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Genel Popülasyonda Su Dengesġ Ölçeğġ'nġn

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Genel Popülasyonda Su Dengesġ Ölçeğġ'nġn TÜRKĠYE CUMHURĠYETĠ MARMARA ÜNĠVERSĠTESĠ SAĞLIK BĠLĠMLERĠ ENSTĠTÜSÜ GENEL POPÜLASYONDA SU DENGESĠ ÖLÇEĞĠ’NĠN TÜRKÇE’YE UYARLANMASI GEÇERLĠK VE GÜVENĠRLĠK ÇALIġMASI NĠLÜFER ġEN YÜKSEK LĠSANS TEZĠ BESLENME VE DĠYETETĠK ANABĠLĠM DALI DANIġMAN Dr. Öğr. Üyesi ġULE AKTAÇ 2020-ĠSTANBUL TEZ ONAYI BEYAN Bu tez çalıĢmasının kendi çalıĢmam olduğunu, tezin planlanmasından yazımına kadar bütün safhalarda etik dıĢı davranıĢımın olmadığını, bu tezdeki bütün bilgileri akademik ve etik kurallar içinde elde ettiğimi, bu tez çalıĢması ile elde edilmemiĢ bütün bilgi ve yorumlara kaynak gösterdiğimi ve bu kaynakları da kaynaklar listesine aldığımı, yine bu tezin çalıĢılması ve yazımı sırasında patent ve telif haklarını ihlal edici bir davranıĢımın olmadığı beyan ederim. Nilüfer ġEN Ġmza ii TEġEKKÜR Tez danıĢmanlığımı üstlenen, çalıĢma boyunca değerli bilgisi ve tecrübesi ile beni yönlendiren, her durumda sabır ve hoĢgörü gösteren hocam Sayın Dr. Öğr. Üyesi ġule AKTAÇ‘a; Beslenme ve Diyetetik Anabilim Dalı baĢkanı Sayın Doç. Dr. F. Esra GÜNEġ‘e, Her zaman yanımda olan ailem, dostlarım ve en büyük destekçim anneme sonsuz teĢekkürlerimi sunarım. iii ĠÇĠNDEKĠLER TEZ ONAYI ................................................................................................................ i BEYAN ........................................................................................................................ ii TEġEKKÜR .............................................................................................................. iii ĠÇĠNDEKĠLER ......................................................................................................... iv TABLOLAR ............................................................................................................. vii ġEKĠLLER .............................................................................................................. viii KISALTMALAR ve SĠMGELER LĠSTESĠ ........................................................... ix ÖZET ........................................................................................................................... 1 SUMMARY ................................................................................................................ 2 1. GĠRĠġ ve AMAÇ .................................................................................................... 3 2. GENEL BĠLGĠLER ............................................................................................... 6 2.1. Vücudun Hayati BileĢeni Su ............................................................................ 6 2.2. Vücut Su Kompozisyonu .................................................................................. 6 2.3. Vücut Su Dengesi ............................................................................................. 9 2.3.1. Vücuda su alımı .................................................................................... 10 2.3.2. Vücuttan su kaybı ................................................................................. 10 2.3.3. Vücut su dengesinin düzenlenmesi ...................................................... 11 2.4. Su Dengesinin Fizyopatolojisi ........................................................................ 12 2.5. Hidrasyon Değerlendirme Teknikleri ............................................................. 13 2.5.1. Dilisyon tekniği .................................................................................... 14 2.5.2. Biyoelektrik impedans analizi .............................................................. 14 2.5.3. Plazma ve serum osmolalitesi .............................................................. 14 2.5.4. Vücut kütle farkı ................................................................................... 15 2.5.5. Ġdrar özgül ağırlığı ................................................................................ 15 2.5.6. Ġdrar osmolalitesi .................................................................................. 16 2.5.7. Ġdrar rengi ............................................................................................. 16 2.5.8. Arginin vazopressin konsantrasyonu .................................................... 16 iv 2.6. Vücut Su Gereksinimi ve Alım Önerileri ....................................................... 16 2.7. Genel Popülasyonda Sıvı Tüketimi ve Tercihleri .......................................... 18 2.8. Hidrasyon ve Sağlık ĠliĢkisi ........................................................................... 18 2.8.1. ġiĢmanlık ve hidrasyon ......................................................................... 19 2.8.2. Kalp-damar hastalıkları ve hidrasyon ................................................... 20 2.8.3. Ġskemik inme hastalığı ve hidrasyon .................................................... 20 2.8.4. Kanser ve hidrasyon ............................................................................. 20 2.8.5. Böbrek hastalıkları ve hidrasyon .......................................................... 21 2.8.6. BaĢ ağrısı ve hidrasyon ......................................................................... 21 2.8.7. Kabızlık ve hidrasyon ........................................................................... 22 2.8.8. BiliĢsel performans ve hidrasyon ......................................................... 22 2.9. Dehidratasyon Açısından Risk Altındaki Gruplar .......................................... 23 2.9.1. Yenidoğanlar ........................................................................................ 23 2.9.2. YaĢlılar ................................................................................................. 24 2.9.3. Kanser hastaları .................................................................................... 24 3. GEREÇ ve YÖNTEM .......................................................................................... 25 3.1. AraĢtırmanın Türü .......................................................................................... 25 3.2. AraĢtırmanın Yeri, Zamanı, Evreni ve Örneklem Seçimi .............................. 25 3.3. Veri Toplama Araçları .................................................................................... 26 3.3.1. Türk toplumuna uyarlanmıĢ Su Dengesi Ölçeği .................................. 26 3.3.2. Ġdrar hidrasyon belirteçleri idrar özgül ağırlığı ve idrar pH‘ı ............... 27 3.3.3. Yirmi dört saatlik geriye dönük besin tüketim kaydı formu ................ 28 3.3.4. Antropometrik ölçümler ....................................................................... 28 3.4. AraĢtırma Verilerinin Toplanması .................................................................. 29 3.5. Su Dengesi Ölçeğinin Türk Toplumuna Uyarlanması, Geçerlik ve Güvenirlik ÇalıĢması ............................................................................................................... 29 3.5.1. Su Dengesi Ölçeği‘nin dil eĢdeğerliliğinin sağlanması ........................ 30 3.5.2. Uzman görüĢlerinin alınması ................................................................ 31 3.5.3. Ön uygulamanın yapılması ................................................................... 31 3.5.4. Su Dengesi Ölçeği‘nin geçerliği ve güvenirliğinin değerlendirilmesi . 31 3.6. Verilerin Ġstatistiksel Değerlendirilmesi ........................................................ 32 4. BULGULAR ......................................................................................................... 34 4.1. Örneklemi Tanıtıcı Bulgular .......................................................................... 34 v 4.2. Ġdrar Biyobelirteçlerine ĠliĢkin Bulgular ........................................................ 36 4.3. Türk Toplumuna UyarlanmıĢ Su Dengesi Ölçeği‘nin Geçerliğine ĠliĢkin Bulgular ................................................................................................................. 36 4.4. Türk Toplumuna UyarlanmıĢ Su Dengesi Ölçeği‘nin Güvenirliğine ĠliĢkin Bulgular ................................................................................................................. 38 4.5. Popülasyonun Sıvı Alımı, Tercihleri, Su dengesi ve Bazı DeğiĢkenler Açısından Ġncelenmesi .......................................................................................... 42 5. TARTIġMA ve SONUÇ ...................................................................................... 49 5.1. Türk Toplumuna UyarlanmıĢ Su Dengesi Ölçeği‘nin Geçerlik ve Güvenirlik Analizlerinin Değerlendirilmesi ............................................................................ 49 5.2. Popülasyonun Su Alımı, Ġçecek Tercihleri, Su dengesi ve Bazı DeğiĢkenler Açısından Değerlendirilmesi ................................................................................. 51 5.3. ÇalıĢmanın Sınırlılıkları ve Güçlü Yönleri .................................................... 58 5.4. Sonuç .............................................................................................................. 58 5.5. Öneriler ........................................................................................................... 60 6. KAYNAKLAR ..................................................................................................... 61 EKLER ...................................................................................................................... 73 ÖZGEÇMĠġ .............................................................................................................. 86 vi TABLOLAR Tablo 1. Vücut dokularında
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