Alzheimer Hastalığı Olan Bireye Bakım Veren Aile Üyelerinin Bakım Verme Sürecindeki Deneyimleri

Giriş: Bakım verme süreci, bakım verenleri farklı boyutlarda etkilemektedir. Amaç: Alzheimer hastalığı olan bireylere bakım veren aile üyelerinin bakım verme sürecindeki deneyimlerinin “Watson İnsan Bakım Teorisi” çerçevesinde anlaşılmasıdır. Yöntem: Tanımlayıcı niteliksel araştırma tasarımı kullanılmış ve kavramsal çerçevesini Watson İnsan Bakım Teorisi oluşturmuştur. Örneklemi 16 aile üyesi oluşturmuştur. Veriler, “yarı yapılandırılmış görüşme formu” kullanılarak “derinlemesine görüşme” yöntemiyle toplanmış olup “içerik analizi” ile değerlendirilmiştir. Araştırmada, etik kurul, araştırmanın yapıldığı kurum ve çalışmaya katılan aile üyelerinden yazılı izinler alınmıştır. Bulgular: Çalışmada bakım verme rolünde zorlanma ve bakım verme rolünden memnun olma şeklinde iki ana tema ve bu temalara ait alt temalar belirlenmiştir. Bakım verme rolünde zorlanma temasının alt temaları: bakımda destek beklentisi, anlaşılmadığını düşünme, ailevi ve sosyal ilişkilerde bozulma ve rollerde değişim, hastalığı kabullenememe, geçmişte yaşanan olumsuz ilişkileri sorgulama, gelecekte bakamama korkusu ve profesyonel destek alma çabasıdır. Bakım verme rolünden memnun olma temasının alt temaları: geçmişte yaşanan olumlu deneyim ve ilişkiler, bakımı borç olarak görme, inançlardır. Sonuç: Belirlenen temalar, sağlık profesyonellerinin bakım verenlere yapacakları girişimleri planlama aşamasında önemli bir rehber niteliğindedir. Bakım verenin bakım sürecinin olumlu yönlerini görmesini sağlamak, eğitim yoluyla bilgi ve becerisini arttırmak, baş etme yöntemlerinin farkında olmak sağlık profesyonellerinin özellikle de hemşirelerin önemli sorumluluklarıdır.

Experiences in the Caregiving Process of Family Caregivers of Individuals with Alzheimer's Disease

Background: Caring process affects caregivers in various aspects. Aim: To give an insight into caring experiences of family members of individuals with Alzheimer’s disease in the framework of Watson’s theory of human caring. Methods: The study has a descriptive, qualitative design and its conceptual framework is based on Watson’s theory of human caring. The study sample was composed of 16 family members. Data were collected with a semi-structured interview form at in-depth interviews. Obtained data were evaluated with content analysis. Ethical approval was obtained from the ethical committee of the institution where the study was performed and written informed consent was taken from the participants. Results: Two main themes were identified: difficulty in caregiving role and satisfaction with caregiving role, and subthemes emerged. Subthemes for difficulty in caregiving role were care related expectations for support, lack of understanding, disrupted familial and social relationships, changes in roles, rejection of the disease, questioning prior negative relationships, fear of inability to give care in the future and attempts to receive professional support. Subthemes for satisfaction with caregiving role were prior positive experiences and relationships, perceive caregiving as gratitude and beliefs.Conclusion: The emerging themes and subthemes can provide guidance for health professionals to design interventions for caregivers of individuals with Alzheimer’s disease. Health professionals, especially nurses should be prepared for taking the responsibility for enabling caregivers to become aware of positive aspects of caregiving, enhancing caregivers’ knowledge and skills for caregiving and helping caregivers to be aware of their coping skills

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  • Abdollahpour, I., Noroozian, M., Nedjat, S., & Majdzadeh, R. (2012). Caregiver burden and its determinants among the family
  • members of patients with dementia in Iran. International Journal of Preventive Medicine, 3(8), 544–551. Alm, A.K., Hellzen, O., & Norbergh, K.G. (2014). Experiences of family relationships when a family member has dementia.
  • Open Journal of Nursing, 4, 520-527. Alvira, M.C., Risco, E., Cabrera, E., Farre, M., Rahm-Hallberg, I., Bleijlevens, M.H., Meyer, G., Koskenniemi, J., Soto, M.E.
  • Zabalegui, A., & Right Time Place Care Consortium. (2015). The association between positive-negative reactions of
  • informal caregivers of people with dementia and health outcomes in eight European countries: a cross-sectional study.
  • Journal of Advance Nursing 71(6), 1417-34. Alzheimer's Disease International. (2013, December). Policy brief for G8 heads of government: the global impact of dementia
  • 2050. London: Alzheimer's Disease International. American Alzheimer’s Association. (2015, March). Alzheimer’s disease facts and figures. Alzheimer’s & Dementia, 11(3), 332-384. Cabote, C. J., Bramble, M., & McCann, D. (2015). Family caregivers’ experiences of caring for a relative with younger onset
  • dementia: a qualitative systematic review. Journal of Family Nursing, 21(3), 443-68. Cheng, S.T., Mak, E.P.M., Lau, R.W.L., Ng, N. S.S., & Lam, L.C.W. (2016). Voices of Alzheimer caregivers on positive
  • aspects of caregiving. The Gerontologist, 56(3), 451-60. Chien, L.Y., Chu, H., Guo, J.L., Liao, Y.M., Chang, L.I., Chen, C.H. et al. (2011). Caregiver support groups in patients with
  • dementia: a meta-analysis. International Journal of Geriatric Psychiatry, 26(10), 1089-1098. Cotelo, N. V., Rodriguez, N.F., Perez, J.A., Iglesias, J.C., & Lago, M.R. (2015). Burden and associated pathologies in family
  • caregivers of Alzheimer’s disease patients in Spain. Pharmacy Practice, 13 (2), 521. Dassel, K.B., Carr, D.C., & Vitaliano, P. (2015). Does caring for a spouse with dementia accelerate cognitive decline? findings
  • from the health and retirement study. The Gerontologist, in press. 1- 10. Day, J.R., Anderson, R.A., & Davis, L.L. (2014). Compassion fatigue in adult daughter caregivers of a parent with dementia.
  • Issues of Mental Health Nursing, 35(10), 796- 804. Dias, R., Santos, R.L., de Sousa, M.F., Nogueira, M.M., Torres, B., Belfort, T., et al. (2015). Resilience of caregivers of people
  • with dementia: a systematic review of biological and psychosocial determinants. Trends Psychiatry Psychotheraphy 2015
  • (1), 13- 19. Dizazzo Miller, R., Pociask, F.D., & Samuel, P. (2013). Understanding resource needs of persons with dementia and their
  • caregivers. Michigan Family Review, 17(1), 1-20. Dupuis, S.L. (2002). Understanding ambiguous loss in the context of dementia care. Journal of Gerontological Social Work
  • (2), 93-115. Durgun Ozan, Y. & Okumuş, H. (2013). Tedavi sonucu başarısız olan infertil kadınların Watson’ın İnsan Bakım Kuramına göre hemşirelik bakımı. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 16, 3. Emiroğlu, O.N. (2004). Hemşirelikte araştırma, ilke, süreç ve yöntemleri. In İ. Erefe (Ed.), Niteliksel araştırma tasarımları (pp.
  • 124). Odak Ofset, 3. Baskı, Ankara. Fauth, E., Hess, K., Piercy, K., Norton, M., Corcoran, C., Rabins, P. et al., (2012). Caregivers' relationship closeness with the
  • person with dementia predicts both positive and negative outcomes for caregivers' physical health and psychological well
  • being. Aging Mental Health, 16(6), 699-711. Garand, L., Lingler, J.H., Deardorf, K.E., DeKosky, S.T., Schulz, R., Reynolds, et al. (2012). Anticipatory grief in new family
  • caregivers of persons with mild cognitive impairment and dementia. Alzheimer Disease Associated Disorder, 26(2), 159– 165. Givens, J.L., Mezzacappa, C., Heeren, T., Yaffe, K., & Fredman, L. (2014). Depressive symptoms among dementia caregivers
  • role of mediating factors. American Journal of Geriatric Psychiatry, 22, 481-488. Herrera, A.P., Lee, J.W., Nanyonjo, R.D., Laufman, L.E., & Torres Vigil, I. (2009). Religious coping and caregiver well-being
  • in Mexican-American families. Aging Mental Health, 13(1), 84-91. Hinton, L., Tran, J.N., Tran, C., & Hinton, D. (2008). Religious and spiritual dimensions of the Vietnamese dementia
  • caregiving experience. Hallym International Journal of Aging, 1, 10(2), 139-160. Jathanna, R.P.N., Latha, K.S., & Bhandary, P.V. (2010). Burden and coping in informal caregivers of persons with dementia: a
  • cross sectional study. Online Journal of Health and Allied Sciences., 9(4), 1-6. Kahn, P.V., Wishart, H.A., Randolph, J.S., & Santulli R.B. (2016). Caregiver stigma and burden in memory disorders: an
  • evaluation of the effects of caregiver type and gender. Current Gerontology and Geriatrics Research, 1, 1- 5. Doi
  • 1155/2016/8316045. Laks, J., Goren A., Duenas, H., Novick, D., & Kahle Wrobleski, K. (2016). Caregiving for patients with Alzheimer’s disease
  • or dementia and its association with psychiatric and clinical comorbidities and other health outcomes in Brazil.
  • International Journal of Geriatric Psychiatry, 31, 176-185. Large, S. & Slinger, R. (2015). Grief in caregivers of persons with Alzheimer’s disease and related dementia: a qualitative
  • synthesis. Dementia, 14(2), 164-183. Lau, B. H.P & Cheng, C. (2015). Gratitude and coping among familial caregivers of persons with dementia. Aging Mental
  • Health, 27, 1-9. Lee, Y. & Smith L. (2012). Qualitative research on Korean American dementia caregivers’ perception of caregiving
  • heterogeneity between spouse caregivers and child caregivers. Journal of Human Behavior in the Social Environment, 22, 115-129. Lou, Q., Liu, S., Huo, Y.R., Liu, M., Liu, S., & Ji, Y. (2015). Comprehensive analysis of patient and caregiver predictors for
  • caregiver burden, anxiety and depression in Alzheimer’s disease. Journal of Clinical Nursing, 24, 2668-2678. Marquez Gonzalez, M., Lopez, J., Romero Moreno, R., & Losada, A. (2012). Anger, spiritual meaning and support from the
  • religious community in dementia care giving. Journal of Religion and Health, 51 (1), 179-186. Mullaney, J.A.B. (2000). The lived experience of using Watson’s actual caring occasions to treat depressed women. Journal of
  • Holistic Nursing, 18(2), 129-142. Navab, E., Negarandeh, R., Peyrovi, H., & Navab, P. (2013). Stigma among Iranian family caregivers of patients with
  • Alzheimer's disease: A hermeneutic study. Nursing Health Science, 15(2), 201-206. Nyman, C.S., & Lutzen, K. (1999). Caring needs of patients with rheumatoid arthritis. Nursing Science Quarterly, 12, 164-169. O'Shaughnessy, M., Lee, K., & Lintern, T. (2010) Changes in the couple relationship in dementia care: spouse carers'
  • experiences. Dementia, 9 (2), 237-258. Özmen Ş.Y. (2013). Türk kültüründe yaşlının yeri ve medyayla yaşlılığın değişen konumu. Milli Folklor, 25 (100), 110- 119. Öztop, H., Şener, A., & Güven, S. (2008). Evde bakımın yaşlı ve aile açısından olumlu ve olumsuz yönleri yönleri. Yaşlı
  • Sorunları Araştırma Dergisi, 1, 39-49. Prorok, J.C., Horgan, S., & Seitz, D.P. (2013). Health care experiences of people with dementia and their caregivers: a meta
  • ethnographic analysis of qualitative studies. Canadian Medical Association Journal, 185 (14), 669–680. Quinn, C., Clare, L., & Woods, R.T. (2012). What predicts whether caregivers of people with dementia find meaning in their
  • role? International Journal of Geriatric Psychiatry, 27, 1195-1202. Quinn, C., Jones, I.R., & Clare, L. (2016). Illness representations in caregivers of people with dementia. Aging Mental Health, 5, 1-9. Raccichini, A., Spazzafumo, L., Castellani, S., Civerchia, P., Pelliccioni, G., & Scarpino, O. (2015). Living with mild to
  • moderate Alzheimer patients increases the caregiver's burden at 6 months. American Journal of Alzheimer’s Disease &
  • Other Dementias, 30(5), 463-467. Raggi, A., Tasca, D., Panerai, S., Neri, W., & Ferri, R. (2015). The burden of distress and related coping processes in family
  • caregivers of patients with Alzheimer's disease living in the community. Journal of the Neurological Sciences, 358, 77– 81. Rathier, L.A., Davis, J.D., Papandonatos, G.D., Grover, C., & Tremont, G. (2015). Religious coping in caregivers of family
  • members with dementia. Journal of Applied Gerontology, 2015, 34 (8), 977-1000. Rosa, E., Lussignoli, G., Sabbatini, F., Chiappa, A., Di Cesare, S., Lamanna, L. & Zanetti O. (2009). Needs of caregivers of the
  • patients with dementia. Archives of Gerontology and Geriatrics, 51(1), 54-8. Santos, R.L., de Sousa, M.F., Ganem, A.C., Silva, T.V., & Dourado, M.C. (2013). Cultural aspects in dementia: differences in
  • the awareness of Brazilian caregivers. Trends in Psychiatry Psychotheraphy, 35(3),191-197. Schüz, B., Czerniawski, A., Davie, N., Miller, L., Quinn, M.G., King, C., et al. (2015). Leisure time activities and mental health in informal dementia caregivers. Applied Psychology: Health and Well Being, 7(2), 230-248. Seima, M.D., Lenardt, M.H., & Caldas, C.P. (2014). Relação no cuidado entre o cuidador familiar e o idoso com Alzheimer.
  • (Care relationship between the family caregiver and the elderly with Alzheimer). Revista Brasileira de Enfermagem
  • (2), 233-240. Shaji, K.S., Smitha, K., Lal, K.P. & Prince, M,J,. (2003). Caregivers of people with Alzheimer's disease: a qualitative study
  • from the Indian 10/66 Dementia Research Network. International Journal of Geriatric Psychiatry, 18(1), 1-6. Shim, B., Barroso, J., & Davis, L.L. (2012). A comparative qualitative analysis of stories of spousal caregivers of people with
  • dementia: Negative, ambivalent, and positive experiences. International Journal of Nursing Studies, 49 (2), 220- 229. Shim, B., Barroso, J., Gilliss, C.L., & Davis, L. L. (2013). Finding meaning in caring for a spouse with dementia. Applied
  • Nursing Research, 26(3), 121-126. Truzzi, A., Valente, L., Ulstein, I., Engelhardt, E., Laks, J., & Engedal, K. (2012). Burnout in familial caregivers of patients
  • with dementia. Revista Brasileira de Psiquiatria, 34(4), 405-412. Türkiye Alzheimer Derneği. (2015). http://www.alzheimerdernegi.org.tr/haber/gelismis-ulkelerde-alzheimer-hastaligi
  • azalirken-turkiyede-artiyor/ Erişim tarihi: 17.02.2015 Türkiye Cumhuriyeti Sağlık Bakanlığı. (2015). Dünya Alzheimer farkındalık günü 21 Eylül 2015. İstatistik, Analiz ve Raporlama
  • http://www.tkhk.gov.tr/Dosyalar/4b30930a266d4833adf9223afa9926ce.pdf Erişim Tarihi: 17.02.16 Daire Başkanlığı Rapor Bülteni, 11. Vidigal, F.C., Ferrari, R.F.R., Rodrigues, D.M.M.R., Marcon, S.S., Baldissera, V.D.A., & Carreira, L. (2014). Satisfaction in
  • caring for older adults with Alzheımer’s: perceptions of the family caregivers. Cogitare Enfermagem, 19(4), 708-715. Vliet, D., Vugt, M.E., Bakker, C., Koopmans, R.T.C.M., Pijnenburg, Y.A.L., Vernooji Dassen, M.J.F.J., et al. (2011).
  • Caregivers’ perspectives on the pre-diagnostic period in early onset dementia: a long and winding road. International
  • Psychogeriatrics, 23(9), 1393–1404. Watson Caring Science Institute [WCSI]. (2010). Core concepts of Jean Watson’s Theory of Human Caring/ Caring Science
  • Erişim tarihi: 17.03.16. Watson, J. (1989). Watson's philosophy and theory of human caring in nursing. In J. Riehl-Sisca (Ed.), Conceptual models for
  • nursing practice (pp. 219-236). Norwalk, CT: Appleton & Lange. Watson, J. (2002). Holistic nursing and caring: a value based approach. Journal of Japan Academy of Nursing Science, 22 (1), 69-74. Watson, J. (2005). Jean Watson: Theory of Human Caring. In M.E. Parker, (Ed.), Nursing theories and nursing practice, (2nd
  • ed., pp. 295-305). Philadelphia: FA Davis Company. Werner, P., Mittelman, M.S., Goldstein, D. & Heinik, J. (2012). Family stigma and caregiver burden in Alzheimer's disease.
  • Gerontologist, 52(1), 89-97. Wezel, N., Francke, A.L., Kayan Acun, E., Ljm Deville, W., Grondelle, N.J. & Blom, M. M. (2016). Family care for
  • immigrants with dementia: the perspectives of female family carers living in the Netherlands. Dementia (London), 15(1), 69-84. World Health Organization (2015, September). The epidemiology and impact of dementia current state and future trends.
  • http://www.who.int/mental_health/neurology/dementia/dementia_thematicbrief_epidemiology.pdf Erişim Tarihi: 16.03.16 Yektatalab, S.H., Kaveh, M.H., Sharif, F., Fallahi Khoshknab, M. & Petramfar, P. (2012). Characteristics of care and
  • caregivers of Alzheimer's patients in elderly care homes: a qualitative research. Iranian Red Crescent Medical Journal, 14(5), 294-9. Yıldırım, A., & Şimşek, H. (Editörler). (2011). Sosyal bilimlerde nitel araştırma yöntemleri (8. Baskı). Seçkin Basımevi, Ankara.