Publication: Obez Yaşlılarda Üriner İnkontinans Yönetimi Programının Yaşam Kalitesi, İnkontinansla Baş Etme ve Yalnızlık Üzerine Etkisi
Abstract
Amaç: Bu araştırmanın amacı 'İnkontinans Yönetim Programının' inkontinansı olan obez yaşlıların inkontinans yaşam kalitesi, inkontinansla baş etme ve yalnızlık durumu üzerine etkisini belirlemektir. Materyal ve Metod: Bu araştırma tek kör randomize ön test-son test kontrol gruplu deneysel araştırma tasarımı tipinde yürütülmüştür. Araştırma deney grubunda 27, kontrol grubunda 27 stres, urge veya mix üriner inkontinans şikâyeti olan obez yaşlılar ile tamamlanmıştır. Araştırmanın ön test verileri yaşlılara Standardize Mini Mental Test yapıldıktan sonra deney ve kontrol grubu için sosyodemografik özellikler anket formu, İnkontinans Yaşam Kalitesi Ölçeği, İnkontinans Farkındalık ve Tutum Ölçeği, Ürogenital Sıkıntı Envanteri-UDI-6, Üriner İnkontinans ve Kegel Egzersizine Yönelik Sağlık İnanç Ölçeği ve Yaşlılar İçin Yalnızlık Ölçeği kullanılarak toplanmıştır. Deney grubuna sekiz hafta süren İnkontinans Yönetim Programı uygulanmış (URİMAP), programın tamamlanmasından üç ay sonra deney ve kontrol gruplarına son testler yapılmıştır. Verilerin analizinde tanımlayıcı istatistiklerin yanı sıra Pearson Ki-Kare testi, Fisher testi, Shapiro-Wilk testi, bağımlı ve bağımsız gruplar için T testleri, Mann-Whitney U testi, Wilcoxon İşaretli Sıralar testi, Pearson Korelasyon Katsayısı, Spearman Sıra Farkları Korelasyon Katsayısı ve etki büyüklüğü için Cohen's d ve r değeri kullanılmıştır. Araştırma başlamadan önce etik kurul izni alınmıştır. Bulgular: Uygulanan girişim sonucunda, deney grubundaki obez yaşlı bireylerin Kegel egzersizini bilme oranı %100, uygulama oranı ise %92.6 olarak tespit edilmiştir. Ayrıca yalnızlık düzeylerinin %14.8'e düştüğü belirlenmiştir. Müdahale sonrasında, İnkontinans Yaşam Kalitesi Ölçeği alt boyutları ve toplam puanı, İnkontinans Farkındalık ve Tutum Ölçeğinin inkontinansla baş etme alt boyutu, Ürogenital Sıkıntı Envanteri (UDI-6) bileşenleri ile Üriner İnkontinans ve Kegel Egzersizine Yönelik Sağlık İnanç Ölçeğinin Kegel egzersizine ilişkin yarar algısı, engel algısı ve öz etkililik alt boyutlarının puan ortalamalarında eğitim öncesine kıyasla istatistiksel olarak anlamlılıklar olduğu saptanmıştır. Ayrıca, deney grubunda Yaşlılar İçin Yalnızlık Ölçeği sosyal yalnızlık alt boyutunda da anlamlı bir farklılık gözlemlenmiştir (p<0.05). Sonuç: Çalışmadan elde edilen sonuçlar doğrultusunda obez yaşlılara URIMAP'a dayalı olarak verilen eğitimin yaşam kalitelerini yükseltmede, baş etme becerilerini artırmada, inkontinans semptomlarını azaltmada etkili olduğu saptanmıştır. Ayrıca çalışmanın pelvik taban kas egzersizleri davranışını gerçekleştirmeye yönelik yarar ve öz etkililik algılarını artırmada ve engel algılarını azaltmada ve yaşlıların sosyal yalnızlıkları azaltmada etkili olduğu bulunmuştur. Programın üriner inkontinanslı obez yaşlılar ve tüm yaşlılar için genel sağlık ve refah düzeylerini artırmaya yönelik kullanılabileceği önerilmektedir. Anahtar Sözcükler: Obez, Yaşlı, Üriner İnkontinans, Yaşam Kalitesi, Baş Etme, Yalnızlık, Eğitim
Objective: The aim of this study is to determine the effect of the 'Incontinence Management Program' on the incontinence-related quality of life, coping with incontinence and loneliness in obese older adults with incontinence. Material and Method: This research was conducted using a single-blind randomized pre-test-post-test control group experimental research design. The study was completed with 27 obese elderly people in the experimental group and 27 in the control group with stress, urge or mixed urinary incontinence complaints. The pre-test data of the study were collected using the Standardized Mini Mental Test for the elderly, then the sociodemographic characteristics questionnaire form, Incontinence Quality of Life, Incontinence Awareness and Attitude Scale, Urogenital Distress Inventory-UDI-6, Health Belief Scale for Urinary Incontinence and Kegel Exercise, and Loneliness Scale for the Elderly for the experimental and control groups. The Incontinence Management Program (URİMAP), which lasted for eight weeks, was applied to the experimental group, and post-tests were applied to the experimental and control groups three months after the completion of the program. In the analysis of data, descriptive statistics, Pearson Chi-Square test, Fisher test, Shapiro-Wilk test, T tests for dependent and independent groups, Mann-Whitney U test, Wilcoxon Signed Rank test, Pearson Correlation Coefficient, Spearman Rank Difference Correlation Coefficient and Cohen's d and r values for effect size were used. Ethics committee approval was obtained before the start of the research. Results: As a result of the intervention, the rate of awareness of Kegel exercises among obese older adults in the experimental group was found to be 100%, and the rate of practice was 92.6%. Additionally, their level of loneliness decreased to 14.8%. After the intervention, statistically significant differences were found in the subdimensions and total score of the Incontinence Quality of Life Scale, the coping with incontinence subdimension of the Incontinence Awareness and Attitude Scale, the components of the Urogenital Distress Inventory (UDI-6), and the subdimensions of the Health Belief Scale Regarding Urinary Incontinence and Kegel Exercises, including perceived benefits, perceived barriers, and self-efficacy related to Kegel exercises, compared to the pre-education scores. Furthermore, a significant difference was also observed in the social loneliness subdimension of the Loneliness Scale for the Elderly within the experimental group (p<0.05). Conclusion: Based on the results of the study, the education provided to obese older adults through the URIMAP program was found to be effective in improving their quality of life, enhancing coping skills, and reducing incontinence symptoms. Additionally, the program was shown to increase perceived benefits and self-efficacy regarding the performance of pelvic floor muscle exercises, reduce perceived barriers, and decrease social loneliness among the elderly. It is recommended that the program be used to improve the general health and well-being of obese older adults with urinary incontinence, as well as the elderly population in general. Keywords: Obesity, Elderly, Urinary Incontinence Quality of Life, Coping, Loneliness, Education
Objective: The aim of this study is to determine the effect of the 'Incontinence Management Program' on the incontinence-related quality of life, coping with incontinence and loneliness in obese older adults with incontinence. Material and Method: This research was conducted using a single-blind randomized pre-test-post-test control group experimental research design. The study was completed with 27 obese elderly people in the experimental group and 27 in the control group with stress, urge or mixed urinary incontinence complaints. The pre-test data of the study were collected using the Standardized Mini Mental Test for the elderly, then the sociodemographic characteristics questionnaire form, Incontinence Quality of Life, Incontinence Awareness and Attitude Scale, Urogenital Distress Inventory-UDI-6, Health Belief Scale for Urinary Incontinence and Kegel Exercise, and Loneliness Scale for the Elderly for the experimental and control groups. The Incontinence Management Program (URİMAP), which lasted for eight weeks, was applied to the experimental group, and post-tests were applied to the experimental and control groups three months after the completion of the program. In the analysis of data, descriptive statistics, Pearson Chi-Square test, Fisher test, Shapiro-Wilk test, T tests for dependent and independent groups, Mann-Whitney U test, Wilcoxon Signed Rank test, Pearson Correlation Coefficient, Spearman Rank Difference Correlation Coefficient and Cohen's d and r values for effect size were used. Ethics committee approval was obtained before the start of the research. Results: As a result of the intervention, the rate of awareness of Kegel exercises among obese older adults in the experimental group was found to be 100%, and the rate of practice was 92.6%. Additionally, their level of loneliness decreased to 14.8%. After the intervention, statistically significant differences were found in the subdimensions and total score of the Incontinence Quality of Life Scale, the coping with incontinence subdimension of the Incontinence Awareness and Attitude Scale, the components of the Urogenital Distress Inventory (UDI-6), and the subdimensions of the Health Belief Scale Regarding Urinary Incontinence and Kegel Exercises, including perceived benefits, perceived barriers, and self-efficacy related to Kegel exercises, compared to the pre-education scores. Furthermore, a significant difference was also observed in the social loneliness subdimension of the Loneliness Scale for the Elderly within the experimental group (p<0.05). Conclusion: Based on the results of the study, the education provided to obese older adults through the URIMAP program was found to be effective in improving their quality of life, enhancing coping skills, and reducing incontinence symptoms. Additionally, the program was shown to increase perceived benefits and self-efficacy regarding the performance of pelvic floor muscle exercises, reduce perceived barriers, and decrease social loneliness among the elderly. It is recommended that the program be used to improve the general health and well-being of obese older adults with urinary incontinence, as well as the elderly population in general. Keywords: Obesity, Elderly, Urinary Incontinence Quality of Life, Coping, Loneliness, Education
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