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Kronik Psikiyatri Hastalarının Fiziksel Sağlık Durumu: İhmal Edilen Bir Alan

Yıl 2013, Cilt: 6 Sayı: 3, 159 - 164, 01.08.2013

Derya Kayar Erginer Neslihan Partlak Günüşen

Öz

Kronik psikiyatri hastalarının morbidite ve mortalite oranları genel nüfustan daha yüksek, yaşam beklentileri daha düşüktür. İlaç yan etkileri, fiziksel belirtilerin ihmali, uyum eksikliği gibi hastalığa bağlı nedenler, sigara kullanımı, kötü beslenme, alkol, sigara ve madde kullanımı, fiziksel aktivite ve hijyen eksikliği gibi yaşam tarzı davranışları ve çevresel etmenler nedeniyle bu hastaların fiziksel sağlığı bozulmaktadır. Kronik psikiyatri hastaların birçoğu kardiyovasküler hastalıklar ya da metabolik komplikasyonlar nedeniyle ölmektedirler. Psikiyatri hastalarının bakımında sadece ruhsal yakınmalara odaklanılmakta, fiziksel belirtiler ihmal edilmektedir. Yurt dışında kronik psikiyatri hastaları için, yapılan araştırma sonuçları doğrultusunda çeşitli izlem araçları geliştirilmiş ve fiziksel sağlığı iyileştirme amacıyla sağlıklı yaşam davranışlarını geliştirmeye yönelik müdahale programları oluşturulmuştur. Ülkemizde kronik psikiyatri hastalarının fiziksel sağlığına yönelik çalışmalar çok az sayıda olup, genelde tanımlayıcı tipte araştırmalardır. Psikiyatri hemşireleri kliniklerde daha çok psikiyatrik açıdan hastaya bakım vermekte, fiziksel sağlık psikiyatri hemşiresinin sorumluluk alanı olarak görülmemektedir. Psikiyatri hemşireleri, fiziksel hastalıklara karşı koruyucu önlemler alma, erken tanılama ve egzersiz, diyet gibi müdahale programları ile sağlıklı yaşam davranışının geliştirilmesinden sorumludur. Bu derlemenin, hemşirelik alanında psikiyatri hastalarının fiziksel sağlığına odaklanan bir çalışma olarak ülkemizde hemşirelik literatürü için önemli bir katkı sağlayacağı ve hemşirelerin bu alandaki sorumluluklarının farkındalığını arttıracağı düşünülmektedir.Anahtar Kelimeler: Kronik Psikiyatri Hastaları, Fiziksel Sağlık, Psikiyatri Hemşireliği.

Anahtar Kelimeler

Kronik Psikiyatri Hastaları Fiziksel Sağlık Psikiyatri Hemşireliği

Kaynakça

  • Açıl, A.A. (2006). Şizofrenik hastalarda fiziksel egzersizin ruhsal durum ve yaşam kalitesi üzerine etkisi. Psikiyatri Hemşireliği Programı Yüksek Lisans Tezi, Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü. Sivas, Türkiye. yüksek lisans tezi, 2006.
  • Arslan, M., Atmaca, A., Ayvaz, G., Başkal, N., Beyhan, Z., Bolu, E. ve ark. (2009). Türkiye endokrinoloji ve metabolizma derneği metabolik sendrom çalışma grubu. Metabolik Sendrom Kılavuzu, 7-13. Erişim tarihi: http://www.turkendokrin.org/files/pdf/metabolik_send rom.pdf 2013.
  • Ateş, M.A. & Durmaz, O. (2010). Şizofreni ve metabolik sendrom. Türkiye Klinikleri Psikiyatri Özel Sayısı, 3(2): 67-73.
  • Blythe, J. & White, J. (2012). Role of the mental health nurse towards physical health care in serious mental illness: An integrative review of 10 years of UK Literature. International Journal of Mental Health Nursing, 21 (3): 193–201.
  • Bonfioli, E., Berti, L., Goss, C., Muraro, F. & Burti, L. (2012). Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials. BMC Psychiatry, 12-78.
  • Bradshaw, T. & Pedley, R. (2012). Evolving role of mental health nurses in the physical health care of people with serious mental health illness. International Journal of Mental Health Nursing, 21 (3): 266–273.
  • Brunero, S. & Lamont, S. (2009). Systematic screening for metabolic syndrome in consumers with severe mental illness. International Journal of Mental Health Nursing, 18 (2): 144-150.
  • Cerit, C., Özten, E. & Yıldız, M. (2008). Şizofreni hastalarında metabolik sendrom sıklığı ve ilişkili etmenler. Türk Psikiyatri Dergisi, 19 (2): 124-132.
  • Collins, E., Tranter, S. & Irvine, F. (2011). The physical health of the seriously mentally ill: an oerview of the literatüre. Journal of Psychiatric and Mental Health Nursing, 19 (7): 638-646.
  • Çetin, M. (2008). Antipsikotik tedavinin hormonal yan etkileri. Sempozyum Dizisi, 66: 61-69.
  • Edward, K., Rasmussen, B. & Munro L. (2010). Nursing care of clients treated with atypical antipsychotics who have a risk of developing metabolic instability and/or type 2 diabetes. Archives of Psychiatric Nursing, 24 (1): 46–53.
  • Gartshore, A. (2009). Does the use of a physical health assesment tool improve the physical health of clients of a community mental health team? Journal of Psychiatric and Mental Health Nursing, 16(6): 578- 580.
  • Gray, R., Hardy, S. & Anderson, K.H. (2009). Psysical health and severe mental illness: if we don’t do something about it, who will? International Journal of Mental Health Nursing, 18 (5): 299-300.
  • Happell, B., Davies, C. & Scott, D. (2012). Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: A systematic review. International Journal of Mental Health Nursing, 21 (3): 236–247.
  • Happell, B., Platania-Phung, C. & Scott, D. (2011). Placing physical activity in mental health care: A leadership role for mental health nurses. International Journal of Mental Health Nursing, 20 (5): 310-318.
  • Happel, B., Platania-Phung, C., Hardy, S., Lambert, T. & Mcallister, M. (2011). A role for mental health nursing in the physical health care of consumers with severe mental illness. Journal of Psychiatric and Mental Health Nursing, 18(8): 706–711.
  • Hardy, S. & Gray, R. (2010). Adapting the severe mental illness physical health improvement profile for use in primary care. International Journal of Mental Health Nursing, 19 (5): 350-355.
  • Hardy, S. & Thomas, B. (2012). Mental and physical helath comorbidity: Political imperatives and practice implications. International Journal of Mental Health Nursing, 21 (3): 289-298.
  • Kaya, M.C., Vırıt, O., Altındağ, A., Selek, S. Bülbül, F. & Bulut, M. (2009). Şizofrenide metabolik sendrom sıklığı, metabolik sendromun özellikleri ve kullanılan antipsikotiklerle ilişkisi. Nöropsikiyatri Arşivi, 46 (1): 13-18.
  • Killian, R., Becker, T., Krüger, K., Schmid, S. & Frasch, K. (2006). Health behavior in psychiatric in-patients compared with a German general population sample. Acta Psychiatrica Scandinava, 114 (4): 242-248.
  • Kısa, C., Cebeci, S., Uysal, Z., Aydemir, Ç. & Göka, E. (2008). Yatarak tedavi gören psikiyatri hastalarında fiziksel hastalık sıklığı. New Symposium Journal, 46 (2): 66-69.
  • Mackin, P., Watkinson, H. M. & Young A. H. (2005). Prevalence of obesity, glucose homeostasis disorders and metabolic syndrome in psychiatric patients taking typical or atypical antipsychotic drugs: a cross- sectional study. Diabetologia, 48 (2): 215–221
  • McCloughen, A. & Foster, K. (2011). Weight gain associated with taking psychotropic medication: An integrative review. International Journal of Mental Health Nursing, 20(3): 202- 222.
  • McCloughen, A., Foster, K., Huws-Thomas, M. & Delgado, C. (2012). Physical health and wellbeing of emerging and young adults with mental illness: An integrative International Journal of Mental Health Nursing, 21 (3): 274–288. international literatüre.
  • Muir- Cochrane, E. (2006). Medical co-morbity risk factors and barriers to care for people with schizophrenia. Journal of Psychiatric and Mental Health Nursing, 13 (4): 447-452.
  • Ohlsen, R.I., Peacock, G. & Smith, S. (2005). Developing a service to monitor and improve physical health in people with serious mental ilness. Journal of Psychiatric and Mental Health Nursing, 12 (5): 614- 619.
  • Öyekçin, D.G. (2009). Bir grup şizofreni ve şizoaffektif bozukluk hastasında metabolik sendrom sıklığı. Anadolu Psikiyatri Dergisi, 10 (1): 26-33.
  • Park, T., Usher, K. & Foster K. (2011). Description of a healthy lifestyle intervention for people with serious mental antipsychotics. International Journal of Mental Health Nursing, 20 (6): 428-437. second-generation
  • Simonelli-Muñoz, A.J., Fortea, M.I., Salorio, P., Gallego- Gomez J.I., Sanchez-Bautista, S. & Balanza, S. (2012). Dietary habits of patients with schizophrenia: A self-reported questionnaire survey. International Journal of Mental Health Nursing, 2012; 21 (3): 220– 228.
  • Shuel, F., White, J., Jones, M. & Gray, R. (2010). Using the serious mental illness health improvement profile (HIP) to identify physical in a cohort of community patients: A pragmatic case series evaluation. International Journal of Nursing Studies, 47 (2): 136- 145.
  • Straker, D., Correl, C.U., Kramer-Ginsberg, E. & Abdulhamid N. (2005). Cost-effective screening for the metabolic syndrome in patientstreated with second-generation American Journal of Psychiatry, 162 (6): 1217–1221.
  • Uğur, M. (2008). Atipik antipsikotik ilaçlar ve psikozlu hastalarda Sempozyum Dizisi, 66: 51-59. metabolik sendrom.
  • Yüksel, N. & Sayın, A. (2006). Antipsikotiklere bağlı metabolik yan etkiler. Klinik Psikiyatri Dergisi, 9 (1):5-16.
  • Weiser, P., Becker, T., Losert, C., Alptekin, K., Berti, L., Burti, L. ve ark. (2009). European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS): background, aims and methods. BMC Public Health, 9:315.
  • White, J., Gray, R. & Jones, M. (2009). The development of the serious mental illness phsical health improvement profile. Journal Mental Health Nursing, 16 (5): 493-498. of Psychiatric and

Yıl 2013, Cilt: 6 Sayı: 3, 159 - 164, 01.08.2013

Derya Kayar Erginer Neslihan Partlak Günüşen

Öz

Morbidity and mortality rates among chronic psychiatric patients are higher than the rates in the general population are, and these patients have a lower life expectancy. These patients’ physical health is impaired due to the following reasons: disease-related factors such as drug side effects, neglect of physical symptoms and lack of compliance, lifestyle behaviors such as poor diet, smoking, alcohol and drug use, and lack of physical activity and hygiene factors, and environmental factors. Many of these patients lose their lives due to cardiovascular diseases or metabolic complications. When care is provided for psychiatric patients, only psychological problems are focused on, but physical symptoms are neglected. In other countries, in line with the results of researches, various tools have been developed to monitor chronic psychiatric patients, and intervention programs aiming to promote healthy lifestyle behaviors have been conducted in order to improve their physical health. On the other hand, in our country, studies of this kind are very few, and the ones available are usually descriptive researches. In psychiatry clinics, psychiatric nurses mostly provide psychiatric care for patients, and patients’ physical health is not regarded among psychiatric nurses’ responsibilities. Psychiatric nurses are responsible for taking preventive measures against physical diseases and developing healthy lifestyle behaviors through intervention programs such as early diagnosis, exercise and diet. It is thought that this review will provide an important contribution to the nursing literature in our country since it is a study focusing on physical health of psychiatric patients in the nursing field and that it will increase nurses’ awareness regarding their responsibilities in this area

Anahtar Kelimeler

Chronic Psychiatric Patients Physical Health Psychiatric Nursing.

Kaynakça

  • Açıl, A.A. (2006). Şizofrenik hastalarda fiziksel egzersizin ruhsal durum ve yaşam kalitesi üzerine etkisi. Psikiyatri Hemşireliği Programı Yüksek Lisans Tezi, Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü. Sivas, Türkiye. yüksek lisans tezi, 2006.
  • Arslan, M., Atmaca, A., Ayvaz, G., Başkal, N., Beyhan, Z., Bolu, E. ve ark. (2009). Türkiye endokrinoloji ve metabolizma derneği metabolik sendrom çalışma grubu. Metabolik Sendrom Kılavuzu, 7-13. Erişim tarihi: http://www.turkendokrin.org/files/pdf/metabolik_send rom.pdf 2013.
  • Ateş, M.A. & Durmaz, O. (2010). Şizofreni ve metabolik sendrom. Türkiye Klinikleri Psikiyatri Özel Sayısı, 3(2): 67-73.
  • Blythe, J. & White, J. (2012). Role of the mental health nurse towards physical health care in serious mental illness: An integrative review of 10 years of UK Literature. International Journal of Mental Health Nursing, 21 (3): 193–201.
  • Bonfioli, E., Berti, L., Goss, C., Muraro, F. & Burti, L. (2012). Health promotion lifestyle interventions for weight management in psychosis: a systematic review and meta-analysis of randomised controlled trials. BMC Psychiatry, 12-78.
  • Bradshaw, T. & Pedley, R. (2012). Evolving role of mental health nurses in the physical health care of people with serious mental health illness. International Journal of Mental Health Nursing, 21 (3): 266–273.
  • Brunero, S. & Lamont, S. (2009). Systematic screening for metabolic syndrome in consumers with severe mental illness. International Journal of Mental Health Nursing, 18 (2): 144-150.
  • Cerit, C., Özten, E. & Yıldız, M. (2008). Şizofreni hastalarında metabolik sendrom sıklığı ve ilişkili etmenler. Türk Psikiyatri Dergisi, 19 (2): 124-132.
  • Collins, E., Tranter, S. & Irvine, F. (2011). The physical health of the seriously mentally ill: an oerview of the literatüre. Journal of Psychiatric and Mental Health Nursing, 19 (7): 638-646.
  • Çetin, M. (2008). Antipsikotik tedavinin hormonal yan etkileri. Sempozyum Dizisi, 66: 61-69.
  • Edward, K., Rasmussen, B. & Munro L. (2010). Nursing care of clients treated with atypical antipsychotics who have a risk of developing metabolic instability and/or type 2 diabetes. Archives of Psychiatric Nursing, 24 (1): 46–53.
  • Gartshore, A. (2009). Does the use of a physical health assesment tool improve the physical health of clients of a community mental health team? Journal of Psychiatric and Mental Health Nursing, 16(6): 578- 580.
  • Gray, R., Hardy, S. & Anderson, K.H. (2009). Psysical health and severe mental illness: if we don’t do something about it, who will? International Journal of Mental Health Nursing, 18 (5): 299-300.
  • Happell, B., Davies, C. & Scott, D. (2012). Health behaviour interventions to improve physical health in individuals diagnosed with a mental illness: A systematic review. International Journal of Mental Health Nursing, 21 (3): 236–247.
  • Happell, B., Platania-Phung, C. & Scott, D. (2011). Placing physical activity in mental health care: A leadership role for mental health nurses. International Journal of Mental Health Nursing, 20 (5): 310-318.
  • Happel, B., Platania-Phung, C., Hardy, S., Lambert, T. & Mcallister, M. (2011). A role for mental health nursing in the physical health care of consumers with severe mental illness. Journal of Psychiatric and Mental Health Nursing, 18(8): 706–711.
  • Hardy, S. & Gray, R. (2010). Adapting the severe mental illness physical health improvement profile for use in primary care. International Journal of Mental Health Nursing, 19 (5): 350-355.
  • Hardy, S. & Thomas, B. (2012). Mental and physical helath comorbidity: Political imperatives and practice implications. International Journal of Mental Health Nursing, 21 (3): 289-298.
  • Kaya, M.C., Vırıt, O., Altındağ, A., Selek, S. Bülbül, F. & Bulut, M. (2009). Şizofrenide metabolik sendrom sıklığı, metabolik sendromun özellikleri ve kullanılan antipsikotiklerle ilişkisi. Nöropsikiyatri Arşivi, 46 (1): 13-18.
  • Killian, R., Becker, T., Krüger, K., Schmid, S. & Frasch, K. (2006). Health behavior in psychiatric in-patients compared with a German general population sample. Acta Psychiatrica Scandinava, 114 (4): 242-248.
  • Kısa, C., Cebeci, S., Uysal, Z., Aydemir, Ç. & Göka, E. (2008). Yatarak tedavi gören psikiyatri hastalarında fiziksel hastalık sıklığı. New Symposium Journal, 46 (2): 66-69.
  • Mackin, P., Watkinson, H. M. & Young A. H. (2005). Prevalence of obesity, glucose homeostasis disorders and metabolic syndrome in psychiatric patients taking typical or atypical antipsychotic drugs: a cross- sectional study. Diabetologia, 48 (2): 215–221
  • McCloughen, A. & Foster, K. (2011). Weight gain associated with taking psychotropic medication: An integrative review. International Journal of Mental Health Nursing, 20(3): 202- 222.
  • McCloughen, A., Foster, K., Huws-Thomas, M. & Delgado, C. (2012). Physical health and wellbeing of emerging and young adults with mental illness: An integrative International Journal of Mental Health Nursing, 21 (3): 274–288. international literatüre.
  • Muir- Cochrane, E. (2006). Medical co-morbity risk factors and barriers to care for people with schizophrenia. Journal of Psychiatric and Mental Health Nursing, 13 (4): 447-452.
  • Ohlsen, R.I., Peacock, G. & Smith, S. (2005). Developing a service to monitor and improve physical health in people with serious mental ilness. Journal of Psychiatric and Mental Health Nursing, 12 (5): 614- 619.
  • Öyekçin, D.G. (2009). Bir grup şizofreni ve şizoaffektif bozukluk hastasında metabolik sendrom sıklığı. Anadolu Psikiyatri Dergisi, 10 (1): 26-33.
  • Park, T., Usher, K. & Foster K. (2011). Description of a healthy lifestyle intervention for people with serious mental antipsychotics. International Journal of Mental Health Nursing, 20 (6): 428-437. second-generation
  • Simonelli-Muñoz, A.J., Fortea, M.I., Salorio, P., Gallego- Gomez J.I., Sanchez-Bautista, S. & Balanza, S. (2012). Dietary habits of patients with schizophrenia: A self-reported questionnaire survey. International Journal of Mental Health Nursing, 2012; 21 (3): 220– 228.
  • Shuel, F., White, J., Jones, M. & Gray, R. (2010). Using the serious mental illness health improvement profile (HIP) to identify physical in a cohort of community patients: A pragmatic case series evaluation. International Journal of Nursing Studies, 47 (2): 136- 145.
  • Straker, D., Correl, C.U., Kramer-Ginsberg, E. & Abdulhamid N. (2005). Cost-effective screening for the metabolic syndrome in patientstreated with second-generation American Journal of Psychiatry, 162 (6): 1217–1221.
  • Uğur, M. (2008). Atipik antipsikotik ilaçlar ve psikozlu hastalarda Sempozyum Dizisi, 66: 51-59. metabolik sendrom.
  • Yüksel, N. & Sayın, A. (2006). Antipsikotiklere bağlı metabolik yan etkiler. Klinik Psikiyatri Dergisi, 9 (1):5-16.
  • Weiser, P., Becker, T., Losert, C., Alptekin, K., Berti, L., Burti, L. ve ark. (2009). European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS): background, aims and methods. BMC Public Health, 9:315.
  • White, J., Gray, R. & Jones, M. (2009). The development of the serious mental illness phsical health improvement profile. Journal Mental Health Nursing, 16 (5): 493-498. of Psychiatric and
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Derya Kayar Erginer Bu kişi benim

Neslihan Partlak Günüşen Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2013
Yayımlandığı Sayı Yıl 2013 Cilt: 6 Sayı: 3

Kaynak Göster

APA Erginer, D. K., & Günüşen, N. P. (2013). Kronik Psikiyatri Hastalarının Fiziksel Sağlık Durumu: İhmal Edilen Bir Alan. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 6(3), 159-164.

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