Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Analysis of the Anxiety Sensitivity and Self-Management in Chronic Illness: Descriptive Research (Correlation Studies)
Kronik Hastalıklarda Anksiyete Duyarlılığı ve Öz Yönetimin Değerlendirilmesi: Tanımlayıcı Araştırma (Korelasyon Çalışmaları)
Şirin ÇELİKKANATa , Safiye ÖZGÜÇb , Ayşe EMİNOĞLUa
aDepartment of Nursing, Gaziantep İslam Science and Technology University of Health Sciences, Gaziantep, Türkiye
bDepartment of Nursing, Gaziantep University of Health Sciences, Gaziantep, Türkiye
Turkiye Klinikleri J Nurs Sci. 2023;15(4):1182-9
doi: 10.5336/nurses.2023-96886
Article Language: EN
Full Text
ABSTRACT
Objective: The current study was carried out to analyze the anxiety sensitivities and self-management levels of individuals diagnosed with chronic illness. Material and Methods: The population of this descriptive and correlational study consisted of individuals who were diagnosed with chronic illness by applying to a training and research hospital. The sample consisted of 160 patients who were diagnosed with chronic illness and met the inclusion criteria of the study. Data from the study was collected through face-to-face applied questionnaires and the personal information form, Anxiety Sensitivity Index-3 (ASI-3), and Chronic Illness Self-Management Scale (CISMS) were used. Results: A highly significant positive correlation was found between the ASI-3 mean score and all of its subscales (p<0.001). While there is a highly significant and positive correlation between the ASI3 mean score and the mean score of the CISMS's subscale of SelfStigma, there are statistically significant and negative correlations between the ASI-3 mean score and the mean scores of the CISMS's subscales of Coping with Stigma, Health Maintenance Efficacy, and Treatment Adherence (p<0.001). There is a statistically significant and negative correlation between the mean scores of the CISMS's subscales of Treatment Adherence and Self-Stigma. Additionally, there are statistically significant and positive correlations between the mean scores of the CISMS's subscales of Coping with Stigma and Health Maintenance Efficacy. Conclusion: In the present study, statistically significant correlations were determined between the mean scores of the ASI-3, the CISMS, and its subscales.

Keywords: Anxiety; nursing; chronic illness; self-management
ÖZET
Amaç: Bu araştırma, kronik hastalık tanısı alan bireylerin anksiyete duyarlılığı ve öz yönetimlerinin değerlendirilmesi amacıyla gerçekleştirilmiştir. Gereç ve Yöntemler: Bu tanımlayıcı ve ilişki arayıcı desendeki araştırmanın evrenini, bir eğitim ve araştırma hastanesine başvurarak kronik hastalık tanışı almış bireyler oluşturmuştur. Örneklemi ise çalışmaya dâhil edilme kriterlerini karşılayan 160 kronik hasta oluşturmuştur. Veriler yüz yüze anket yolu ile toplanmış olup, kişisel bilgi formu, Anksiyete Duyarlılık İndeksi-3 (ADİ-3) ve Kronik Hastalık Öz Yönetim Ölçeği (KHÖYÖ) kullanılmıştır. Bulgular: ADİ-3 toplam puanı ile tüm alt boyutları arasında pozitif yönde ileri düzeyde anlamlı bir ilişki saptanmıştır (p<0,001). ADİ-3 toplam puanı ile kendini damgalama arasında pozitif yönde ileri düzeyde anlamlı bir ilişki var iken; baş etme, sağlık bakım etkinliği ve tedavi uyumu arasında negatif yönde anlamlı bir ilişki belirlenmiştir (p<0,001). KHÖYÖ alt boyutlarından tedavi uyumu ile kendini damgalama arasında negatif yönde; baş etme ve sağlık bakım etkinliği arasında pozitif yönde anlamlı bir ilişki saptanmıştır. Sonuç: Çalışmada, kronik hastalıklarda anksiyete duyarlılığı ile öz yönetimin bileşenleri arasında anlamlı ilişki bulunmuştur.

Anahtar Kelimeler: Anksiyete; hemşirelik; kronik hastalık; öz yönetim
REFERENCES:
  1. Basu J, Avila R, Ricciardi R. Hospital readmission rates in U.S. States: are readmissions higher where more patients with multiple chronic conditions cluster? Health Serv Res. 2016;51(3):1135-51. [Crossref]  [PubMed]  [PMC] 
  2. RAND [Internet]. © 1994-2023 RAND Corporation. [Cited: June 24, 2023]. Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Available from: [Link] 
  3. Tüzer V. Kronik hastalıklar ve yeti yitiminde sistemik aile yaklaşımı [Systemic family approach to chronic illness and disability]. Klinik Psikiyatri Dergisi. 2001;4(3):193-201. [Link] 
  4. World Health Organization [Internet]. © 2022 WHO. [Cited: December 25, 2022]. Open Accsess 2022. Available from: [Link] 
  5. Pierobon A, Giardini A, Callegari S, Majani G. Psychological adjustment to a chronic illness: the contribution from cognitive behavioural treatment in a rehabilitation setting. G Ital Med Lav Ergon. 2011;33(1 Suppl A):A11-8. [PubMed] 
  6. Kwakkenbos L, Willems LM, van den Hoogen FH, van Lankveld WG, Beenackers H, van Helmond TF, et al. Cognitive-behavioural therapy targeting fear of progression in an interdisciplinary care program: a case study in systemic sclerosis. J Clin Psychol Med Settings. 2014;21(4):297-312. [Crossref]  [PubMed] 
  7. Lebel S, Mutsaers B, Tomei C, Leclair CS, Jones G, Petricone-Westwood D, et al. Health anxiety and illness-related fears across diverse chronic illnesses: a systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One. 2020;15(7):e0234124. [Crossref]  [PubMed]  [PMC] 
  8. Horenstein A, Potter CM, Heimberg RG. How does anxiety sensitivity increase risk of chronic medical conditions? Clinical Psychology: Science and Practice. 2018;25(3):e12248. [Crossref] 
  9. Aquin JP, El-Gabalawy R, Sala T, Sareen J. Anxiety disorders and general medical conditions: current research and future directions. Focus (Am Psychiatr Publ). 2017;15(2):173-81. [Crossref]  [PubMed]  [PMC] 
  10. Grady PA, Gough LL. Self-management: a comprehensive approach to management of chronic conditions. Am J Public Health. 2014;104(8):e25-31. [Crossref]  [PubMed]  [PMC] 
  11. Schulman-Green D, Jaser S, Martin F, Alonzo A, Grey M, McCorkle R, et al. Processes of self-management in chronic illness. J Nurs Scholarsh. 2012;44(2):136-44. [Crossref]  [PubMed]  [PMC] 
  12. Anekwe TD, Rahkovsky I. Self-management: a comprehensive approach to management of chronic conditions. Am J Public Health. 2018;108(Suppl 6):S430-6. [Crossref]  [PMC] 
  13. Bos-Touwen I, Schuurmans M, Monninkhof EM, Korpershoek Y, Spruit-Bentvelzen L, Ertugrul-van der Graaf I, et al. Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study. PLoS One. 2015;10(5):e0126400. [Crossref]  [PubMed]  [PMC] 
  14. Bayliss EA, Steiner JF, Fernald DH, Crane LA, Main DS. Descriptions of barriers to self-care by persons with comorbid chronic diseases. Ann Fam Med. 2003;1(1):15-21. [Crossref]  [PubMed]  [PMC] 
  15. Jerant AF, von Friederichs-Fitzwater MM, Moore M. Patients' perceived barriers to active self-management of chronic conditions. Patient Educ Couns. 2005;57(3):300-7. [Crossref]  [PubMed] 
  16. Özçetin A, Kılıç O, Ataoğlu A, Ölmez SB, Hisarvant A. A comparison of personality characteristics between patients with cancer and the control group. Duzce Medical Journal. 2019;21(3):204-9. [Crossref] 
  17. Farris BD, Duffell P, MacFadyen AI, Haiman Z. Binary black hole accumulation during inspiration and merger. Monthly Notices of the Royal Astronomical Society: Letters. 2015;447(1):L80-4. [Crossref] 
  18. Taylor S, Zvolensky MJ, Cox BJ, Deacon B, Heimberg RG, Ledley DR, et al. Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychol Assess. 2007;19(2):176-88. [Crossref]  [PubMed] 
  19. Mantar A, Yemez B, Alkın T. Anksiyete duyarlılığı indeksi-3'ün Türkçe formunun geçerlik ve güvenilirlik çalışması [The validity and reliability of the Turkish version of the anxiety sensitivity index-3]. Türk Psikiyatri Dergisi. 2010;21(3):1-11. [Link] 
  20. Ngai SSY, Cheung CK, Ng YH, Tang HY, Ngai HL, Wong KHC. Development and validation of the chronic illness self-management (CISM) scale: Data from a young patient sample in Hong Kong. Children and Youth Services Review. 2020;114:105077. [Crossref] 
  21. Öztürk YE, Yeşildal M, Arık Ö, Fidan Y. Kronik hastalık Öz Yönetim Ölçeğinin Türkçe geçerlilik güvenilirliği [Turkish validity and reliability of the chronic disease self-management scale]. Journal of Academic Value Studies. 2021;7(3):375-81. [Crossref] 
  22. Orem DE. Nursing: Concepts of Practice. 5th ed. St. Louis: Mosby-Yearbook; 2001.
  23. Koşar C, Besen DB. Kronik hastalıklarda hasta aktifliği: kavram analizi [Patient activation in chronic diseases: concept analyse]. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi. 2015;8(1):45-51.
  24. Norman SB, Lang AJ. The functional impact of anxiety sensitivity in the chronically physically ill. Depress Anxiety. 2005;21(4):154-60. [Crossref]  [PubMed] 
  25. Otto MW, Smits JAJ. Anxiety sensitivity, health behaviors, and the prevention and treatment of medical illness. Clin Psychol (New York). 2018;25(3):e12253. [Crossref]  [PubMed]  [PMC] 
  26. Günler OE. Kronik hastalıkların yol açtığı bazı toplumsal problemler [Certain social problems caused by chronic illnesses]. Selçuk Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2019;(42):392-400.
  27. Jaacks LM, Liu W, Ji L, Mayer-Davis EJ. Type 1 diabetes stigma in China: a call to end the devaluation of individuals living with a manageable chronic disease. Diabetes Res Clin Pract. 2015;107(2):306-7. [Crossref]  [PubMed] 
  28. Saunders B. Stigma, deviance and morality in young adults' accounts of inflammatory bowel disease. Sociol Health Illn. 2014;36(7):1020-36. [Crossref]  [PubMed] 
  29. Lin MY, Liu MF, Hsu LF, Tsai PS. Effects of self-management on chronic kidney disease: A meta-analysis. Int J Nurs Stud. 2017;74:128-37. [Crossref]  [PubMed] 
  30. Kidd T, Carey N, Mold F, Westwood S, Miklaucich M, Konstantara E, et al. A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life. PLoS One. 2017;12(10):e0185931. [Crossref]  [PubMed]  [PMC] 
  31. Chandler SK, Robins JL, Kinser PA. Nonpharmacologic interventions for the self-management of anxiety in Parkinson's disease: a comprehensive review. Behav Neurol. 2019;2019:8459579. [Crossref]  [PubMed]  [PMC] 
  32. Smith KJ, Deschênes SS, Schmitz N. Investigating the longitudinal association between diabetes and anxiety: a systematic review and meta-analysis. Diabet Med. 2018;35(6):677-93. [Crossref]  [PubMed]  [PMC] 
  33. Liu X, Haagsma J, Sijbrands E, Buijks H, Boogaard L, Mackenbach JP, et al. Anxiety and depression in diabetes care: longitudinal associations with health-related quality of life. Sci Rep. 2020;10(1):8307. [Crossref]  [PubMed]  [PMC] 
  34. Seo K, Song Y. Self-stigma among Korean patients with diabetes: a concept analysis. J Clin Nurs. 2019;28(9-10):1794-807. [Crossref]  [PubMed] 
  35. Abdoli S, Doosti Irani M, Hardy LR, Funnell M. A discussion paper on stigmatizing features of diabetes. Nurs Open. 2018;5(2):113-9. [Crossref]  [PubMed]  [PMC] 

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