Pediatrik Yoğun Bakımdan Taburculuk Sonrası Görülen Post-Travmatik Stres Bozukluğu ve Azaltılmasında Hemşirenin Rolü

Post travmatik stres bozukluğu (PTSB) travma sonrası ortaya çıkan, çocuk veya ailenin travmatik olayı kötü rüyalar, geçmişe dönüş, halisünasyonlar yoluyla yeniden deneyimlemesi; travmayı anımsatan olaylardan, duygulardan, aktivitelerden, konuşmalardan, mekanlardan ve insanlardan kaçınması ve aşırı uyarılma davranışı sergilemesiyle karakterize, bu semptomların en az 1 ay boyunca devam etmesi ile seyreden ciddi bir mental bozukluktur. Yoğun bakım gibi yaşamın tehdit altında olduğunu gösteren bir ünitede bulunmak hem çocuk hem de aile için kriz yaratan bir durumdur. Bu üniteden taburcu olduktan sonra çocukta ve ailede hatırlamak istemeyecekleri anıların hatırlanması ile PTSB ortaya çıkmaktadır. Bu nedenle taburculuk öncesi PTSB’nun erken tanımlanması ve hastanede uygun hemşirelik girişimlerinin uygulanması semptomların azaltılmasında önemlidir.

-

Post traumatic stress disorder (PTSD) a mental disorder that causes after trauma occurring, the patient or family's traumatic event, bad dreams, flashbacks, hallucinations through again to experience trauma reminiscent of events, feelings, activities, conversations, places, and people avoidance and hyperarousal behavior, merchandising, characterized by the to continue for at least 1 month of symptoms. Indicates that life is under threat, such as intensive care units are in a crisis for both the child and family is a situation that creates. After being discharged from this unit as well as the child in the family will want to remember to remember memories with PTSD arises. Therefore, in the hospital prior to discharge ptsb'n early identification and implementation of appropriate nursing interventions is essential in reducing symptoms

___

  • Begnoche WW. Posttraumatic stres symptoms in the pediatric intensive care unit. JSPN 2007;12(2): 84-92.
  • Karande S, Kelkar A, Kulkarni M. Recollections of Indian children after discharge from an intensive care unit. Pediatr Crit Care Med 2005;6:303-07.
  • Rees G, Gledhill J, Garralda ME, Nadel S. Psychiatric outcome following paediatric intensive care unit (PICU) admission: a cohort study. Intensive Care Med 2004;30:1607-14.
  • Vidyasagar D. Stress of admission to pediatric intensive care unit on children. Pediatr Crit Care Med 2005;6:374-76.
  • Şuer T. Posttravmatik stres bozukluğu. İ. Ü. Cerrahpaşa Tıp Fakültesi Sürekli Tıp Eğitimi Etkinlikleri, Medikal Açıdan Stres ve Çareleri. Sempozyum Dizisi 2005;47:205-10.
  • Mulvihill D. Nursing care of children after a traumatic incident. Issues in Comprehensive Pediatric Nursing 2007;30:15-28.
  • Kessler RC, Berglund P, Delmer O, Jin R, Merikangas KR, & Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 2005;62(6):593-602.
  • Kessler R, Avenevoli S, Costello EJ, Georgiades K, Green JG, Gruber MJ. et al. Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Sample. Archives of General Psychiatry 2012;69:372-80.
  • Cuthbertson BH, Hull A, Strachan M, Scott J. Posttraumatic stress disorder after critical illness requiring general intensive care. Journal of Intensive Care Medicine 2004;30(3):450-55.
  • Zink KA, McCain GA. Post-Traumatic stress disorder in children and adolescents with motor vehicle related ınjuries. JSPN 2003;8(3):99-106.
  • Oflaz F. Hasta çocuk ve ebeveynlerinin pediatrik yoğun bakım deneyimi ve travmatik stres. C.U. Hemşirelik Yüksekokulu Dergisi 2008;12(1):53-59.
  • Granja C, Gomes E, Amaro A, Ribeiro O, Jones C, Carneiro A, Costa-Pereira A. Understanding posttraumatic stres disorder-related symptoms after critical care: The early ilness amnesia hypothesis. Crit Care Med 2008;36(10):2801-809.
  • Baker C. Preventing ICU syndrome in children. Paediatric Nursing 2004;16(10):32-35.
  • Griffiths J, Fortune G, Barber V, Young JD. The Prevalence of post traumatic stres disorder in survivors of ICU treatment: a systematic review. Intensive Care Med 2007;33:1506-518.
  • Bronner MB, Knoester H, Bos AP, Last BF, Grootenhuis MA. Posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment compared to children who survived a major fire disaster. Child and Adolescent Psychiatry and Mental Health 2008b; 2:1-9.
  • Judge D, Nadel S, Vergnaud S, Garralda ME. Psychiatric adjustment following meningooccal disease treated on a PICU. Intensive Care Med 2002;28:648-50.
  • Schreier H, Ladakakos C, Morabito D, Chapman L, Knudson M. Posttraumatic stres symptoms in children after mild to moderate pediatric trauma: A longitudinal examination of symptom prevalence, correlates and parent-child symprom reporting. The Journal of Trauma Injury, Infection and Critical Care 2005;58(2):353-63.
  • Rennick JE, Johnson CC, Dougherty G. Children’s psychological responses after critical illness and exposure to invasive technology. J Dew Behaw Pediatr 2002;23:133-44.
  • Muranjan MN, Bırajdar SB, Shah HR, Sundaraman P, Tullu MS. Psychological Consequences in Pediatric Intensive Care Unit Survivors: The Neglected Outcome. Indıan Pedıatrıcs 2007;45(17):99-103.
  • Perkonigg A, Pfister H, Stein MB, Hofler M, Lieb R, Maercker A, Wittchen HU. Longitudinal course of posttraumatic stress disorder and posttraumatic stress disorder symptoms in a community sample of adolescents and young adults. Am J Psychiatry 2005;162(7):1320-327.
  • Playfor S, Thomas D, Choonara I. Recollection of children following intensive care. Arch Dis Child 2007;83:445-48.
  • Bronner MB, Knoester H, Bos AP, Last BF, Grootenhuis MA. Follow-up after pediatric intensive care treatment: parental posttraumatic stres. Acta Paediatrica 2008a; 97:181-86.
  • Colville G, Cream P. Post-traumatic growth in parents after a child’s admission to intensive care: maybe Nietzsche was right?. İntensive Care Med 2009;35:919-23.
  • Bal Yılmaz H, Ersun A. Hasta çocuk ve ebeveynlerinde post-travmatik stres bozukluğu. Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi 2010;26(3):45-50.
  • Balluffi A, Kassam-Adams N, Kazak A, Tucker M, Dominguez T, Helfaer M. Traumatic stres in parents of children admitted to the pediatric intensive care unit. Pediatr Crit Care Med 2004;5(6): 547-53.
  • Shears D, Nadel S, Gledhill J, Garralda ME. Short-term psychiatric adjustment of children and their parents following meningococcal disease. Pediatr Crit Care Med 2005;6:39-43.
  • Helfricht S, Latal B, Fischer JE, Tomaske M, Landolt MA. Surgery related posttraumatic stres disorder in parents of children undergoing cardiopulmonary bypass surgery. A prospective cohort study. Pediatr Crit Care Med 2008;9(2):217-23.
  • Terzi B, Kaya N. Yoğun bakım hastasında hemşirelik bakımı. Dahili ve Cerrahi Bilimler Yoğun Bakım Dergisi 2011;1:21-5.
  • Erdemir F. [Nursing Diagnosis Hand Book]. 7. Baskı. İstanbul: Nobel Tıp Kitapevleri; 2005.
  • Birol L. [Nursing Process]. 9. Baskı, İzmir: Etki Matbaacılık; 2009.
  • Sönmez Düzkaya D, Bozkurt G. Yoğun bakım hastasının evde bakımı. Yoğun Bakım Hemşireliği Dergisi 2012;16(1):21-8.
  • Mclntosh S, Mata M. Early detection of posttraumatic stres disorder in children. Journal of Trauma Nursing 2008;13(3):126-30.