Kanser Hastalarına Sunulan Psikososyal Hizmetler ve Hemşirelerin Psikososyal Değerlendirme ve Müdahalede Yaşadığı Zorluklar: Ülke Çapında Bir Araştırma

Year 2024, , 101 - 110, 25.06.2024

Nazmiye Yıldırım , Perihan Güner , Figen İnci

https://doi.org/10.17049/jnursology.1425828

Abstract

Amaç: Bu çalışma temelde kanser hastalarına sunulan psikososyal hizmetlerin mevcut durumunu ve hemşirelerin hastaların psikososyal gereksinimlerini karşılama yollarına ilişkin görüşlerini belirlemeyi amaçlamaktadır. Ayrıca hastaların psikososyal gereksinimlerinin karşılanmasının önündeki engellerin değerlendirilmesini ve hemşirelerin psikososyal tanılama ve müdahale uygulamalarında zorluk düzeylerinin ölçülmesini amaçlanmaktadır.

Yöntemler: Türkiye'nin 12 coğrafi bölgesinden seçilen 32 hastanede, erişkin kanser hastalarına doğrudan bakım veren 1189 hemşirenin yer aldığı çok merkezli, kesitsel bir çalışmadır. Veriler, araştırmanın amacına uygun olarak hazırlanan anket aracılığıyla toplanmıştır.

Bulgular: Katılımcıların dörtte üçü hastanelerinde psikososyal destek hizmeti sağlandığını ve %67,7'si bu hizmetin psikiyatri konsültasyonu ile verildiğini bildirmiştir. Yaklaşık yarısı (%49) tüm sağlık çalışanlarının hastaların psikososyal gereksinimlerini karşılamakla yükümlü olduğunu, özellikle hemşirelik görevlerinin ayrılmaz bir parçası olduğunu belirtmiştir. Ancak organizasyonel koşulların (%48,2-%30,7), hastaların psikososyal gereksinimlerinin karşılanmasında en önemli engel olduğu bildirilmiştir. Katılımcıların en çok "cinsel sorunlar" ve "tedaviyi reddetme", en az da "hastaların hastalığa tepkileri" konusunda hastaların psikososyal gereksinimlerini değerlendirmede ve müdahale etmede zorluk yaşadığı ortaya çıkmıştır. Ayrıca katılımcıların 19 psikososyal boyuttan yedisini değerlendirmede ve beşine müdahale etmede daha fazla zorluk yaşadıkları belirlenmiştir (P<,05).

Sonuç: Bu çalışma Türkiye'de psikososyal hizmetlerin daha iyi yapılandırılmasına katkı sağlayabilir. Aynı zamanda psikososyal bakım eğitiminin planlanmasına da rehberlik edebilir. Hemşire-hasta oranı başta olmak üzere kurumsal engellerin aşılması ve hemşirelerin psikososyal bakım kapasitesinin geliştirilmesi gerekmektedir.

Keywords

Kanser, Hemşirelik, Psikososyal Onkoloji, Anket

Ethical Statement

The study was initiated after approval from Koç University’s Ethics Committee (Protocol number: 2016.162 IRB 3.092) and after written permission from participating institutions and informed consent of participants were obtained.

Supporting Institution

This work was supported by the Vehbi Koç Foundation Nursing Fund, in Istanbul, Turkey [grant number 2016.2-2].

Project Number

VKV-2016-2.2.

Thanks

The authors also would like to thank to all participant nurses and unit managers for their support during conduction of this study.

Psychosocial Services Provided to Cancer Patients and Nurses' Difficulties in Psychosocial Assessment and Intervention: A Nationwide Study

Abstract

Objective: The study mainly aims to determine the current state of psychosocial services offered to cancer patients and the views of nurses regarding the ways to meet patients’ psychosocial needs. Other aims to evaluate barriers to meeting patients’ psychosocial needs and measure nurses' difficulty level of psychosocial assessment and intervention practices.

Methods: This multicenter, cross-sectional study was conducted with 1189 nurses providing direct care to adult cancer patients in 32 hospitals in 12 geographical regions of Türkiye. The data were collected by a survey prepared in accordance with the aims of the study.

Results: Three-quarters of the participants reported that their hospital has psychosocial support services while 67.7% stated that this service was provided by psychiatry consultation. Nearly half (49%) stated that all healthcare professionals are responsible for meeting patients’ psychosocial needs, especially it is an integral part of their nursing duties. However, organizational conditions (48.2%-30.7%) are the most important barriers to meeting the psychosocial needs of the patients. Participants have difficulty mostly in assessing and intervening in psychosocial needs of patients mostly in "sexual problems" and "rejection of treatment", and least in "patients’ reactions to illness". Also, the participants have more difficulty in assessing seven of the 19 psychosocial dimensions and intervening in five (P<.05).

Conclusion: This study may be contributed to better structuring of psychosocial services in Türkiye. It can also guide the planning of psychosocial care training. Institutional barriers need to be overcome, especially the nurse-patient ratio, and the psychosocial care capacity of nurses should be improved.

Keywords

Cancer, Nursing, Psychosocial Oncology, Survey

Project Number

VKV-2016-2.2.

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