Toksik Strese Maruz Kalan Çocuk ve Hemşirenin Rolü

Toksik stres, çocuğun uzun süren stresörlere yanıt olarak ortaya çıkan fizyolojik değişiklikler ve stres-tepki artışıdır. Çocuk istismarı, ihmali gibi olumsuz, travmatik, stresli deneyimleri içerir. Toksik stres beyin yapısını bozmakta, organ ve sistemleri etkilemekte, stresle başa çıkmayı ve uyum sağlamayı olumsuz etkilemektedir. Pediatri hemşireleri, çocuklarda toksik stresi önlemede ve ebeveynlere rehberlik sağlayarak psikolojik dayanıklılığı arttırmada önemli rol oynamaktadır. Bu derlemede toksik strese maruz kalmanın çocukta ne gibi olumsuz etkilere neden olabileceği ve bununla ilgili önleyici hemşirelik yaklaşımları, başa çıkma ve destek müdahalelerinin neler olduğu üzerinde durulması amaçlanmıştır.

Anahtar Kelimeler:

Çocuk İstismarı, Çocuk Sağlığı, Hemşirelik, Psikolojik Stres

Children Exposed to Toxic Stress and The Nurse’s Role

Toxic stress is the physiological changes that occur in response to prolonged stressors and increased stress-response. It includes negative, traumatic, stressful experiences such as child abuse and child neglect. Toxic stress disrupts the brain structure, affects organs and systems, and negatively affects coping with stress and adaptation mechanisms. In this review, it is aimed to focus on what kind of negative effects exposure to toxic stress can cause on children and what are preventive nursing approaches, coping and support interventions related to this.

Keywords:

Child Abuse, Child Health, Nursing, Psychological Stress,

PDF

___

1. Selye, H. (1976). “Forty Years of Stress Research: Principal Remaining Problems and Misconceptions”. Can Med Assoc J, 115 (1), 53-56.
2. Perkins, A. (2019). “Toxic Stress in Children: Impact Over a Lifetime”. Nursing Made Incredibly Easy. 17 (2), 42-49.
3. Shonkoff, J. P. and Garner, A. S. (2012). “The Lifelong Effects of Early Childhood Adversity and Toxic Stress”. Pediatrics, 129 (1), e232-e246. doi:10.1542/ peds.2011-2663
4. Public Health Institute. (2014). “Addressing the Health Consequences of Childhood Trauma”. Erişim adresi: https://www.phi.org/about/impacts/addressing-the-health-consequences-of-childhood-trauma/. (Erişim tarihi: 17.4.2021).
5. Centers for Disease Control and Prevention. (2019). “Adverse Childhood Experiences (ACEs) Preventing Early Trauma to Improve Adult Health”. Erişim adresi: https://www.cdc.gov/vitalsigns/aces/pdf/vs-1105-aces-H.pdf. (Erişim tarihi: 17.4.2021).
6. United States Department of Health and Human Services. (2013). “Child Maltreatment”. Erişim adresi: http://www.acf.hhs.gov/programs/cb/research-data-technology/ statistics-research/child-maltreatment. (Erişim tarihi: 18.04.2021).
7. Franke, H. A. (2014). “Toxic Stress: Effects, Prevention and Treatment”. Children, 1 (3), 390-402.
8. Hornor, G. (2015). “Childhood Trauma Exposure and Toxic Stress: What the PNP Needs to Know”. J Pediatr Health Care, 29 (2), 191-198.
9. Francis, L, DePriest, K, Wilson, M. and Gross, D. (2018). “Child Poverty, Toxic Stress and Social Determinants of Health: Screening and Care Coordination”. Online J Issues Nurs, 23 (3), 2.
10. Shonkoff, J. P, Boyce, W. T. and McEwen, B. S. (2009). “Neuroscience, Molecular Biology and the Childhood Roots of Health Disparities: Building a New Framework for Health Promotion and Disease Prevention”. JAMA, 301 (21), 2252-2259.
11. Shonkoff, J. P. (2012). “Leveraging the Biology of Adversity to Address the Roots of Disparities in Health and Development”. PNAS, 109 (2), 17302-17307.
12. Johnson, S. B, Riley, A. W, Granger, D. A. and Riis, J. (2013). “The Science of Early Life Toxic Stress for Pediatric Practice and Advocacy”. Pediatrics, 131 (2), 319-327.
13. Dowd, M. D. (2017). “Early Adversity, Toxic Stress and Resilience: Pediatrics for Today.” Pediatr Ann, 46 (7), e246–e249. doi: 10.3928/19382359-20170615-01
14. Hughes, K, Bellis, M.A, Hardcastle, K. A, Sethi, D, Butchart, A, Mikton, C, Jones, L. and Dunne, M. P. (2017). “The Effect of Multiple Adverse Childhood Experiences on Health: A Systematic Review and Meta-Analysis”. Lancet Public Health, 2, e356-e366.
15. Bucci, M, Marques, S. S, Oh, D. and Harris, N. B. (2016). “Toxic Stress in Children and Adolescents”. Advances in Pediatrics, 63 (1), 403-428.
16. Garner, A.S. (2013). “Home Visiting and the Biology of Toxic Stress: Opportunities to Address Early Childhood Adversity”. Pediatrics, 132, S65-S73. doi:10.1542/peds.2013-1021D
17. Felitti, V. J, Anda, R. F, Nordenberg, D, Williamson, D. F, Spitz, A. M, Edwards, V, Koss, M. P. and Marks, J. S. (1998). “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. The Adverse Childhood Experiences (ACE) Study”. Am J Prev Med, 14 (4), 245-258. doi: 10.1016/s0749-3797(98)00017-8.
18. Dube, S. R, Anda, R. F, Felitti, V. J, Chapman, D.P, Williamson, D. F. and Giles, W. H. (2001). “Childhood Abuse, Household Dysfunction and the Risk of Attempted Suicide Throughout the Life Span: Findings From the Adverse Childhood Experiences Study”. JAMA, 286 (24), 3089-3096.
19. Burke, N. J, Hellman, J. L, Scott, B. G, Weems, C. F. and Carrion, V. G. (2011). “The Impact of Adverse Childhood Experiences on an Urban Pediatric Population”. Child Abuse Neg, 35 (6), 408-413. doi: 10.1016/j.chiabu.2011.02.006.
20. Flaherty, E. G, Thompson, R, Dubowitz, H, Harvey, E. M, Proctor, L. J. and Runyan, D. K. (2013). “Adverse Childhood Experiences and Child Health in Early Adolescence”. JAMA Pediatr, 167 (7), 622-629.
21. Bethell, C. D, Newacheck, P, Hawes, E. and Halfon, N. (2014). “Adverse Childhood Experiences: Assessing the Impact on Health and School Engagement and the Mitigating Role of Resilience”. Health Affairs, 33 (12), 2106-2115.
22. Bright, M. A, Alford, S. M, Hinojosa, M. S, Knapp, C. and Fernandez-Baca, D. E. (2014).“Adverse Childhood Experiences and Dental Health in Children and Adolescents”. Community Dent Oral Epidemiology, 43 (3), 193-199.
23. Wing, R, Gjelsvik, A, Nocera, M. and McQuaid, E. L. (2015). “Association Between Adverse Childhood Experiences in the Home and Pediatric Asthma”. Annals of Allergy Asthma & Immunology, 114 (5), 379-384.
24. Kalmakis, K. A. and Chandler, G. E. (2015). “Health Consequences of Adverse Childhood Experiences: A Systematic Review”. Journal of the American Association of Nurse Practitioners, 27 (8), 457-465.
25. Heard-Garris, N, Cale, M, Camaj, L, Hamati, M. and Dominguez, T. (2018). “Transmitting Trauma: A Systematic Review of Vicarious Racism and Child Health”. Soc Sci Med, 199, 230-240.
26. Condon, E. M, Holland, M. L, Slade, A, Redeker, N. S, Mayes, L. C. and Sadler, L. S. (2019). “Associations Between Maternal Experiences of Discrimination and Biomarkers of Toxic Stress in School‐Aged Children”. Maternal and Child Health Journal, 23,1147–1151
27. Centers for Disease Control and Prevention. (2020). “Adverse Childhood Experiences Study”. Erişim adresi: https://www.cdc.gov/violenceprevention/aces/index.html. (Erişim tarihi: 2.2.2020).
28. Miller-Lewis, L. R, Searle, A. K, Sawyer, M. G, Baghurst, P. A. and Hedley, D. (2013). “Resource Factors for Mental Health Resilience in Early Childhood: An Analysis with Multiple Methodologies”. Child and Adolescent Psychiatry and Mental Health, 7 (1), 6. http://dx.doi.org/10.1186/1753-2000-7-6
29. Shoemark, H, Harcourt, E, Arnup, S. J. and Hunt, R. W. (2016). “Characterising the Ambient Sound Environment for Infants in Intensive Care Wards”. Journal of Paediatrics Child Health, 52 (4), 436-440. https://doi.org/10.1111/jpc.13084
30. Beal, J. A. (2019). “Toxic Stress in Children”. MCN Am J Matern Child Nurs, 44 (1), 53.
31. Kelly, M. M. and Li, K. (2018). “Poverty, Toxic Stress and Education in Children Born Preterm”. Nursing Research, 68 (4), 275-284. doi: 10.1097/NNR.0000000000000360
32. Alio, A. (2017). “Toxic Stress and Maternal and Infant Health: A Brief Overview and Trips for Community Health Workers”. Erişim adresi: https://www.urmc.rochester.edu/MediaLibraries /URMCMedia/finger-lakes-regionalperinatal/documents/Toxic-Stress-_27June2017_Final.pdf. (Erişim tarihi: 02.04.2021).
33. Samara, M, Hammuda, S, Vostanis, P, El-Khodary, B. and Al-Dewik, N. (2020). “Children’s Prolonged Exposure to the Toxic Stress of War Trauma in the Middle East”. BMJ, 19, 371, m3155.
34. Çavuşoğlu, H. (2019). Çocuk Sağlığı Hemşireliği. Ankara: Sistem Ofset Yayıncılık.
35. Christian, B. J. (2013). “Translational Research - The Stress and Uncertainty of Hospitalization and Strategies for Pediatric Nurses to Improve the Quality of Care for Children and Families”. J Pediatr Nurs, 41, 140-45.
36. Zheng, R, Zhou, Y, Qiu, M, Yan, Y, Yue, J, Yu, L, Lei, X, Tu, D. and Hu, Y. (2021). “Prevalence and Associated Factors of Depression, Anxiety and Stress Among Hubei Pediatric Nurses During COVID-19 Pandemic”. Compr Pschiatry, 104, 152217.