Bakımda Yeni Bir Yaklaşım: Travma Bilgisi İçeren Bakım

Year 2020, , 176 - 184, 30.09.2020

Müjde Çalıkuşu İncekar , Mary Coughlın Zerrin Çiğdem

https://doi.org/10.38108/ouhcd.746215

Abstract

Yenidoğan Yoğun Bakım Üniteleri’nde (YYBÜ) travma bilgisini içeren bakım yaklaşımını uygulamak, preterm ve yüksek riskli yenidoğanların kısa ve uzun dönem sonuçlarını iyileştirmede yaşamsal öneme sahiptir. Yaşamın en erken ve en savunmasız evresindeki bu bebeklerin bakım sürecini travma gözüyle değerlendiren sağlık çalışanları, yenidoğanın hastanede yattığı dönemde beyin gelişimini daha iyi destekleyerek erken dönem olumsuz yaşam deneyimini hafifletebilir. YYBÜ’de olumsuz uyaranların varlığı ve olumlu uyaranların eksikliği, bebek için yıkıcı olan önemli stres etmenlerini oluşturur. Riskli yenidoğanlar için olası toksik stres faktörleri; YYBÜ’nin fiziksel çevresinden (parlak aydınlatma, yüksek sesler, zararlı kokular gibi), psikososyal ortamından (el tutma, sarmalama, kanguru bakımı, olumlu duyusal uyaranlardan yoksun bırakılma gibi destekleyici sosyal etkileşimlerin olmaması) ve klinik uygulamalarından (bebeğin sağlığı ve güvenliği için gerekli klinik prosedürler) kaynaklanabilir. Travma bilgisi içeren yaşa uygun bakım, hayatın başında travmanın fizyolojik, nörobiyolojik ve duygusal boyutta olumsuz etkilerini tanıyan gelişimsel bir kavramdır ve kanıta dayalı, yaşa uygun bakım stratejileri ile travma deneyimine ilişkin zararlı etkileri hafifletmeyi amaçlar. Bu kavram klinik uygulamada yenidoğanın daha sonraki yaşamında temel fiziksel, bilişsel, sosyal ve duygusal olarak sağlık ve iyiliğini korumak ve güvenliğini sağlamak için uygun bir çevre oluşturur. Travma bilgisi içeren bakım ile yüksek riskli yenidoğanların, ebeveynlerinin ve sağlık çalışanlarının YYBÜ’de travmadan korunması, var olan travma durumunda gerekli tedavi ve bakımların uygulanması ve travma sonrası üçüncül korumanın sağlanmasına yönelik yaklaşımlar ele alınmalıdır.

Keywords

Hemşirelik, preterm, travma bilgisi içeren bakım, yenidoğan yoğun bakım

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