Tekrarlayan Ektopik Gebelik Olgusunda Yaşanan Depresyon ve Anksiyeteye Yönelik Verilen Hemşirelik Bakımının Stetler Modeli’ne Uyarlanması

Year 2022, Volume: 4 Issue: 2, 103 - 110, 12.08.2022

Melike Kahveci , Oya Kavlak

https://doi.org/10.48071/sbuhemsirelik.1079553

Abstract

Gebelik kaybı hem kadınlar hem de aileleri için psikolojik ve duygusal bozukluklara neden olabilen önemli bir durumdur. Yaşanılan bu durum her kadının farklı duygular hissetmesine ve farklı tepkiler vermesine neden olabilmektedir. Kadınların bu kayba vermiş olduğu tepki kişiden kişiye farklılık gösterse de, yapılan çalışmalarda daha önce gebelik kaybı yaşayan kadınların daha fazla stres, depresyon ve anksiyete yaşadığı görülmüştür. Yaşanan bu psikolojik bozukluklar çoğu zaman göz ardı edilmektedir. Bu dönemde verilen bakım ve danışmanlık hizmetlerinin kadının psikolojisi üzerinde önemli bir etkisi vardır. Hemşireler anksiyete ve depresif belirtileri azaltmak için kadınları anlamaya ve yaşadığı sıkıntıları çözmeye yönelik girişimler yapmalı, sosyal desteklerini artırıp, eşleri de sürecin içine dahil ederek duygularını ifade etmelerini sağlamalıdırlar. Kayıp sonrası dönemde de kadınların psikolojik durumları değerlendirilmeli, bunlara yönelik girişimler yapılmalı, gerekirse psikolojik destek almaları sağlanmalıdır. Stetler Modeli, kanıta dayalı bakımın geliştirilmesinde kullanılan bir modeldir. Modelin kullanım amacı, kanıta dayalı uygulamalar doğrultusunda hastaya uygun olan en iyi bakımı sağlamaktır. Bu olgu sunumu ile tekrarlayan ektopik gebelik olgusunun kayıp sonrası yaşadığı depresyon ve anksiyeteye yönelik verilen hemşirelik bakımının, Stetler Modeli’ne uyarlanması amaçlanmıştır.

Keywords

Anksiyete, depresyon, ektopik gebelik, hemşirelik

Adaptation of Nursing Care for Depression and Anxiety Experienced in the Case of Recurrent Ectopic Pregnancy to the Stetler Model

Abstract

Pregnancy loss is an important condition that can cause psychological and emotional disorders for both women and their families. This situation can cause each woman to feel different emotions and to give different reactions. Although the response of women to this loss differs from person to person, studies have shown that women who have experienced pregnancy loss before the experience have more stress, depression and anxiety. These psychological disorders are often overlooked. The care and counseling services provided during this period have a significant impact on the psychology of women. In order to reduce anxiety and depressive symptoms, nurses should take initiatives to understand women and solve their problems, increase their social support and enable them to express their feelings by including their spouses in the process. In the post-disappearance period, the psychological status of women should be evaluated, interventions should be made, and if necessary, they should be provided with psychological support. The Stetler Model is a model used in the development of evidence-based care. The purpose of the model is to provide the best appropriate care to the patient in line with evidence-based practices. With this case report, it was aimed to adapt the nursing care given for the depression and anxiety experienced by the recurrent ectopic pregnancy case to the Stetler Model.

Keywords

Anxiety, depression, ectopic pregnancy, nursing

References

• Adolfsson, A. (2011). Women’s well-being improves after missed miscarriage with more active support and application of Swanson’s Caring Theory. Psychology Research and Behavior Management, 4, 1. doi: 10.2147/PRBM.S15431
• Andershed, B., & Olsson, K. (2009). Review of research related to Kristen Swanson’s middle-range theory of caring. Scandinavian Journal of Caring Sciences, 23(3), 598-610. doi: 10.1111/j.1471-6712.2008.00647.x
• Benute, G.R.G., Bordini, D.C.N., Juhas, T.R., Cabar, F.R., Pereira, P.P., Lucia, M.C.S.D., & Francisco, R.P.V. (2016). Depression, stress and guilt are linked to the risk of suicide associated to ectopic pregnancy. Medical Express, 3(3). doi: 10.5935/MedicalExpress.2016.03.07
• Bishop, K.K. (2007). Utilization of the Stetler Model: Evaluating the scientific evidence on screening for postpartum depression risk factors in a primary care setting. Kentucky Nurse, 55(1), 7.
• Blackmore, E.R., Côté-Arsenault, D., Tang, W., Glover, V., Evans, J., Golding, J., & O’connor, T. G. (2011). Previous prenatal loss as a predictor of perinatal depression and anxiety. The British Journal of Psychiatry, 198(5), 373–378. doi: 10.1192/bjp.bp.110.083105
• Carvalho, A.C.D., Silva, M. E. D., Matos, B. M., Bottino, C. M. D. C., Abrahão, A. R., Cohrs, F. M., & Bottino, S. M. B. (2016). Depression in women with recurrent miscarriages-an exploratory study. Revista Brasileira de Ginecologia e Obstetrícia, 38(12), 609-614. doi: 10.1055/s-0036-1597667
• Chojenta, C., Harris, S., Reilly, N., Forder, P., Austin, M.P., & Loxton, D. (2014). History of pregnancy loss increases the risk of mental health problems in subsequent pregnancies but not in the postpartum. PLos One, 9(4), e95038. doi: 10.1371/journal.pone.0095038
• Ciliska D., DiCenso, A., Melynk, B. M., Fineout-Overholt, E., Stetler, C.B., Cullent, L., & Dang, D. (2011). Models to guide implementation of evidence-based practice. In: Melnyk B. M., & Finout-Overholt, E. (Eds.), Evidence-based Practice in Nursing and Healthcare: A Guide to Best Practice (2nd ed., pp. 241–275). Philadelphia, PA: Wolters-Kluwer.
• Clarke, N., DiCicco-Bloom, B., & Limbo, R. (2019). Application of caring theory to nursing care of women experiencing stillbirth. MCN: The American Journal of Maternal/Child Nursing, 44(1), 27-32. doi:10.1097/NMC.0000000000000494
• Dünya Sağlık Örgütü (DSÖ). (2018). Maternal mortality. Factsheet No. 364 Retrieved from (10.02.2022): https://www.who.int/newsroom/fact-sheets/detail/maternal-mortality
• Farren, J., Jalmbrant, M., Ameye, L., Joash, K., Mitchell-Jones, N., Tapp, S., … Bourne, T. (2016). Post-traumatic stress, anxiety and depression following miscarriage or ectopic pregnancy: A prospective cohort study. Bri̇ti̇sh Medi̇cal Journal Open, 6(11). doi: 10.1136/bmjopen-2016-011864
• Farren, J., Mitchell-Jones, N., Verbakel, J. Y., Timmerman, D., Jalmbrant, M., & Bourne, T. (2018). The psychological impact of early pregnancy loss. Human Reproduction Update, 24(6), 731-749. doi: 10.1093/humupd/dmy025
• Farren, J., Jalmbrant, M., Falconieri, N., Mitchell-Jones, N., Bobdiwala, S., Al-Memar, M., … Bourne, T. (2020). Post traumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: A multicenter, prospective, cohort study. American Journal of Obstetrics and Gynecology, 222(4), 367-e1. doi: 10.1016/j.ajog.2019.10.102
• Gao, L., Qu, J., & Wang, A.Y. (2020). Anxiety, depression and social support in pregnant women with a history of recurrent miscarriage: A cross-sectional study. Journal of Reproductive and Infant Psychology, 38(5), 497-508. doi: 10.1080/02646838.2019.1652730
• Hasani, S., Mirghafourvand, M., Esmaeilpour, K., & Sehhatie Shafaie, F. (2021). The effect of counseling based on health promotion awareness on mental health and self-esteem in women with ectopic pregnancy: a randomized controlled clinical trial. The Journal of Maternal-Fetal & Neonatal Medicine, 34(11), 1687-1694. doi:10.1080/14767058.2019.1644314
• He, L., Wang, T., Xu, H., Chen, C., Liu, Z., Kang, X., & Zhao, A. (2019). Prevalence of depression and anxiety in women with recurrent pregnancy loss and the associated risk factors. Archives of Gynecology and Obstetrics, 300(4), 1061-1066. doi: 10.1007/s00404-019-05264-z
• Imperial College London. (2020). Miscarriage and ectopic pregnancy may trigger long-term post-traumatic stress. Retrieved from (10.02.2022): http://www.sciencedaily.com/releases/ 2020/01/200114224449.html
• Jurkovic, D., & Wilkinson, H. (2011). Diagnosis and management of ectopic pregnancy. British Medical Journal, 342. doi: 10.1136/bmj.d3397
• Jurkovic, D., & Salman, G. (2016). Ectopic pregnancy and pregnancy of unknown location. In Guerriero, W. P., & Martins, J. L. Alcazar (Eds.), Managing Ultrasonography in Human Reproduction (pp. 215–234). Berlin: Springer.
• Kolte, A.M., Olsen, L.R., Mikkelsen, E.M., Christiansen, O.B., & Nielsen, H.S. (2015). Depression and emotional stress is highly prevalent among women with recurrent pregnancy loss. Human Reproduction, 30(4), 777-782. doi: 10.1093/humrep/dev014
• Li, C., Zhao, W.H., Zhu, Q., Cao, S.J., Ping, H., Xi, X., …Zhang, J. (2015). Risk factors for ectopic pregnancy: A multi-center case-control study. BMC Pregnancy and Childbirth, 15(1), 1-9. doi: 10.1186/s12884-015-0613-1
• McCarthy, F.P., Moss-Morris, R., Khashan, A.S., North, R.A., Baker, P.N., Dekker, G., …O’Donoghue, K. (2015). Previous pregnancy loss has an adverse impact on distress and behaviour in subsequent pregnancy. British Journal of Obstetrics and Gynaecology: An International Journal of Obstetrics&Gynaecology, 122(13), 1757-1764. doi: 10.1111/1471-0528.13233
• Moini, A., Hosseini, R., Jahangiri, N., Shiva, M., & Akhoond, M. R. (2014). Risk factors for ectopic pregnancy: A case–control study. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 19(9), 844-849.
• Ozan, J., & Thomas, M.B. (2018). Management of ectopic pregnancy. Ambulatory Gynecology. Chapter 9, (pp. 139–145). Springer. doi:10.1007/978-1-4939-7641-6_9
• Parashi, S., Moukhah, S., & Ashrafi, M. (2014). Main risk factors for ectopicpregnancy: a case-control study in a sample of Iranian women. International Journal of Fertility & Sterility, 8(2), 147-154.
• Peters, M.D., Lisy, K., Riitano, D., Jordan, Z., & Aromataris, E. (2015). Caring for families experiencing stillbirth: Evidence-based guidance for maternity care providers. Women and Birth, 28(4), 272-278. doi: 10.1016/j.wombi.2015.07.003
• Romp, C.R., & Kiehl, E. (2009). Applying the Stetler Model of research utilization in staff development: Revitalizing a preceptor program. Journal for Nurses in Professional Development, 25(6), 278-284. doi: 10.1097/NND.0b013e3181c2654a
• Shadman, S.S., & Vedadhir, A. (2020). A life-saving endeavor: The meanings and strategies of coping in patients with ectopic pregnancy in Iran. Current Psychology, 1-10. doi:10.1007/s12144-020-01037-z
• Shely, A.B. (2019). Improving breastfeeding rates and duration through education and support in the primary care setting (Doctoral dissertation), The University of Arizona, United States of America.
• Sivalingam, V.N., Duncan, W.C., Kirk, E., Shephard, L.A., & Horne, A.W. (2011). Diagnosis and management of ectopic pregnancy. Journal of Family Planning and Reproductive Health Care, 37(4), 231-240. doi: 10.1136/jfprhc-2011-0073
• Snyder, C.H., Facchiano, L., & Brewer, M. (2011). Using evidence-based practice to improve the recognition of anxiety in Parkinson’s disease. The Journal for Nurse Practitioners, 7(2), 136-141. doi: 10.1016/j.nurpra.2010.08.017
• Stetler, C.B. (2001). Updating the stetler model of research utilization to facilitate evidence-based practice. Nursing Outlook, 49(6), 272–279. doi: 10.1067/mno.2001.120517
• Sudsawad, P. (2007). Knowledge translation introduction to models, strategies and measures. Southwest Educational Development Laboratory, National Center for the Dissemination of Disability Research, 12-15. Retrieved from (10.02.2022): https://ktdrr.org/ktlibrary/articles_pubs/ktmodels/