Clinical Trial Details
— Status: Recruiting
Administrative data
NCT number |
NCT05910203 |
Other study ID # |
CumhuriyetU Health Sc |
Secondary ID |
|
Status |
Recruiting |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
December 1, 2023 |
Est. completion date |
December 1, 2024 |
Study information
Verified date |
February 2024 |
Source |
Cumhuriyet University |
Contact |
Funda Tuncer Sahin, 1 |
Phone |
+905308262386 |
Email |
fundatuncersahin[@]gmail.com |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Health is a main human right and a need for every human being. However, due to some
congenital or acquired reasons, individuals may be disabled and cannot participate in social
life at the same level as their normally developing peers. The gradual increase in the world
population, the advances in the treatment of chronic diseases and the prolongation of life
expectancy at birth, along with the increase in economic, social and psychological problems
and deterioration in environmental conditions show that the number of disabled individuals
will increase in the future. Diseases caused by the use of tobacco and tobacco products rank
first among preventable diseases in the world, and tobacco use is a very important public
health problem. Nurses use various models developed as a guide in developing goals for
lifestyle change in individuals and in interventions to achieve this. One of the studies they
conduct based on the models is smoking cessation. It is believed that the studies to be
carried out will strengthen the perceptions of individuals about protecting and improving
their health and will guide the way in which the obstacles to smoking cessation can be
perceived and resolved more easily. Based on this, it is thought that the smoking cessation
study to be carried out by using HBM in visually impaired individuals will draw attention to
unhealthy lifestyle behaviors and smoking addiction, which is one of these behaviors. The
study was designed experimentally with "pretest-posttest control group". Before and after the
planned smoking cessation training given based on HBM, the scores of Fagerström Nicotine
Dependence Test and the smoking cessation scale according to HBM and hemoglobin and CO
measurement values of the visually impaired individuals will be compared. Statistical package
program will be used for coding, statistical analysis and evaluation of the data to be
obtained from the study. T-test will be used in independent groups and t-test in dependent
groups depending on the distribution features of the data in the statistical analysis. The
normality distribution of the data will be evaluated by Wilk's, Kurtosis and Skewness
coefficients. In the data distributed normally, non-parametric tests, Kruskal Wallis test or
Mann-Whitney test will be used, and parametric tests, dependent and independent groups'
t-test in two variables and ANOVA (analysis of variance) will be used in two or more
variables.
Description:
Health is a basic human right and need for every human being, but individuals may be disabled
due to some congenital or acquired reasons. Disability is defined as a person's difficulty in
adapting to social life and meeting their daily needs due to the loss of their physical,
mental, spiritual, sensory and social abilities at various degrees, and therefore needing
support in different areas. From a sociological point of view, a disabled individual is an
individual whose accessibility is limited not because of health-related problems, but rather
as a result of social pressures. In the World Health Organization (WHO) 2011 World Disability
Report, it is stated that 15.6% of the population over the age of 18 worldwide is a disabled
person. According to the statistics of two thousand twenty one; There are 284,366 visually
impaired individuals in our country. The ratio of visually impaired individuals to the total
number of disabled individuals is 10% (Statistics Bulletin of the Disabled and Elderly,
December 2021). Visually impaired individuals are those who have complete or partial vision
loss or impairment in one or both eyes. The inability to notice the presence or movement of
an object in a certain area from the environment, the inability to notice faint shapes or
letters, the inability to distinguish shapes or letters that should be visible from a
distance of 6 meters, no matter what glasses are worn, means "low vision-visibility
insufficiency". In other words, low vision is the state of not being able to see what a
"normal" person of the same age can see, and this cannot be achieved no matter what glasses
are worn. The gradual increase in the world population, the advances in the treatment of
chronic diseases, the prolongation of life expectancy at birth, the increase in economic,
social and psychological problems and the deterioration in environmental conditions indicate
that the number of disabled individuals will increase in the future. The increase in the
number of disabled individuals brings with it an increase in the problems faced by disabled
individuals. Disabled individuals are placed among disadvantaged groups in society and face
negative discrimination in terms of participation in social life, access to education
opportunities, work and employment. Accordingly, individuals with disabilities may be poor,
deprived of social security, and have difficulties in accessing and receiving health
services. In the reports published recently, it is reported that the health level of
individuals with disabilities is lower than the other segments of the society (United
Nations, 2020).
Recent epidemiological studies indicate that low diet quality, smoking and alcohol use, and
low physical activity are directly related to an increased risk of eye diseases. In addition,
there are data that smoking reduces visual acuity and the perception of the brightness of
colors in visually impaired individuals. Although smoking is one of the most common habits in
the world, it causes deterioration of people's health with the harmful substances it contains
and even causes death of individuals. Every year, many people lose their health due to
smoking or exposure to cigarette smoke. In addition, physical inactivity In addition to an
unhealthy diet, tobacco and tobacco products use, which is responsible for approximately 80%
of the problems that cause disability such as coronary heart disease and cerebrovascular
diseases, ranks first among the causes of preventable diseases. Smoking is an important
public health problem that causes an increase in the burden of disease. Studies have shown
that risky behaviors that negatively affect health, such as smoking, unhealthy diet, and
insufficient physical activity, are more common in disabled individuals than in healthy
individuals. According to the study conducted in the USA, it was concluded that 24.6% of
disabled individuals are addicted to cigarettes. In addition to the lack of data on why
disabled individuals start smoking, there are also studies showing that social environment
and family attitudes have an effect on smoking behavior. In addition, disabled individuals
who may encounter situations of not being accepted by the society may have psychological
problems and may turn to cigarettes as a coping mechanism. Recent epidemiological studies
indicate that low diet quality, smoking and alcohol use, and low physical activity are
directly related to an increased risk of eye diseases. In addition, there are studies showing
that smoking reduces visual acuity and the perception of the brightness of colors in visually
impaired individuals. Programs for risky groups such as children, women and disabled
individuals, who are special targets in terms of tobacco use, are becoming widespread
throughout the world within the scope of combating tobacco. To ensure a comprehensive tobacco
control program, continuity of community-based smoking cessation programs is required. Health
professionals working in primary care, especially public health nurses, have important duties
in ensuring continuity. In the programs developed, especially public health nurses are
required to reach disabled people and provide counseling and guidance that disabled people
need. Improving the health of individuals with disabilities and bringing them into society is
possible through the education of individuals, the education of families, and the provision
of health and care services to the disabled child as a whole (Çoban and Özcebe, 2019). In
addition to their educational role, public health nurses have roles in providing counseling
to disabled people, providing the support tools needed by disabled people, and reintegrating
them into society. With the roles they fulfill while improving the health of disabled people,
they can raise awareness about creating the perception of health and illness of disabled
people (Emlek Sert, 2021). With the appropriate risk assessment, the public health nurse can
eliminate the vulnerable-risk individuals in the society and the disabled individuals, who
are one of these groups, before their health problems develop, and they can preserve their
existing skills with screening and treatment practices. In addition, public health nurses
should develop a relationship of trust with the individual, advocate, be a teacher and role
model for the individual, and increase the capacity of individuals. In addition, they should
raise awareness of disabled individuals in the society and work with vulnerable groups when
necessary. Public health nurses should provide guidance on changing lifestyles (healthy
lifestyle practices such as nutrition and physical activity) to improve the health of
individuals with disabilities. Disabled individuals, especially visually impaired
individuals, may have problems in accessing health services. Visually impaired individuals
who do not have the ability to move independently and cannot go out on their own may not want
to go to a health institution they have not been to before, because of the anxiety of having
problems, or they may not know which institution or unit to apply for their health problems.
At this point, public health nurses are required to provide the disabled individuals with the
necessary counseling in the field of health in their environment. In addition, nurses should
establish a relationship of trust with disabled individuals and give the message that they
are available when they need it. Nurses benefit from the models developed as a guide in the
interventions aimed at developing goals for lifestyle change in individuals and realizing it.
One of their studies based on models is smoking cessation. Nurses benefit from multiple
different behavior modification models in their interventions for smoking cessation. In
addition to smoking cessation models, they can also use peer education, training on smoking
addiction and the harms of smoking, and motivational interview techniques.
Studies show that nursing practices, which are made by taking the change stages of the
transtheoretic model (TTM), which is used as a guide in facilitating behavior change, are one
of the guiding models that can enable the individual to better understand the reasons for
change and/or not change, and can facilitate behavior change. When TTM is applied considering
the stages of change, it appears as one of the models that have been proven to have a
positive effect on individuals' smoking cessation behavior. Another model that nurses take as
a guide for smoking cessation is the Health Belief Model. The Health Belief Model (HBM) is
frequently used today to explain the actions taken to protect and improve health. The model,
which focuses on perceived health risks, explains screening behaviors and also explains
patient behavior, patient role behaviors and the factors that facilitate the realization of
health behaviors. The Health Belief Model (HBM) is frequently used in studies related to
screening and early diagnosis such as breast self-examination. HBM is effectively used in the
management of chronic diseases such as diabetes mellitus, in the Covid-19 vaccine and other
vaccines, in protecting and promoting the health of individuals.
Although HBM is not a preferred model in studies on smoking or smoking cessation, it has
recently been used to prevent negative health-related behaviors such as smoking. It is
thought that the studies to be carried out will strengthen the perceptions of individuals
about protecting and improving their health and will guide the way in which the obstacles in
front of smoking cessation can be perceived and resolved more easily.
In the studies carried out with education and counseling for visually impaired individuals,
the observation list was used during the training, and improvements were recorded in the
visually impaired individuals after the training. In addition, it has been determined that
the training and consultancy activities given to the visually impaired individuals on the
subjects they need are beneficial for the development of the visually impaired individuals
and they are more willing to solve their current problems. It has been concluded that the
education given after the needs analysis of individuals makes their lives easier in their
daily lives.
The purpose of this research; The purpose of this study will be to determine the effect of
the planned education based on the health belief model on the smoking perception and behavior
of visually impaired individuals. of the study; It is thought that it will draw attention to
unhealthy lifestyle behaviors in disabled individuals and smoking addiction, which is one of
these behaviors, and that the findings to be obtained from the study may guide nurses and
health policies that can be developed in this direction on the effectiveness of SIM-based
planned education and counseling approach, especially in gaining healthy lifestyle behaviors
in visually impaired individuals. In addition, it is thought that nurses who will work with
disabled individuals can be an example for reaching and approaching disabled individuals.