Bipolar Bozukluğu Olan Hastalara Yapılan Stresle Başetme Eğitiminin Stres Belirtileri, Algılanan Stres Düzeyi ve Stresle Baş Etme Tarzlarına Etkisi

Abstract

Bu araştırma, bipolar bozukluk tanısı ile psikiyatri kliniğinde yatan hastalara verilen stresle baş etme eğitiminin stres belirtileri, başa çıkma tutumları ve algılanan stres düzeyi etkisini belirlemek amacıyla yapılmıştır. Araştırma ön test – son test, kontrol gruplu deneysel bir çalışmadır. Çalışmanın örneklemini bir üniversite hastanesi psikiyatri kliniğinde bipolar bozukluk tanısı ile takip edilen 60 hasta oluşturmuştur. Araştırmanın verileri Kişisel Bilgi Formu, Stres Belirtileri Ölçeği (SBÖ), Başa Çıkma Tutumlarını Değerlendirme Ölçeği (COPE) ve Algılanan Stres Ölçeği (ASÖ) ile toplanmıştır. Deney grubuna üç oturumdan oluşan Stresle Baş etme Eğitim programı uygulanmıştır. Verilerin değerlendirilmesinde için student t testi, Varyans analizi ve ki kare testi kullanılmıştır. Deney grubundaki bireylerin SBÖ toplam puan ortalaması uygulama öncesi 57,62±13,77 iken uygulama sonrası 37,14±5,91 olmuştur ve aradaki fark anlamlıdır (p<0,05). COPE puan ortalaması uygulama öncesi 144,30±19,73, uygulama sonrasında 193,17±15,27 olup, puanlar arasındaki fark istatistiksel olarak anlamlıdır (p<0,05). ASÖ toplam puan ortalaması uygulama öncesi 43,23±10,12 uygulama sonrası 7,50±5,19 olarak belirlenen deney grubunun öntest-sontest puan ortalamaları arasındaki fark anlamlıdır (p<0,05). Kontrol grubundaki bireylerin SBÖ, COPE ve ASÖ öntest ve son test puan ortalamaları arasında anlamlı fark yoktur (p>0,05). Deney ve kontrol grubu SBÖ, COPE ve ASÖ puan ortalamaları açısından karşılaştırıldığında gruplar arasındaki fark istatiksel olarak anlamlıdır (p<0.0,5). Çalışmanın sonucunda bipolar hastalara uygulanan stresle başetme programının etkili olduğu söylenebilir.

Keywords

• Bipolar bozukluk
• stresle başetme eğitimi
• stres belirtileri
• başetme tarzları
• algılanan stres

The Effect of Stress Coping Trainıng Given to Patients with Bipolar Disorder on Their Stress Symptoms Perceived Stress Level and Coping Styles

Abstract

This study was conducted to determine the effect of stress coping training given to patients hospitalized in a psychiatric clinic with the diagnosis of bipolar disorder on their stress symptoms, stress coping styles and perceived stress levels. This study was an experimental pretest-posttest control group design. The sample of the study consisted of 60 patients with bipolar disorder who were followed at the Psychiatry Clinic of Cumhuriyet University Health Services Application and Research Hospital. Data were collected using Personal Information Form, the Stress- Symptom Scale (SSS), COPE Inventory, and Perceived Stress Scale (PSS). Stress Coping Training program consisting of three sessions was applied to the experimental group. Student t test, variance analysis and chi-square test were used for the evaluation of the data. According to the findings obtained from the study, the mean SSS total score of the individuals in the experimental group was 57.62±13.77 before the application, while the mean SSS score of the experimental group after the application was 37.14±5.91 (p<0.05). The mean COPE score was 144.30±19.73 before the application, 193.17±15.27 after the application and the difference between the scores was statistically significant (p<0.05). The mean PSS total score was 43.23±10.12 before the application, 7.50±5.19 after the application and the difference between the pretest-posttest mean scores of experimental group was significant (p<0.05). It was determined that there was no significant difference between the SSS, COPE and PSS pretest-posttest mean scores of the individuals in the control group (p>0.05). When the experimental and control groups were compared in terms of SSS, COPE and PSS mean scores, the difference between the groups was found to be significant (p<0.05). At the end of the study, it was observed that the stress coping program applied to bipolar patients was effective.

Keywords

• Bipolar disorder
• stress coping training
• stress symptoms
• coping styles
• perceived stress

References

1. Ağargün, M.Y., Beşiroğlu, L., Kıran, Ü. K., Özer, Ö. A., & Kara, H. (2005). COPE (Başa Çıkma Tutumlarını Değerlendirme Ölçeği):Psikometrik özelliklere ilişkin bir ön çalışma. Anadolu Psikiyatri Dergisi, 6:221-226.
2. Aksoy, A., & Kelleci, M. (2016). Bipolar Hastalarda İlaç Uyumu: Stresle Başetme ve Sosyal Destekle İlişkisi. Dusunen Adam The Journal of Psychiatry and Neurological Sciences, 29:210-218.
3. Bender, R.E., Alloy, L.B., Syliva, L.G., Urosevic, S., & Abramson, L.Y. (2010). Generation of life events in bipolar spectrum disorders: A re-examination and extension of the stress generation thery. Journal of Clinical Pyschology, 66(9), 907-926.
4. Bender, R. E., & Alloy, L. B. (2011). Life Stress and Kindling in Bipolar Disorder: Review of the Evidence and Integration with Emerging Biopsychosocial Theories. NIH-PA Author Manuscript, 31(3): 383–398.
5. Berghost, L. H., Kumar, P., Greve, D. N., Deckersbach, T., Ongur, D., Dutra, S. J., et al. (2016). Stress and Reward Processing in Bipolar Disorder: A functional Magnetic Resonance İmaging Study. Bipolar Disorders, 18(7),602-611.
6. Blixen, C., Levin, J. B., Cassidy, K. A., Perzynski, A. T., & Sajatovic, M. (2016:). Coping Strategies Used By Poorly Adherent Patients For Self-Managing Bipolar Disorder. Patient Preference and Adherence, 10 1327–1335.
7. Casement, M. D., Goldstein, T. R., Gratzmiller, S. M., & Franzenb, P. L. (2018). Social stress response in adolescents with bipolar disorder. Psychoneuroendocrinology, 158-169.
8. Chan, S. H., & Tse, S. (2018). Coping with amplified emotionality among people with bipolar disorder: A longitudinal study. Journal of Affective Disorders, 303-312.

9. Corry, J., Green, M., Roberts, G., Fullerton, J. M., Schofield, P. R., & Mitchell, P. B. (2017). Does perfectionism in bipolar disorder pedigrees mediate associations between anxiety/stress and mood symptoms? İnternational Journal of Bipolar Disorder, 5:34.
10. Dikyar Altun, F. (2014). uzmanlık tezi. Ö. Metin içinde, Bipolar Bozukluk Tanılı Hastalarda Mevcut Tedaviye Ek Olarak verilen Psikoeğitimin Tedaviye Uyuma, İşlevselliğe, Yaşam Kalitesine, Hastanın Sosyal Destek Algısına ve Yaşam Olayları ile Başaçıkma Becerilerine Etkisi (s. 33-40). Antalya: Yök Tez.
11. Dodd, A., Lockwood, E., Mansell, W., & Claus, J. P. (2019). Emotion regulation strategies in bipolar disorder: A systematic and critical. Journal of Affective Disorders, 262-284.
12. Engel-Yeger, B., Gonda, X., Muzio, C., Risosi, G., Pompili, M., Amore, M., et al. (2016). Braziliann Journal of Psychiatry. Sensory processing patterns, coping strategies, and quality of life among patients with unipolar and bipolar disorders, 38(3);207-15.
13. Eskin, M., Harlak, H., Demirkıran, F., & Dereboyu, Ç. (2013). Algılanan Stres Ölçeğinin Türkçeye Uyarlanması:Güvenirlik ve Geçerlik Analizi. New/Yeni Symposium Journal, Cilt 51 | Say› 3.
14. Faurholt, M., Frest, J. M., Chistansem, E. M., Bardrem, J. E., Vinberg, M., & Kessing, L. v. (2019). The validity of daily anxiety reported using smart reports in patients with bipolar disorder and its relationship with stress, quality of life and functioning. Journeal of disorder, 100-107.
15. Fletcher, K., Parker, G. B., & Manicavasagar, V. (2013). Coping profiles in bipolar disorder. Comprehensive Psychiatry, 54 :1177–1184.
16. Goossens, P. J., Knoppert, E. M., Klein, -v., & Achterberg, T. (2008). Coping Styles of Outpatients With a Bipolar Disorder. Archives of Psychiatric Nursing,, 22(5);245-253.
17. Işık, E. (2013). İki Uçlu Bozuklukta Psikofarmakolojik Tedavinin Gerekçeleri, Genel Tedavi İlkeleri ve Uygulama Biçimleri. Journal of Mood Disorders, 3(1): 23-25. Johnson, S. L. (2005). Life events in bipolar disorder: Towards more specific models. NIH Public Access, 25(8): 1008–1027.
18. Kılıç, C., & Eşel, E. (2002). Stres Tepkisi Süreci. Klinik Psikofarmakoloji Bülteni, 12,41-48.
19. Kim, Y. E., Miklowitz, D. J., Biuckians, A., & Mullen, K. (2007). Life Stress and the Course Of Early-Onset Bipolar Disorder. Journal Affective Disorder, 99(1- 3): 37–44.
20. Knowles, R., Tai, S., Christensen, I., & Bentall, R. (2005). Coping with depression and vulnerability to mania:A factor analytic study of the Nolen- Hoeksema(1991) Response Styles Questionnaire. British Journal of Clinical Psychology, 44, 99–112.
21. Lex, C., Bazner, E., & Meyer, T. D. (2017). Does Stress Play A Significant Role in Bipolar Disorder? A meta-analysis. Journal Of Affective Disorder, 208.298- 308. Maçkalı, Z. (2014). Bipolar Bozuklukta Bilişsel Yatkınlık-Stres Kuramları. Türk Psikoloji Yazıları, 17(33):15-28.
22. Maiera, E. (2012). Bipolar Disorder And Stress. Psychiatria Danubina, 24(1):59-60.
23. Miklowitz, D. J., & Johnson, S. J. (2009). Social and Familial Factors in the Course of Bipolar Disorder: Basic Processes and Relevant Interventions. NIH Public Access Author Manuscript, 16(2): 281–296.
24. Molz, A. R., Black, C. L., Shapero, B. G., Bender, R. E., Alloy, L. B., & Abramson, L.Y. (2013). Aggression and Impulsivity as Predictors of Stress Generation in Bipolar Spectrum Disorders. J Affect Disord., 5; 146(2): 272–280.
25. Moon, E., Chang, J. S., Choi, S., Ha, T. H., Cha, B., Cho, H. S., et al. (2014). Characteristics o fstress-coping behaviors in patients. PsychiatryResearch, 69-74. Nieto, E., Bonebarro, A., & Vieta, E. (2019). Completed suicide in bipolar disorder patients: cohort study after first admission. Journeal Of Disorder, 340-344.
26. Nitzburg, G.C., Russo, M., Cuesta-Diaz, A., Ospina, L., Shanahan, M., Perez- Rodriguez, M., et al. (2016). Coping strategies and real World functioning in bipolar disorder. Journal of Affective Disorders, 185–188.
27. Oliveria, R.C., Filho, L.D., & Brietzko, E. (2010). New perspectives on coping in bipolar disorder. Psychology & Neuroscience, 3:161-165.
28. Özarslan, Z., Fıstıkcı, N., Keyvan, A., Uğurad, Z. I., & Saygılı, S. (2013). Depresyon hastalarının stres ile başa çıkma stratejileri. Marmara Medical Journal, 26:130-5. Öztürk, O., & Uluşahin, A. (2008). Ruh Sağlığı ve Bozuklukları I. Ankara.
29. Pavlickova, H., Varese, F., Smith, A., Myin-Germeys, I., Turnbull, O. H., Emsley, R., et al. (2013). The Dynamics of Mood and Coping in Bipolar Disorder:Longitudinal Investigations of the Inter-Relationshipbetween Affect, Self-Esteem and Response Styles. Dynamics of Response Styles in Bipolar Disorder.
30. Sadock, B. J., & Sadock, V. A. (2007). Kaplan&Sadock's Comprehensive Textbook of Psychiatry. Ankara: Güneş Kitabevi.
31. Shapero, B. G., Weiss, R. B., Burke, T. A., Boland, E. M., Abramson, L. Y., & Alloy, L. B. (2017). Kindling of Life Stress in Bipolar Disorder: Effects of. Behavior Therapy, 48:322–334.
32. Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Healt Sciences.
33. Varo, C., Murru, A., Salagre, E., Jiménez, E., Solé, B., Montejo, L., et al. (2019). Behavioral addictions in bipolar disorders:A systematic review. European Neuropsychopharmacology, 29;76-97.
34. Videbeck, L. C., & Schultz, J. M. (2013). Lippincott's Manuel of Psychiatric Nursing Care Plans. New York: Wolters Kluwer Health.
35. Willert, M. V., Thulstrup, A., Hertz, J., & Bonde, J. P. (2009). Changes in stress and coping from a randomized controlled trial of a three-month stress management intervention. Scand J Work Environ Health, 35(2):145-152.
36. Wilson, L., Crowe, M., Scott, A., & Lacey, C. (2016). Psychoeducation for bipolar disorder: A discourse analysis. Mental Healt Nursing, 123-126. Zagreb, C. (2012). Bipolar Disorder and Stress. Psychiatria Danubina, 24(1):59-60.