PATIENTS' VIEWS ON PROVIDING PSYCHOLOGICAL SUPPORT IN PRIMARY HEALTH CARE SERVICES

Öz

The comprehensive and holistic delivery of healthcare services is crucial for protecting and improving individuals' physical and mental health. This study aims to contribute to primary healthcare services by identifying the need for and quality of psychological support in primary healthcare and enhancing psychological support services to improve service quality and performance. In this context, semi-structured interviews were conducted with 69 patients who visited a family health center. The data obtained were analyzed using the content analysis method. Participants frequently stated their desire to receive psychological support, found the provision of psychological support services at family health centers (FHC) to be appropriate, and highlighted numerous advantages of such services in terms of healthcare delivery.

Anahtar Kelimeler

• Primary healthcare services
• psychological health
• biopsychosocial model
• psychological counseling.

Hastaların Birinci Basamak Sağlık Hizmetlerinde Psikolojik Destek Sunulmasına İlişkin Görüşleri

Öz

Sağlık hizmetlerinin kapsamlı ve bütüncül bir yaklaşımla sunulması, bireylerin hem fiziksel hem de ruhsal sağlığını koruma ve iyileştirme açısından büyük önem taşımaktadır. Bu araştırmada, birinci basamak sağlık hizmetlerinde psikolojik destek ihtiyacını ve niteliğini saptayarak, hizmet kalitesinin ve performansın arttırılması için psikolojik destek hizmetlerinin iyileştirilmesi yönünde birinci basamak sağlık hizmetlerine katkı yapmak amaçlanmıştır. Bu doğrultuda aile sağlığı merkezine başvuran 69 hasta ile yarı yapılandırılmış görüşmeler gerçekleştirilmiştir. Elde edilen veriler içerik analizi yöntemi ile analiz edilmiştir. Katılımcı hastalar yüksek sıklıkla psikolojik destek almak istediklerini, aile sağlığı merkezlerinde psikolojik destek hizmetinin verilmesini uygun buldukları ve bu durumun, hizmet açısından birçok avantajları bulunduğunu ifade etmişlerdir.

Anahtar Kelimeler

• Birinci basamak sağlık hizmetleri
• psikolojik sağlık
• biyopsikosoyal model
• psikolojik danışma.

Kaynakça

1. Baş, T., & Akturan, U. (2013). Qualitative research methods: Qualitative data analysis with Nvivo [in Turkish]. Seçkin Yayıncılık.
2. Borrell-Carrió, F., Suchman, A. L., & Epstein, R. M. (2004). The biopsychosocial model 25 years later: Principles, practice, and scientific inquiry. The Annals of Family Medicine, 2(6), 576–582. https://doi.org/10.1370/afm.245
3. Bower, P., & Gilbody, S. (2005). Stepped care in psychological therapies: Access, effectiveness and efficiency: Narrative literature review. The British Journal of Psychiatry, 186(1), 11–17. https://doi.org/10.1192/bjp.186.1.11
4. Cohen, S., Janicki-Deverts, D., & Miller, G. E. (2007). Psychological stress and disease. JAMA, 298(14), 1685–1687. https://doi.org/10.1001/jama.298.14.1685
5. Danese, A., Pariante, C. M., Caspi, A., Taylor, A., & Poulton, R. (2007). Childhood maltreatment predicts adult inflammation in a life-course study. Proceedings of the National Academy of Sciences, 104(4), 1319–1324. https://doi.org/10.1073/pnas.0610362104
6. Danese, A., Caspi, A., Williams, B., Ambler, A., Sugden, K., Mika, J., et al. (2010). Biological embedding of stress through inflammation processes in childhood. Molecular Psychiatry, 16(3), 244–246. https://doi.org/10.1038/mp.2010.5
7. Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. https://doi.org/10.1126/science.847460
8. Ershler, W. B., & Keller, E. T. (2000). Age-associated increased interleukin-6 gene expression, late-life diseases, and frailty. Annual Review of Medicine, 51, 245–270. https://doi.org/10.1146/annurev.med.51.1.245

9. Farre, A., & Rapley, T. (2017). The new old (and old new) medical model: Four decades navigating the biomedical and psychosocial understandings of health and illness. Healthcare, 5(4), 88. https://doi.org/10.3390/healthcare5040088
10. Fava, G. A., & Sonino, N. (2000). Psychosomatic medicine: Emerging trends and perspectives. Psychotherapy and Psychosomatics, 69(4), 184–197. https://doi.org/10.1159/000012395
11. Frankel, R. M., Quill, T. E., & McDaniel, S. H. (Eds.). (2003). The biopsychosocial approach: Past, present, and future. University Rochester Press.
12. Friedman, H. S., & Adler, N. E. (2011). The intellectual roots of health psychology. In H. S. Friedman (Ed.), The Oxford handbook of health psychology (pp. 3–14). Oxford University Press.
13. Fulford, K. W. M. (2005). Values in psychiatric diagnosis: Developments in policy, training and research. Psychopathology, 38(4), 171–176. https://doi.org/10.1159/000086090
14. Gilbody, S., Bower, P., & Whitty, P. (2006). Costs and consequences of enhanced primary care for depression: Systematic review of randomised economic evaluations. The British Journal of Psychiatry, 189(4), 297–308. https://doi.org/10.1192/bjp.bp.105.012089
15. Glouberman, S., & Zimmerman, B. (2002). Complicated and complex systems: What would successful reform of Medicare look like? In Commission on the Future of Health Care in Canada (Vol. 8, pp. 21–53). Toronto: Commission on the Future of Health Care in Canada.
16. Jones, D. R., Macias, C., Barreira, P. J., Fisher, W. H., Hargreaves, W. A., & Harding, C. M. (2004). Prevalence, severity, and co-occurrence of chronic physical problems of persons with serious mental illness. Psychiatric Services, 55(11), 1250–1257. https://doi.org/10.1176/appi.ps.55.11.1250
17. Kathol, R. G., Butler, M., McAlpine, D. D., & Kane, R. L. (2010). Barriers to physical and mental condition integrated service delivery. Psychosomatic Medicine, 72, 511–518. https://doi.org/10.1097/PSY.0b013e3181e2c4a0
18. Katon, W., Von Korff, M., Lin, E., Walker, E., Simon, G. E., Bush, T., & Russo, J. (1995). Collaborative management to achieve treatment guidelines: Impact on depression in primary care. JAMA, 273(13), 1026–1031. https://doi.org/10.1001/jama.1995.03520370068039
19. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593–602. https://doi.org/10.1001/archpsyc.62.6.593
20. Lehman, B. J., David, D. M., & Gruber, J. A. (2017). Rethinking the biopsychosocial model of health: Understanding health as a dynamic system. Social and Personality Psychology Compass, 11(8), e12328. https://doi.org/10.1111/spc3.12328
21. Libby, P. (2007). Inflammatory mechanisms: The molecular basis of inflammation and disease. Nutrition Reviews, 65(12), 140–146. https://doi.org/10.1301/nr.2007.dec.s140-s146
22. McEwen, B. S., & Gianaros, P. J. (2010). Central role of the brain in stress and adaptation: Links to socioeconomic status, health, and disease. Annals of the New York Academy of Sciences, 1186(1), 190–222. https://doi.org/10.1111/j.1749-6632.2009.05331.x
23. McLaren, N. (1998). A critical review of the biopsychosocial model. Australian & New Zealand Journal of Psychiatry, 32(1), 86–92. https://doi.org/10.3109/00048679809062712
24. Mental Health Commission. (2022). An Coillín Annual Inspection Report 2024: 25–28 June 2024. Mental Health Commission.
25. Miller, G. E., Chen, E., & Parker, K. J. (2011). Psychological stress in childhood and susceptibility to the chronic diseases of aging: Moving toward a model of behavioral and biological mechanisms. Psychological Bulletin, 137(6), 959–997. https://doi.org/10.1037/a0024768
26. Patel, V., & Thornicroft, G. (2009). Packages of care for mental, neurological, and substance use disorders in low-and middle-income countries: PLoS Medicine Series. PLoS Medicine, 6(10), e1000160. https://doi.org/10.1371/journal.pmed.1000160
27. Schwartz, G. E., & Weiss, S. M. (1978). Behavioral medicine revisited: An amended definition. Journal of Behavioral Medicine, 1(3), 249–251.
28. Schulz, R., & Sherwood, P. R. (2008). Physical and mental health effects of family caregiving. Journal of Social Work Education, 44(sup3), 105–113. https://doi.org/10.5175/JSWE.2008.773247702
29. Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: A meta-analytic study of 30 years of inquiry. Psychological Bulletin, 130(4), 601–630. https://doi.org/10.1037/0033-2909.130.4.601
30. Straub, R. O. (2007). Health psychology: A biopsychosocial approach. Macmillan.
31. Suls, J., & Rothman, A. (2004). Evolution of the biopsychosocial model: Prospects and challenges for health psychology. Health Psychology, 23(2), 119–125. https://doi.org/10.1037/0278-6133.23.2.119
32. Taylor, S. E. (2011). Social support: A review. In H. S. Friedman (Ed.), The Oxford handbook of health psychology (pp. 189–214). Oxford University Press.
33. Taylor, S. E., Lehman, B., Kiefe, C., & Seeman, T. (2006). Relationship of early life stress and psychological functioning to adult C-reactive protein in the Coronary Artery Risk Development in Young Adults Study. Biological Psychiatry, 60(8), 819–824. https://doi.org/10.1016/j.biopsych.2006.03.016
34. Yıldırım, A., & Şimşek, H. (2021). Qualitative research methods in social sciences [in Turkish]. Pegem.
35. Wade, D. T., & Halligan, P. W. (2004). Do biomedical models of illness make for good healthcare systems? BMJ, 329(7479), 1398–1401. https://doi.org/10.1136/bmj.329.7479.1398
36. World Health Organization. (2002). The world health report 2002. Geneva: World Health Organization.