Şizofreni Hastalığında Umut Kavramı / The Concept of Hope in Schizophrenia Disease

Şizofreni; düşünce, duygu ve davranışlarda önemli bozulmalara yol açan, bireyi derinden yıkıcı psikopatolojik etkileri olan kronik bir hastalıktır. Şizofreni hastaları hastalığın yol açtığı fizyolojik sorunlarla beraber, hastalığa yönelik toplumdaki yanlış bilgi ve inanışların doğurduğu önyargı, damgalanma ve dışlanma sorunlarıyla da karşı karşıyadır. Tüm bu sorunlar, şizofreni hastalarının geleceğe yönelik pozitif beklenti hislerini azaltarak, umutsuzluğun hastalar arasında yaygın olarak görülmesine neden olmaktadır. Umut, şizofreni hastalarının hastalıkla mücadele etmelerini sağlayan, tedavinin etkinliğini artıran iyileşmenin en önemli belirleyicilerinden birisi olarak kabul edilmektedir. Şizofreni hastalığının tanı, tedavi ve rehabilitasyon aşamalarında en fazla hastaların yanlarında bulunan sağlık profesyoneli hemşirelerdir. Bu nedenle, umudun artırılmasına yönelik girişimlerin hemşireler tarafından iyi bilinmesi gerekmektedir. Bu derlemenin amacı; şizofreni hastalarının umut düzeylerinin belirlenmesi ve artırmaya yönelik girişimlerde bulunulması konusunda hemşirelere yol göstermek ve bu konuda farkındalık oluşturmaktır.

Anahtar Kelimeler:

Şizofreni, umut, hemşirelik girişimleri

The Concept of Hope in Schizophrenia Disease

Schizophrenia is a chronic disease that has destructive psychopathological effects causing profound impairments in thoughts, feelings and behaviors in individuals. Along with the physiological problems caused by disease, the patients with schizophrenia also faces prejudice, stigmatization and alienation problems caused by misinformation and beliefs in society regarding the disease. All these problems reduce the positive expectations patients with schizophrenia for the future and cause widespread despair among these patients. Hope is considered to be one of the most important determinants of healing that increases the effectiveness of the treatment, enabling patients with schizophrenia to fight against the disease. Nurses are the most prominent health care professionals, which are close the patients in the diagnosis, treatment, and rehabilitation stages of the schizophrenia disease. Therefore, interventions used for increasing hope should be known by nurses well. The aim of this review is to guide nurses to perform interventions to determine and increase the levels of hope of the patients with schizophrenia as well as raising awareness in this regard.

Keywords:

Schizophrenia, hope, nursing interventions,

PDF

___

1. Aghevli MA, Blanchard JJ, Horan WP. The expression and experience of emotion in schizophrenia: a study of social interactions. Psychiatry Res. 2003;119(3):261-270.
2. Öztürk O, Uluşahin N. Ruh Sağlığı ve Bozuklukları. 13. Baskı. Ankara: Nobel Tıp Kitapevi; 2015. p.189-261.
3. Yüksel N. Ruhsal Hastalıklar, 4. Baskı. Ankara: Akademisyen Tıp Kitapevi; 2014. p.325-375.
4. Lysaker PH, Clements CA, Wright DE, Evans J, Marks KA. Neurocognitive correlates of helplessness, hopelessness, and well-being in schizophrenia. The Journal of Nervous and Mental Disease. 2001;189(7):457-462.
5. Brohan E, Elgie R, Sartorius N, Thornicroft G, GAMIAN-Europe Study Group. Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries. Schizophrenia Research. 2010;122(1):232-238.
6. Noh C, Choe K, Yang B. Hope from the perspective of people with schizophrenia (Korea). Archives of Psychiatric Nursing. 2008;22(2):69-77.
7. Lysaker PH, Vohs JL, Tsai J. Negative symptoms and concordant impairments in attention in schizophrenia: associations with social functioning, hope, self-esteem and internalized stigma. Schizophrenia Research. 2009;110(1):165-172.
8. Mashiach-Eizenberg M, Hasson-Ohayon I, Yanos, PT, Lysaker PH, Roe D. Internalized stigma and quality of life among persons with severe mental illness: the mediating roles of self-esteem and hope. Psychiatry Research. 2013;208(1):15-20.
9. Fitzgerald R. The sources of hope. New York: Pergamon; 1979. p.224-254.
10. Corrigan PW, McCracken SG, Holmes EP. Motivational interviews as goal assessment for persons with psychiatric disability. Community Mental Health Journal. 2001;37(2): 113-122.
11. White RG, McCleery M, Gumley AI, Mulholland C. Hopelessness in schizophrenia: the impact of symptoms and beliefs about illness. The Journal of Nervous and Mental Disease. 2007;195(12):968-975.
12. Kylma J, Juvakka T, Nikkonen M, Korhonen T, Isohanni M. Hope and schizophrenia: an integrative review. Journal of Psychiatric and Mental Health Nursing. 2006;13:651-664.
13. Moore SL. Hope makes a difference. Journal of Psychiatric and Mental Health Nursing. 2005;12(1):100-105.
14. Öz F. Sağlık Alanında Temel Kavramlar, 2. Baskı. Ankara: Mattek Matbaacılık Basımevi; 2010. p.189-224.
15. Schrank B, Hayward M, Stanghellini G, Davidson L. Hope in psychiatry. Advances in Psychiatric Treatment. 2011;17(3):227-235.
16. Snyder CR, Crowson JJ. Hope and coping with cancer by collage women. J Pers. 1998;66(2):195-214.
17. Akman Y, Korkut F. Umut ölçeği üzerine bir araştırma. Eğitim Fakültesi Dergisi. 1993;9(2):193-203.
18. Landeen J, Pawlick J, Woodside H, Kirkpatrick H, Byrne C. Hope, quality of life, and symptom severity in individuals with schizophrenia. Psychiatric Rehabilitation Journal. 2000;23(4):364-369.
19. Miller J, Powers M. Development of an ınstrument to measure hope. Nursing Research. 1988;37:6-10.
20. Menninger K. The academic lecture: Hope. American Journal of Psychiatry, 1959;116(6):481-491.
21. Gelling L, Fitzgerald MA, Blight I. Hope in the ICU: A qualitative study exploring nurses' experiences of the concept of hope. Nursing in Critical Care. 2002;7(6):271-277.
22. Heszen-Niejodek I, Gottschalk LA, Januszek M. Anxiety and hope during the course of three different medical illnesses: A longitudinal study. Psychotherapy and Psychosomatics. 1999;68(6):304-312.
23. Schrank B, Stanghellini G, Slade M. Hope in psychiatry: a review of the literature. Acta Psychiatrica Scandinavica. 2008;118(6):421-433.
24. Lysaker PH, Campbell K, Johannesen JK. Hope, awareness of illness, and coping in schizophrenia spectrum disorders. Journal of Nervous and Mental Disease. 2005;193(5):287–292.
25. Salerno EM. Hope, power and perception of self in individuals recovering from schizophrenia: a Rogerian perspective. Visions: The Journal of Rogerian Nursing Science. 2002;10(1):23-36.
26. Hofer A, Mizuno Y, Frajo-Apor B, Kemmler G, Suzuki T, Pardeller S, et al. Resilience, internalized stigma, self-esteem, and hopelessness among people with schizophrenia: Cultural comparison in Austria and Japan. Schizophrenia Research. 2016;171(1):86-91.
27. Lyu J, Zhang J. Characteristics of schizophrenia suicides compared with suicides by other diagnosed psychiatric disorders and those without a psychiatric disorder. Schizophrenia Research. 2014;155(1):59-65.
28. Yıldırım DL. Şizofren hastaların umut düzeyinin yaşam kalitesine etkisi. Marmara Üniversitesi, Sağlık Bilimleri Enstitüsü, Psikiyatri Hemşireliği Anabilim Dalı, Yüksek Lisans Tezi, İstanbul, 2009.
29. Olçun Z. Şizofreni Hastalarının İçselleştirilmiş Damgalanma ve Umut Düzeyleri Arasındaki İlişki. Atatürk Üniversitesi, Sağlık Bilimleri Enstitüsü, Psikiyatri Hemşireliği Anabilim Dalı, Yüksek Lisans Tezi, Erzurum, 2016.
30. Vaillot MC. Living and dying. Hope: the restoration of being. The American Journal of Nursing. 1970;70(2),:268-273.
31. Korner IN. Hope as a method of coping. Journal of Consulting and Clinical Psychology. 1970;34(2):134-139.
32. Barut JK, Dietrich MS, Zanoni PA, Ridner SH. Sense of belonging and hope in the lives of persons with schizophrenia. Archives of Psychiatric Nursing. 2016;30(2):178-184.
33. Lee EH. Fatigue and hope: relationships to psychosocial adjustment in Korean women with breast cancer. Applied Nursing Research. 2001;14(2):87-93.
34. Lai YH, Chang JTC, Keefe FJ, Chiou CF, Chen SC, Feng SC, et al. Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients. Cancer Nursing, 2003;26(6):485-493.
35. Kelleci M. Kanser hastalarının umudunun geliştirilmesine yönelik hemşirelik girişimleri. Anadolu Psikiyatri Dergisi. 2005;6(1):41-47.
36. Kavradım ST, Özer ZC. Kanser tanısı alan hastalarda umut. Psikiyatride Güncel Yaklaşımlar. 2014;6(2):154-164.
37. Aslan Ö, Sekmen K, Kömürcü Ş, Özet A. Kanserli hastalarda umut. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2007;11(2):18-24.
38. Duggleby W. Hope at the end of life. J Hosp Palliat Nurs. 2001;3(2):51-64.
39. Cutcliffe J, Herth, K. The concept of hope in nursing 2: hope and mental health nursing. British Journal of Nursing. 2002;11(13):885-893.
40. Kirkpatrick H, Landeen J, Byrne C, Woodside H, Pawlick J, Bernardo A. Hope and schizophrenia: clinicians identify hope-instilling strategies. Journal of Psychosocial Nursing and Mental Health Services. 1995;33(6):15-19.