Taburculuk sonrası tedaviye gelmeyen psikotik hastaların özellikleri

Amaç: Bu çalışmada şizofreni ve benzeri psikotik bozukluklarda hastaların ayaktan izleme gelmeme nedenlerini saptamayı amaçladık. Yöntem: 1998-2004 yılları arasında kliniğimizde yatarak tedavi gören psikotik hastalardan, taburculuktan sonra kontrol muayenelerine gelmeyenlerin sosyodemografik özellikleri, hastalıkla ilgili değişkenleri, kliniğimize gelmeme nedenleri, dosya tarama ve telefon anketi aracılığı ile saptanmaya çalışıldı. Bulgular: Taburcu olduktan sonra tedavilerini ayaktan sürdürmek üzere kliniğimize başvurmadığını saptadığımız 118 hastadan 75'ine ulaşıldı. Ulaşılan hastaların yaş ortalaması 34.89±10.08 (ortanca=34, min-maks=17-76 yaş) idi. Yetmiş biri (%62.8) erkek, 42'si (%37.2) kadındı. Hasta grubumuzun büyük bir bölümü şizofreni tanısı alanlardan oluşmaktaydı (%72.6). Kronik süreç izleyen, bu nedenle uzun süre tedavi görmeleri gereken şizofreni ve sanrısal bozukluk hastalarının tedavi için kliniğimize gelmeme nedenleri arasında sevk alamama, ulaşım güçlüğü, hastanın köyde yaşıyor olması, hastaneye getirecek aile üyesinin olmaması, hastanın aileye sorun çıkarmaması gibi çevresel sorunlar bulunmaktaydı. Düzensiz ilaç kullanan ya da kullanmayanların ilaç kullanmama nedenleri büyük oranda ilacın yararına inanmama ve ilaç yan etkileriydi. Hastaların hastalıkları hakkında yeterince bilgi sahibi olmamaları da tedavi ekibinin tutumuna ilişkin bir olumsuz etkendi. Tartışma: Kronik psikoz hastalarının taburculuk sonrası tedaviyi düzenli sürdürmeleri, hastalığın seyri açısından önem taşımaktadır. Ayaktan tedaviyi sürdürmeye eıjgel olan birçok etken, düzeltilebilir etkenlerdendir. Sonuç: Klinikler ve sağlık ocakları ile işbirliği, hastanın ve ailesinin hastalık süreci, belirtileri ve tedavisi konusunda bilgilendirilmesi tedaviye devam etme oranını arttıracak önlemlerdir.

Anahtar Kelimeler:

Ayaktan hasta, Randevular ve çizelgeler, Anketler, Şizofreni ve psikotik özellikli bozukluklar

Characteristics of psychotic patients don't come to appointments

Objective: In this study we aimed to determine the reasons why the patients don't come to outpatient follow-up in schizophrenia and other psychotic disorders. Methods: The sociodemographic features of the psychotic patients who had inpatient treatment at our clinic between the years 1998 and 2004; and didn't come to their follow-up examination after being discharged, their variables about the illness, the reasons why they didn't come to our clinic were tried to be determined by means of file scanning and telephone questionnaire. Results: Seventy-one of118 patients whom we determined that didn't apply to our clinic to receive ambulatory treatment were reached. The mean age of the patients was 34.89+10.08 (median=34, min-max-17-76). Seventy-one of them (%62.8) were male, 42 of them (%37.2) were female. A large proportion of our patient group consisted of the people who had schizophrenia diagnosis (%72.6), Among the reasons why the chronic psychotic patients didn't come to our clinic for treatment were environmental problems such as not to be able to get a patient transfer paper, transportation difficulty, the patient's living in a village, not to have a family member to bring him/her to the hospital, the patient's not creating oroblems for his/her family. The reasons why the patients use their drugs irregularly or don't use were mostly about not believing the drugs to be useful and side effects of the drugs. It had also a negative factor in the attitude of treatment team that the patients didn't have enough information about their illnesses. Discussion: It is important for the process of the illness that chronic psychosis patients continue their treatment regularly after being discharged. Many factors hindering the ambulatory treatment are factors which are able to be improved. Conclusion: Cooperation with other psychiatry clinics and village clinics, to give information to the patient and his/her family about the process, symptoms and treatment of the illness are the precautions which will increase the rate in continuing the treatment.

Keywords:

Outpatients, Appointments and Schedules, Questionnaires, Schizophrenia and Disorders with Psychotic Features,

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