Araştırma Makalesi
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Evaluation of Self-Care Agency, Self-Management, and Adaptation to Illness in Patients with Psychosis and Chronic Diseases

Yıl 2025, Cilt: 5 Sayı: Ek 1 , 70 - 82 , 19.12.2025
https://izlik.org/JA76MW98GM

Öz

Individuals diagnosed with psychosis may experience difficulties in managing their chronic diseases due to cognitive and emotional challenges. Evaluating the self-care agency, self-management, and adaptation to illness of these patients is crucial for understanding their capacity to maintain their health. This study aimed to assess the level of chronic disease management among patients diagnosed with psychotic disorders. This cross-sectional descriptive study was conducted with 70 female patients in the women's ward of a regional psychiatric hospital. All participants were followed up for at least one year and had at least one chronic disease in addition to a psychosis diagnosis. Data were collected using a patient information form, the Positive and Negative Syndrome Scale (PANSS), the Self-Care Agency Scale (SCAS), and the Chronic Disease Self-Management Scale (CDSMS). Among the participants, 64.3% were ≥ 40 years old, 54.3% were married, and 82.8% had a secondary or higher level of education. Additionally, 58.6% were smokers, 65.7% were diagnosed with non-organic psychosis, and 25.7% had chronic diseases for more than six years. Comorbidities included diabetes mellitus (31.4%), thyroid disorders (45.7%), and hypertension (17.2%). A negative correlation was found between total scores on the PANSS and SCAS (r = -0.61, p < 0.01). Furthermore, strong positive correlations were observed between the total score of the SCAS and subdimensions of the CDSMS, including self-stigma, coping with stigma, treatment adherence, and healthcare efficacy (p < 0.01). These findings indicate that severe psychotic symptoms negatively impact patients’ self-care abilities, and stigma reduces treatment adherence.

Kaynakça

  • Arciniegas, D. B. (2015). Psychosis. Continuum (Minneap Minn), 21(3), 715–736. https://doi.org/10.1212/01.CON.0000466662.89908.e7 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
  • Bekiroğlu, S. (2021). Ruhsal hastalığa sahip bireylere yönelik damgalama: Etkileyen faktörlere ve bireyler üzerindeki etkilerine dair kavramsal bir çalışma. OPUS Uluslararası Toplum Araştırmaları Dergisi, 17(33), 595–618. https://doi.org/10.26466/opus.825384
  • Boşgelmez, Ş., & Yıldız, M. (2017). Türkiye’de ruhsal hastalığı olan bireylerde sigara kullanımı: Epidemiyolojik bulgular. Addicta, 4(2), 286–303. https://doi.org/10.15805/addicta.2017.4.2.0035
  • Chen, C., Chen, Y., Huang, Q., Yan, S., & Zhu, J. (2022). Self-care ability of patients with severe mental disorders: Based on community patients investigation in Beijing, China. Frontiers in Public Health, 10, 847098. https://doi.org/10.3389/fpubh.2022.847098
  • Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., … Carvalho, A. F. (2017). Prevalence, incidence, and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: A large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163–180. https://doi.org/10.1002/wps.20420
  • Çelik, A., & Yıldırım, Z. (2016). Ruhsal hastalıklarda öz bakım ve ilaç uyumu. Psikiyatri Hemşireliği Dergisi, 7(3), 121–128. https://doi.org/10.5505/phd.2016.43533
  • De Bartolomeis, A., Prinzivalli, E., Caccavale, S., Tomasetti, C., Iasevoli, F., & Marmo, F. (2022). Linking inflammation, aberrant glutamate–dopamine transmission, and postsynaptic density remodeling in schizophrenia. Molecular Neurobiology, 59(12), 7029–7071. https://doi.org/10.1007/s12035-022-02976-3
  • Delibaş, L., & Çam İkiz, F. (2018). Psikotik bozukluklarda sosyal işlevsellik ve yaşam kalitesi. Turkish Journal of Clinical Psychiatry, 21(4), 406–414. https://doi.org/10.5505/kpd.2018.56423
  • Demirel, A., Demirel, Ö., & Uğur, M. (2015). Atipik antipsikotiklere bağlı metabolik sendrom. Psikiyatride Güncel Yaklaşımlar, 7(1), 81–97. https://doi.org/10.5455/cap.20140527123634
  • De Hert, M., Correll, C. U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., … Leucht, S. (2011). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry, 10(2), 138– 151. https://doi.org/10.1002/j.2051-5545.2011.tb00036.x
  • Döngel Demirel, B., Tamam, L., & Kır, G. (2017). Şizofrenide görülen tıbbi durumlar. Psikiyatride Güncel Yaklaşımlar, 9(3), 363–378. https://doi.org/10.18863/pgy.281842
  • Dubreucq, J., Plasse, J., & Franck, N. (2021). Self-stigma in serious mental illness: A systematic review. Schizophrenia Bulletin, 47(5), 1261–1287. https://doi.org/10.1093/schbul/sbaa181
  • Gerretsen, P., Plitman, E., Rajji, T. K., & Graff-Guerrero, A. (2014). The effects of aging on insight into illness in schizophrenia: A review. International Journal of Geriatric Psychiatry, 29(11), 1145–1161. https://doi.org/10.1002/gps.4154
  • Guo, X., Zhang, Z., Wei, Q., Lv, H., Wu, R., & Zhao, J. (2013). The relationship between obesity and neurocognitive function in Chinese patients with schizophrenia. BMC Psychiatry, 13, 109. https://doi.org/10.1186/1471-244X-13-109
  • Hayırkuş, B., & Çapar, A. (2024). Yaşlı bireylerin öz bakım gücü ile psikolojik iyi oluşları arasındaki ilişki: Bir huzurevi örneği. Turkish Journal of Family Medicine and Primary Care, 18(3), 336–345.
  • Herdem, A., Taşdemir, M., & Yılmaz, B. (2017). Psikozun erken dönemi: Tanı ve tedavi açısından bir gözden geçirme. Psikiyatride Güncel Yaklaşımlar, 9(3), 306–322.
  • Hsu, J.-H., Chien, I.-C., Lin, C.-H., Chou, Y.-J., Bih, S.-H., & Lee, C.-H. (2013). Increased risk of chronic obstructive pulmonary disease in patients with schizophrenia: A population-based study. Psychosomatics, 54(4), 345–351. https://doi.org/10.1016/j.psym.2012.12.008
  • Kapıcı, Y., Bulut, G. Ü. C., Tekin, A., & Abuş, S. (2022). Şizofreni hastalarında on yıllık kardiyovasküler hastalık riski ile klinik özellikler arasındaki ilişki. Türk Psikiyatri Dergisi, 33(4), 253– 260. https://doi.org/10.5080/u26111
  • Kessler, T., & Lev-Ran, S. (2019). The association between comorbid psychiatric diagnoses and hospitalization-related factors among individuals with schizophrenia. Comprehensive Psychiatry, 89, 7–15. https://doi.org/10.1016/j.comppsych.2018.12.004
  • Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis and schizophrenia: The widening gap between basic and clinical neuroscience. Translational Psychiatry, 8(1), 30. https://doi.org/10.1038/s41398-017-0071-9
  • Kostakoğlu, A. E., Batur, S., Tiryaki, A., & Göğüş, A. (1999). Pozitif ve Negatif Sendrom Ölçeğinin (PANSS) Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türk Psikoloji Dergisi, 14(44), 23–32.
  • Lee Abdisa, L., Fekadu, A., Girma, E., Shibre, T., & Medhin, G. (2020). Self-stigma, quality of life and schizophrenia: A cross-sectional survey in Ethiopia. PLOS ONE, 15(3), e0230304. https://doi.org/10.1371/journal.pone.0230304
  • Li, Q., Du, X., Zhang, Y., et al. (2017). The prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia. Psychiatry Research, 251, 131–136. https://doi.org/10.1016/j.psychres.2017.02.041
  • Marder, S. R., & Cannon, T. D. (2019). Schizophrenia. The New England Journal of Medicine, 381(18), 1753–1761. https://doi.org/10.1056/NEJMra1808803
  • Nahcivan, N. Ö. (2004). A Turkish language equivalence of the Exercise of Self-Care Agency Scale. Western Journal of Nursing Research, 26(7), 813–824.
  • Öztürk, Y. E., Yeşildağ, M., Arık, Ö., & Fidan, Y. (2021). Kronik Hastalık Öz Yönetim Ölçeğinin Türkçe geçerlilik güvenilirliği. Journal of Academic Value Studies, 7(3), 375–381. https://doi.org/10.29228/javs.52376
  • Schalbroeck, R., van Hooijdonk, C. F. M., Bos, D. P. A., Booij, J., & Selten, J.-P. (2024). Chronic social stressors and striatal dopamine functioning in humans: A systematic review of SPECT and PET studies. Molecular Psychiatry, 29(12), 3841–3856. https://doi.org/10.1038/s41380-024-02581-x
  • Suetani, S., Veronese, N., Luchini, C., Mavridis, D., Solmi, M., Stubbs, B., & Correll, C. U. (2021). Increased rates of respiratory disease in schizophrenia: A systematic review and meta-analysis. Schizophrenia Research, 238, 13–21. https://doi.org/10.1016/j.schres.2021.08.015
  • Wearne, T. A., & Cornish, J. L. (2018). A comparison of methamphetamine-induced psychosis and schizophrenia: A review of positive, negative, and cognitive symptomatology. Frontiers in Psychiatry, 9, 491. https://doi.org/10.3389/fpsyt.2018.00491
  • World Health Organization. (2022a). Noncommunicable diseases progress monitor 2022. World Health Organization. https://www.who.int/publications/i/item/9789240054462 World Health Organization. (2022b, January 10). Schizophrenia. https://www.who.int/news-room/factsheets/detail/schizophreni

Yıl 2025, Cilt: 5 Sayı: Ek 1 , 70 - 82 , 19.12.2025
https://izlik.org/JA76MW98GM

Öz

Kaynakça

  • Arciniegas, D. B. (2015). Psychosis. Continuum (Minneap Minn), 21(3), 715–736. https://doi.org/10.1212/01.CON.0000466662.89908.e7 American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
  • Bekiroğlu, S. (2021). Ruhsal hastalığa sahip bireylere yönelik damgalama: Etkileyen faktörlere ve bireyler üzerindeki etkilerine dair kavramsal bir çalışma. OPUS Uluslararası Toplum Araştırmaları Dergisi, 17(33), 595–618. https://doi.org/10.26466/opus.825384
  • Boşgelmez, Ş., & Yıldız, M. (2017). Türkiye’de ruhsal hastalığı olan bireylerde sigara kullanımı: Epidemiyolojik bulgular. Addicta, 4(2), 286–303. https://doi.org/10.15805/addicta.2017.4.2.0035
  • Chen, C., Chen, Y., Huang, Q., Yan, S., & Zhu, J. (2022). Self-care ability of patients with severe mental disorders: Based on community patients investigation in Beijing, China. Frontiers in Public Health, 10, 847098. https://doi.org/10.3389/fpubh.2022.847098
  • Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., … Carvalho, A. F. (2017). Prevalence, incidence, and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: A large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163–180. https://doi.org/10.1002/wps.20420
  • Çelik, A., & Yıldırım, Z. (2016). Ruhsal hastalıklarda öz bakım ve ilaç uyumu. Psikiyatri Hemşireliği Dergisi, 7(3), 121–128. https://doi.org/10.5505/phd.2016.43533
  • De Bartolomeis, A., Prinzivalli, E., Caccavale, S., Tomasetti, C., Iasevoli, F., & Marmo, F. (2022). Linking inflammation, aberrant glutamate–dopamine transmission, and postsynaptic density remodeling in schizophrenia. Molecular Neurobiology, 59(12), 7029–7071. https://doi.org/10.1007/s12035-022-02976-3
  • Delibaş, L., & Çam İkiz, F. (2018). Psikotik bozukluklarda sosyal işlevsellik ve yaşam kalitesi. Turkish Journal of Clinical Psychiatry, 21(4), 406–414. https://doi.org/10.5505/kpd.2018.56423
  • Demirel, A., Demirel, Ö., & Uğur, M. (2015). Atipik antipsikotiklere bağlı metabolik sendrom. Psikiyatride Güncel Yaklaşımlar, 7(1), 81–97. https://doi.org/10.5455/cap.20140527123634
  • De Hert, M., Correll, C. U., Bobes, J., Cetkovich-Bakmas, M., Cohen, D., Asai, I., … Leucht, S. (2011). Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry, 10(2), 138– 151. https://doi.org/10.1002/j.2051-5545.2011.tb00036.x
  • Döngel Demirel, B., Tamam, L., & Kır, G. (2017). Şizofrenide görülen tıbbi durumlar. Psikiyatride Güncel Yaklaşımlar, 9(3), 363–378. https://doi.org/10.18863/pgy.281842
  • Dubreucq, J., Plasse, J., & Franck, N. (2021). Self-stigma in serious mental illness: A systematic review. Schizophrenia Bulletin, 47(5), 1261–1287. https://doi.org/10.1093/schbul/sbaa181
  • Gerretsen, P., Plitman, E., Rajji, T. K., & Graff-Guerrero, A. (2014). The effects of aging on insight into illness in schizophrenia: A review. International Journal of Geriatric Psychiatry, 29(11), 1145–1161. https://doi.org/10.1002/gps.4154
  • Guo, X., Zhang, Z., Wei, Q., Lv, H., Wu, R., & Zhao, J. (2013). The relationship between obesity and neurocognitive function in Chinese patients with schizophrenia. BMC Psychiatry, 13, 109. https://doi.org/10.1186/1471-244X-13-109
  • Hayırkuş, B., & Çapar, A. (2024). Yaşlı bireylerin öz bakım gücü ile psikolojik iyi oluşları arasındaki ilişki: Bir huzurevi örneği. Turkish Journal of Family Medicine and Primary Care, 18(3), 336–345.
  • Herdem, A., Taşdemir, M., & Yılmaz, B. (2017). Psikozun erken dönemi: Tanı ve tedavi açısından bir gözden geçirme. Psikiyatride Güncel Yaklaşımlar, 9(3), 306–322.
  • Hsu, J.-H., Chien, I.-C., Lin, C.-H., Chou, Y.-J., Bih, S.-H., & Lee, C.-H. (2013). Increased risk of chronic obstructive pulmonary disease in patients with schizophrenia: A population-based study. Psychosomatics, 54(4), 345–351. https://doi.org/10.1016/j.psym.2012.12.008
  • Kapıcı, Y., Bulut, G. Ü. C., Tekin, A., & Abuş, S. (2022). Şizofreni hastalarında on yıllık kardiyovasküler hastalık riski ile klinik özellikler arasındaki ilişki. Türk Psikiyatri Dergisi, 33(4), 253– 260. https://doi.org/10.5080/u26111
  • Kessler, T., & Lev-Ran, S. (2019). The association between comorbid psychiatric diagnoses and hospitalization-related factors among individuals with schizophrenia. Comprehensive Psychiatry, 89, 7–15. https://doi.org/10.1016/j.comppsych.2018.12.004
  • Kesby, J. P., Eyles, D. W., McGrath, J. J., & Scott, J. G. (2018). Dopamine, psychosis and schizophrenia: The widening gap between basic and clinical neuroscience. Translational Psychiatry, 8(1), 30. https://doi.org/10.1038/s41398-017-0071-9
  • Kostakoğlu, A. E., Batur, S., Tiryaki, A., & Göğüş, A. (1999). Pozitif ve Negatif Sendrom Ölçeğinin (PANSS) Türkçe uyarlamasının geçerlilik ve güvenilirliği. Türk Psikoloji Dergisi, 14(44), 23–32.
  • Lee Abdisa, L., Fekadu, A., Girma, E., Shibre, T., & Medhin, G. (2020). Self-stigma, quality of life and schizophrenia: A cross-sectional survey in Ethiopia. PLOS ONE, 15(3), e0230304. https://doi.org/10.1371/journal.pone.0230304
  • Li, Q., Du, X., Zhang, Y., et al. (2017). The prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia. Psychiatry Research, 251, 131–136. https://doi.org/10.1016/j.psychres.2017.02.041
  • Marder, S. R., & Cannon, T. D. (2019). Schizophrenia. The New England Journal of Medicine, 381(18), 1753–1761. https://doi.org/10.1056/NEJMra1808803
  • Nahcivan, N. Ö. (2004). A Turkish language equivalence of the Exercise of Self-Care Agency Scale. Western Journal of Nursing Research, 26(7), 813–824.
  • Öztürk, Y. E., Yeşildağ, M., Arık, Ö., & Fidan, Y. (2021). Kronik Hastalık Öz Yönetim Ölçeğinin Türkçe geçerlilik güvenilirliği. Journal of Academic Value Studies, 7(3), 375–381. https://doi.org/10.29228/javs.52376
  • Schalbroeck, R., van Hooijdonk, C. F. M., Bos, D. P. A., Booij, J., & Selten, J.-P. (2024). Chronic social stressors and striatal dopamine functioning in humans: A systematic review of SPECT and PET studies. Molecular Psychiatry, 29(12), 3841–3856. https://doi.org/10.1038/s41380-024-02581-x
  • Suetani, S., Veronese, N., Luchini, C., Mavridis, D., Solmi, M., Stubbs, B., & Correll, C. U. (2021). Increased rates of respiratory disease in schizophrenia: A systematic review and meta-analysis. Schizophrenia Research, 238, 13–21. https://doi.org/10.1016/j.schres.2021.08.015
  • Wearne, T. A., & Cornish, J. L. (2018). A comparison of methamphetamine-induced psychosis and schizophrenia: A review of positive, negative, and cognitive symptomatology. Frontiers in Psychiatry, 9, 491. https://doi.org/10.3389/fpsyt.2018.00491
  • World Health Organization. (2022a). Noncommunicable diseases progress monitor 2022. World Health Organization. https://www.who.int/publications/i/item/9789240054462 World Health Organization. (2022b, January 10). Schizophrenia. https://www.who.int/news-room/factsheets/detail/schizophreni
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Ruh Sağlığı Hemşireliği
Bölüm Araştırma Makalesi
Yazarlar

Mehmet Fentci 0000-0001-6983-8491

Melis Şen Yılmaz 0000-0002-6405-3385

Gönderilme Tarihi 10 Mart 2025
Kabul Tarihi 16 Ekim 2025
Yayımlanma Tarihi 19 Aralık 2025
IZ https://izlik.org/JA76MW98GM
Yayımlandığı Sayı Yıl 2025 Cilt: 5 Sayı: Ek 1

Kaynak Göster

APA Fentci, M., & Şen Yılmaz, M. (2025). Evaluation of Self-Care Agency, Self-Management, and Adaptation to Illness in Patients with Psychosis and Chronic Diseases. Fenerbahçe University Journal of Health Sciences, 5(Ek 1), 70-82. https://izlik.org/JA76MW98GM