Nefroloji Sosyal Hizmet: Hemodiyaliz Tedavisi Gören Kronik Böbrek Hastalarının Psikososyal Zorlukları ve İhtiyaçları/Nephrology Social Work: Psychosocial Challenges and Needs of Chronic Kidney Disease Patients Undergoing Hemodialysis

Abstract

Amaç: Bu araştırma, İstanbul’da hemodiyaliz tedavisi gören kronik böbrek hastalarının yaşadığı psikososyal zorlukları ve ihtiyaçları nefroloji sosyal hizmeti perspektifiyle incelemeyi amaçlamaktadır. Gereç ve Yöntem: Nitel araştırma yönteminin benimsendiği çalışmada fenomenolojik desen kullanılmıştır. Kartopu örnekleme yöntemiyle ulaşılan 14 gönüllü hasta ile derinlemesine görüşmeler gerçekleştirilmiştir. Veriler, yarı yapılandırılmış görüşme soruları aracılığıyla toplanmış ve yansıtıcı tematik analiz yöntemiyle sistematik olarak kategorize edilmiştir. Bulgular: Analizler sonucunda beş ana tema belirlenmiştir: psikolojik ve duygusal zorluklar, sosyal geri çekilme, makineye bağımlılık, finansal yük ve diyetsel kısıtlamalar. Hastalar; teşhis sonrası kabullenmeme, depresyon, anksiyete ve suçluluk gibi duyguların yanı sıra uyku sorunları ve fiziksel güç kaybı yaşadıklarını belirtmişlerdir. Tedavi sürecinin iş yaşamını olumsuz etkilediği, maddi kayıplara yol açtığı ve sosyal izolasyonu tetiklediği saptanmıştır. Makineye bağımlılık ve katı diyetler, hastaların yaşam kalitesini düşüren diğer temel unsurlar olarak öne çıkmaktadır. Sonuç: Hemodiyaliz hastaları, uzun tedavi süreçlerinin getirdiği zorluklarla başa çıkabilmek için hem tıbbi hem de psikososyal açıdan profesyonel desteğe ihtiyaç duymaktadır. Bu doğrultuda tedavi öncesi veya tedavi sonrası hastalar için kısa süreli psikososyal hazırlık ve uyum programları hazırlanabilir. Programda; hastalara hastalık hakkında bilgi vermek, tedavi öncesi ve sonrası süreci açıklamak, psikoeğitim oturumları hazırlamak, kaygı yönetimi çerçevesinde gevşeme ve nefes egzersizleri yaptırmak, sosyal izolasyonu önlemek amacıyla networklar oluşturup hastaları dahil etmek gibi uygulamalar yapılabilir. Söz konusu müdahalelerin sağlık kurumları bünyesinde, sosyal hizmet uzmanları ve multidisipliner sağlık ekipleri tarafından standart bir uygulama haline getirilmesi önerilmektedir.

Keywords

• Hemodiyaliz
• Kronik Böbrek Hastalığı
• Nefroloji Sosyal Hizmet
• Psikososyal Zorluklar

Ethical Statement

The ethical suitability of the study was approved by the İstanbul Aydın University Social Sciences Ethics Committee (dated 03.08.2023 and no E-88083623-020-92715). Ethics Committee approval 2023/07 Meeting No. was reported to the researchers.

Nephrology Social Work: Psychosocial Challenges and Needs of Chronic Kidney Disease Patients Undergoing Hemodialysis/Nefroloji Sosyal Hizmet: Hemodiyaliz Tedavisi Gören Kronik Böbrek Hastalarının Psikososyal Zorlukları ve İhtiyaçları

Abstract

Aim: This research aims to examine the psychosocial challenges and needs of chronic kidney disease patients undergoing hemodialysis treatment in Istanbul from a nephrology social work perspective. Materials and Methods: A phenomenological design was used in this qualitative research study. In-depth interviews were conducted with 14 volunteer patients reached through snowball sampling. Data was collected through semi-structured interview questions and systematically categorized using reflective thematic analysis. Results: Five main themes were identified as a result of the analyses: psychological and emotional difficulties, social withdrawal, dependence on machines, financial burden, and dietary restrictions. Patients reported experiencing feelings of denial, depression, anxiety, and guilt after diagnosis, as well as sleep problems and loss of physical strength. It was found that the treatment process negatively affected work life, led to financial losses, and triggered social isolation. Dependence on machines and strict dietary regimens stood out as other key factors reducing the patients’ quality of life. Conclusion: Hemodialysis patients need professional support, both medically and psychosocially, to cope with the challenges of long treatment processes. In this regard, short-term psychosocial preparation and adaptation programs can be developed for patients before or after treatment. These programs may include providing information about the disease, explaining the pre-treatment and post-treatment process, preparing psychoeducational sessions, conducting relaxation and breathing exercises within the framework of anxiety management, and creating networks and involving patients to prevent social isolation. It is recommended that these interventions become standard practice within healthcare institutions, carried out by social workers and multidisciplinary healthcare teams.

Keywords

• Chronic Kidney Disease
• Hemodialysis
• Nephrology Social Work
• Psychosocial Challenges

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