Perceived barriers in diabetes management and the impact of self-management on self-care behaviors

individuals with diabetes in diabetes management on self-care behaviors and self- management perception. In addition, it is to examine the relationship between the perceived obstacles of the diabetic and the diabetic's sociodemographic, disease characteristics and metabolic parameters. Materials and Methods: The study was designed as a descriptive-relationship type and was conducted between September 2022 and February 2023 by Istanbul Prof. Dr. It was conducted with diabetic patients who agreed to participate in the study in the inpatient internal medicine services of Cemil Taşçıoğlu City Hospital. As a result of the analysis performed with the G-Power 3.1 program, with a 95% confidence interval and a power ratio of 0.95, the frequency of occurrence was accepted as 0.5 and the standard deviation was ±0.05, and the number of diabetics was determined as 300. 300 diabetic patients who met the inclusion criteria were identified by simple random sampling. Data were collected through face-to-face interview. Before the study, a pilot test was conducted on 20 diabetics to determine the understandability of the survey questions. The data were obtained using the "Individual with Diabetes Information Form", "Diabetes Self-Care Activities Questionnaire", "Barriers in Diabetes Scale" and "Diabetes Self-Management Perception Scale (DÖYAS)". Results: : In the study, it was found that 51.3% of individuals with diabetes were women, 35.3% had a diagnosis period between 6 and 10 years, and 78.7% had a chronic disease other than diabetes. 52% of diabetics have retinopathy and 43.7% use insulin. Diabetics perform the most self-care activities on diet (x :3.61±0.72) and the least on exercise (x :2.3±1.4). It was determined that more than half of the individuals with diabetes (56.2%) perceived obstacles in the use of insulin, and approximately one third (36.7%) had compliance with diabetes treatment. Participants experience the most obstacles in self-monitoring (x : 0.68±0.88) and the least in their relationships with health professionals (x : 0.028±0.38). It was found that the Perception of Self- Management in Diabetes was at a moderate level (x : 21.8±2.97). Age, gender, marital status, duration of diagnosis, having another chronic disease, and experiencing complications were found to be associated with different sub-dimensions of perception of obstacles in life with diabetes (p<0.05). Among self-care activities, diet score is associated with perception of obstacles in medication use (r: -0.208) and lifestyle changes (r: -0.236), and exercise score is associated with perception of obstacles in lifestyle changes (r: -0.576). Frequency of checking blood sugar score is related to perception of obstacle in coping with diabetes (r: 0.141) (p<0.05). As the perception of obstacles in coping with diabetes increases, the perception of self-management increases at a weak level (r:0.019). No relationship was found between the perception of diabetes self-management and diabetes self-care activities and obstacles experienced in diabetes (p<0.001). Poor metabolic parameters cause the diabetic to perceive obstacles in making lifestyle changes and in areas related to medication use (p<0.005). Conclusion: For successful diabetes management, it is important to reduce the obstacles perceived by the diabetic and teach them to cope with the obstacles, to perform self-care activities, to strengthen their self-management and to improve their metabolic parameters. In this context, nurses working with diabetics should evaluate the obstacles experienced by diabetics and the impact of these obstacles on the self- care activities and self-management of diabetics and take this into account in their training. Future studies can be conducted comparatively between different diabetes groups and genders. There is a need for appropriate, easily accessible and sustainable program support from diabetes policy makers to increase the ability to combat obstacles in life with diabetes in order to improve self-care behaviors and self-efficacy. Key Words: Diabetes, perceived barriers to diabetes management, diabetes self-care behaviors, diabetes self-management