Palyatif Bakım Kapsamında Psikoterapiler ve Uygulamaları

Yıl 2019, Cilt: 5 Sayı: 1, 7 - 14, 01.01.2019

Onur Yılmaz Ahmet Öztürk

Öz

Kanser hastaları ve diğer ölümcül ve/veya kronik hastalıkları olanlar için geliştirilen palyatif bakım, özellikle son on yılda multidisipliner bir tedavi yaklaşımı olarak geniş kullanım alanı bulmaya başlamıştır. Palyatif bakımda psikoterapi uygulamaları ise halen gelişimini sürdürmektedir. Psikoterapi ekollerinden klasik Bilişsel Davranışçı Terapi BDT , BDT nin üçüncü dalga ekolleri Sanat Terapi uygulamaları kanser hastaları başta olmak üzere palyatif bakım kapsamında kullanılmaktadır. Varoluşçu felsefenin ve varoluşçu psikoterapilerin palyatif bakım sürecinde kullanım öyküsü daha kısıtlı olsa da, bu özel popülasyonun psikolojik ihtiyaçlarına yanıt verebilecek uygulamalardan biri olabilir. Bu derlemenin içeriğinde palyatif bakım kapsamında günümüze kadar kullanılmış olan değişik psikoterapi ekollerinin bir bölümü ile bundan sonra bu alanda etkin olabilecek başka psikoterapi ekolleri tartışılmıştır

Anahtar Kelimeler

Palyatif bakım, Bilişsel davranışçı terapi, Varoluşçu psikoterapi, Sanat terapi

Psychotherapies and their Practice within the Context of Palliative Care

Öz

Palliative care is carried out for patients who have cancer and/or other chronic or fatal diseases. It has been put to use particularly in the last decade. However, psychotherapeutic approaches within the context of palliative care are still being developed. Among psychotherapy approaches, Cognitive Behavioral Therapy CBT , third wave CBT approaches and Art Therapy are performed as part of palliative care, particularly for patients who have cancer. Even existentialist philosophy and existential psychotherapies have a limited story of usage in the course of palliative care and are supposed to be one of the psychotherapeutic approaches for the patients’ psychological problems. Certain parts of various psychotherapy approaches practised within the context of palliative care and other approaches that might be useful for this purpose are discussed in this review

Anahtar Kelimeler

Palliative care, Cognitive behavioral therapy, Existential psychotherapy, Art therapy

Kaynakça

• 1. Dünya Sağlık Örgütü (WHO) Definition of palliative care. Erişim tarihi: 26 Nisan 2016, [http://www.who.int/ cancer/palliative/definition/en/]).
• 2. Temel JS, Greer, JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 2010; 363(8):733-42.
• 3. Gore JM, Brophy CJ, Greenstone MA. How well do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? A comparison of palliative care and quality of life in COPD and lung cancer. Thorax 2000; 55(12):1000-6.
• 4. Yeloğlu ÇH, Güveli H, Hocaoğlu Ç. Son Dönem hastalarında psikiyatrik yaklaşım. Literatür Sempozyum 2014; 1(2):43-50.
• 5. Zimmermann C. Death denial: obstacle or instrument for palliative care? An analysis of clinical literature. Sociology of Health and Illness 2007; 29(2):297-314.
• 6. Cohen ST, Block S. Issues in psychotherapy with terminally ill patients. Palliative and Supportive Care. 2004; 2(2):181-9.
• 7. Faller H, Schuler M, Richard M, Heckl U, Weis J, Küffner R. Effects of psychooncologic interventions on emotional distress and quality of life in adult patients with cancer: Systematic review and meta-analysis. J Clin Oncol 2013; 31(6):782-93.
• 8. Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kilbourn KM, Craft, LL et al. Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst 2012; 104(13):990-1004.
• 9. Okuyama T, Nakane Y, Endo C, Seto T, Kato M, Seki N. et al. Mental health literacy in Japanese cancer patients: Ability to recognize depression and preferences of treatments comparison with Japanese lay public. Psychooncology 2007; 16:834-42.
• 10. Gielissen MF, Verhagen CA, Bleijenberg G. Cognitive behaviour therapy for fatigued cancer survivors: Longterm follow-up. Br J Cancer 2007; 97:612-8.
• 11. Mannix KA, Blackburn IM, Garland A, Gracie J, Moorey S, Reid B, et al. Effectiveness of brief training in cognitive behaviour therapy techniques for palliative care practitioners. Palliat Med 2006; 20:579-84.
• 12. Semple CJ, Dunwoody L, Sullivan K, Kernohan WG. Patients with head and neck cancer prefer individualized cognitive behavioural therapy. European Jornal of Cancer Care 2006; 15:220-7.
• 13. Moorey S, Greer S. Psychological therapy for patients with cancer. Washington DC. Oxford. Heinemann Medical Books, American Psychiatric Press.1989.
• 14. Hopko DR, Bell JL, Armento M, Robertson S, Mullane C, Wolf N, et al. Cognitive behavior therapy for depressed cancer patients in a medical care setting. Behavior Therapy 2008; 9:126-36.
• 15. Folkman S, Greer S. Promoting psychological well being in the face of serious illness: when theory, research and practice inform each other. Psychooncology 2000; 9(1):11- 9.
• 16. Kissane DW, Bloch S, Smith GC, Miach P, Clarke DM, Ikin J, et al. Cognitive existential group psychotherapy for women with primary breast cancer: A randomised controlled trial. Psychooncology 2003; 12(6):532-46.
• 17. Edelman S, Kidman AD. Description of a group cognitive behaviour therapy programme with cancer patients. Psychooncology 1999; 8:306-14.
• 18. Ng GC, Boks MPM, Zainal NZ, Wit NJ. The prevalence and pharmacotherapy of depression in cancer patients. J Affect Disord 2011; 131:1-7.
• 19. Savard J, Simard S, Giguere I, Ivers H, Morin CM, Maunsell E, et al. Randomized clinical trial on cognitive therapy for depression in women with metastatic breast cancer: Psychological and immunological effects. Palliative and Supportive care 2006; 4(3):219-37.
• 20. Trill MD. Anxiety and sleep disorders in cancer patients. Eur J Cancer 2013; 11(2):216-24.
• 21. Greer JA, Traeger L, Bemis H, Solis J, Hendriksen ES, Park ER, et al. A pilot randomized controlled trial of brief cognitive-behavioral therapy for anxiety in patients with terminal cancer. The Oncologist 2012; 17(10):1337-45.
• 22. Ateşçi FÇ, Oğuzhanoğlu NK, Baltalarlı B, Karadağ F, Özdel O, Karagöz N. Kanser hastalarında psikiyatrik bozukluklar ve ilişkili etmenler. Türk Psikiyatri Dergisi 2003; 14:145-52.
• 23. Davidson JR, MacLean AW, Brundage MD, Schulze K. Sleep disturbance in cancer patients. Soc Sci Med 2002; 54:1309-21.
• 24. Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL. Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998-2004). Sleep 2006; 29:1398-414.
• 25. Alexander V, Gutierrez A, Campbell V, Schwartz D, Tatum BC. A Dialectical behavioral therapy adaptation in reducing depression, anxiety, and self-harm in older adults. International Journal of Psychological and Behavioral Sciences 2017; 4(5).
• 26. Foley E, Baillie A, Huxter M, Price M, Sinclair E. Mindfulness-based cognitive therapy for individuals whose lives have been affected by cancer: A randomized controlled trial. J Consult Clin Psychol 2010; 78(1):72-9.
• 27. Feros DL, Lane L, Ciarrochi J, Blackledge JT. Acceptance and Commitment Therapy (ACT) for improving the lives of cancer patients: A preliminary study, Psycooncology 2013; 22(22):459-64.
• 28. Frankl VE. İnsanın anlam arayışı. Budak S. (Çev). 2.Baskı. İstanbul: Okuyan Us Yayınları, 2013.
• 29. Afşaroğlu E, Okutur K, Demir G. Beliefs of Turkish cancer patients on the genesis of cancer: “why do I have cancer?”. Journal of the Balkan Union of Oncology 2010; 15:303-9.
• 30. Molassiotisa A, Chan CW, Yam BM, Chan ES, Lam CS. Life after cancer: Adaptation issues faced by Chinese gynaecological cancer survivors in Hong Kong. Psychooncology 2002; 11:114-23.
• 31. Hammer K, Mogensen O, Hall EOC. Hope as experienced in women newly diagnosed with gynaecological cancer. European Journal of Oncology Nursing 2009; 13:274-9.
• 32. Kierkegaard S. Korku ve titreme. Düzen N.E. (Çev.). Ankara: Pharmakon Kitap, 2014.
• 33. Lukas E, Fabry JB. Meaningful living: Logotherapeutic guide to health. New York: Grove Press, 1984:140.
• 34. Ascher LM. Paradoxical intention and recursive anxiety. In: Ascher LM ed. Therapeutic paradox. New York: Guilford Press 1989; 93-137.
• 35. Zammit C. The art of healing: a journey through cancer: implications for art therapy. Journal of The American Art Therapy Association 2011; 18(1):27-36.
• 36. Bar-Sela G, Atid L, Danos S, Gabay N, Epelbaum R. Art therapy improved depression and influenced fatigue levels in cancer patients on chemotherapy. Psychooncology. 2007; 16:980-4.
• 37. Favara-Scacco C, Smirne G, Schilirò G, Di Cataldo A. Art therapy as support for children with leukemia during painful procedures. Pediatric Blood and Cancer 2001; 36(4):474-80.
• 38. Yıldırım G, Gürkan A. Müziğin kemoterapi yan etkilerine ve kaygı düzeyine etkisi. Anadolu Psikiyatri Dergisi 2007; 8:37-45.
• 39. Bradt J, Dileo C, Grocke D, Magill L. Music interventions for improving psychological and physical outcomes in cancerpatients. Cochrane Database Syst Rev. 2016; 8(8):CD006911.
• 40. Chochinov HM, Hack T, Hassard T, Kristjanson LJ, McClement S, Harlos M. Dignity therapy: A novel psychotherapeutic intervention for patients near the end of life. J Clin Oncol 2005; 23(24):5520-5.