THE RELATIONSHIP BETWEEN PSYCHOLOGICAL AND SOCIAL PROBLEMS OF THE SPOUSES WHO CARED FOR THE TERMINAL CANCER PATIENTS

Yıl 2003, Cilt: 5 Sayı: 2, 24 - 33, 01.12.2003

Elçin Babaoğlu

Öz

Purpose: The aim of this study is to determine the psychological and social problems of the spouses who cared for the terminal cancer patients. Material and Method: It was held descriptif study. The data of this study were collected by applying a “personnel information form” and “physiological and social problems inventory”. The sample of the study, which consists of 103 persons, was the spouses who cared for the terminal cancer patients and stayed in four hospitals of Ankara in between 1.8.2000 and 1.4.2001. These hospitals are University of Ankara İbn-i Sina Hospital, Demetevler Oncology Hospital, University of Hacettepe Hospital and Numune Hospital. The descriptive statistics and correlation matrices were used for the analyses of the study. Findings and Results: In this study, it has been determined that experiencing psychological and social problems of the spouses who cared for the patients with the terminally ill cancer. It have been observed that the most frequent experienced psychological problem is depressive affect and the most frequent experienced social problem is impaired social interactions. In addition, it has been determined that physiological and social problems are interacting each other. It was found that spiritual distress and hopelessness are related with ineffective coping and ineffective role performance; ineffective coping is related with impaired home maintenance and caregiver role strain. The following signiŞcant relations are found for the social problems. These relations are between; impaired home maintenance, social interaction and role performance, deŞcient diversional activity, social isolation. At the same time it have been observed a relationship between ineffective role performance and social isolation, too

Anahtar Kelimeler

Cancer, terminal stage, spouse of the patient, caring, physiological problems, social problems

TERMİNAL DÖNEM KANSER HASTASINA BAKIM VEREN EŞLERİN DUYGUSAL VE SOSYAL SORUNLARI ARASINDAKİ İLİŞKİ

Öz

Amaç: Araştırma, terminal dönem kanser hastasına bakım veren eşlerin duygusal ve sosyal sorunlarını belirlemek amacıyla yapılmıştır.Gereç-Yöntem: Tanımlayıcı bir araştırmadır. Veriler, 1 Ağustos 2000 ve 1 Nisan 2001 tarihleri arasında “Kişisel Bilgi Formu” ve “Duygusal ve Sosyal Sorunları Belirleme Formu” ile toplanmıştır. Araştırmanın örneklemini, Hacettepe Üniversitesi Erişkin Hastanesi, Ankara Üniversitesi İbn-i Sina Hastanesi, Ankara Numune Eğitim ve Araştırma Hastanesi ve Doktor Abdurrahman Yurtarslan Ankara Onkoloji Eğitim ve Araştırma Hastanesi’nde terminal dönem kanser hastasına bakım veren 103 eş oluşturmuştur. Verilerin değerlendirilmesinde yüzdelik, puan ortalamaları ve korelasyon analizi kullanılmıştır. Bulgular ve Sonuçlar: Araştırmada terminal dönem kanser hastasına bakım veren eşlerin duygusal ve sosyal alanda sorunlar yaşadıkları saptanmıştır. Duygusal sorunlardan en fazla depresif duygulanım yaşanırken, sosyal sorunlardan ise en fazla değişim sosyal etkileşimde yaşanmaktadır. Ayrıca, duygusal ve sosyal sorunların karşılıklı olarak birbirini etkilediği belirlenmiştir. Duygusal sorunlardan spiritual sıkıntı ve ümitsizliğin etkisiz bireysel başetme ve rol performansında değişim ile, etkisiz bireysel başetmenin günlük işleri sürdürme ve bakım verici rolünde zorlanma ile ilişkili olduğu bulunmuştur. Sosyal sorun alanlarında ise günlük işleri sürdürmede yetersizlik ile sosyal etkileşimde ve rol performansında değişim arasında ilişki olduğu diğer yandan, eğlence faaliyetlerinde değişim ile rol performansında değişim arasında ilişki olduğu gözlenmiştir. Aynı zamanda rol performansında değişimin de sosyal izolasyonla ilişkili olduğu saptanmıştır

Anahtar Kelimeler

Kanser, terminal dönem, hastanın eşi, bakım verme, duygusal sorunlar, sosyal sorunlar

Kaynakça

• Anderson B. L., Golden-Kreutz M. (1996) Sexual Self-Concept for The Woman with Cancer. In Baider L., Cooper C. L., Kaplan De Nour. (Ed). Cancer and The Family (337-366). England, John Wiley & Sons.
• Blanchard, C., Albrecht, T., Ruckduschel, J. (1997) The Crisis of Cancer: Psychological Impact on Family Caregivers. Oncology, 11(2): 221-228.
• Bloom J. R. (1996) Social Support of the Cancer Patient and The Role of the Family. In Baider L., Cooper C. L., Kaplan De Nour. (Ed). Cancer and The Family (53-69). England, John Wiley & Sons
• Breitbart W., Chochinov H. M., Passik S. (1999) Psychiatric Aspects of Palliative Care. In Doyle D., Hanks G. W. C., MacDonald N (Ed). Oxford Textbook of Palliative Medicine. New York, Oxford University Press.
• Carmen, W.H., Chan, R., Phil, M. (1999) Stress Associated with Tasks for Family Caregiver of Patients with Cancer in Hong Kong. Cancer Nursing, 22(4): 260-265.
• Carpenito L. J. (1999) Hemşirelik Tanıları El Kitabı. (Çev. Erdemir F.) 7. Bs., İstanbul, Nobel Tıp Kitabevleri.
• De Nour A. C., Manor O., Hadani P. E., Baider L., Kaufman B., Peretz T. (1996) Mutuality of Fate: Adaptation and Psychological Distress in Cancer Patients and Their Partners. In Baider L., Cooper C. L., Kaplan De Nour. (Ed). Cancer and The Family (173-185). England, John Wiley & Sons.
• Degner, L., Gow, C., Thompson, L. (1991) Criti- cal Nursing Behaviours in Care for the Dying. Cancer Nursing, 14 (5): 246-253.
• Derogatis, L.R., Morrow, G.R., Fetting, J., Penman, D., Piasetsky, S., Schmale, A.M., Henrichs, M., Carniceke, L.M. (1983) The Prevalence of Psychiatric Disorders Among Cancer Patients. JAMA. 249 (6): 54-61.
• Devrimci, H. (1996) İbn-i Sina Hastanesi Tıbbi Onkoloji Kliniğinde Yatarak Tedavi Gören Kanser Hastaları ve Yakınlarında Psikiyatrik Morbidite, Yayımlanmamış Uzmanlık Tezi, Ankara Üniversitesi Tıp Fakültesi Psikiyatri Ana Bilim Dalı.
• Eng, A.M. (1993) The Hospice Interdisciplinary Team: A Synergistic Approach to the Care of Dying Patients and Their Families. Holistic Nursing Practice, 7 (4):49-56.
• Ferrell, B. R. (1999) The Family. In Doyle, D., Hanks, G. W.C., Mac Donald, N. (Ed). Oxford Textbook of Palliative Medicine. (909-917). New York, Oxford University Press.
• Flanagan, J., Holmes, S. (2000) Social Perceptions of Cancer and Their Impacts: Implications for Nursing Practice Arising from the Literature. Journal of Advanced Nursing, 32 (3): 740-749.
• Flaskerud, J.C., Carter, P.A., Lee, P. (2000) Dist- ressing Emotions in Female Caregivers of People with AIDS, Age-related Demantions, and Advanced Stage Cancers. Perspective’s in Psychiatric Care, 36(4): 121-130.
• Given, B., Given, C. W. (1996) Family Caregiver Burden From Cancer Care. In Mc Corcley, R., Grant, M., Stromsburg, F., Bond, S. B. (Ed). Cancer Nursing and Comprehensive Textbook. (93-107) Philedelphia, WB Saunders.
• Given, C., Stommel, M., Given, B., Osuch, J., Kurtz, M., Kurtz, J. (1993) The Influence of Cancer Patients’ Symptoms and Functional States on Patients’ Depression and Family Caregivers’ Reaction and Depression. Health Psychology, 12( 4): 277-285.
• Haddad, P., Pitceathly, C., Maguire, P. (1996) Psychological Morbidity in The Partners of Cancer Patients. In Baider L., Cooper C. L., Kaplan De Nour. (Ed). Cancer and The Family (257-267). England, John Wiley & Sons.
• Hunt M. (1991) The Truth about Terminal Cancer. Nursing. 4(40): 9-11.
• Kanser Bildirimlerinin Değerlendirilmesi (1997). 1. Bs. Ankara, T.C. Sağlık Bakanlığı Kanserle Savaş Daire Başkanlığı.
• Kellner, M., Henrich, G., Sellschopp, A., Beutel, M. (1996) Between Distress and Support of Cancer Patients. In Baider L., Cooper C. L., Kaplan De Nour. (Ed). Cancer and The Family (187-223). England, John Wiley & Sons.
• İl ve İlçe Merkezlerinde Ölüm İstatistikleri- 1997 (1998). Ankara, T.C. Başbakanlık Devlet İsta- tistik Enstitüsü.
• Maguire, P. (1985) The Psychological Impact of Cancer. British Journal of Hospital Medicine, 8(8): 45-53.
• Massie, M., Spiegel, L., Lederberg, M., Holland, J. (1995) Psychiatric Complications in Cancer Patients. In Murphy, G., Lawrence, W., Len- hard, R. (Ed). American Cancer Society Text- book of Clinical Oncology (335-378). Atlanta, The American Cancer Society.
• Northouse, L. (1996) Sharing the Cancer Expe- rience: Husbands of Women with Initial and Recurrent Breast Cancer. In Baider L., Cooper C. L., Kaplan De Nour. (Ed). Cancer and The Family (305-317). England, John Wiley & Sons.
• Ostwald K. (2000) Family Caregiver Research: Multidisciplanary Approaches to Reduce Family Stress. Nursing and Health Sciences. 2(2): 27-35.
• Öz, F. (1998) Ailede Kanser Olgusu. Hemşirelik Forumu, 1(5): 206-210.
• Öz, F. (2001) Hastalık yaşantısında belirsizlik. Türk Psikiyatri Dergisi, 12 (1): 61-68.
• Persson, L., Rasmusson, M. (1998) Spouses View During Their Partner’s Illness and Treatments. Cancer Nursing, 21(2): 97-105.
• Reimer, J., Davies, B., Martens, N. (1991) Pallia- tive Care: The Nurses Role in Helping Families Through The Transition of Fading Away. Cancer Nursing, 14 (6): 321-327.
• Schnoll, R., Harlow, L., Brower, L. (2000) Spiri- tuality, Demographic and Disease Factors, and Adjustment to Cancer. Cancer Practice, 8(6): 298-304.
• Schulz, K. H., Schulz, H., Schulz, O., Kerkjarto, M. (1996) Family Structure and Psychosocial Stress in Families of Cancer Patients. In Baider L., Cooper C. L., Kaplan De Nour. (Ed). Cancer and The Family (225-255). England, John Wiley & Sons.
• Shyu, Y. L. (2000) Patterns of Care Giving When Family Caregivers Face Competing Needs. Journal of Advanced Nursing, 31(1): 35-43.
• Smeenk, F., Witte, L.P., Haastregt, J. C. M., Schip- per, R. M., Biezemans, H.P.H., Crebolder, H. J. M. (1998) Transmural Care of Terminal Cancer Patients: Effects on the Quality of Life of Direct Caregivers. Nursing Research. 47(3): 129-136.
• Weihs, K., Reiss D. (1996) Family Reorganisation in Response to Cancer: A Developmental Pers- pective. In Baider, L., Cooper, C. L., Kaplan, De Nour. (Ed). Cancer and The Family (2-27). England, John Wiley & Sons.