Examining the effect of pre-operative stress management training prepared in the metaverse universe on blood sugar, life parameters and anxiety level in the postoperative process in patients using insulin and diagnosed with Type 2 diabetes

Diabetes, which has become a serious health problem today and causes great financial and moral losses by creating various complications in the current disease state; It is among the leading causes of disease-related death in many countries. Diabetes Mellitus Type 2 (Type 2 DM), the most common form of diabetes, is a chronic disease characterized by insulin resistance and loss of beta cell function. Due to the increase in the incidence of diabetes and its complications requiring surgical intervention, the number of individuals with diabetes who undergo surgical intervention is increasing. However, due to surgical stress that may occur before surgery, some hormones may increase, inhibit insulin secretion and cause deterioration in blood sugar regulation. This research aims to examine the effect of preoperative stress management training prepared in the metaverse on blood sugar, life parameters and anxiety levels in the postoperative period in patients who were diagnosed with Diabetes Mellitus Type 2 and started insulin treatment. It was planned as a randomized controlled study. The population of the research consisted of patients who were admitted to the General Surgery Service of Süleyman Demirel University Research and Practice Hospital in the preoperative period, who were diagnosed with Type 2 DM at an earlier date than their hospitalization and started using insulin therapy, and who agreed to participate in the research. G. Power analysis was performed to determine the number of patients to be sampled, and a total of 60 patients were divided into experimental and control groups using the sealed envelope randomization method. The patients in the experimental group were shown the stress management video prepared in the metaverse using an ipad 9th Generation 64GB Wi-Fi 10.2 before surgery, and the control group was trained with the traditional narrative method. The data of the study were collected with the help of the patient diagnosis form, validation check of DASS 21 which is short form of Depression, Stress and Anxiety Scale (DASS 42) has been carried out, and the form developed to evaluate the physiological findings of stress. Evaluations of the patients'vital parameters were made in 5 different time periods, before the patient's surgery (24 hours, 12 hours and just before) and after the surgery (12 hours and 24 hours). In statistical analysis of data; Kruskal-Wallis, Mann Whitney-U, anova and paired groups t tests were used. 51.70% of the patients in the entire study group are women, 81.70% are married, the average age is 55.88±11.14, the average duration of diabetes is 24.75±9.36 years and the last hba1c value is 7.26% on average. It was found to be ±0.63. When the DASS-21 scale scores were examined, no significant difference was observed between the experimental and control groups in the first measurements; A highly significant difference was observed among the final scale scores among all sub-dimensions (p<0.001). Anxiety, stress and depression scores of the experimental group decreased more than the control group, showing statistical significance. When the measurements made at 5 different times were evaluated in terms of the parameters considered as physiological indicators of stress, it was observed that the time*group binary interactions of blood sugar, pulse, systolic and diastolic blood pressures, respiratory rate and oxygen saturation parameters in the experimental and control groups showed significance (p < 0.05). Based on the study results; It shows that it is important to provide stress management training as it contributes to pre-operative blood sugar regulation, stabilization of life parameters and relief of anxiety, and that the method chosen for this training changes the effectiveness of the training. Since the education given in the Metaverse universe is a more effective method than the education given with the traditional narrative method, it is a preferable education method in patient education.