Palyatif Bakım Hastalarında Psikososyal Semptomların Yönetimi

Modern palyatif bakım, görece olarak tıbbın ihmal ettiği ileri evre hastalığı olan bireylerin ve ailelerinin fiziksel ve psikolojik ıstırabına yanıt olarak ortaya çıkmıştır. Hastaların fiziksel semptomlarını hafifletmek için geliştirilen sistematik yaklaşımlarda ciddi ilerlemeler kaydedilmiş olmasına rağmen psikolojik semptomların yönetiminde alınan yol henüz yeterli değildir. Diğer taraftan psikolojik semptomların hafifletilmesine yönelik girişimler de rutin palyatif bakıma dahil edilememiş ve rastlantısal olarak uygulanmaktadır. Psikolojik bakımın bu görece ihmali, modern tıbbın tüm branşlarını kapsayan önemli bir sorundur. Bunun nedeni yaşamı sınırlayan bir hastalık durumunda gelişen psikolojik/ psikiyatrik semptomların hem hasta yakınları hem de sağlık çalışanları tarafından normal kabul edilmesi, empati içeren girişimlerin profesyoneller için zahmetli, kazanılması ve öğrenilmesi zor ve pahalı, ancak alıcılar için belki de tüm tıbbi girişimlerin içinde en ucuzu olmasıdır. Bu anlamda bakıldığında genel olarak psikolojik girişimler biyoloji ve teknolojiyi içeren girişimlerden daha az değerli olma eğilimindedir. Son on yılda palyatif bakım alan hasta ve ailelerinin psikososyal gereksinimlerine yönelik uygulanan girişimlerin etkinliğine dair kanıtlar da artış göstermektedir. Bu derlemede palyatif bakım hastalarına yönelik olarak gerçekleştirilen psikolojik girişimlerin etkinliğine dair kanıtların incelenmesi amaçlanmıştır.

Anahtar Kelimeler:

Anksiyete, Depresyon, Distres, Palyatif bakım, Psikolojik girişimler

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