Kemoterapi hastalarının hatalı tıbbi uygulama algısının ve deneyimlerinin belirlenmesi
Determination of chemotherapy patients' perceptions and experiences about medical errors
- Tez No: 417235
- Danışmanlar: DOÇ. DR. AYTEN DEMİR
- Tez Türü: Yüksek Lisans
- Konular: Hemşirelik, Nursing
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2015
- Dil: Türkçe
- Üniversite: Ankara Üniversitesi
- Enstitü: Sağlık Bilimleri Enstitüsü
- Ana Bilim Dalı: Hemşirelik Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 158
Özet
Kanser Tedavisinde Hata ve Güvenlik Ölçeği'nin Türk dili için geçerlik ve güvenirliğini belirlemek amacıyla yapılan bu çalışma tanımlayıcı ve kesitsel niteliktedir. Bu çalışmayla ayrıca kemoterapi alan hastaların kemoterapi uygulamaları ile ilgili endişeleri, kemoterapi uygulama hataları ile ilgili deneyimleri, kemoterapi güvenliği uygulamalarına genel bakış açıları ve hata önleme stratejilerine yönelik algılarının bu ölçek yolu ile değerlendirilmesi amaçlandı. Bu araştırma Ankara'da yer alan Ankara Üniversitesi Tıp Fakültesi Cebeci Araştırma ve Uygulama Hastanesi ve İbn-i Sina Araştırma ve Uygulama Hastanesinde Ekim 2014 ile Mart 2015 tarihleri arasında yürütüldü. Araştırmanın örneklemini Türkçe anlayıp konuşabilen, kanser teşhisi konulmuş ve en az bir kür tedavi almış olan, 18 yaşından büyük olan, terminal dönemde olmayan, çalışmaya katılmayı kabul eden ve bilgilendirilmiş onam formunu imzalayan 400 hasta oluşturdu. Verilerin analizi için verilerin tanımlanmasında sayı, yüzde, ortalama, standart sapma, minimum ve maksimum değerleri kullanıldı. İki grubun karşılaştırmasında sürekli değişkenler için t testi, kesikli değişkenlerin karşılaştırılmasında ise ki-kare (χ²) veya Fisher'in kesin ki-kare testi kullanıldı. Çoklu grup karşılaştırılması ANOVA testi, post hoc olarak Bonferroni testi ile yapıldı. Kanser Tedavisinde Hata ve Güvenlik Ölçeği'nin geçerlik analizlerinde dil geçerliği, kapsam geçerliği ve yapı geçerliği incelendi. Dil geçerliği için Almanca'dan Türkçe'ye ve Türkçe'den Almanca'ya çeviri, kapsam geçerliği için uzman görüşü alma, yapı geçerliği için faktör analizi yöntemleri kullanıldı. Güvenirlik analizinde ise iç tutarlık ve zamana göre değişmezlik belirlendi. İç tutarlık Cronbach α katsayısı, zamana göre değişmezlik Spearman korelasyon katsayısı hesaplanarak değerlendirildi. p değeri
Özet (Çeviri)
This study – which is designed to determine the validity and safety of Survey on Errors and Safety in Cancer Treatment for Turkish language – is a descriptive and cross-sectional study. This study also aims to determine the chemotherapy patients' apprehensions about chemotherapy applications, experiences about chemotherapy application errors, perspectives on chemotherapy safety applications and perceptions on error prevention strategies via the survey. This study carried out at Ankara University Medical Faculty Cebeci Training and Research Hospital and Ibn-i Sina Training and Research Hospital between October 2014 and March 2015. The study sample included 400 patients those can speak Turkish, diagnosed with cancer and received a cure at least once, older than 18 years age, not at terminal stage, consented to participate in the study and signed an informed consent form. Data were descripted by number, percentage, mean, standard deviation, minimum and maximum values and these data used for data analysis. For the comparison of two groups, t test was used for continuous variables and chi square test (χ²) or Fischer's exact chi square test was used for discrete variables. Multiple group comparisons performed by ANOVA test and post hoc Bonferroni test. Language validity, extent validity and structure validity were examined for validity analysis of Survey on Errors and Safety in Cancer Treatment. From German to Turkish translations used for examining language validity as well as from Turkish to German translations, expert consultations used for examining extent validity, factor analysis used for examining structure validity. Internal consistency and time wise consistency were determined for reliability analysis. Internal consistency was evaluated by calculating Cronbach α coefficient value and time wise consistency was evaluated by calculating Spearman correlation coefficient value. The results those had a p value lower than 0.05 approved as statistically significant. The mean of the participants was 55.23±12.13 ages (20-82 ages). Two hundred and thirteen (53.3%) of the patients were women and 188 (47%) were primary school graduate. The most frequent cancer type among the study population was gastrointestinal system cancer – 137 patients (34.25%). Breast cancer was the most frequent cancer type among women participants – 109 patients (51.1%). Lung cancer was the third most frequent cancer type – 75 patients (18.75%). One hundred and fifty eight patients (39.5%) received only chemotherapy meanwhile 149 patients (37.3%) underwent surgery in addition to chemotherapy. Forty per cent of the patients received chemotherapy 5 cures or less while 21 or more chemotherapy cures given to 7.75%of the patients. Two hundred and twenty three participants (55.8%) were not aware of their disease's stage while 49 patients (12.3%) stated that they had a stage 4 disease. One hundred and eighteen of the patients (29.5%) had a relapse history. Besides, 185 patients (46.3%) had a positive family history of cancer. Forty two per cent of the patients had a cancer history for longer than a year meanwhile rest of the patients diagnosed in the recent year. Sixty two patients (15.5%) completed chemotherapy while 338 patients (84.5%) did not. After factor analysis, we determined that among 17 items that included more than one question item 3's and item 4's basic components gathered under only one factor and rest of the items gathered under 2 factors. We also determined that the factor load point values were higher than 0.60 for each, items did not include any unnecessary, uncertain, irrelevant questions, there was no need to take out any questions and the existing state of the scale was valid. Spearman correlation coefficient values were used for testing constancy against time and were determined higher than 0.70 for each item and statistically significant. The best test and repetition test results determined from item 21 (r=0.981), item 25 (r=0,981) and item 15 (r=0,979). Internal consistency analysis showed that Cronbach α coefficient were higher than 0.70 for each item. The best Cronbach α coefficient values were determined from item 26 (Cronbach α= 0,952), item 24 (Cronbach α= 0,925) and item 4 (Cronbach α= 0,921). Sixty seven patients (16.8%) had apprehensions about errors those could occur while their treatment and 44 patients (11%) notified that an error had occurred while their treatments. Eighty per cent of the patients stated that there is a little chance of a patient taking the wrong medicine while their cancer treatment, 63 patients (15.8%) stated that there is a high risk of infection due to lack of hygiene. More than 85%of the patients were the same mind about the doctors and the nurses had done everything lest errors had occurred, had done their jobs very rigorous and carefully, had been careful about hand hygiene and they had informed the patients about the treatment schedule and 65%of the patients stated that patients had been informed if anything had gone wrong. However, approximately 70%of the patients expressed that they had not been informed about how to prevent from errors and reporting the possible errors had not been wanted. Eighty nine per cent of the patients expressed an opinion about that patients could contribute to prevent errors. Fifty seven per cent stated that they are careful about all possible errors however the rate of the patients that acted properly when the behaviors which they should pay attention were exemplified, were less than 15%. The most frequent factors that hindered the patients' being careful about possible errors were; inadequacy of patients knowledge (88%), bad health condition or patients attitudes (85%). These data reveal that the error and safety survey for cancer treatment is valid and reliable for Turkish people. Patients should be informed and encouraged for participating in preventing errors.
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