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Düşük İyot Diyeti Dönemindeki Hastalarda Hemşirenin Rolü

Yıl 2022, Cilt: 44 Sayı: 6, 862 - 872, 28.11.2022
https://doi.org/10.20515/otd.1145894

Öz

Bu çalışmada, total tiroidektomi sonrası hastaların düşük iyot diyeti sürecine uyumunda hemşirenin rolünün değerlendirilmesi amaçlanmıştır. Çalışma, randomize olmayan (ön-test son-test) vaka gruplu müdahale araştırması olup, Eskişehir Osmangazi Üniversitesi Sağlık, Uygulama ve Araştırma Hastanesi Nükleer Tıp Polikliniğinde, dahil edilme kriterlerine uyan 18 hasta ile gerçekleştirilmiştir. Verilerin toplanmasında Tanımlayıcı Özellikler Veri Formu, Hasta İzlem Formu (hastaların boy, kilo, kan basıncı değerleri) ve Başetme-Uyum Süreci Ölçeği kullanılmıştır. Çalışmaya dahil edilen hastalara yaklaşık 30-45 dk. sürecek hemşirelik süreci uygulanmıştır. Düşük iyot diyetinin 7. ve 14. günlerinde hastaların öğrenmek istedikleri konularda açıklamalarda bulunulmuş, genel durumları hakkında bilgi alınmış ve tekrar hemşirelik süreci uygulanmıştır. Radyoaktif iyot tedavisi için nükleer tıp polikliniğine gelen hastalara düşük iyot diyeti öncesi ve sonrası Hasta İzlem Formu ve Başetme-Uyum Süreci Ölçeği uygulanarak, hemşirelik sürecinin etkinliği değerlendirilmiştir. Normal dağılım gösteren sayısal değişkenlerin diyet öncesi ve sonrası karşılaştırılmasında Eşleştirilmiş t testi ve normal dağılmayan değişkenlerin karşılaştırılmasında Wilcoxon testi kullanılmıştır. Verilerin analizi, SPSS for Windows version 24.0 programı ile yapılmıştır. Hastalar diyet öncesi ve diyet sonrası karşılaştırıldığında; hastalarda beden kütle indeksi değerleri bakımından anlamlı fark gözlenmezken (P>0.05), hastaların sistolik ve diyastolik kan basıncı değerleri başlangıç ölçümlerine göre anlamlı düşüş göstermiştir (P<0.01). Başetme-Uyum Süreci Ölçeği alt boyutlarında ve ölçeğin toplam puanında başlangıç değerlerine göre anlamlı düzeyde artış görülmüştür (P<0.01). Düşük iyot diyeti döneminde olan hastalara uygulanan hemşirelik sürecinin hastaların başetme-uyum düzeylerini arttırdığı görülmüştür. Bu bağlamda söz konusu dönemindeki hastalara yönelik poliklinikte uygun ortamın düzenlenmesi, eğitim programlarının rutinleştirilmesi, hemşirelik sürecinin planlanması ve uygulanması ile ilgili çalışmaların arttırılması önerilmektedir.

Kaynakça

  • 1. Kamel Hasan O, De Brabandere S, Rachinsky I, et al. Microscopic positive tumor margin increases risk for disease persistence but not recurrence in patients with stage T1-T2 differentiated thyroid cancer. J Thyroid Res. 2020; 1-9.
  • 2. Pacini F, Schlumberger M, Dralle H, et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol. 2006;154(6):787-803.
  • 3. Lee KJ, Chang SO, Jung KY. Experiences with a low-iodine diet: A qualitative study of patients with thyroid cancer receiving radioactive iodine therapy. Eur J Oncol Nurs. 2016;23:43-50.
  • 4. Lee M, Lee YK, Jeon TJ, et al. Low iodine diet for one week is sufficient for adequate preparation of high dose radioactive iodine ablation therapy of differentiated thyroid cancer patients in iodine-rich areas. Thyroid. 2014;24(8):1289-1296.
  • 5. Dobrenic M, Huic D, Zuvic M, et al. Usefulness of low iodine diet in managing patients with differentiated thyroid cancer-initial results. Radiol Oncol. 2011;45(3):89-195.
  • 6. Ju DL, Park YJ, Paik HY, et al. Dietary evaluation of a low-iodine diet in Korean thyroid cancer patients preparing for radioactive iodine therapy in an iodine-rich region. Nutr Res Pract. 2016;10(2):167-174.
  • 7. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009;19(11):1167-1214.
  • 8. England CY, Moss L, Beasley M, et al. A Survey of UK centres on low iodine diet recommendations prior to radioiodine ablation therapy for differentiated thyroid cancer. Eur Thyroid J. 2020;9(3):132-138.
  • 9. Perros P, Colley S, Boelaert K, et al. Guidelines for the management of thyroid cancer. Clin Endocrinol. 2014;81:1-122.
  • 10. Li JH, He ZH, Bansal V, et al. Low iodine diet in differentiated thyroid cancer: a review. Clin Endocrinol. 2016;84(1):3-12.
  • 11. Kim M, Kim HI, Jeon MJ, et al. Eighth edition of tumor-nodemetastasis staging system improve survival predictability for papillary, but not follicular thyroid carcinoma: A multicenter cohort study. Oral Oncol. 2018;87:97-103.
  • 12. Kim SK, Yun GY, Kim KH, et al. Severe hyponatremia following radioactive iodine therapy in patients with differentiated thyroid cancer. Thyroid. 2014;24(4):773-777.
  • 13. Resmi Gazete. Hemşirelik Yönetmeliği [İnternet]. 2010 [cited 2021 july 10]. Available from: www.resmigazete.gov.tr/main.aspx
  • 14. Roy C. (2009). The Roy adaptation model. Upper Saddle River: Pearson Prentice Hall Health. 3rd ed. New Jersey, p. 35–50.
  • 15. Roy C. Extending the Roy Adaptation Model to meet changing global needs. Nurs Sci Q. 2011;24(4):345-351.
  • 16. Çatal E. (2015). Koroner arter baypas greftli hastalarda hemşirelik girişimlerinin öğrenim gereksinimlerinin karşılanması, iyileşme algısı, başetme-uyum ve yaşam kalitesine etkisi (Doktora Tezi). Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü, İzmir.
  • 17. Romeiro J, Caldeira S, Herdman TH, et al. Nursing diagnoses: what about NANDA‐I syndromes? International Nursing Review. 2020;67(4):562-567.
  • 18. Murphy S, Mc Mullin R, Brennan S, et al. Exploring implementation of the careful nursing philosophy and professional practice model© in hospital‐based practice. J Nurs Manag. 2018;26(3):263-273.
  • 19. American Thyroid Association. (2016). Low iodine diet [İnternet]. Cited 2021 july 15, Available from: http://www.thyroid.org/low-iodine-diet/
  • 20. Thyroid Cancer Canada. (2017). A short-term diet to prepare for radioactive, iodine treatment or scan [İnternet]. Cited 2021 july 15, Available from: https://www.thyroidcancercanada.org/en/treatments/radioactive-iodinetreatment
  • 21. Thyroid Cancer Survivors’ Association. (2020). One-page low-iodine diet Guide [İnternet]. Cited 2021 july 15, Available from: http://www.thyca.org/
  • 22. An JH, Song KH, Kim DL, et al. Effects of thyroid hormone withdrawal on metabolic and cardiovascular parameters during radioactive iodine therapy in differentiated thyroid cancer. J Int Med Res. 2017;45(1):38-50.
  • 23. Hinds SR, Stack AL, Stocker DJ. Low-iodine diet revisited: importance in nuclear medicine imaging and management. Clin Nucl Med. 2008;33(4):247-250.
  • 24. Kim HK, Lee SY, In Lee J, et al. Daily urine iodine excretion while consuming a low‐iodine diet in preparation for radioactive iodine therapy in a high iodine intake area. Clin Endocrinol. 2011;75(6):851- 856.
  • 25. Chung JH. Low iodine diet for preparation for radioactive iodine therapy in differentiated thyroid carcinoma in Korea. Endocrinol Metab. 2013;28(3):157-163.

The Role of the Nurse in Patients on Low Iodine Diet Period

Yıl 2022, Cilt: 44 Sayı: 6, 862 - 872, 28.11.2022
https://doi.org/10.20515/otd.1145894

Öz

In this study, it was aimed to evaluate the role of the nurse in the adaptation of patients with the low iodine diet process after total thyroidectomy. The study was a non-randomized (pre-test post-test) case group intervention study and was conducted with 18 patients who met the inclusion criteria in the Nuclear Medicine Polyclinic of Eskişehir Osmangazi University Health, Application and Research Hospital. The Descriptive Characteristics Data Form, the Patient Follow-up Form (height, weight, blood pressure values of the patients) and the Coping-Adaptation Process Scale were used to collect the data. Approximately 30-45 minutes to the patients included in the study. The ongoing nursing process was applied. On the 7th and 14th days of the low iodine diet, the patients were informed about the subjects they wanted to learn, information was obtained about their general condition, and the nursing process was applied again. The effectiveness of the nursing process was evaluated by applying the Patient Follow-up Form and the Coping-Adaptation Process Scale before and after the low iodine diet to the patients who came to the nuclear medicine outpatient clinic for radioactive iodine treatment. Paired t-test was used to compare normally distributed numerical variables before and after diet, and Wilcoxon test was used to compare non-normally distributed variables. Data analysis was done with SPSS for Windows version 24.0 program. When the patients were compared before and after the diet; While no significant difference was observed in terms of body mass index values in the patients (P>0.05), the systolic and diastolic blood pressure values of the patients showed a significant decrease compared to the initial measurements (P<0.01). A significant increase was observed in the Coping-Adaptation Process Scale sub-dimensions and the total score of the scale compared to the baseline values (P<0.01). It has been observed that the nursing process applied to patients in the low iodine diet period increased the coping-adaptation levels of the patients. In this context, it is recommended to 

Kaynakça

  • 1. Kamel Hasan O, De Brabandere S, Rachinsky I, et al. Microscopic positive tumor margin increases risk for disease persistence but not recurrence in patients with stage T1-T2 differentiated thyroid cancer. J Thyroid Res. 2020; 1-9.
  • 2. Pacini F, Schlumberger M, Dralle H, et al. European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol. 2006;154(6):787-803.
  • 3. Lee KJ, Chang SO, Jung KY. Experiences with a low-iodine diet: A qualitative study of patients with thyroid cancer receiving radioactive iodine therapy. Eur J Oncol Nurs. 2016;23:43-50.
  • 4. Lee M, Lee YK, Jeon TJ, et al. Low iodine diet for one week is sufficient for adequate preparation of high dose radioactive iodine ablation therapy of differentiated thyroid cancer patients in iodine-rich areas. Thyroid. 2014;24(8):1289-1296.
  • 5. Dobrenic M, Huic D, Zuvic M, et al. Usefulness of low iodine diet in managing patients with differentiated thyroid cancer-initial results. Radiol Oncol. 2011;45(3):89-195.
  • 6. Ju DL, Park YJ, Paik HY, et al. Dietary evaluation of a low-iodine diet in Korean thyroid cancer patients preparing for radioactive iodine therapy in an iodine-rich region. Nutr Res Pract. 2016;10(2):167-174.
  • 7. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid, 2009;19(11):1167-1214.
  • 8. England CY, Moss L, Beasley M, et al. A Survey of UK centres on low iodine diet recommendations prior to radioiodine ablation therapy for differentiated thyroid cancer. Eur Thyroid J. 2020;9(3):132-138.
  • 9. Perros P, Colley S, Boelaert K, et al. Guidelines for the management of thyroid cancer. Clin Endocrinol. 2014;81:1-122.
  • 10. Li JH, He ZH, Bansal V, et al. Low iodine diet in differentiated thyroid cancer: a review. Clin Endocrinol. 2016;84(1):3-12.
  • 11. Kim M, Kim HI, Jeon MJ, et al. Eighth edition of tumor-nodemetastasis staging system improve survival predictability for papillary, but not follicular thyroid carcinoma: A multicenter cohort study. Oral Oncol. 2018;87:97-103.
  • 12. Kim SK, Yun GY, Kim KH, et al. Severe hyponatremia following radioactive iodine therapy in patients with differentiated thyroid cancer. Thyroid. 2014;24(4):773-777.
  • 13. Resmi Gazete. Hemşirelik Yönetmeliği [İnternet]. 2010 [cited 2021 july 10]. Available from: www.resmigazete.gov.tr/main.aspx
  • 14. Roy C. (2009). The Roy adaptation model. Upper Saddle River: Pearson Prentice Hall Health. 3rd ed. New Jersey, p. 35–50.
  • 15. Roy C. Extending the Roy Adaptation Model to meet changing global needs. Nurs Sci Q. 2011;24(4):345-351.
  • 16. Çatal E. (2015). Koroner arter baypas greftli hastalarda hemşirelik girişimlerinin öğrenim gereksinimlerinin karşılanması, iyileşme algısı, başetme-uyum ve yaşam kalitesine etkisi (Doktora Tezi). Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü, İzmir.
  • 17. Romeiro J, Caldeira S, Herdman TH, et al. Nursing diagnoses: what about NANDA‐I syndromes? International Nursing Review. 2020;67(4):562-567.
  • 18. Murphy S, Mc Mullin R, Brennan S, et al. Exploring implementation of the careful nursing philosophy and professional practice model© in hospital‐based practice. J Nurs Manag. 2018;26(3):263-273.
  • 19. American Thyroid Association. (2016). Low iodine diet [İnternet]. Cited 2021 july 15, Available from: http://www.thyroid.org/low-iodine-diet/
  • 20. Thyroid Cancer Canada. (2017). A short-term diet to prepare for radioactive, iodine treatment or scan [İnternet]. Cited 2021 july 15, Available from: https://www.thyroidcancercanada.org/en/treatments/radioactive-iodinetreatment
  • 21. Thyroid Cancer Survivors’ Association. (2020). One-page low-iodine diet Guide [İnternet]. Cited 2021 july 15, Available from: http://www.thyca.org/
  • 22. An JH, Song KH, Kim DL, et al. Effects of thyroid hormone withdrawal on metabolic and cardiovascular parameters during radioactive iodine therapy in differentiated thyroid cancer. J Int Med Res. 2017;45(1):38-50.
  • 23. Hinds SR, Stack AL, Stocker DJ. Low-iodine diet revisited: importance in nuclear medicine imaging and management. Clin Nucl Med. 2008;33(4):247-250.
  • 24. Kim HK, Lee SY, In Lee J, et al. Daily urine iodine excretion while consuming a low‐iodine diet in preparation for radioactive iodine therapy in a high iodine intake area. Clin Endocrinol. 2011;75(6):851- 856.
  • 25. Chung JH. Low iodine diet for preparation for radioactive iodine therapy in differentiated thyroid carcinoma in Korea. Endocrinol Metab. 2013;28(3):157-163.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Nedıme Kosgeroglu 0000-0003-2567-9868

Dilek Gümüş 0000-0002-5338-9377

Handan Koyuncu 0000-0002-8023-7555

Yayımlanma Tarihi 28 Kasım 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 44 Sayı: 6

Kaynak Göster

Vancouver Kosgeroglu N, Gümüş D, Koyuncu H. Düşük İyot Diyeti Dönemindeki Hastalarda Hemşirenin Rolü. Osmangazi Tıp Dergisi. 2022;44(6):862-7.


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