Palyatif Bakım Ünitesinde Çalışan Hekim ve Hemşirelerin Dispne Tedavisinde Morfin Kullanımı ile İlgili Yaklaşımlarının İncelenmesi

Yıl 2022, Cilt: 11 Sayı: 2, 387 - 394, 30.06.2022

Vildan Kocatepe Özlem Oruç Pınar Bağcı Seyhan Yaman Sevinç Birol Perihan Aydın

https://doi.org/10.37989/gumussagbil.868726

Öz

Dispnenin yönetiminde etkinliği kanıtlanan opiodlerden olan morfin ağrıda olduğu gibi opioid reseptörlerine bağlanarak ventilasyonu, anksiyeteyi ve santral dispne algısını azaltır. Bu çalışmada amaç, palyatif bakım ünitesinde (PBÜ) çalışan hekim ve hemşirelerin dispne tedavisinde morfin uygulamaları ile ilgili yaklaşımlarını incelemekti. Tanımlayıcı araştırmanın evrenini beş hastanenin PBÜ’de çalışan 80 hemşire ve 30 hekim oluşturdu. Çalışmada veri toplama aracı olarak “Tanımlayıcı Özellikler Formu” ve “Hekimlerin/ Hemşirelerin Morfin Kullanımı ile İlgili Yaklaşımları Anketi” kullanıldı. Hemşirelerin 31(%38,8)’i dispneli hasta ile her gün karşılaştıklarını ifade etti. Hemşirelerin 61(%76,3)’i hastalara reçete edilen morfini uygularken diğer ilaçlara göre daha fazla dikkatli olması gerektiğini; 77(%96,3)’si ise solunum deprese edici etkilerinden dolayı hastayı daha sık takip etmesi gerektiğini ifade etti. Hekimlerin yarısı dispneli hasta ile her gün karşılaştıklarını, 18(%60)’i PBÜ’de dispne tedavisinde morfin reçete ettiklerini bildirdi. Hekimlerin 27(%90)’si dispneli hastalarda morfin ilk seçenek tedavi yaklaşımı olmadığını düşündüklerini ifade etti. Dispne yönetimindeki etkinliği kanıtlanmış olsa da, yan etkileri, yasal sorumlulukları, uygulama sırasında karşılaşılabilecek tıbbi hatalar nedeniyle hekimlerin morfinleri reçete ederken, hemşirelerin uygularken tedirgin oldukları görülmüştür.

Anahtar Kelimeler

Dispne, Morfin, Hemşireler, Hekimler

Destekleyen Kurum

yok

Proje Numarası

-

Teşekkür

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Examining the Approaches of Physicians and Nurses Working in Palliative Care Unit Concerning the Use of Morphine in the Dyspnea Treatment

Öz

Being among the opioids which have been proven to be effective in the management of dyspnea, morphine reduces ventilation, anxiety and central dyspnea perception by being bound to opioid receptors as in pain. The purpose in this study was to examine the approaches of physicians and nurses working in palliative care unit (PCU) concerning morphine administrations in the dyspnea treatment. The population of the descriptive study comprised 80 nurses and 30 physicians who were working in the PCUs of five hospitals. In the study the “Descriptive Characteristics Form” and “Approaches of Physicians/Nurses Concerning Use of Morphine Survey” were used as data collection tool. Thirty one (38.8%) of the nurses stated that they encountered with patients with dyspnea every day. Of the nurses, 61 (76.3%) indicated that they had to be more careful when administering the prescribed morphine to patients compared to other medicine and 77 (96.3%) indicated that they had to follow patients more frequently due to respiratory-depression impacts. Half of the physicians stated that they encountered with patients with dyspnea every day and 18 (60%) stated that they prescribed morphine in the dyspnea treatment in the PCU. 27 (90%) of the physicians thought that morphine was not the first option treatment approach in patients with dyspnea. Although the effectiveness of morphine in the management of dyspnea has been proved, it has been seen that physicians hesitate when prescribing it and nurses hesitate when applying it due to its side effects, legal responsibilities and medical errors that may be encountered during the administration.

Anahtar Kelimeler

Dyspnea, Morphine, Nurses

Proje Numarası

-

Kaynakça

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