Hasta penceresinden Covid-19 tanısıyla tek başına bir hastane odasında olmak: nitel çalışma

Yıl 2021, Cilt: 46 Sayı: 1, 223 - 232, 31.03.2021

Ebru Şahan

Öz

Amaç: Bu çalışmada Covid-19 tanısı ile hastaneye yatırılan hastalarda krize müdahele girişimlerine ve psikolojik destek istenmesine neden olan ortak temaların araştırılması ve Koronavirüs pandemisinin erken döneminde İstanbul’daki üçüncü basamak bir hastanede izolasyonun psikososyal etkilerinin hasta penceresinden incelenmesi amaçlandı.
Gereç ve Yöntem: Veriler Mart 2020’nin ikinci yarısında hastaneye yatırılmış Covid-19 tanılı veya şüpheli hastalarla yapılan telefon görüşmelerinden ve hastane kayıtlarından toplandı. Nitel verilerin içerik analizinde, sıklıkla tekrarlanan veya katılımcının yoğun vurgu yaptığı olay ve olgulardan kodlar, kodlardan kategoriler ve kategorilerden temalar çıkarılmıştır.
Bulgular: Çalışmaya 18 kadın, 20 erkek olmak üzere toplam 38 kişi dahil edildi. Dört genel tema kuruldu: “beklenmedik hastalık”, “tecrit edilme”, “belirsizlik”, “damgalanma”. İlk olarak hastalığın beklenmedik bir şekilde ortaya çıkmasının şok tepkisi oluşturduğu, inkar savunmasının çalıştığı, hayat planlarının kesintiye uğramasının kabullenilemediği gözlendi. Hastaların kendilerini hapse veya hücreye atılmış, cezalandırılıyor algılamalarının, bu duruma girdikleri için pişmanlık hissetmelerinin, otoriteye karşıt gelme, kaçma, kendine veya başkasına zarar verme düşüncelerinin tecrit edilme temasıyla bağlantılı olduğu belirlendi.
Sonuç: İzolasyonun psikolojik yönlerine odaklanmak sadece uzun dönemde stres, kaygı, depresyonu azaltmada değil aynı zamanda daha başlangıçta karantina uygulamaları ve kurallarına katılım motivasyonunu ve uyumu artırmada etkili olabilir.

Anahtar Kelimeler

eyleme vurma, Koronavirüs, karantina, yalnızlık, sosyal destek, pandemi, uyum bozuklukları

Being in a hospital room alone with the diagnosis of Covid-19 from a patient perspective: a qualitative study

Öz

Purpose: The aim of this study was to investigate common themes for psychological interventions and support in patients hospitalized with the diagnosis of Covid-19 and to examine the psychosocial impacts of isolation from the patient perspective during early phase of Coronavirus pandemic in a tertiary center in Istanbul.
Materals and Methods: The data were collected from phone calls and hospital records of hospitalized patients suspected or diagnosed with Covid-19 during the second half of March 2020. In the content analysis of qualitative data, codes, categories and themes were extracted from the events and phenomena frequently repeated or emphasized by the participants.
Results: A total of 38 people, 18 women and 20 men, were included in the study. Four general themes were established: "unexpected illness", "isolation", "uncertainty", "stigmatization". First, it was observed that the unexpected emergence of the disease induced a shock response, the defense of denial was on duty, and the interruption of life plans could not be accepted. The perceptions of the patients under being imprisoned theme were being punished, feeling of regret, the thoughts of opposing authority, running away, harming themselves or others.
Conclusion: Focusing on the psychological aspects of isolation is effective not only in reducing stress, anxiety, depression in the long term, but also increases motivation and compliance with quarantine practices and rules at the very beginning.

Anahtar Kelimeler

Coronavirus, quarantine, pandemic

Kaynakça

• 1. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. Coronavirus disease 2019 (COVID-19): a perspective from China. 200490 (2020).
• 2. Zhang, J., Dong, X, Cao, Y.-Y. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Allergy. [published online February 19, 2020].
• 3. Duan C, Linder H, Huremović D. Societal, Public, and [emotional] epidemiological aspects of a Pandemic. Psychiatry of Pandemics: Springer; 2019:45-53.
• 4. Ko CH, Yen CF, Yen JY, Yang MJ. Psychosocial impact among the public of the severe acute respiratory syndrome epidemic in Taiwan. Psychiatry Clin Neurosci. 2006;60: 397-403.
• 5. Paladino L, Sharpe RP, Galwankar SC, Sholevar F, Marchionni C, Papadimos TJ, et al. Reflections on the Ebola public health emergency of international concern, part 2: the unseen epidemic of posttraumatic stress among health-care personnel and survivors of the 2014–2016 Ebola outbreak. J Glob Infect Dis. 2017;9:45.
• 6. Kim H-C, Yoo S-Y, Lee B-H, Lee SH, Shin H-S. Psychiatric findings in suspected and confirmed middle east respiratory syndrome patients quarantined in hospital: a retrospective chart analysis. Psychiatry Investig. 2018;15:355.
• 7. Dai L, Wang X, Jiang T, Li P, Wang Yu, Wu S, et al. Anxiety and Depression Symptoms of Patients in Fangcang Shelter Hospital During the COVID-19 Outbreak in China: a Web-Based Cross-Sectional Study. 2020.
• 8. Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry 2020.
• 9. Guo Q, Zheng Y, Shi J, Wang J, Li G, Li C, et al. Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study. Brain Behav Immun. 2020;88:17-27.
• 10. Kong X, Zheng K, Tang M, Kong F, Zhou J, Diao L, et al. Prevalence and factors associated with depression and anxiety of hospitalized patients with COVID-19. 2020.
• 11. Baltaci A. Nitel Araştırma Süreci: Nitel Bir Araştırma Nasıl Yapılır? AEÜSBED. 2019;5:368-88.
• 12. Creswell JW. Educational research: Planning, conducting, and evaluating quantitative: Prentice Hall Upper Saddle River, NJ; 2002.
• 13. Abad C, Fearday A, Safdar N. Adverse effects of isolation in hospitalised patients: a systematic review. J Hosp Infect. 2010;76:97-102.
• 14. Day HR, Perencevich EN, Harris AD, Gruber-Baldini, AL, Himelhoch SS, Brown CH, et al. Depression, anxiety, and moods of hospitalized patients under contact precautions. Infect Control Hosp Epidemiol. 2013;34:251-8.
• 15. Jiang YN, Zhou W, Zhao XH, Hong X, Wei J. Post-traumatic stress disorder in convalescent patients of severe acute respiratory syndrome:(1) H-MRS study. Zhonghua yi xue za zhi. 2013;93:366-9.
• 16. Dailey SF, Kaplan D. Shelter-in-place and mental health: an analogue study of well-being and distress. J Emerg Manag. 2014;12:121-31.