YOĞUN BAKIM HEMŞİRELERİNDE STRESİN AZALTILMASINA YÖNELİK NONFARMAKOLOJİK YAKLAŞIMLAR: SİSTEMATİK BİR DERLEME

Year 2019, Volume: 23 Issue: 2, 87 - 101, 31.08.2019

Zehra Gök Metin

Abstract

Amaç: Bu sistematik derleme, yoğun bakım ünitesi (YBÜ)’nde çalışan hemşirelerin algıladıkları stresi azaltmada kullanılan nonfarmakolojik yaklaşımları ve bu yaklaşımların etkilerini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Bu derleme, Cochrane Sistematik Derleme Rehberi temel alınarak yapılandırılmıştır. Konuyla ilgili tam metinler Cochrane, PubMed, ScienceDirect, Türk Medline ve ULAKBİM Tıp veri tabanlarını içeren toplam 5 veri tabanı üzerinden taranmıştır. Tüm araştırmalar, dahil edilme kriterleri açısından incelenmiş, veriler araştırmacı tarafından bütünleştirici özetleme yoluyla yorumlanmıştır. Toplam 10 makale değerlendirmeye alınmıştır. Bulgular: Derleme kapsamına alınan çalışma bulgularına göre, YBÜ hemşirelerinin stres düzeylerini azaltmada meditasyon (n=5), masaj (n=2), aromaterapi (n=1), progresif kas gevşeme egzersizleri (n=1) ve Yoga (n=1) gibi nonfarmakolojik yaklaşımların uygulandığı görülmüştür. Çalışmaların yarısının (n=5) Amerika Birleşik Devletleri’nde yürütüldüğü ve çoğunluğunun (n=7) hemşirelerin stres düzeyini değerlendirmede “Algılanan Stres Ölçeği” kullandıkları belirlenmiştir. Araştırmalar yarı-deneysel (n=6), randomize kontrollü (n=3) ve karma tip (n=1) tasarımda gerçekleştirilmiş, örneklemlere en az 13, en fazla 90 hemşire dahil edilmiştir. Uygulama süresinin minimum 4 gün, maksimum 8 hafta arasında değiştiği gözlenmiştir. Aromaterapi dışında kalan diğer tüm uygulamalar sertifika sahibi, deneyimli bir eğitmen tarafından yürütülmüştür. Araştırmaların çoğunda hemşirelerin algıladıkları stres düzeyinde azalma olduğu bildirilmiştir. Sonuç: Bu çalışma, YBÜ hemşirelerinde stres düzeyini azaltmada nonfarmakolojik yaklaşımların etkili olduğunu ve ülkemizde konuya yönelik herhangi bir araştırma yayınlanmadığını ortaya koymuştur. Bu kapsamda, nonfarmakolojik yaklaşımların etkilerini inceleyen yeni randomize kontrollü araştırmalara gereksinim duyulmaktadır.

Keywords

Hemşire, nonfarmakolojik yaklaşımlar, sistematik derleme, stres, yoğun bakım ünitesi

References

• KAYNAKLAR 1. Balsanelli AP, Cunha ICKO. The work environment in public and private intensive care units. Acta Paulista de Enfermagem. 2013;26(6):561-8.2. Altınöz Ü, Demir S. Yoğun bakımda çalışan hemşirelerde çalışma ortamı algısı, psikolojik distres ve etkileyen faktörler. Psikiyatri Hemşireliği Dergisi. 2017;8(2):95-101.3. Karanikola M, Giannakopoulou M, Mpouzika M, Kaite CP, Tsiaousis GZ, Papathanassoglou ED. Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature. Revista da Escola de Enfermagem da USP. 2015;49(5):847-57.4. Zaybak A, Çevik K. Yoğun Bakım Ünitesindeki Stresörlerin Hasta ve Hemşireler Tarafından Algılanması. Turkish Journal of Medical & Surgical Intensive Care Medicine/Dahili ve Cerrahi Bilimler Yogun Bakim Dergisi. 2015;6(1).5. Şengül Ü, Özlem D, Karabacak Ü. Yoğun bakımda çalışan hemşirelerin örgütsel stres düzeylerinin belirlenmesi. Yoğun Bakım Hemşireliği Dergisi. 2015;19(1):15-20.6. Preto VA, Pedrão LJ. Stress among nurses who work at the intensive care unit. Revista da Escola de Enfermagem da USP. 2009;43(4):841-8.7. Dede M, Çınar S. Dahiliye yoğun bakım hemşirelerinin karşılaştıkları güçlükler ve iş doyumlarının belirlenmesi. Maltepe Üniversitesi Hemşirelik Bilim ve Sanatı Dergisi. 2008;1(1):3-14.8. Andolhe R, Barbosa RL, Oliveira EMd, Costa ALS, Padilha KG. Stress, coping and burnout among Intensive Care Unit nursing staff: associated factors. Revista da Escola de Enfermagem da USP. 2015;49(SPE):58-64.9. Hegney DG, Craigie M, Hemsworth D, Osseiran‐Moisson R, Aoun S, Francis K, et al. Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in A ustralia: study 1 results. Journal of Nursing Management. 2014;22(4):506-18.10. Kızılırmak M, Demir S. Hastanede çalışan hemşirelerde depresyon ve yaşam kalitesinin incelenmesi. TAF Preventive Medicine Bulletin. 2016;15(2).11. El-aal NHA, Hassan NI. Relationship between staff nurse’satisfaction with quality of work and their levels of depression, anxiety, and stress in critical care units. Journal of American Science. 2014;10(1s).12. Dizer B, İyigün E, Kılıç S. Yoğun bakım hemşirelerinin tükenmişlik düzeylerinin belirlenmesi. Yoğun Bakım Hemşireliği Dergisi. 2008;12(1):1-11.13. Muşlu C. Birinci basamak ve hastanede çalışan hemşirelerde Anksiyete, Depresyon ve Hayat Kalitesi. Konuralp Tıp Dergisi. 2012;2012(1):17-23.14. Şahin DS, Önal Ö, Kılınç AS, Sütlü SP, editors. Acil ve yoğun bakımda çalışan hemşirelerde yaşam kalitesinin değerlendirilmesi. Halk Sağlığı Kongresi; 2014: Halk Sağlığı Kongresi.15. Tashani O, Burnett D, Phillips G. The Effect of Brief Mindfulness Meditation on Cold-Pressor Induced Pain Responses in Healthy Adults. Pain Studies and Treatment. 2017;5:11-9.16. Palmer JB, Lane D, Mayo D, Schluchter M, Leeming R. Effects of music therapy on anesthesia requirements and anxiety in women undergoing ambulatory breast surgery for cancer diagnosis and treatment: a randomized controlled trial. Journal of Clinical Oncology. 2015;33(28):3162.17. Gok Metin Z, Arikan Donmez A, Izgu N, Ozdemir L, Arslan IE. Aromatherapy massage for neuropathic pain and quality of life in diabetic patients. Journal of Nursing Scholarship. 2017;49(4):379-88.18. Bower JE, Crosswell AD, Stanton AL, Crespi CM, Winston D, Arevalo J, et al. Mindfulness meditation for younger breast cancer survivors: a randomized controlled trial. Cancer. 2015;121(8):1231-40.19. Lee C-H, Lai C-L, Sung Y-H, Lai MY, Lin C-Y, Lin L-Y. Comparing effects between music intervention and aromatherapy on anxiety of patients undergoing mechanical ventilation in the intensive care unit: a randomized controlled trial. Quality of Life Research. 2017;26(7):1819-29.20. Boitor M, Martorella G, Arbour C, Michaud C, Gélinas C. Evaluation of the preliminary effectiveness of hand massage therapy on postoperative pain of adults in the intensive care unit after cardiac surgery: a pilot randomized controlled trial. Pain Management Nursing. 2015;16(3):354-66.21. Davis C, Cooke M, Holzhauser K, Jones M, Finucane J. The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses. Australasian Emergency Nursing Journal. 2005;8(1-2):43-50.22. dos Santos TM, Kozasa EH, Carmagnani IS, Tanaka LH, Lacerda SS, Nogueira-Martins LA. Positive effects of a stress reduction program based on mindfulness meditation in Brazilian nursing professionals: Qualitative and quantitative evaluation. Explore. 2016;12(2):90-9.23. Davies WR. Mindful meditation: healing burnout in critical care nursing. Holistic Nursing Practice. 2008;22(1):32-6.24. Brennan MK, DeBate RD. The effect of chair massage on stress perception of hospital bedside nurses. Journal of Bodywork and Movement Therapies. 2006;10(4):335-42.25. Bernstein AM, Kobs A, Bar J, Fay S, Doyle J, Golubic M, et al. Yoga for stress management among intensive care unit staff: A pilot study. Alternative and Complementary Therapies. 2015;21(3):111-5.26. Higgins J, Altman D, Sterne J. assessing risk of bias in included studies. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1. 0 (updated March 2011). The Cochrane Collaboration; 2011. 2011.27. Pemberton E, Turpin PG. The effect of essential oils on work-related stress in intensive care unit nurses. Holistic nursing practice. 2008;22(2):97-102.28. Nazari F, Mirzamohamadi M, Yousefi H. The effect of massage therapy on occupational stress of Intensive Care Unit nurses. Iranian journal of nursing and midwifery research. 2015;20(4):508.29. Bazarko D, Cate RA, Azocar F, Kreitzer MJ. The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. Journal of workplace behavioral health. 2013;28(2):107-33.30. Lan HK, Subramanian P, Rahmat N, Kar PC. The effects of mindfulness training program on reducing stress and promoting well-being among nurses in critical care units. Australian Journal of Advanced Nursing, The. 2014;31(3):22.31. Duchemin A-M, Steinberg BA, Marks DR, Vanover K, Klatt M. A small randomized pilot study of a workplace mindfulness-based intervention for surgical intensive care unit personnel: effects on salivary α-amylase levels. Journal of occupational and environmental medicine/American College of Occupational and Environmental Medicine. 2015;57(4):393.32. Mahon MA, Mee L, Brett D, Dowling M. Nurses' perceived stress and compassion following a mindfulness meditation and self compassion training. Journal of research in nursing. 2017;22(8):572-83.33. Patel MP. A study to assess the effectiveness of progressive muscle relaxation therapy on stress among staff nurses working in selected hospitals at Vadodara City. IOSR Journal of Nursing and Health Science. 2014;3(3):34-59.34. Bodhi B. What does mindfulness really mean? A canonical perspective. Contemporary Buddhism. 2011;12(01):19-39.35. Kabat-Zinn J. Wherever you go, there you are: Mindfulness meditation in everyday life: Hachette Books; 2009.36. Goyal M, Singh S, Sibinga EM, Gould NF, Rowland-Seymour A, Sharma R, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA internal medicine. 2014;174(3):357-68.37. Winbush NY, Gross CR, Kreitzer MJ. The effects of mindfulness-based stress reduction on sleep disturbance: a systematic review. EXPLORE: the Journal of Science and Healing. 2007;3(6):585-91.38. Rosenzweig S, Greeson JM, Reibel DK, Green JS, Jasser SA, Beasley D. Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice. Journal of psychosomatic research. 2010;68(1):29-36.39. Boyle CC, Stanton AL, Ganz PA, Crespi CM, Bower JE. Improvements in emotion regulation following mindfulness meditation: Effects on depressive symptoms and perceived stress in younger breast cancer survivors. Journal of consulting and clinical psychology. 2017;85(4):397.40. Lee S-H, Kim J-Y, Yeo S, Kim S-H, Lim S. Meta-analysis of massage therapy on cancer pain. Integrative cancer therapies. 2015;14(4):297-304.41. Metin ZG, Ozdemir L. The effects of aromatherapy massage and reflexology on pain and fatigue in patients with rheumatoid arthritis: a randomized controlled trial. Pain Management Nursing. 2016;17(2):140-9.42. Rashvand F. Effect of massage therapy on postoperative nausea and vomiting in cancer patients receiving chemotherapy. International Journal of Nursing. 2016.43. Schaub C, Von Gunten A, Morin D, Wild P, Gomez P, Popp J. The Effects of Hand Massage on Stress and Agitation Among People with Dementia in a Hospital Setting: A Pilot Study. Applied psychophysiology and biofeedback. 2018;43(4):319-32.44. Bennett S, Bennett MJ, Chatchawan U, Jenjaiwit P, Pantumethakul R, Kunhasura S, et al. Acute effects of traditional Thai massage on cortisol levels, arterial blood pressure and stress perception in academic stress condition: A single blind randomised controlled trial. Journal of bodywork and movement therapies. 2016;20(2):286-92.45. Malekshahi F, Aryamanesh F, Fallahi S. The effects of massage therapy on sleep quality of patients with end-stage renal disease undergoing hemodialysis. Sleep and Hypnosis. 2018;20:91-5.46. Boitor M, Martorella G, Maheu C, Laizner AM, Gélinas C. Effects of Massage in Reducing the Pain and Anxiety of the Cardiac Surgery Critically Ill—a Randomized Controlled Trial. Pain Medicine. 2018;19(12):2556-69.47. Singer J, Schneider R. Smart Scents: A guide to effective aromatherapy: Ebozon Verlag; 2016.48. Yaghoobi K, Kaka G, Davoodi S, Ashayeri H. Therapeutic effects of Lavandula angustifolia. Journal of Gorgan University of Medical Sciences. 2016;17(4).49. Chen MC, Fang SH, Fang L. The effects of aromatherapy in relieving symptoms related to job stress among nurses. International journal of nursing practice. 2015;21(1):87-93.50. Yesudian S, Haich E. Yoga: Uniting East and West: Routledge; 2018.51. Cramer H, Anheyer D, Lauche R, Dobos G. A systematic review of yoga for major depressive disorder. Journal of Affective Disorders. 2017;213:70-7.52. Sciarrino NA, DeLucia C, O'Brien K, McAdams K. Assessing the effectiveness of yoga as a complementary and alternative treatment for post-traumatic stress disorder: a review and synthesis. The Journal of Alternative and Complementary Medicine. 2017;23(10):747-55.53. Sagadore T, Selkow N, Begalle R. The Effectiveness of A 4-Week Yoga Intervention on Core Muscle Activation, Pain and Functional Disability Among Healthy and Low Back Pain Participants. Yoga Practice Phys Ther: YPPT-132. 2017.54. Price M, Spinazzola J, Musicaro R, Turner J, Suvak M, Emerson D, et al. Effectiveness of an extended yoga treatment for women with chronic posttraumatic stress disorder. The Journal of Alternative and Complementary Medicine. 2017;23(4):300-9.55. Roozbahani T, Nourian M, Saatchi K, Moslemi A. Effect of Progressive Muscle Relaxation on Anxiety in Pre-University Students: A Randomized Controlled Clinical Trial. Advances in Nursing & Midwifery. 2017;27(1):32-7.56. Gangadharan P, Madani AH. Effectiveness of Progressive Muscle Relaxation Techniques on Depression, Anxiety and Stress among Undergraduate Nursing Students. Int J Health Sci Res. 2018;8(2):155-63.