Kanser Tanılı Bireylerde Başa Çıkma Stratejisi Olarak Öz-şefkat ve Öz-şefkati Geliştirmeye Yönelik Müdahaleler: Literatür Derlemesi

Öz

Erken teşhis ve tedavilerdeki ilerlemeler kanser hastalarının hayatta kalma süresini önemli ölçüde artırmaktadır. Bununla birlikte, kanser tedavisi almanın bireyler için oldukça zor bir yaşam deneyimi olduğu bilinmektedir. Kanser hastaları genellikle kanser ve tedavisinden kaynaklanan uzun vadeli fiziksel ve psikososyal sorunlar yaşamaktadır. Bireylerin yaşamış olduğu sorunlara yönelik baş etme mekanizmalarını harekete geçirmenin önemi yapılan çalışmalarda vurgulanmaktadır. Öz-şefkatin, zorlu yaşam olayları karşısında bireyin kendi kendini yatıştırabilmesi, kendi kendine yetebilmesi ve gereksinim duyduğu kabul ve anlayışı kendisine gösterebilmesi açısından duygu düzenleyici bir başa çıkma stratejisi olduğu ifade edilmektedir. Bu derlemede kanser tanılı bireylerde öz-şefkatle ilişkili faktörler, öz-şefkat düzeyini geliştirmeye yönelik uygulanan müdahaleler ve etkilerine yönelik literatürün sentezlenmesi amaçlanmaktadır. Literatür incelemesi sonucunda öz-şefkatin hasta sonuçları üzerine olumlu etkileri olduğu, fiziksel ve psikolojik faktörlerle ilişkili olduğu ve öz-şefkat düzeyini geliştirmeye yönelik bilinçli özşefkat programı, şefkat odaklı terapi, öz-şefkat odaklı yazma uygulamaları, sevgi dolu-şefkat meditasyonu, şefkatli zihin eğitimi, kabul ve kararlılık terapisi gibi uygulamaların yer aldığı görülmüştür. Bu derleme makalenin kanser tanılı bireylere yönelik öz-şefkati geliştirme programları konusunda sağlık profesyonellerinde farkındalığın artmasına katkı sağlayabileceği ve deneysel çalışmaların planlanmasında araştırmacılara yol gösterici olabileceği düşünülmektedir.

Anahtar Kelimeler

• hemşirelik
• kanser
• öz-şefkat
• baş etme becerileri
• kanser

Self-Compassion as a Coping Strategy and Interventions to Enhance Self-compassion in Individuals Diagnosed with Cancer

Öz

Advances in early detection and treatments have significantly increased the survival of cancer patients. However, receiving cancer treatment is known to be a very difficult life experience for individuals. Cancer patients often experience long-term physical and psychosocial problems resulting from cancer and its treatment. The importance of activating coping mechanisms for the problems experienced by individuals is emphasized in studies. It is stated that self-compassion is an emotion-regulating coping strategy in terms of self-soothing, self-sufficiency, and self-acceptance and understanding in the face of challenging life events. In this review aims to synthesize the literatüre on factors related to self-compassion, interventions to improve self-compassion level and their effects in individuals diagnosed with cancer. As a result of literature review, it was seen that self-compassion has positive effects on patient outcomes, is associated with physical and psychological factors, and there are practices such as mindful self-compassion program, compassion focused therapy, self-compassion focused writing practices, loving-kindness meditation, compassionate mind training, acceptance and commitment therapy to improve the level of self-compassion. It is thought that this review article may contribute to increasing the awareness of health professionals about self-compassion development programs for individuals diagnosed with cancer and may guide researchers in planning experimental studies.

Anahtar Kelimeler

• Coping skills
• nurse
• cancer
• self-compassion

Kaynakça

1. Fitzmaurice C, Abate D, Abbasi N, Abbastabar H, Abd-Allah F, Abdel-Rahman O, et al. Global, regional, and national cancer incidence, mortal¬ity, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2017 a systematic analysis for the global burden of disease study. JAMA on¬cology. 2019.
2. GLOBOCAN. Global cancer observatory: World Health Organization International Agency for Research on Cancer; 2020.
3. Allemani C, Matsuda T, Di Carlo V, Harewood R, Matz M, Nikšić M, et al. Global surveillance of trends in cancer survival 2000–14 (CONCORD-3): analysis of individual records for 37 513 025 pa¬tients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. The Lancet. 2018;391(10125):1023-75.
4. Gallicchio L, Tonorezos E, de Moor JS, Elena J, Farrell M, Green P, et al. Evidence gaps in can¬cer survivorship care: a report from the 2019
5. National Cancer Institute Cancer Survivorship Workshop. JNCI: Journal of the National Can¬cer Institute. 2021;113(9):1136-42.
6. Salvetti MdG, Machado CSP, Donato SCT, Silva AMd. Prevalence of symptoms and quality of life of cancer patients. Revista Brasileira de En¬fermagem. 2020;73:e20180287.
7. Zhang H, Watson-Singleton NN, Pollard SE, Pit¬tman DM, Lamis DA, Fischer NL, et al. Self-Crit¬icism and Depressive Symptoms: Mediating Role of Self-Compassion. Omega (Westport). 2019;80(2):202-23.
8. Przezdziecki A, Sherman KA. Modifying affec¬tive and cognitive responses regarding body image difficulties in breast cancer survivors us¬ing a self-compassion-based writing interven¬tion. Mindfulness. 2016;7:1142-55.

9. Neff K. Self-compassion: An alternative con¬ceptualization of a healthy attitude toward one¬self. Self and identity. 2003;2(2):85-101.
10. Neff KD. The development and validation of a scale to measure self-compassion. Self and identity. 2003;2(3):223-50.
11. Yıldırım M, Sarı T. Öz-şefkat Ölçeği Kısa For¬mu’nun Türkçe Uyarlaması: Geçerlik ve Güve¬nirlik Çalışması. Abant İzzet Baysal Üniversitesi Eğitim Fakültesi Dergisi. 2018;18(4):2502-17.
12. Deniz M, Kesici Ş, Sümer AS. The validity and re¬liability of the Turkish version of the Self-Com¬passion Scale. Social Behavior and Personality: an international journal. 2008;36(9):1151-60.
13. Ümran A, Ahmet A, ABACI R. Öz-duyarlık Ölçeği: Geçerlik ve güvenirlik çalışması. Hac¬ettepe Üniversitesi Eğitim Fakültesi Dergisi. 2007;33(33):1-10.
14. Neff KD. Self-compassion: Theory, method, re¬search, and intervention. Annual review of psy¬chology. 2023;74:193-218.
15. Li W, Zhang X, Yuan M, Hu J, Li S. Factors as¬sociated with self-compassion in Chinese oesophageal cancer patients undergoing oe¬sophagectomy: Based on self-determination theory. Current Psychology. 2023:1-13.
16. Korkmaz B. Öz-duyarlık: psikolojik belirtiler ile ilişkisi ve psikoterapide kullanımı. Psikiyatride Güncel Yaklaşımlar. 2018;10(1):40-58.
17. Gilbert P, Procter S. Compassionate mind train¬ing for people with high shame and self-crit¬icism: overview and pilot study of a group therapy approach. Clinical Psychology & Psy¬chotherapy. 2006;13(6):353-79.
18. Raes F, Pommier E, Neff KD, Van Gucht D. Con¬struction and factorial validation of a short form of the Self-Compassion Scale. Clinical Psychol¬ogy & Psychotherapy. 2011;18(3):250-5.
19. Jiang H, Wang W, Mei Y, Zhao Z, Lin B, Zhang Z. A scoping review of the self-reported compas¬sion measurement tools. BMC Public Health. 2023;23(1):2323.
20. Luo Y, Meng R, Li J, Liu B, Cao X, Ge W. Self-com¬passion may reduce anxiety and depression in nursing students: a pathway through perceived stress. Public Health. 2019;174:1-10.
21. Arambasic J, Sherman KA, Elder E, Austra¬lia BCN. Attachment styles, self‐compassion, and psychological adjustment in long‐term breast cancer survivors. Psycho‐oncology. 2019;28(5):1134-41.
22. Karagöz Ş, Uzunbacak HH. Öz-Şefkat Konusun¬da Yayınlanan Makalelerin Bibliyometrik Ana¬lizi. Uluslararası Yönetim Akademisi Dergisi. 2023;6(2):410-20.
23. Leary MR, Tate EB, Adams CE, Batts Allen A, Hancock J. Self-compassion and reactions to unpleasant self-relevant events: the implica¬tions of treating oneself kindly. Journal of per¬sonality and social psychology. 2007;92(5):887.
24. Sirois FM, Molnar DS, Hirsch JK. Self-compas¬sion, stress, and coping in the context of chron¬ic illness. Self and Identity. 2015;14(3):334-47.
25. Phillips WJ, Hine DW. Self-compassion, physical health, and health behaviour: A meta-analysis. Health Psychology Review. 2021;15(1):113-39.
26. Mistretta EG, Davis MC. Meta-analysis of self-compassion interventions for pain and psychological symptoms among adults with chronic illness. Mindfulness. 2021:1-18.
27. Lumley MA, Cohen JL, Borszcz GS, Cano A, Rad¬cliffe AM, Porter LS, et al. Pain and emotion: a biopsychosocial review of recent research. Jour¬nal of clinical psychology. 2011;67(9):942-68.
28. Zhu L, Yao J, Wang J, Wu L, Gao Y, Xie J, et al. The predictive role of self‐compassion in can¬cer patients’ symptoms of depression, anxiety, and fatigue: A longitudinal study. Psycho‐on¬cology. 2019;28(9):1918-25.
29. Costa J, Pinto‐Gouveia J. Experiential avoid¬ance and self‐compassion in chronic pain. Journal of Applied Social Psychology. 2013;43(8):1578-91.
30. Thompson BL, Waltz J. Self-compassion and PTSD symptom severity. J Trauma Stress. 2008;21(6):556-8.
31. Trompetter HR, de Kleine E, Bohlmeijer ET. Why Does Positive Mental Health Buffer Against Psychopathology? An Exploratory Study on Self-Compassion as a Resilience Mechanism and Adaptive Emotion Regulation Strategy. Cognit Ther Res. 2017;41(3):459-68.
32. Neff KD, Germer CK. A pilot study and random¬ized controlled trial of the mindful self-compas¬sion program. J Clin Psychol. 2013;69(1):28-44.
33. Dodds SE, Pace TW, Bell ML, Fiero M, Negi LT, Raison CL, et al. Feasibility of Cognitive¬ly-Based Compassion Training (CBCT) for breast cancer survivors: a randomized, wait list controlled pilot study. Support Care Cancer. 2015;23(12):3599-608.
34. Cheung EO, Cohn MA, Dunn LB, Melisko ME, Morgan S, Penedo FJ, et al. A randomized pilot trial of a positive affect skill intervention (les¬sons in linking affect and coping) for women with metastatic breast cancer. Psychooncolo¬gy. 2017;26(12):2101-8.
35. Campo RA, Bluth K, Santacroce SJ, Knapik S, Tan J, Gold S, et al. A mindful self-compassion videoconference intervention for nationally recruited posttreatment young adult cancer survivors: feasibility, acceptability, and psy¬chosocial outcomes. Support Care Cancer. 2017;25(6):1759-68.
36. Sherman KA, Przezdziecki A, Alcorso J, Kilby CJ, Elder E, Boyages J, et al. Reducing Body Image-Related Distress in Women With Breast Cancer Using a Structured Online Writing Ex¬ercise: Results From the My Changed Body Randomized Controlled Trial. J Clin Oncol. 2018;36(19):1930-40.
37. Peeters N. The needs and wishes of cancer pa¬tients regarding a smartphone-supported self-help intervention based on self-compassion and mindfulness exercises: a qualitative study: University of Twente; 2017.
38. Schellekens MPJ, Karremans JC, van der Drift MA, Molema J, van den Hurk DGM, Prins JB, et al. Are Mindfulness and Self-Compassion Related to Psychological Distress and Com¬munication in Couples Facing Lung Can¬cer? A Dyadic Approach. Mindfulness (N Y). 2017;8(2):325-36.
39. Kılıç A, Hudson J, McCracken LM, Ruparelia R, Fawson S, Hughes LD. A Systematic Review of the Effectiveness of Self-Compassion-Re¬lated Interventions for Individuals With Chron¬ic Physical Health Conditions. Behav Ther. 2021;52(3):607-25.
40. Salzberg S, Kabat-Zinn J. Lovingkindness: The revolutionary art of happiness: Shambhala Publications; 2004. Ferrari M, Hunt C, Harrysunker A, Abbott MJ, Beath AP, Einstein DA. Self-compassion in¬terventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness. 2019;10(8):1455-73.
41. Neff K, Germer C. The transformative effects of mindful self-compassion. Mindful Retrieved from. 2019.
42. Germer C, Neff K. Mindful self-compassion (MSC). Handbook of mindfulness-based pro¬grammes: Routledge. 2019:357-67.
43. Hoffman C, Baker B. Effects of Mindful Self-Compassion Program on Psychological Well-being and levels of Compassion in people affected by Breast Cancer. Altern Ther. Health Med. 2023;29:36-41.
44. Brooker J, Julian J, Millar J, Prince HM, Kene¬aly M, Herbert K, et al. A feasibility and accept¬ability study of an adaptation of the Mindful Self-Compassion program for adult cancer pa¬tients. Palliat Support Care. 2020;18(2):130-40.
45. Gilbert P. The origins and nature of com¬passion focused therapy. Br J Clin Psychol. 2014;53(1):6-41.
46. Mirzakhani M, Gharraee B, Zahedi Tajrishi K, Khanjani S, Noorbala AA, Safaei Nodehi SR. Effect of Compassion-focused Therapy on De¬pression, anxiety, Stress, and Quality of Life in Patients With Cancer: A Clinical Trial. Iranian Journal of Psychiatry and Clinical Psychology. 2023;29(2):142-55.
47. Mehrabi N, Amiri H, Omidi A, Sarvizadeh M. The Effectiveness of Group Compassion-Focused Therapy on Body Image and Interpersonal Stress among Women with Breast Cancer: A Randomized Controlled Trial. Iran J Psychiatry Behav Sci. 2024;In Press(In Press):e139764.
48. Galante J, Galante I, Bekkers MJ, Gallach¬er J. Effect of kindness-based meditation on health and well-being: a systematic review and meta-analysis. J Consult Clin Psychol. 2014;82(6):1101-14.
49. Tonelli ME, Wachholtz AB. Meditation-based treatment yielding immediate relief for med¬itation-naïve migraineurs. Pain Manag Nurs. 2014;15(1):36-40.
50. Wren AA, Shelby RA, Soo MS, Huysmans Z, Jarosz JA, Keefe FJ. Preliminary efficacy of a lovingkindness meditation intervention for patients undergoing biopsy and breast cancer surgery: A randomized controlled pilot study. Supportive Care in Cancer. 2019;27:3583-92.
51. Telke S, Leininger B, Hanson L, Kreitzer MJ. A randomized trial of 21 days of loving kindness meditation for stress reduction and emotional well-being within an online health community for patients, family, and friends experiencing a cancer health journey. Journal of integrative and complementary medicine. 2022;28(2):158-67.
52. Mifsud A, Pehlivan MJ, Fam P, O’Grady M, van Steensel A, Elder E, et al. Feasibility and pilot study of a brief self-compassion intervention addressing body image distress in breast can¬cer survivors. Health psychology and behavior¬al medicine. 2021;9(1):498-526.
53. Austin J, Schroevers MJ, Van Dijk J, Sander¬man R, Børøsund E, Wymenga AMN, et al. Com¬pas-Y: A mixed methods pilot evaluation of a mobile self-compassion training for people with newly diagnosed cancer. Digital Health. 2023;9:20552076231205272.
54. Hayes SC, Luoma JB, Bond FW, Masuda A, Lil¬lis J. Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy. 2006;44(1):1-25.
55. Robinson P, Hayes SC. Acceptance and com¬mitment: A model for integration. In: Cum¬mings NA, Cummings JL, Johnson JN. (eds.) Behavioral health in primary care: A guide for clinical integration. Psychosocial Press; 1997. p. 177-203.
56. Fishbein JN, Judd CM, Genung S, Stanton AL, Arch JJ. Intervention and mediation effects of target processes in a randomized controlled trial of Acceptance and Commitment Therapy for anxious cancer survivors in community on¬cology clinics. Behaviour Research and Thera¬py. 2022;153:104103.
57. Linardon J. Can Acceptance, Mindfulness, and Self-Compassion Be Learned by Smartphone Apps? A Systematic and Meta-Analytic Review of Randomized Controlled Trials. Behav Ther. 2020;51(4):646-58.