AKCİĞER KANSERİ OLAN HASTALARIN ÖLÜM ANKSİYETESİNE YÖNELİK GİRİŞİMLERDE PSİKİYATRİ HEMŞİRESİNİN ETKİLİLİĞİNİN İNCELENMESİ Olcay ÇAM, Nalan GÖRDELES BEŞER

Amaç: Bu araştırma, akciğer kanseri olan hastaların ölüm anksiyetesine yönelik, psikiyatri hemşiresinin girişimlerinin etkinliğini ortaya koymak amacıyla deneysel olarak yapılmıştır. Gereç ve Yöntem: Araştırma 15 Mayıs 2005-30 Haziran 2006 tarihleri arasında Ödemiş Devlet Hastanesi Göğüs Servisine tedavi almak üzere hastaneye yatan, Akciğer kanseri tanısı almış, terminal dönemde olmayan, herhangi bir psikiyatri tanısı almamış ve araştırmaya katılmayı kabul eden yetişkin 30 deney, 30 kontrol grubunda olmak üzere 60 hasta ile yapılmıştır. Araştırmanın verileri, Hasta Bilgi Formu, Sonuç Kriterleri Formu, Beck Anksiyete Envanteri, Beck Depresyon Envanteri ve Beck Umutsuzluk Ölçeği ile toplanmıştır. Girişimler öncesi hem kontrol hem de deney grubundaki hastalara tüm form ve ölçekler uygulanmıştır. Hasta Bilgi Formu ile belirlenen problemler doğrultusunda, Hemşirelik Girişimi Formundaki girişimlerden yararlanılarak deney grubundaki hastalarla belirli aralıklarla, haftada yaklaşık 3-4 kez olmak üzere görüşmeler yapılmıştır. Deney grubundaki hastalarla görüşmeler tamamlandıktan sonra Sonuç Kriterleri Formu, Beck Anksiyete Envanteri, Beck Depresyon Envanteri ve Beck Umutsuzluk Ölçeği tekrar uygulanmıştır. Kontrol grubundaki hastalara ise, aynı anket uygulamaları benzer şekildeki zaman aralıkları ile başlangıçta ve sonrasında olmak üzere iki kez uygulanmıştır. Deney grubundaki hastaların görüşme öncesi ve sonrası, kontrol grubundaki hastaların ilk ve son uygulamadaki Form ve ölçeklere verdikleri cevapların puanları toplanmıştır. Puanlar her bir grupta ilk ve son uygulamalar kendi arasında, daha sonra ise, iki grubunun ilk ve son puanları birbirleriyle karşılaştırılmıştır. Bulgular ve Sonuç: Araştırmaya katılan hem kontrol hem de deney grubundaki hastaların %33.’ü 42-55 yaş grubunda olduğu, yine %33.’ü 65 ve üzerinde, %90’ı erkek ve evli, %100’ünün dini inancının İslam, %90’ı kemoterapi ile tedavi gördüğü, %53.3’ünün 1 yıldan fazla süredir bu hastalıkla yaşadığı, %53’ünün hastalığın 1. evresinde olduğu bulunmuştur. Deney grubundaki hastaların görüşmeler ve girişimler sonucunda öncesine göre; Ölüm anksiyetesinde azalma, depresyon semptomlarında ve umutsuzluk düzeylerinde azalma olduğu, kontrol grubundaki hastalarda ise anlamlı bir değişim olmadığı saptanmıştır.

Anahtar Kelimeler:

Akciğer Kanseri, Ölüm Anksiyetesi, Psikiyatri hemşireliği

STUDY OF THE EFFICACY OF PSYCHIATRIC NURSES IN THEIR INTERVENTIONS WITH REGARD TO THE DEATH ANXIETY OF LUNG CANCER PATIENTS

Aim: This study was carried out as an experimental design before empirical study for the purpose of setting forth the efficacy of psychiatric nurses in their interventions with regard to the death anxiety of lung cancer patients. Method: The survey was carried out on 60 adult patients, 30 of whom belonged to the experimental group and the remaining 30 belonging to the control group, all of whom agreed to participate in the survey. All of them had been hospitalized for treatment in the Chest Diseases Department of Ödemiş State Hospital with the diagnosis of lung cancer; none of them were in the terminal stage and again none of them had received a psychiatric diagnosis. Homogeneity among the patients was obtained by considering features such as their age, sex and the type of lung cancer, its stage and treatment. The data for the study was gathered by a Patient Information Form prepared tospecify the identification and the requirements of the patient, The outcome Criteria Form that was prepared to assess the interventions of the nurses in relation to Death Anxiety, Beck Anxiety Inventory, Beck Depression Inventory and Beck Hopelessness Inventory. Before the interventions, all forms and measures were applied to the patients in both the control and experimental groups. In parallel with the problems detected through the Patient Information Form, using the interventions in The Nursing Interventions Form, three or four meetings were held with the experimental group of patients at regular intervals. After these meetings were complete, the Outcome Criteria Form, Beck Anxiety Inventory, Beck Depression Inventory and Beck Hopelessness Scale were re-applied. The same scales and forms were applied to the control group patients for the second time as with the experiment group approximately one week after the first application. The points in the answers provided by the experimental group of patients before and after the meetings, and the answers provided by the control group patients at the first and last application of the forms and scales were added. The points were compared within their own groups, and then the first and last points of each group were also compared. Findings and Results: The survey demonstrated that 33 percent of the surveyed patients in both control and experimental groups were aged 42-55, 33 percent were aged over 65, 90 percent were male and married, 100 percent were Muslim, 90 percent were receiving chemotherapy treatment, 53.3 percent had been struggling with the disease for over one year and 53 percent were in the first phase of the disease. When asked to describe death in accordance with their religious belief, 60 percent of the experimental group of patients and 33.3 percent of the control group patients responded that it was an act of God. When asked to express what death meant to them, 63.4 percent of the experimental group of patients and 33.3 percent of the control group patients upheld that death was a natural thing and everybody would die eventually. The survey also revealed that the experimental group of patients collected more points of outcome criteria when the points before and after the meetings and interventions were compared. Conversely, they collected fewer points in The Beck Anxiety Inventory, Beck Hopelessness Scale, Beck Depression Inventory. These outcomes suggest that there was a decrease in death anxiety or increase in outcome criteria points , and also a decrease in depression symptoms and hopelessness levels. On the other hand, the survey further showed that the patients aged over 65 from the same experimental group of patients displayed higher death anxiety than the patients aged 42-55, the patients that had lived with the disease for over one year higher than those who were recently diagnosed, and the patients in the fourth phase higher than those who were in the first and second phase. It was detected that the former felt symptoms of anxiety and depression and hopelessness more strongly than the rest. No meaningful change was detected in the control group

Keywords:

Lung cancer, death anxiety, psychiatric nursing,

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