Introduction: According to the World Health Organization, chronic diseases are defined as slow progressing, incurable by medical interventions, long-term, require periodic follow-ups and support care in order to reduce the severity of the disease andenhanceoneʼs physical functions and autonomyfortheir care management. Chronic diseases cause major changes andchallenges in patientsʼ daily life as a result ofcontinuousobservations, long-term follow-ups and care requirements, irreversible pathologies, persistent inadequacies or limitations of movement.In addition, chronically ill individuals become a financial burden to their family and society. For this reason, it is of utmost importance that chronic disease management is strengthened not only for the treatment of the disease but also for patients gaining self-management skills.

Objective: This study was conducted to evaluate the perception ofpatients with chronic diseases regarding the treatment and care services they receivedand to identify the factors that impeded this careprocess.

Methods: The sample of the study consisted of 191 volunteers with chronic illnesses who were treated in public and private hospitals in February, March and April 2017. “The Patient Assessment of Chronic Illness Care -Patient Form” and “Patient Information Form” were filled with face-to-face interview method. The data were evaluated by Cronbach alpha, mean, percent and Pearson correlation analyzes using the SPSS 24 packet program.

Results: In the study, the mean age of the sample group was 66.02 ± 15.57 (min: 21, max: 95 years), 52.4% were male, 47.6% were female, 74.9% were married, 43.5% were primary school graduates, 47.1% received care support and 99% had health insurance. 49.7% of the participants had diabetes mellitus, 17.8% had hypertension and 12% had heart disease. The examination in this study revealed that the 3 most common problems in continuity of treatment and care for chronic diseases; 36.6% were unable to manage the sypmtoms and complications, 12% were regular follow-up incompetencies and lack of self-care, and 10.5% were the stress of living with thediseases for life. The participants were asked what would reduce the burden of their treatment and care, 36.1% of the responses were reduced complications, 20.9% full recovery from the illness and 11.5% adequate information and education. The Patient Assessment of Chronic Illness Care scale, subscale means weredetermined as following: Patient Participation (Items 1-3) 3.89 ± 1.23, Decision Making (Items 4-6) 3.86 ± 1.03, Objective Determination (Items 7-11) 3.54 ± 1.31, Problem Solving (Items 12-15) 3.80 ± 1.14, Monitoring / Coordination (Items 16-20) 3.40 ± 1.23. The overall scale mean was (1-20 items) 3.65 ± 1.44. Cronbach alpha of the scale was analysed which was .93. The determination of higher subscale scores in patient participation, decision making and problem solving reflects that the participants were more satisfiedin chronic disease care.

Conclusion: In recent years,the increasing prevalence of chronic diseases has revealed the importance of chronic disease management which requires planning of treatment and follow-up, improvement of care results and quality, and patient satisfaction. The services provided to individuals with chronic illnesses should be assessed regularlyso that the quality is maintained and improved. When the health care services provided to participants were evaluatedin the survey, it was observed that the results were above the average scale score. Non the less, it was also appeared that individuals with chronic disease should be strengthened byeducating them regularly for management of regular follow-upsandcomplications.

Keywords: Chronic Care, Health Management, Self Care, Nursing

Biogrpahy:
Hediye Arslan Özkan is a professor in the Yeditepe University, Turkey. She has copleted her PhD at İstanbul Üniversitesi in 1985.