Medication Adherence, Self-Efficacy, Self-Esteem, Depression Level and Nursing Approach in Depression

Yıl 2025, Cilt: 8 Sayı: 3, 404 - 412, 26.12.2025

Ahmet Göktaş , Kadriye Buldukoğlu

https://doi.org/10.54189/hbd.1573936

Öz

Depression is an important health problem both in our country and in the world. One of the most important elements of the treatment and care process in depression is treatment adherence. Medication adherence is the regular use of psychotropic medications to reduce the symptoms of depression and prevent relapse. Patients who do not take their medications regularly are evaluated negatively in terms of medication adherence. Medication non-adherence is one of the most common reasons for treatment failure for depression. Side effects of medication, lack of knowledge, lack of insight and the perception that medication is ineffective underlie treatment non-adherence. Self-efficacy is a concept that expresses an individual's belief in his/her ability to perform the necessary behaviors to achieve desired outcomes. Low levels of self-efficacy in patients with depression may cause them to have difficulty in fulfilling their roles and responsibilities. Self-esteem is a concept related to an individual's perception of himself/herself. Low self-esteem is one of the most important symptoms of depression and is one of the factors that can negatively affect the treatment process. The level of depression refers to the severity of the patient's depressive symptoms. The level of depression can vary from mild to severe and can significantly affect the patient's quality of life. Determining the level of depression plays an important role in monitoring the symptoms of depression and evaluating the effectiveness of treatment and nursing care. Nurses can assume important roles in improving medication adherence, self-efficacy, self-esteem and depression level of patients with depression. In this context, the aim of this study is to explain the medication adherence, self-efficacy, self-esteem, depression level and nursing approach in patients with depression.

Anahtar Kelimeler

Depression , Medication Adherence , Self Concept , Self Efficacy , Psychiatric Nursing

Depresyonda Tedavi Uyumu, Öz Yeterlik, Benlik Saygısı, Depresyon Düzeyi ve Hemşirelik Yaklaşımı

Öz

Depresyon, hem ülkemizde hem de dünyada önemli bir sağlık problemidir. Depresyonda tedavi ve bakım sürecinin en önemli unsurlarından biri tedaviye uyumdur. Tedavi uyumu, depresyonun semptomlarını azaltmak ve nüksü önlemek için psikotrop ilaçların düzenli olarak kullanılmasıdır. İlaçlarını düzenli almayan hastalar, tedavi uyumu bakımından olumsuz değerlendirilmektedir. Tedaviye uyumsuzluk, depresyon tedavisinin başarısız olmasının en yaygın nedenlerinden biridir. Tedaviye uyumsuzluğun altında ilaç yan etkileri, bilgi eksikliği, iç görü eksikliği ve ilaçların etkisiz olduğu algısı yatmaktadır. Öz yeterlik, bireyin istenen sonuçları elde etmek için gerekli davranışları gerçekleştirme becerisine olan inancını ifade eden bir kavramdır. Depresyon hastalarında düşük öz yeterlik düzeyi, hastaların rol ve sorumluluklarını yerine getirmekte zorlanmalarına neden olabilmektedir. Benlik saygısı ise, bireyin kendisi hakkındaki algısıyla ilgili bir kavramdır. Düşük benlik saygısı, depresyonun en önemli belirtilerinden biri olmakla birlikte tedavi sürecini olumsuz etkileyebilen faktörlerdendir. Depresyon düzeyi, hastanın depresif belirtilerinin şiddetini ifade eder. Depresyon düzeyi, hafiften şiddetliye kadar değişebilmekte ve hastanın yaşam kalitesini önemli ölçüde etkileyebilmektedir. Depresyon düzeyini belirlemek, depresyonun belirtilerini izlemede, tedavi ve hemşirelik bakımının etkinliğini değerlendirmede önemli rol oynamaktadır. Hemşireler depresyon hastalarının tedavi uyumunu, öz yeterliğini, benlik saygısını ve depresyon düzeyini iyileştirmede önemli roller üstlenebilir. Bu kapsamda bu çalışmanın amacı, depresyon hastalarının tedavi uyumu, öz yeterlik, benlik saygısı, depresyon düzeyi ve hemşirelik yaklaşımını açıklamaktır.

Anahtar Kelimeler

Benlik Kavramı , Depresyon , Öz Yeterlik , Psikiyatri Hemşireliği , Tedavi Uyumu

Etik Beyan

Etik onaya gerek yoktur.

Kaynakça

• Akiskal HS. (2017). Mood disorders: Historical introduction and conceptual overview. BJ. Sadock, VA. Sadock, P. Ruiz (Eds.), Kaplan and Sadock’s comprehensive textbook of psychiatry içinde (10. bs., s. 4099-4139). Philadelphia: Wolters Kluwer.
• Albal E, Kutlu Y. (2010). The relationship between the depression coping self-efficacy level and perceived social support resources. Journal of Psychiatric Nursing, 1, 115-120.
• Alhalaiqa F, Deane KH, Gray R. (2013). Hypertensive patients' experience with adherence therapy for enhancing medication compliance: A qualitative exploration. Journal of Clinical Nursing, 22(13-14), 2039-2052.
• Athanasos P. (2017). Mood disorders. K. Evans, D. Nizette, A. O’Brien (Eds.), Psychiatric and mental health nursing içinde (4. bs., s. 917-962). Australia: Elsevier.
• Aydemir Ö. (2011). Major depresif bozuklukta tedavi hedefleri ve tedavinin izlenmesi. Klinik Psikofarmakoloji Bülteni-Bulletin of Clinical Psychopharmacology, 21, 1-9.
• Bahar A. (2023). Determining the relationship between the level of self-efficacy and quality of life on coping with depression. Journal of Education and Research in Nursing, 20(3), 255-260.
• Bandura A. (1997a). Self-efficacy: The exercise of control. New York: W.H. Freeman and Company.
• Bandura A. (1977b). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.
• Başoğul C, Buldukoğlu K. (2020). Neuman Systems Model with depressed patients: A randomized controlled trial. Nursing Science Quarterly, 33, 148-158.
• Boyd MA. (2018). Psychosocial theoretic basis of psychiatric nursing. MA. Boyd (Ed.), Psychiatric nursing contemporary practice içinde (6. bs., s. 165-203). Philadelphia: Wolter Kluwer.
• Bulechek GM, Butcher HK, Dochterman JM, Wagner C. (2013). Nursing Interventions Classification (NIC). Missouri: Elsevier.
• Bulechek GM, Butcher HK, Dochterman JM, Wagner C. (2017). Hemşirelik girişimleri sınıflaması (NIC). (F. Erdemir, S. Kav, A. Akman Yılmaz, Çev.) İstanbul: Nobel Tıp Kitabevleri.
• Butcher HK, Bulechek GM, Dochterman JM, Wagner CM. (2018). Nursing Interventions Classification (NIC). Missouri: Elsevier.
• Carpenito LJ. (2017). Handbook of Nursing Diagnosis. 15th ed. Philadelphia: Wolters Kluwer.
• Casañas R, Catalán R, Penadés R, Real J, Valero S, Muñoz MA, et al. (2015). Evaluation of the effectiveness of a psychoeducational intervention in treatment-naïve patients with antidepressant medication in primary care: A randomized controlled trial. The Scientific World Journal, Special Issue, 718607. doi:10.1155/2015/718607
• Casañas R, Catalán R, Val JL, Real J, Valero S, Casas M. (2012). Effectiveness of a psycho-educational group program for major depression in primary care: A randomized controlled trial. BMC Psychiatry, 12, 230.
• Chen TH, Lu RB, Chang AJ, Chu DM, Chou KR. (2006). The evaluation of cognitive–behavioral group therapy on patient depression and self-esteem. Archives of Psychiatric Nursing, 20, 3-11.
• Ebrahimi H, Navidian A, Keykha R. (2014). Effect of supportive nursing care on self esteem of patients receiving electroconvulsive therapy: A randomized controlled clinical trial. Journal of Caring Sciences, 3, 149-156.
• Farooq S. Naeem F. (2014). Tackling nonadherence in psychiatric disorders: Current opinion. Neuropsychiatric Disease and Treatment, 1069-1077.
• Fortinash KM, Worret PAH. (2007). Psychiatric nursing care plans. 5th ed. Philadelphia: Mosby Elsevier.
• Gast A, Mathes T. (2019). Medication adherence influencing factors-an (updated) overview of systematic reviews. Systematic reviews, 8, 1-17.
• Göktaş A. (2021). Roy uyum modeline temellendirilmiş depresyonda psikiyatrik bakım uygulamasının tedavi uyumu, genel öz yeterlik, benlik saygısı ve depresyon düzeyine etkisi. (Yayımlanmamış Doktora Tezi). Akdeniz Üniversitesi Sağlık Bilimleri Enstitüsü, Antalya.
• Göktaş A, Buldukoğlu K. (2023). Depresyon, psikiyatrik bakım ve model kullanımı: Depresyonun Roy Uyum Modeline göre analizi ve hemşirelik süreci. Hemşirelik Bilimi Dergisi, 6(1), 55-70.
• Günaydın N, Barlas GÜ. (2017). Effectiveness of a group and brochure psychoeducation intervention to improve depression level and treatment continuity among adults with depression in Turkey: A controlled study. Biomedical Research, 28, 1493-1499.
• Hilbert S, Goerigk S, Padberg F, Nadjiri A, Übleis A, Jobst A, et al. (2018). The role of self-esteem in depression: A longitudinal study. Behavioural and Cognitive Psychotherapy, 47, 244-250.
• Hobelmann JG, Clark MR. (2017). Psychosomatic medicine: Management of chronic pain. BJ. Sadock, VA. Sadock, P. Ruiz (Eds.), Kaplan and Sadock’s comprehensive textbook of psychiatry içinde (10. bs., s. 6101-6130). Philadelphia: Wolters Kluwer.
• Khalifeh AH, Alhalaiqa FN, Hamaideh SH, Horne R, Hamdan‐Mansour AM. (2023). The effect of adherence therapy on medication adherence, health beliefs, self‐efficacy, and depressive symptoms among patients diagnosed with major depressive disorder. International Journal of Mental Health Nursing, 32(3), 778-790.
• Khatooni M, Rahimi S, Bahrami M. (2024). The relationship between stress, anxiety, depression and medication adherence behavior in patients with epilepsy: A cross-sectional study. Epilepsy & Behavior, 151, 109616.
• Kroenke K, Spitzer RL, Williams JB. (2001). The PHQ‐9: Validity of a brief depression severity measure. Journal of General İnternal Medicine, 16, 606-613.
• Ladwig GB, Martinez-Kratz M. (2017). List of nursing diagnoses by letter S: Chronic low self-esteem. BJ. Ackley, GB. Ladwig, MBF. Makic (Eds.), Nursing diagnosis handbook an evidence-based quide to planning care içinde (11 bs., s. 763-767). Missouri: Elsevier.
• Lönnfjord V, Hagquist C. (2018). The psychometric properties of the Swedish version of the general self-efficacy scale: A Rasch analysis based on adolescent data. Current Psychology, 37, 703-715.
• McManus F, Waite P, Shafran R. (2009). Cognitive-behavior therapy for low self-esteem: A case example. Cognitive and Behavioral Practice, 16, 266-275.
• Motioleslam M, Fereidooni-Moghadam M, Etemadifar M, Mohebi Z. (2024). Medication adherence and its relationship with self-esteem among patients with epilepsy in Isfahan, Iran. Epilepsy & Behavior, 155, 109776.
• Nasstasia Y, Baker A, Lewin T, Halpin S, Hides L, Kelly B, et al. (2019). Motivational interviewing as a prelude to an exercise intervention enhances program engagement and self-efficacy in youth with major depression. Journal of Science and Medicine in Sport, 22, 98-99.
• National Institute for Health and Care Research. (2020). Combined drug and psychological therapies may be most effective for depression. (Erişim tarihi: 26.06.2024), https://evidence.nihr.ac.uk/alert/combined-drug-and-psychological-therapies-may-be-most-effective-for-depression/
• Neacşu V. (2013). The efficiency of a cognitive-behavioral program in diminishing the intensity of reactions to stressful events and increasing self-esteem and self-efficiency in the adult population. Procedia-Social and Behavioral Sciences, 78, 380-384
• Orth U, Robins RW. (2013). Understanding the link between low self-esteem and depression. Current Directions in Psychological Science, 22, 455-460.
• Roaldset Å, Sandberg H. (2019). Effect of group psychoeducation for major depressive disorder: a systematic review. (Yayımlanmamış Yüksek Lisans Tezi). The Arctic University of Norway Faculty of Health Sciences, Department of Community Medicine, Tromso.
• Sadock BJ, Sadock VA, Ruiz P. (2015). Synopsis of psychiatry: Behavioral sciences/clinical psychiatry. Philadelphia: Wolters Kluwer.
• Sarı YE, Kokoğlu B, Balcioglu H, Bilge U, Colak E, Unluoglu I. (2016). Turkish reliability of the patient health questionnaire-9. Biomedical Research, Special Issue, 460-462.
• Semahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. (2020). Psychotropic medication non-adherence and its associated factors among patients with major psychiatric disorders: A systematic review and meta-analysis. Systematic Reviews, 9, 1-18.
• Schwartz HA, Eichstaedt J, Kern M, Park G, Sap M, Stillwell D, et al. (2014). Towards assessing changes in degree of depression through facebook. Workshop on Computational Linguistics and Clinical Psychology: From Linguistic Signal to Clinical Reality, 118-125.
• Sirey JA, Banerjee S, Marino P, Bruce ML, Halkett A, Turnwald M, et al. (2017). Adherence to depression treatment in primary care: A randomized clinical trial. JAMA Psychiatry, 74(11), 1129-1135
• Temel M, Kutlu FY. (2015). Gordon's model applied to nursing care of people with depression. International Nursing Review, 62, 563-572.
• Townsend MC. (2016). Ruh sağlığı ve psikiyatri hemşireliğinin temelleri: Kanıta dayalı uygulama bakım kavramları. (G. Ançel, Çev.) Ankara: Akademisyen Tıp Kitabevi.
• Townsend MC, Morgan KI. (2018). Psychiatric mental health nursing: Concepts of care in evidence-based practice. Philadelphia: FA Davis Company.
• Trigoboff E. (2014a). Mood disorders. CN. Kneisl, E. Trigoboff (Eds.), Contemporary psychiatric-mental health nursing içinde (3. bs., s. 336-365). London: Pearson Education.
• Trigoboff E. (2014b). Cognitive and behavioral interventions. CN. Kneisl, E. Trigoboff (Eds.), Contemporary psychiatric-mental health nursing içinde (3. bs., s. 639-653). London: Pearson Education.
• Varcarolis EM. (2013). Essentials of psychiatric mental health nursing. 2nd ed. China: Elsevier Saunders.
• Videbeck SL. (2020). Psychiatric-mental health nursing. Philadelphia: Lippincott Williams & Wilkins.
• Vuorilehto MS, Melartin TK, Riihimäki K, Isometsä ET. (2016). Pharmacological and psychosocial treatment of depression in primary care: Low intensity and poor adherence and continuity. Journal of Affective Disorders, 202, 145-152.
• Waite P, McManus F, Shafran R. (2012). Cognitive behaviour therapy for low self-esteem: A preliminary randomized controlled trial in a primary care setting. Journal of Behavior Therapy and Experimental Psychiatry, 43, 1049-1057.
• Warren BJ. (2018). Depression. MA. Boyd (Ed.), Psychiatric nursing contemporary practice içinde (6. bs., s. 756-797). Philadelphia: Wolter Kluwer
• Wen J, Yeh TP, Xie H, Yu X, Tang J, Chen, Y. (2020). Resilience, self-esteem, self-efficacy, social support, depression and ART adherence among people living with HIV in Sichuan, China. AIDS Care, 33(11), 1414-1421
• WHO. (2023). Depressive disorders (depression). (Erişim Tarihi: 27.06.2024), https://www.who.int/news-room/fact-sheets/detail/depression
• Yatham LN, Kennedy SH. (2017). Mood disorders: Pharmacological treatment of depression and bipolar disorders. BJ. Sadock, VA. Sadock, P. Ruiz (Eds.), Kaplan and Sadock’s comprehensive textbook of psychiatry içinde (10. bs., s. 4299-4358). Philadelphia: Wolters Kluwer.