Palyatif Bakımda Yaşlı Hasta ve Ailesine Verilen Psikososyal Desteğin Etkisi

Year 2022, Volume: 15 Issue: 1, 27 - 36, 29.06.2022

Abdullah Sarman , Hasan Köse , Emine Sarman

https://doi.org/10.46414/yasad.1061036

Abstract

Yaşamı tehdit eden ve uzun süreli bakım gerektiren hastalıklar hasta ve ailesini birçok yönden etkilemektedir. Bu hastalıklar nedeniyle tedavi gören kişilere multidisipliner bir bakım uygulanmaktadır. Bu bakım sayesinde yaşam kalitesini arttıran, ağrı gibi fiziksel, psikososyal ve ruhsal sorunların önlenmesini sağlayan, iyi bir planlama ile yaşanan acının önlenmesi ve hafifletilmesi hedeflenmektedir. Çok yönlü bir değerlendirme sürecini öngören, hayatın olağan akışında hastanın rutinlerini sürdürmeye odaklanan ve ölümü normal sürecin bir parçası olarak gören bu bakım anlayışı palyatif bakım olarak isimlendirilmektedir. Bu makalede palyatif bakımda psikososyal yönden destekleyici hemşirelik girişimlerini, bunların bileşenleri ve bu müdahalelerin etkileri hakkında bilgi vermek amaçlanmaktadır. Ölümcül hastalık ve bu hastalığın beraberinde getirdiği olumsuz süreçlerle mücadele etmek zorunda olan hasta ve ailelerinin yaşamlarının son dönemlerinde alışkın oldukları ortamlarda almak istedikleri bakımın, bu dönemi huzur içerisinde geçirmelerine yardımcı olabildiği, fiziksel ve psikolojik sağlığa yönelik tehlikelere karşı bireyi koruduğu, yaşam kalitesini yükselttiği, iyileşme sürecini ve travma sonrası stres bozukluğu gibi olumsuz duyguların önüne geçmeyi kolaylaştırdığı belirlenmiştir. Bu alanda yapılacak araştırma sayısının arttırılmasının bakım kalitesinin yükseltilmesi ve hastaların memnuniyet düzeylerinin artmasına katkı sağlayacağı düşünülmektedir.

Keywords

Hemşirelik, Palyatif bakım, Psikolojik destek, Psikososyal destek, Sosyal destek, Yaşlı

Supporting Institution

Yok.

Project Number

Yok.

Thanks

Yok.

The Effect of Psychosocial Support Given to Older Adults Patient and Their Families in Palliative Care

Abstract

Diseases that are life-threatening and require long-term treatment affect the patient and his family in many ways. Interdisciplinary care is applied to people who are being treated for these diseases. This care aims to prevent and alleviate the pain experienced with a good planning, which provides the prevention of physical, psychosocial and mental problems such as pain that increases the quality of life. This understanding of care, which provides for a multi-dimensional assessment process, focuses on maintaining the patient's routine in the normal course of life and considers death as part of the normal process, is called palliative care. This article aimed at conducting a systematic review to identify the components of palliative care and the effects of psychosocial nursing interventions on palliative care patients and their families. The care that patients and their families want to receive in the conditions to which they are accustomed in the last period of their lives, who have to fight a deadly disease and the negative processes that it brings, can help them calmly go through this period, protect a person from dangers for the physical and psychological health, improve quality of life, improve the healing process. It has been found to help prevent negative emotions such as posttraumatic stress disorder and post-traumatic stress disorder. It is believed that increasing the number of research in this area will improve the quality of care and improve patient satisfaction.

Keywords

Nursing, older adults, palliative care, psychological support, psychosocial support, social support

Project Number

Yok.

References

• Baider, L., Peretz, T., Hadani, P. E., & Koch, U. (2001). Psychological intervention in cancer patients: A randomized study. General Hospital Psychiatry, 23(5), 272–277. doi: 10.1016/S0163-8343(01)00158-X.
• Becqué, Y. N., Rietjens, J., van Driel, A. G., van der Heide, A., & Witkamp, E. (2019). Nursing interventions to support family caregivers in end-of-life care at home: A systematic narrative review. International Journal of Nursing Studies, 97, 28–39. doi: 10.1016/j.ijnurstu.2019.04.011.
• Bell, S. P., Orr, N. M., Dodson, J. A., Rich, M. W., Wenger, N. K., Blum, K., Harold, J. G., Tinetti, M. E., Maurer, M. S., & Forman, D. E. (2015). What to expect from the evolving field of geriatric cardiology. Journal of the American College of Cardiologyl, 66(11), 1286–1299. doi: 10.1016/j.jacc.2015.07.048.
• Bernad, D., Zysnarska, M., & Adamek, R. (2010). Social support for cancer-Selected problems. Reports of Practical Oncology and Radiotherapy, 15(2), 47–50. doi: 10.1016/j.rpor.2010.02.002.
• Bloomer, M. J., Botti, M., Runacres, F., Poon, P., Barnfield, J., & Hutchinson, A. M. (2019). End-of-life care for older people in subacute care: A retrospective clinical audit. Collegian, 26(1), 22–27. doi: 10.1016/j.colegn.2018.02.005.
• Bridge, D. T. (2008). Curing diseases and healing suffering: Inspiration from developments in palliative medicine. International Journal of Gerontology, 2(2), 29–32. doi: 10.1016/S1873-9598(08)70007-3.
• Chan, C.-K., Wong, S. S.-H., Ho, E. T.-L., Cheng, Y.-Y., Lam, W.-O., Tang, A. W.-C., & Ho, Y.-W. (2010). Supportive management in patients with end-stage renal disease: Local experience in Hong Kong. Hong Kong Journal of Nephrology, 12(1), 31–36. doi: 10.1016/S1561-5413(10)60006-3.
• Chow, K., & Dahlin, C. (2018). Integration of palliative care and oncology nursing. Seminars in Oncology Nursing, 34(3), 192–201. doi: 10.1016/j.soncn.2018.06.001.
• Delisle, M. E., Ward, M., Helewa, R. M., Hochman, D., Park, J., & McKay, A. (2019). Timing of palliative care in colorectal cancer patients: Does it matter? Journal of Surgical Research, 241, 285–293. doi: 10.1016/j.jss.2019.04.009.
• Ellis, E. M., Barnato, A. E., Chapman, G. B., Dionne-Odom, J. N., Lerner, J. S., Peters, E., Nelson, W. L., Padgett, L., Suls, J., & Ferrer, R. A. (2019). Toward a conceptual model of affective predictions in palliative care. Journal of Pain and Symptom Management, 57(6), 1151–1165. doi: 10.1016/j.jpainsymman.2019.02.008.
• Evans, J. M., Mackinnon, M., Pereira, J., Earle, C. C., Gagnon, B., Arthurs, E., Gradin, S., Buchman, S., & Wright, F. C. (2019). Integrating early palliative care into routine practice for patients with cancer: A mixed methods evaluation of the integrate project. Psychooncology, 28, 1261–1268. doi: 10.1002/pon.5076.
• Gale, M., Kawai, F., Pan, C., Morris, J., & Gasperino, J. (2016). Withdrawal of mechanical ventilation: A systematic review and approach following two unusual cases. Chest, 150(4, Supplement), 945A. doi: 10.1016/j.chest.2016.08.1047.
• Garcia, J. B. S., Rodrigues, R. F., & Lima, S. F. (2014). A estruturação de um serviço de cuidados paliativos no Brasil: Relato de experiência. Revista Brasileira de Anestesiologia, 64(4), 286–291. doi: 10.1016/j.bjan.2013.06.007.
• Gottlieb, B. H., & Bergen, A. E. (2010). Social support concepts and measures. Journal of Psychosomatic Research, 69(5), 511–520. doi: 10.1016/j.jpsychores.2009.10.001.
• Grande, G., Stajduhar, K., Aoun, S., Toye, C., Funk, L., Addington-Hall, J., Payne, S., & Todd, C. (2009). Supporting lay carers in end of life care: Current gaps and future priorities. Palliative Medicine, 23(4), 339–344. doi: 10.1177/0269216309104875.
• Hegarty, M., & Currow, D. C. (2007). Palliative aged care: Collaborative partnerships between gerontology, geriatrics and palliative care. International Journal of Gerontology, 1(3), 112–117. doi: 10.1016/S1873-9598(08)70031-0.
• Higginson, I. J., Gomes, B., Calanzani, N., Gao, W., Bausewein, C., Daveson, B. A., Deliens, L., Ferreira, P. L., Toscani, F., Gysels, M., Ceulemans, L., Simon, S. T., Cohen, J., Harding, R., & Project PRISMA. (2014). Priorities for treatment, care and information if faced with serious illness: A comparative population-based survey in seven European countries. Palliative Medicine, 28(2), 101–110. doi: 10.1177/0269216313488989.
• Hombrados-Mendieta, I., García-Martín, M. A., & Gómez-Jacinto, L. (2013). The relationship between social support, loneliness, and subjective well-being in a Spanish sample from a multidimensional perspective. Social Indicators Research, 114(3), 1013–1034. doi: 10.1007/s11205-012-0187-5.
• Karabulut, N., & Çetinkaya, F. (2011). The impact on the level of anxiety and pain of the training before operation given to adult patients. Surgical Science, 2(6), 303–311. doi: 10.4236/ss.2011.
• Kavalieratos, D., Gelfman, L. P., Tycon, L. E., Riegel, B., Bekelman, D. B., Ikejiani, D. Z., Goldstein, N., Kimmel, S. E., Bakitas, M. A., & Arnold, R. M. (2017). Palliative care in heart failure: Rationale, evidence, and future priorities. Journal of the American College of Cardiology, 70(15), 1919–1930. doi: 10.1016/j.jacc.2017.08.036.
• Kurucová, R., Žiaková, K., Gurková, E., & Šrámeková, G. (2018). Annoying symptoms and social support in patients with cancer. Kontakt, 20(3), e273–e277. doi: 10.1016/j.kontakt.2018.08.002.
• Lee, A., Khulusi, S., & Watson, R. (2019). Gastroesophageal cancer patients need earlier palliative intervention-using data to inform appropriate care. European Journal of Oncology Nursing, 40, 126–130. doi: 10.1016/j.ejon.2019.04.004.
• Li, L., Li, S., Wang, Y., Yi, J., Yang, Y., He, J., & Zhu, X. (2017). Coping profiles differentiate psychological adjustment in Chinese women newly diagnosed with breast cancer. Integrative Cancer Therapies, 16(2), 196–204. doi: 10.1177/1534735416646854.
• Li, M., Tse, L. A., Chan, W. C., Kwok, C. H., Leung, S. L., Wu, C., Yu, W. C., Yu, I. T., Yu, C. H., Wang, F., Sung, H., & Yang, X. R. (2016). Evaluation of breast cancer risk associated with tea consumption by menopausal and estrogen receptor status among Chinese women in Hong Kong. Cancer Epidemiology, 40, 73–78. doi: 10.1016/j.canep.2015.11.013.
• Lund, L., Ross, L., Petersen, M. A., & Groenvold, M. (2014). Cancer caregiving tasks and consequences and their associations with caregiver status and the caregiver’s relationship to the patient: A survey. BMC Cancer, 14(1), 1–13. doi: 10.1186/1471-2407-14-541.
• Liu, L., Yang, Y. L., Wang, Z. Y., Wu, H., Wang, Y., & Wang, L. (2015). Prevalence and positive correlates of posttraumatic stress disorder symptoms among Chinese patients with hematological malignancies: A cross-sectional study. PLOS ONE, 10(12), e0145103. doi: 10.1371/journal.pone.0145103.
• Luttik, M. L., Jaarsma, T., Moser, D., Sanderman, R., & van Veldhuisen, D. J. (2005). The importance and impact of social support on outcomes in patients with heart failure. Journal of Cardiovascular Nursing, 20(3), 162–169. doi: 10.1097/00005082-200505000-00007.
• Munoz-Mendoza, J. (2015). Competencies in palliative care for cardiology fellows. Journal of the American College of Cardiology, 65(7), 750–753. doi: 10.1016/j.jacc.2014.12.030.
• Mejia, P. C. G., Feliciano, E. E., Hussien, M. K., Boshra, A. Y., Feliciano, A. Z., Malabanan, M. C., Alsharyah, H., Osman, A., Abdalla, Y., Arambulo, D. D., Gonzales, F. M., & Yngente, A. K. N. (2019). Synopsis of critically appraised literature on palliative nursing care. International Journal of Africa Nursing Sciences, 100152. doi: 10.1016/j.ijans.2019.100152.
• Northouse, L. L., Katapodi, M. C., Song, L., Zhang, L., & Mood, D. W. (2010). Interventions with family caregivers of cancer patients: Meta-analysis of randomized trials. CA: A Cancer Journal for Clinicians, 60(5), 317–339.doi: 10.3322/caac.20081.
• Özbayır, T., Demir, F., Candan, Y., Coşkun, İ., & Dramalı, A. (2003). Hastaların perioperatif döneme ilişkin izlenimlerinin incelenmesi. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 6(1), 14–23.
• Perrar, K. M., Schmidt, H., Eisenmann, Y., Cremer, B., & Voltz, R.. (2015). Needs of people with severe dementia at the end-of-life: A systematic review. Journal of Alzheimer's Disease, 43(2), 397–413. doi: 10.3233/JAD-140435.
• Pivodic, L., Pardon, K., Morin, L., Addington-Hall, J., Miccinesi, G., Cardenas-Turanzas, M., Onwuteaka-Philipsen, B., Naylor, W., Ruiz Ramos, M., Van den Block, L., Wilson, D. M., Loucka, M., Csikos, A., Rhee, Y. J., Teno, J., Deliens, L., Houttekier, D., Cohen, J., & EURO IMPACT. (2016). Place of death in the population dying from diseases indicative of palliative care need: A cross-national population-level study in 14 countries. Journal of Epidemiology and Community Health, 70(1), 17–24. doi: 10.1136/jech-2014-205365.
• Rızalar, S., Ozbas, A., Akyolcu, N., & Gungor, B. (2014). Effect of perceived social support on psychosocial adjustment of Turkish patients with breast cancer. Asian Pacific Journal of Cancer Prevention, 15(8), 3429–3434. doi: 10.7314/apjcp.2014.15.8.3429.
• Rowland, C., Hanratty, B., Pilling, M., van den Berg, B., & Grande, G. (2017). The contributions of family care-givers at end of life: A national post-bereavement census survey of cancer carers’ hours of care and expenditures. Palliative Medicine, 31(4), 346–355. doi: 10.1177/0269216317690479.
• Saunders, S., Killackey, T., Kurahashi, A., Walsh, C., Wentlandt, K., Lovrics, E., Scott, M., Mahtani, R., Bernstein, M., Howard, M., Tanuseputro, P., Goldman, R., Zimmermann, C., Aslakson, R. A., Isenberg, S. R., & American Academy of Hospice and Palliative Medicine Research Committee Writing Group. (2019). Palliative care transitions from acute care to community-based care-a systematic review. Journal of Pain and Symptom Management, 58(4), 721–734.e1. doi: 10.1016/j.jpainsymman.2019.06.005.
• Shoemaker, L. K., Estfan, B., Induru, R., & Walsh, T. D. (2011). Symptom management: An important part of cancer care. Cleveland Clinic Journal of Medicine, 78(1), 25–34. doi: 10.3949/ccjm.78a.10053.
• Sidebottom, A. C., Jorgenson, A., Richards, H., Kirven, J., & Sillah, A. (2015). Inpatient palliative care for patients with acute heart failure: Outcomes from a randomized trial. Journal of Palliative Medicine, 18(2), 134–142. doi: 10.1089/jpm.2014.0192.
• Smith, S., Brick, A., O'Hara, S., & Normand, C. (2014). Evidence on the cost and cost-effectiveness of palliative care: A literature review. Palliative Medicine, 28(2), 130–150. doi: 10.1177/0269216313493466.
• Super, A. (2001). The context of palliative care in progressive illness. In B. Ferrel & N. Coyle (Eds.), In Textbook of Palliative Nursing. Oxford University Press.
• Terzi, Ş. (2008). Üniversite öğrencilerinin psikolojik dayanıklılıkları ve algıladıkları sosyal destek arasındaki ilişki. Türk Psikolojik Danışma ve Rehberlik Dergisi, 3(29), 1–11.
• Vaughn, F., Wichowski, H., & Bosworth, G. (2007). Does preoperative anxiety level predict postoperative pain? AORN Journal, 85(3), 589–604. doi: 10.1016/S0001-2092(07)60130-6.
• Velligan, D. I., Weiden, P. J., Sajatovic, M., Scott, J., Carpenter, D., Ross, R., & Docherty, J. P. (2010). Strategies for addressing adherence problems in patients with serious and persistent mental illness: Recommendations from the expert consensus guidelines. Journal of Psychiatric Practice, 16(5), 306–324.doi: 10.1097/01.pra.0000388626.98662.a0.
• Yang, Y. L., Liu, L., Li, M. Y., Shi, M., & Wang, L. (2016). Psychological disorders and psychosocial resources of patients with newly diagnosed bladder and kidney cancer: A cross-sectional study. PLOS ONE, 11(5), 1–18. doi: 10.1371/journal.pone.0155607.
• Yang, Y. L., Liu, L., Wang, X. X., Wang, Y., & Wang, L. (2014). Prevalence and associated positive psychological variables of depression and anxiety among Chinese cervical cancer patients: A cross-sectional study. PLoS ONE, 9(4), e94804. doi: 10.1371/journal.pone.0094804.
• Yang, Y., Sun, G., Dong, X., Zhang, H., Xing, C., & Liu, Y. (2019). Preoperative anxiety in Chinese colorectal cancer patients: The role of social support, self-esteem and coping styles. Journal of Psychosomatic Research, 121, 81–87. doi: 10.1016/j.jpsychores.2019.02.009.