Sezgi Cinar Pakyuz

Scale development study: The Fluid Control in Hemodialysis Patients

AIM The aim of this study was to develop a valid and reliable measurement instrument to identify knowledge, behaviors, and attitudes of hemodialysis (HD) patients about fluid control as these patients are inadequate in ensuring and sustaining fluid control. METHODS The sample of this methodological study consisted of 276 HD patients who are being treated in two public and two private hemodialysis centers. The validity of the scale was assessed through content validity, construct validity, and similar scale validity, and its reliability through item analysis, internal consistency coefficient and test-retest. For the content validity of the scale, expert views were assessed, and opinions of a Turkish language specialist were obtained. RESULTS According to the exploratory factor analysis, the scale had 24 items and three subdimensions, namely, knowledge, behavior, and attitude. The total variance explained was found to be 51.15%. Cronbachs alpha reliability coefficient of the Fluid Control in Hemodialysis Patients Scale (FCHPS) turned out to be 0.88 and Cronbachs alpha for its subdimensions were 0.92, 0.80, and 0.67, respectively. The correlation value between test and retest was 0.94 (P < 0.001). A moderate significant correlation (r = 0.58, P < 0.001) was found between the scale scores and the scores of the Dialysis Diet and Fluid Restrictions Non-adherence Questionnaire. CONCLUSION The FCHPS that was developed has good validity and reliability. This scale can be used to measure knowledge, behavior, and attitude of hemodialysis patients about fluid restriction.

Hypertension management: what is the role of case management?

Objective The aim of this study was to determine the effect of case management on hypertension management and on adherence to antihypertensive medication and chronic disease care of patients with hypertension. Method This study was conducted as an experimental and randomized controlled study. The sample of the study consisted of randomly selected patients with hypertension who did not have communication problems, who used antihypertensive medication treatment and whose treatment had been continuing for at least six months. The study group was given individual training (Hypertension causes, the risk factors, significance, unwanted side effects, medication treatment, changes in life style) and was applied case management model in hypertension - joint care protocol but no intervention was offered to the control group. Data was collected using the adherence to antihypertensive medication scale, the patient assessment of chronic illness care in the first and six months later interview. Results There was no significant difference between the study and control group according to adherence to antihypertensive medication and patient assessment of chronic illness care in the first interview. Otherwise, there were significant differences between the study and control group according to blood pressure, adherence to antihypertensive medication and patient assessment of chronic illness care in the six months later interview. The adherence to antihypertensive medication total score and the patient assessment of chronic illness care total score were significantly higher in the study group compared with control group in the six months later interview. Conclusion The case management plays an important role the in control of hypertension, and can improve adherence to antihypertensive medication and chronic illness care.

Scale development study: The Fluid Control in Hemodialysis Patients: Fluid control in hemodialysis

AIM The aim of this study was to develop a valid and reliable measurement instrument to identify knowledge, behaviors, and attitudes of hemodialysis (HD) patients about fluid control as these patients are inadequate in ensuring and sustaining fluid control. METHODS The sample of this methodological study consisted of 276 HD patients who are being treated in two public and two private hemodialysis centers. The validity of the scale was assessed through content validity, construct validity, and similar scale validity, and its reliability through item analysis, internal consistency coefficient and test-retest. For the content validity of the scale, expert views were assessed, and opinions of a Turkish language specialist were obtained. RESULTS According to the exploratory factor analysis, the scale had 24 items and three subdimensions, namely, knowledge, behavior, and attitude. The total variance explained was found to be 51.15%. Cronbachs alpha reliability coefficient of the Fluid Control in Hemodialysis Patients Scale (FCHPS) turned out to be 0.88 and Cronbachs alpha for its subdimensions were 0.92, 0.80, and 0.67, respectively. The correlation value between test and retest was 0.94 (P < 0.001). A moderate significant correlation (r = 0.58, P < 0.001) was found between the scale scores and the scores of the Dialysis Diet and Fluid Restrictions Non-adherence Questionnaire. CONCLUSION The FCHPS that was developed has good validity and reliability. This scale can be used to measure knowledge, behavior, and attitude of hemodialysis patients about fluid restriction.

The eating experiences of patients hospitalized in a muscular dystrophy ward in Japan: A phenomenological study

The aim of this study was to explore the life experiences of patients hospitalized in a muscular dystrophy ward in Japan, with particular focus on their eating experiences. Participant observation and unstructured interviews were conducted, and data analyzed by employing Merleau-Ponty’s phenomenology. Nine patients agreed to participate in this study, although only five were included in the analysis. The overarching theme of patients’ eating experiences was “cultivating new eating habits,” which patients nurtured according to their surrounding environment and in response to the increasing medical support and their progressive functional decline. The new eating habits were organized into five sub-themes: “moving my body at my own will,” “eating independently,” “learning to accept the percutaneous endoscopic gastrostomy tube,” “an alternative to having meals” and “using tube feeding.” These new eating habits engendered in patients a “richer,” multisensory perception of eating, one where they do not merely rely on taste. Key words: Muscular dystrophy ward, patients, eating experiences, phenomenology.