ONKOLOJİ ÇALIŞANLARINDA DOLAYLI TRAVMATİZASYON ÜZERİNE BİR GÖZDEN GEÇİRME

Onkolojik bakım alanında çalışan sağlık bakım profesyonelleri (hekimler, hemşireler, sosyal çalışmacılar, psikologlar vd.), kanser hastalarına ve ailelerine, kanserin yaşamsal tehdit yaratan yüklerini taşımalarında -farklı mesleki roller taşıyor olsalar da- destek olurlar. Kanser hastasıyla çalışmanın doğasında yüksek bir duygusal yoğunluk vardır. Bu yoğunluğu üzerinde taşıyan onkoloji profesyonelleri ise dolaylı travmatizasyon tehdidi altına girer. Birçok araştırma onkoloji profesyonellerinin işleriyle ilgili travmatik tepkiler verdiğini ortaya çıkartmıştır. Ne var ki, dolaylı travmatizasyonu niceliksel ölçme araçlarıyla saptamak güçtür. Ayrıca onkoloji alanının olumlu yönleri bu yaşantıyı gölgede bırakabilmektedir. Kişisel kazanımlar, ekip üyeleriyle duygusal yükü paylaşma, yaşamsal dersler öğrenme ve çalışanların işlerine yüksek değerler atfetmesi onkoloji alanının olumlu yönlerindendir. Bu makalede dolaylı travmatizasyonun nedenleri, çalışanlar üzerindeki potansiyel etkileri ve travmadan korunma yolları incelenmektedir.

A Review on Vicarious Traumatization of Oncology Professionals

Oncology health care professionals (physicians, nurses, social workers, psychologists etc.) play different but important roles in helping cancer patients and their families bear the life-threatening burdens of cancer. There is a high level of emotional intensity in the nature of working with cancer patient. This may put oncology professionals at risk for experiencing vicarious traumatization. Many research results indicate that most oncology professionals have traumatic responses related to their work. However, the vicarious traumatization is difficult to detect through quantitative measures. Besides, the positive aspects of oncology field overshadow this particular experience. Positive aspects of oncology field include personal rewards, sharing the emotional burden with team members, life lessons learned and value workers assigned to their work. This article examines the reasons of vicarious traumatization, its possible impacts on professionals and ways to be protected from trauma.

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  • Alter, C., Pelcovitz, D., Axelrod, A., Goldenberg, B., Harris, H., Meyers, B., et al. (1996). Identification of PTSD in cancer survivors. Psychosomatics, 37(2), 137.
  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders, 4th Edition (DSM-IV), Washington, DC: American Psychiatric Association.
  • Artinian, B. M. (1995). Risking involvement with cancer patients. Western Journal of Nursing Research, 17(3), 292-304. Blair, D. T., & Ramones, V. A. (1996). Understanding vicarious traumatization. Journal of Psychosocial Nursing and Mental Health Services, 34(11), 24-30.
  • Bride, B. E., Jones, J. L., & Macmaster, S. A. (2007). Correlates of secondary traumatic stress in child protective services workers. Journal of Evidence-Based Social Work, 4(3), 69-80.
  • Bush, N.J. (2009). Compassion fatigue: Are you at risk?, Oncology nursing forum, 36(1), 24-28.
  • Cornille, T. A., & Meyers, T. W. (1999). Secondary traumatic stress among child protective service workers. Traumatology, 5(1), 15-31.
  • Cunningham, M. (1996). Vicarious traumatization: Impact of trauma work on the clinician. Adelphi University.
  • Cunningham, M. (2003). Impact of trauma work on social work clinicians: Empirical findings. Social Work, 48(4), 451-459.
  • Dane, B., & Chachkes, E. (2001). The cost of caring for patients with an illness. Social Work in Health Care, 33(2), 31-51.
  • Dunkley, J., & Whelan, T. A. (2006). Vicarious traumatisation: Current status and future directions. British Journal of Guidance & Counselling, 34(1), 107-116.
  • Figley, C.R. (1999). Compassion fatigue: Toward a new understanding of the costs of caring. In B.H. Stamm (Ed.), Secondary traumatic stress: Self-care issues for clinicians, researchers and educators (2nd ed., pp. 3–29). Lutherville, MD: Sidran Press.
  • Graham J. & Ramirez A. (2002). Improving the working lives of cancer clinicians. European Journal of Cancer Care, 188–192.
  • Hermann, J., & Carter, J. (1994). The dimensions of oncology social work: Intrapsychic, interpersonal and environmental interventions, Seminars in Oncology, 21(6), 712-717.
  • Hiradfar, A., Esfandiari, N., Pedram, M. (2010). Prevalence of secondary traumatic stress in oncology staff from a referral cancer center of Iran. Iranian Journal of Pediatric Hematology. 1 (Supplement 1):16.
  • Işıkhan, V. (2006). Onkoloji alaninda bakım verenlerin tükenmişliği, Toplum ve Sosyal Hizmet, 17(2), 7-24.
  • Işıkhan, V., Comez, T., & Danis, M. (2004). Job stress and coping strategies in health care professionals working with cancer patients. European Journal of Oncology Nursing, 8(3), 234-244.
  • Jenkins, S. R., & Baird, S. (2002). Secondary traumatic stress and vicarious trauma: A validational study. Journal of traumatic stress, 15(5), 423-432.
  • Kadambi, M. A., & Truscott, D. (2007). Vicarious trauma among therapists working with sexual violence, cancer and general practice. Canadian Journal of Counselling/Revue Canadienne de Counseling, 38(4). 260-276.
  • Kangas, M., Jane, L., Richard H., Bryant, A. (2002). Posttraumatic stress disorder following cancer: A conceptual and empirical review. Clinical Psychology Review, 22: 499–524.
  • Katz, R.S. and Genevay, B. (2002). Our patients, our families, ourselves: the impact of the professional’s emotional responses on end-oflife care. American Behavioral Scientist 46: 327.
  • Little, S. (2002). Vicarious traumatisation. Emergency nurse: The journal of the RCN Accident and Emergency Nursing Association, 10(6), 27. Maslach, C. (1982). Burnout: The cost of caring. New Jersey, Prentice Hall. içinde Işıkhan, V. (2006).
  • McCann, I. L., & Pearlman, L. A. (1990). Vicarious traumatization: A framework for understanding the psychological effects of working with victims. Journal of traumatic stress, 3(1), 131-149.
  • Mishne, J. (1998). Unanticipated fatal illness: Stimulus for intense transference and countertransference phenomena. Journal of Analytic Social Work, 5, 41-62.
  • Neumann, D. A., & Gamble, S. J. (1995). Issues in the professional development of psychotherapists: Countertransference and vicarious traumatization in the new trauma therapist. Psychotherapy: Theory, research, practice, training, 32(2), 341.
  • O’Connor, M. F. (2001). On the etiology and effective management of professional distress and impairment among psychologists. Professional Psychology: Research and Practice, 32(4), 345.
  • Pearlman, L. A., & Mac Ian, P. S. (1995). Vicarious traumatization: An empirical study of the effects of trauma work on trauma therapists. Professional Psychology: Research and Practice, 26(6), 558-565.
  • Pearlman, L. A., & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors: WW Norton & Co.
  • Penson, R. T., Dignan, F. L., Canellos, G. P., Picard, C. L., & Lynch Jr, T. J. (2000). Burnout: caring for the caregivers. The Oncologist, 5(5), 425-434.
  • Posluszny, D. M., Edwards, R. P., Dew, M. A., & Baum, A. (2011). Perceived threat and PTSD symptoms in women undergoing surgery for gynecologic cancer or benign conditions. Psycho‐Oncology, 20(7), 783-787.
  • Preyde, M., & Synnott, E. (2009). Psychosocial intervention for adults with cancer: A metaanalysis. Journal of Evidence-Based Social Work, 6(4), 321-347. Quinal, L, Harford, S., Rutledge, D. (2009). Secondary traumatic stress in oncology staff. Cancer Nursing, 32: E1-E7.
  • Rodrigues, A. B., & Chaves, E. C. (2008). Stressing factors and coping strategies used by oncology nurses. Revista latino-americana de enfermagem, 16(1), 24-28.
  • Rohan, E., & Bausch, J. (2009). Climbing everest: Oncology work as an expedition in caring. Journal of Psychosocial Oncology, 27(1), 84-118.
  • Sabin-Farrell, R., & Turpin, G. (2003). Vicarious traumatization: Implications for the mental health of health workers? Clinical Psychology Review, 23(3), 449-480.
  • Sabo, B. M. (2008). Adverse psychosocial consequences: compassion fatigue, burnout and vicarious traumatization: are nurses who provide palliative and hematological cancer care vulnerable? Indian Journal of Palliative Care, 14(1), 23.
  • Schauben, L. J., & Frazier, P. A. (1995). Vicarious trauma the effects on female counselors of working with sexual violence survivors. Psychology of Women Quarterly, 19(1), 49-64.
  • Schou, K.C. (1993). Awareness contexts and the construction of dying in the cancer treatment setting: ‘Micro’ and ‘Macro’ levels in narrative analysis. In D. Clark (Ed.), The Sociology of Death: Theory, Culture, Practice (pp. 238-263), Cambridge: Blackwell Publishers.
  • Sexton, L. (1999). Vicarious traumatisation of counsellors and effects on their workplaces. British Journal of Guidance and Counselling, 27(3), 393-403.
  • Sinclair, H. A. H., & Hamill, C. (2007). Does vicarious traumatisation affect oncology nurses? A literature review. European Journal of Oncology Nursing, 11(4), 348-356. Smith, MY, Redd WH, Peyser, C, Vogl D (1999) Post-traumatic stress disorder in cancer: A review. Psychooncology; 8: 521-537.
  • Stamm, B. H. (1997). Work-related secondary traumatic stress. PTSD Research Quarterly, 8(2), 1-8.
  • Stamm, B.H. (1999). Secondary traumatic stress: Self-care issues for clinicians, researchers and educators (2nd ed.). Lutherville, MD: Sidran Press.
  • Staples, J.K., Wilson, A.T., Pierce, B. and Gordon, J.S. (2007). Effectiveness of CancerGuides®: A study of an integrative cancer care training program for health professionals. Integr Cancer Ther, 6: 14.
  • Stearns, N. (2001). Professional issues in oncology social work. İçinde M. Lauria, P.J., Clarke, J., Hermann ve N. Stearns (Ed.), Social Work in Oncology: Supporting Survivors, Families, and Caregivers (pp. 213-232). Atlanta, GA: American Cancer Society. Tokgöz, G., Yaluğ, İ., Özdemir, S., Yazıcı, A., Uygun, K. ve Aker, T. (2008). Kanserli hastalarda travma sonrası stres bozukluğunun yaygınlığı ve ruhsal gelişim, New/Yeni Symposium Journal, 46(2), 51-61.
  • Tuncay, T. ve İl, S. (2009). Sosyal hizmet uygulamasında empatiyi yeniden düşünmek, Toplum ve Sosyal Hizmet, 20(2), 39-56.
  • Weinberg, H., Nuttman-Shwartz, O. and Gilmore, M. (2005). Trauma groups: An overview. Group Analysis, 2005 38: 187.
Toplum ve Sosyal Hizmet-Cover
  • ISSN: 2147-3374
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2000
  • Yayıncı: Hacettepe Üniversitesi İktisadi ve İdari Bilimler Fakültesi