Multipl Skleroz Hastaları için Geliştirilen Bir Grup Psikoeğitim Programının Değerlendirilmesi

Year 2019, Volume: 6 Issue: 3, 289 - 311, 01.10.2019

Dilek Demirtepe-saygılı

https://doi.org/10.31682/ayna.589657

Abstract

Kronik hastalıklar uzun sureli, kısıtlayıcı ve uyum gerektiren durumlardır. Bazı
hastalar bu uyum sürecinde hastalıkla baş etmede zorlanır ve bunun sonucunda
psikolojik sağlıkları olumsuz yönde etkilenir. Pek çok farklı kronik hastalık için
psikososyal destek amaçlı müdahale programları geliştirilmiştir. Bu çalışmanın amacı
kronik bir sinir sistemi bozukluğu olan Multipl Skleroz tanısı almış hastalar için
geliştirilen bir grup psikoeğitim programının geliştirilme sürecinin ve sonuçlarının
değerlendirilmesidir. En az üç en çok 30 yıl önce Multipl Skleroz tanısı almış
katılımcılardan oluşan üç ayrı gruba stres yönetimi, iletişim ve duygu düzenleme
konularında toplam 20 oturumluk bir psikoeğitim programı uygulanmıştır. Programın
sonuçlarını değerlendirmek için program bitiminde her grup için bir odak grubu
görüşmesi yapılmıştır. İçerik analizi sonucunda öğrenme, sosyal destek, günlük hayata
aktarma, özgüven ve terapi ilişkisi temaları ortaya çıkmıştır. Temalar değişim
süreçlerinin katılımcıların bakış açısıyla detaylı olarak incelenmesini sağlamıştır.
Bulgulara dayanarak benzer gruplar için geliştirilecek grup destek programlarına ve
etkililik çalışmalarına katkıda bulunacak çıkarımlar yapılmıştır.

Keywords

Multipl Skleroz, psikoeğitim, odak grup, kronik hastalık

Thanks

Bu çalışmanın bir bölümü 15. Avrupa Psikoloji Kongresi’nde sunulmuştur.

Development and Evaluation of a Group Psychoeducation Program for Patients with Multiple Sclerosis

Abstract

Chronic illnesses are long-term and decapitating conditions by definition, and they
require adaptation. Some patients have difficulty in coping during the adaptation
process, and as a result they have negative well-being. Various intervention programs
were developed for chronic illnesses to provide psychosocial support. The aim of the
current study was to develop a group psychoeducation program for people with
Multiple Sclerosis, which is a chronic nervous system disorder, and to evaluate its
effectiveness. Three different groups, consisting of participants diagnosed with
Multiple Sclerosis at least three, at most 30 years ago, were administered a 20-sessionpsychoeducation about stress management, healthy communication, and emotion
regulation. Focus group interviews were conducted to evaluate their effectiveness.
Content analysis revealed five themes which were learning, social support, transfer to
daily life, self-esteem and therapeutic relationship. The themes provided in-depth
information to investigate the process of change from the perspective of the group
participants. Based on the current results, inferences were made for the development
and effectiveness of further similar target groups interventions.

Keywords

Multiple Sclerosis, psychoeducation, focus group, chronic illness

References

• Anderson, J. K., Turner, A., & Clyne, W. (2017). Development and feasibility of the help to Overcome Problems Effectively (HOPE) self-management intervention for people living with multiple sclerosis. Disability and Rehabilitation, 39(11), 1114-1121, doi: 10.1080/09638288.2016.1181211.
• Baylor, C., Yorkston, K., Bamer, A., Britton, D., & Amtmann, D. (2010). Variables associated with communicative participation in people with multiple sclerosis: A regression analysis. American Journal of Speech-Language Pathology, 19(2), 143-153.
• Beitman, B. D., & Manring, J. (2009). Theory and practice of psychotherapy integration. In Gabbard, G. O. (Ed.), Textbook of psychotherapy treatments (pp. 705-726). Washington DC: American Psychiatric Publishing.
• Birnbaum, G. (2013). Multiple Sclerosis: Clinician’s guide to diagnosis and treatment (2nd ed.) (pp. 80). New York: Oxford University Press.
• Bloor, M., Frankland, J., Thomas, M., & Robson, K. (2001). Focus groups in social research. London: SAGE.
• Brown, R. F., Valpiani, E. M., Tennant, C. C., Dunn, S. M., Sharrock, M., Hodgkinson, S., & Pollard, J. D. (2009). Longitudinal assessment of anxiety, depression, and fatigue in people with multiple sclerosis. Psychology and Psychotherapy, 82(1), 41–56. doi: 10.1348/147608308X345614.
• Calandri, E., Graziano, F., Borghi M., & Bonino S. (2017). Improving the quality of life and psychological well-being of recently diagnosed multiple sclerosis patients: Preliminary evaluation of a group-based cognitive behavioral intervention. Disability and Rehabilitation, 39(15), 1474-1481. doi: 10.1080/09638288.2016.1198430.
• Cheng, C. (2001). Assessing coping flexibility in real-life and laboratory settings: A multimethod approach. Journal of Personality and Social Psychology, 80(5), 814-833.
• Cheung, P. P. P., Siu, A. M. H., Brown, T., & Yu, M. (2018). A social-cognitive intervention prgram for adolescents with autism: A pilot study. Journal of Occupational Therapy, Schools, and Early Intervention, 11(1), 37-48.
• Çınarbaş, D. C. (2015). Kişilerarası süreç grupları: Etkinliği, evreleri, etik kaideleri ve Türkiye kültürüne uygunluğu. Türk Psikoloji Yazıları, 18(1), 73–80.
• Conway, V. J., & Terry, D. J. (1992). Appraised controllability as a moderator of the effectiveness of different coping strategies: A test of the goodness of fit hypothesis. Australian Journal of Psychology, 44(1), 1–7.
• Dünya Sağlık Örgütü (2004). Palliative Care: The solid facts. Copenhagen: WHO.
• Eschlerman, K. J., Alarcon, G. M., Lyons, J. B., Stokes, C., K., & Schneider, T. (2012). The dynamic nature of the stress appraisal process and the infusion of affect. Anxiety, Stress, & Coping, 25(3), 309-327.
• Garnefski, N., & Kraaij, V. (2006). Relationships between cognitive emotion regulation strategies and depressive symptoms: A comparative study of five specific samples. Personality and Individual Differences, 40(8), 1659– 1669. doi: 10.1016/j.paid.2005.12.009.
• Goretti, B., Portaccio, E., Zipoli, V., Hakiki, B., Siracusa, G., Sorbi, S., & Amato, M. P. (2009). Coping strategies, psychological variables and their relationship with quality of life in multiple sclerosis. Neurological Sciences: Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 30(1), 15–20. doi:10.1007/s10072-008-0009-3.
• Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. doi:10.1023/B:JOBA.0000007455.08539.94.
• Gross, J. J. (2001). Emotion regulation in adulthood: Timing is everything. Current Directions in Psychological Science, 10(6), 214-219. doi: 10.1111/1467-8721.00152.
• Gross, J. J. (2007). Handbook of Emotion Regulation. New York: Guilford.
• Gross, J. J., & Jazaieri, H. (2014). Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science, 2(4), 387-401.
• Gross, J. J., Sheppes, G., & Urry, H. L. (2011). Emotion generation and emotion regulation: A distinction we should make (carefully). Cognition and Emotion, 25(5), 765–781. doi: 10.1080/02699931.2011.555753
• Harel, Y., Barak, Y., & Achiron, A. (2007). Dysregulation of affect in multiple sclerosis. New phenomenological approach. Psychiatry and Clinical Neurosciences, 61(1), 94-98.
• Henry, A., Tourbah, A., Camus, G., Deschamps, R., Mailhan, L., Castex, C., … Montreuil, M. (2019). Anxiety and depression in patients with multiple sclerosis: The mediating effects of perceived social support. Multiple Sclerosis and Related Disorders, 27(1), 46–51. doi:10.1016/j.msard.2018.09.039.
• Hernandez, M. M., Eisenberg, N., Valiente, C., Spinrad, T. L., VanSchyndel, S. K., Diaz, A., … Piña, A. A. (2015). Observed emotion frequency versus intensity as predictors of socioemotional maladjustment. Emotion, 15(6), 699-704. doi: 10.1037/emo0000099.
• Holland, N. J., Murray, T. J., & Reingold, S. C. (2007). Multiple Sclerosis: A guide for the newly diagnosed (3rd ed.), (pp. 4-5). New York, N.Y.: Demos Health.
• Holmes, J. M., Ford, E., Yuill, F., Drummond, A. E. R., & Lincoln, N. B. (2012). Attendance at a psychological support group for people with multiple sclerosis and low mood. Disability and Rehabilitation, 34(15), 1323–1327. doi: 10.3109/09638288.2011.642927.
• Kehler, M. D., & Hadjistavropoulos, H. D. (2009). Is health anxiety a significant problem for individuals with multiple sclerosis? Journal of Behavioral Medicine, 32(2), 150–61. doi: 10.1007/s10865-008-9186-z.
• Lazarus, R. S. (1991). Emotion and Adaptation. New York: Oxford University Press.
• Lazarus, R. S., & Folkman, S. (1984). Stress, Appraisal and Coping. New York: Springer.
• Lode, K., Bru, E., Klevan, G., Myhr, K. M., Nyland, H., & Larsen, J. P. (2009). Depressive symptoms and coping in newly diagnosed patients with multiple sclerosis. Multiple Sclerosis, 15(5), 638-643.
• Lovera, J., & Reza, T. (2013). Stress in multiple sclerosis: Review of new developments and future directions. Current Neurology and Neuroscience Reports, 13(11), 398.
• Motl, R. W., McAuley, E., & Snook, E. M. (2007). Physical activity and quality of life in multiple sclerosis: Possible roles of social support, self-efficacy, and functional limitations. Rehabilitation Psychology, 52(2), 143–151. doi: 10.1037/0090-5550.52.2.143.
• Murray, T. (1995). Psychosocial aspects of multiple sclerosis. Neurologic Clinics, 13(1), 197–223.
• Norcross, J. C. (2010). The therapeutic relationship. In B. L. Duncan, S. D. Miller, B. E. Wampold, & M. A. Hubble (Eds.). The heart and soul of change: Delivering what works in therapy (2nd ed.), (pp. 113-142). Washington DC: APA.
• Norcross, J. C. & Wampold, B. E. (2011). Evidence based therapy relatonships: Research conclusions and clinical practices. In J. C. Norcross (Eds.). Psychotherapy relationships that work:Evidence-based responsiveness (2nd ed.), (pp. 423-430). New York: Oxford University Press.
• Öztaş, P., Şeker, N., & Taşkıntuna, N. (2012). Kronik böbrek yetmezliği olan hastalarda grup terapisi süreci. Nöropsikiyatri Arşivi, 49(1), 63-67.
• Pakenham, K. I. (2006). Investigation of the coping antecedents to positive outcomes and distress in multiple sclerosis (MS). Psychology and Health, 21(5), 633–649. doi: 10.1080/14768320500422618
• Paliokosta, E., Diareme, S., Kolaitis, G., Tsalamanios, E., Ferentinos, S., Anasontzi, S., & Romer, G. (2009). Breaking bad news: Communication around parental multiple sclerosis with children. Families, Systems and Health, 27(1), 64–76. doi: 10.1037/a0015226
• Petrie, K., & Revenson, T. (2005). Editorial: New psychological interventions in chronic illness:Towards examining mechanisms of action and improved targeting. Journal of HealthPsychology, 10(2), 179-184.
• Phillips, L. H., Henry, J. D., Nouzova, E., Cooper, C., Radlak, B., & Summers, F. (2014). Difficulties with emotion regulation in multiple sclerosis: Links to executive function, mood, and quality of life. Journal of Clinical and Experimental Neuropsychology, 36(8), 831-842.
• Plummer, B. A., Velicer, W. F., Redding, C. A., Prochaska, J. O., Rossi, J. S., Pallonen, U. E., & Meier, K. S. (2001). Stage of change, decisional balance, and temptations for smoking: Measurement and validation in a large, school-based population of adolescents. Addictive Behaviors, 26(4), 551-571.
• Plutchik, R. (2000). Emotions in the practice of psychotherapy. Washington DC: APA.
• Power, M. & Dalgleish, T. (2008) Cognition and emotion: From order to disorder (2nd ed.). New York: Psychology Press.
• Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change in smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 520-528.
• Prochaska, J. O., & Prochaska, J. M. (2010). Self-directed change: A transtheoretical model. In J. E. Maddux, J. P. Tangney, J. E. Maddux, & J. P. Tangney (Eds.). Social psychological foundations of clinical psychology (ss. 431–440). New York, NY: Guilford Press.
• Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38-48.
• Rigby, S. A, Thornton, E. W., & Young, C. A. (2008). A randomized group intervention trial to enhance mood and self-efficacy in people with multiple sclerosis. British Journal of Health Psychology, 13(4), 619–631. doi: 10.1348/135910707X241505.
• Sá, M. J. (2008). Psychological aspects of multiple sclerosis. Clinical Neurology and Neurosurgery, 110(9), 868–877. doi: 10.1016/j.clineuro.2007.10.001.
• Schimmiack, U., & Diener, E. (1997). Affect intensity: Seperating intensity and frequency in repeatedly measured affect. Journal of Personality and Social Psycology, 73(6), 1313-1329.
• Schapiro, R. T. (2007). Managing the symptoms of Multiple Sclerosis. New York: Demos.
• Silverman, D. (1993). Interpreting qualitative data: Methods for analysing talk, text and interaction. London: Sage.
• Smith, J. A., & Eatough, V. (2007). Interpretative phenomenological analysis. In E. Lyons, & A. Coyle (Eds.). Analysing qualitative data in psychology. London: Sage.
• Smith, J. A., & Osborn, M. (2003). Interpretative phenomenological analysis. In J. A. Smith (Ed.). Qualitative psychology: A practical guide to research methods. London: Sage.
• Willig, C. (2008). Introducing qualitative research in psychology: Adventures in theory and method (2nd ed.). New York: McGraw Hill Open University Press.
• Yalom, I. D. (1995). The Theory and practice of group psychotherapy (4th ed.). New York, US: Basic Books.
• Yorkston, K. M., Klasner, E. R., & Swanson, K. M. (2001). Communication in context: a qualitative study of the experiences in individuals with multiple sclerosis. American Journal of SpeechLanguage Pathology, 10(2), 126–137.