye ve yaşam tarzı önerilerine uyum
sağlaması önemlidir.

Anahtar Kelimeler: Hipertansiyon, Hill-Bone Tedaviye Uyum Ölçeği,
Depresyon Anksiyete Stres Ölçeği, Tedaviye Uyum.

Abstract:
AIM: Hypertension is a serious public health problem, and it is very
important to provide primary health care services against hypertension, to
make an early diagnosis and to form a conscious patient group in order to
prevent possible complications. Adopting lifestyle changes and adapting to
medical treatment recommendations is the basis of treatment for
hypertensive individuals. In this study, it was aimed to investigate the level
of adherence to treatment in patients with hypertension and to reveal the
associated factors affecting treatment.
MATERIALS and METHODS: Individuals over the age of 18 who applied to
Prof Dr Süleyman Yalçın City Hospital Family Medicine outpatient clinic
between 15.02.2021 and 15.05.2021 for any reason and accepted to
participate in the study were included in the study. Individuals under the
age of 18, patients with communication disabilities, and those followed for a
psychiatric illness were excluded from the study. A questionnaire form
consisting of questions prepared to measure the sociodemographic
characteristics, hypertension-related characteristics and dietary habits of
the patients, the Hill-Bone Hypertension Treatment Adherence Scale and
the DASS-21 scale to determine the mood characteristics that affect the
treatment compliance of the patients were administered by me during the
face-to-face interview.
RESULTS: 200 patients who filled out the questionnaires were included in
the study. 73.8% of the patients participating in the study were female and
26.2% were male. The mean age of the participants in the study was
calculated as 58.21±11.86 years. In our study, compliance with treatment
in hypertension patients was quite high (86.5%). When the HBHTUÖ
nutrition subgroup scores were examined, the relationship between age and
adherence to treatment was found to be statistically significant. It was
observed that the HBHTUÖ, interview sub-score of patients who smoked or
consumed alcohol was strongly high in patients who did not smoke or drink AIM: Hypertension is a serious public health problem, and it is very
important to provide primary health care services against hypertension, to
make an early diagnosis and to form a conscious patient group in order to
prevent possible complications. Adopting lifestyle changes and adapting to
medical treatment recommendations is the basis of treatment for
hypertensive individuals. In this study, it was aimed to investigate the level
of adherence to treatment in patients with hypertension and to reveal the
associated factors affecting treatment.
MATERIALS and METHODS: Individuals over the age of 18 who applied to
Prof Dr Süleyman Yalçın City Hospital Family Medicine outpatient clinic
between 15.02.2021 and 15.05.2021 for any reason and accepted to
participate in the study were included in the study. Individuals under the
age of 18, patients with communication disabilities, and those followed for a
psychiatric illness were excluded from the study. A questionnaire form
consisting of questions prepared to measure the sociodemographic
characteristics, hypertension-related characteristics and dietary habits of
the patients, the Hill-Bone Hypertension Treatment Adherence Scale and
the DASS-21 scale to determine the mood characteristics that affect the
treatment compliance of the patients were administered by me during the
face-to-face interview.
RESULTS: 200 patients who filled out the questionnaires were included in
the study. 73.8% of the patients participating in the study were female and
26.2% were male. The mean age of the participants in the study was
calculated as 58.21±11.86 years. In our study, compliance with treatment
in hypertension patients was quite high (86.5%). When the HBHTUÖ
nutrition subgroup scores were examined, the relationship between age and
adherence to treatment was found to be statistically significant. It was
observed that the HBHTUÖ, interview sub-score of patients who smoked or
consumed alcohol was strongly high in patients who did not smoke or drink alcohol. The rate of compliance with hypertension treatment was also
significantly lower in patients with high depression severity. As anxiety
severity decreases, hypertension treatment compliance moderately
increases. As the severity of stress decreases, hypertension treatment
compliance increases moderately.
CONCLUSION: Treatment compliance rates of hypertension patients were
found to be high and many factors affecting adherence to treatment were
determined. Hypertension is a serious public health problem, and it is
important that patients comply with treatment and lifestyle
recommendations in order to fully comply with hypertension treatment, to
raise awareness of the side effects of the disease and to inform the society
for early diagnosis and to control hypertension.

Key Words: Hypertension, Hill-Bone Treatment Adherence Scale,
Depression Anxiety Stress Scale, Treatment Adherence.