Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Kronik Obstrüktif Akciğer Hastalarında COVID-19 Korkusunun Günlük Yaşam Aktiviteleri, Semptom Kontrolü ve Ölüm Kaygısı Düzeyine Etkisi: Kesitsel Bir Çalışma
The Effect of Fear of COVID-19 on Activities of Daily Living, Symptom Control and Death Anxiety Level in Chronic Obstructive Pulmonary Patients: A Cross-Sectional Study
Neşe ÖZDEMİRa,b, Nuray ENÇc
aİstanbul Üniversitesi-Cerrahpaşa Lisansüstü Eğitim Enstitüsü, İç Hastalıkları Hemşireliği ABD, İstanbul, Türkiye
bMuş Alparslan Üniversitesi Sağlık Bilimleri Fakültesi, İş Sağlığı ve Güvenliği ABD, Muş, Türkiye
cİstanbul Üniversitesi-Cerrahpaşa Florence Nightingale Hemşirelik Fakültesi, İç Hastalıkları Hemşireliği ABD, İstanbul, Türkiye
Turkiye Klinikleri J Nurs Sci. 2022;14(4):1155-65
doi: 10.5336/nurses.2022-90773
Article Language: TR
Full Text
ÖZET
Amaç: Bu araştırma, kronik obstrüktif akciğer hastalarında, koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] korkusunun günlük yaşam aktiviteleri, semptom kontrolü ve ölüm kaygısı düzeyine etkisini incelemek amacıyla gerçekleştirildi. Gereç ve Yöntemler: Tanımlayıcı-kesitsel türde planlanan araştırma, Eylül 2021-Kasım 2021 tarihleri arasında Muş Devlet Hastanesi Göğüs Hastalıkları Polikliniğe başvuran 217 kronik obstrüktif akciğer hastalığı (KOAH) hastası ile yürütüldü. Araştırmanın verileri; Kişisel Bilgi Formu, COVID-19 Korkusu Ölçeği, Katz Günlük Yaşam Aktiviteleri Ölçeği (GYAÖ), KOAH Değerlendirme Testi [COPD Assessment Test (CAT)], Modifiye Tıbbi Araştırma Konseyi [Modified Medical Research Council (MMRC)] Anketi ve Ölüm Kaygısı Ölçeği ile toplandı. Verilerin değerlendirilmesinde; tanımlayıcı istatistikler, bağımsız örneklem t-testi, tek yönlü varyans analizi testi, Sperman korelasyon analizi kullanıldı. Bulgular: Araştırmaya katılan hastaların yaş ortalamasının 68,7±14,6 yıl olduğu, %44,2'sinin kadın, %55,8'inin erkek, %%77,4'ünün evli, %71'inin okuma yazmasının olmadığı, %56,7'sinin çalışmadığı, %50,7'sinin gelir durumunun orta düzeyde olduğu saptandı. Araştırmaya katılan hastaların COVID-19 Korkusu Ölçeği puan ortalamasının 21,82±5,84, GYAÖ puan ortalamasının 3,79±1,73, CAT puan ortalamasının 27,58±4,21 MMRC Anketi puan ortalamasının 3,23±1,29, Ölüm Kaygısı Ölçeği puan ortalamasının ise 7,92±3,79 olduğu saptandı. Hastaların COVID-19 Korkusu ile GYAÖ (r=-0,169, p=0,013) puan ortalaması arasında negatif yönde zayıf bir ilişkinin olduğu saptandı. Ayrıca COVID-19 Korkusu ile Ölüm Kaygısı Ölçeği (r=0,464, p=0,000) puan ortalaması arasında pozitif yönde anlamlı bir ilişkinin olduğu fakat semptom kontrolü (CAT veya MMRC) (r=-0,102, p=0,133 veya r=-0,069, p=0,313) arasında anlamlı bir ilişkinin olmadığı saptandı. Sonuç: KOAH hastalarının COVID19 korkusu, ölüm kaygısı, CAT, MMRC, GYAÖ puanları ortalamalarının yüksek olduğu, hastalarda COVID-19 korkusu arttıkça günlük yaşam aktivitelerinde azalma olduğu ve ölüm kaygısı düzeyinin arttığı saptandı.

Anahtar Kelimeler: Kronik obstrüktif akciğer hastalığı; COVID-19; korku; günlük yaşam aktiviteleri; kaygı
ABSTRACT
Objective: This study was carried out to examine the effect of fear of coronavirus disease-2019 (COVID-19) on activities of daily living, symptom control and death anxiety in chronic obstructive pulmonary patients. Material and Methods: The study planned as descriptive-crosssectional, was conducted with 217 chronic obstructive pulmonary disease (COPD) patients who applied to the Chest Diseases Outpatient Clinic of Muş State Hospital between September 2021 and November 2021. Data collection of the study was carried out with Personal Information Form, COVID-19 Fear Scale, Katz Daily Living Activities Scale (DLAS), COPD Assessment Test (CAT), Modified Medical Research Council (MMRC) Scale and Death Anxiety Scale. Data were evaluated with; descriptive statistics, independent sample t-test, one way ANOVA test, Spearman correlation analysis. Results: The mean age of the patients participating in the study was 68.7±14.6 years, 44.2% female, 55.8% male, 77.4% married, 71% illiterate, 56.7% unemployed, 50.7% moderate income. The mean score of the COVID-19 Fear Scale of the patients participating in the study was 21.82±5.84, the mean of the DLAS score was 3.79±1.73, the mean of the CAT score was 27.58±4.21, the mean score of the MMRC Scale was 3.23±1.29, and the mean of the Death Anxiety Scale was detected to 7.92±3.79. It was determined that there was a weak negative correlation between the patients' fear of COVID-19 and the mean score of the DLAS (r=- 0.169, p=0.013). In addition, it was determined that there was a positive and significant relationship between the fear of COVID-19 and Death Anxiety Scale (r=0.464, p=0.000) mean score, but there was no significant relationship between symptom control (CAT or MMRC) (r=-0.102, p=0.133 or r=- 0.069, p=0.313). Conclusion: The mean scores of fears of COVID-19, death anxiety, CAT, MMRC, DLAS scores of COPD patients are high. And as the fear of COVID-19 increased in the patients, it was determined that the daily life activities decreased and the level of death anxiety increased.

Keywords: Chronic obstructive pulmonary disease; COVID-19; fear; daily living activities; anxiety
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www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com