Palyatif Bakımda Fizyoterapistin Rolü ve Kanıta Dayalı Uygulamalar

Öz

Fizyoterapistler, kişilerin hareket ve fonksiyonel yeteneklerini geliştiren, bu yetenekleri sürdüren ve herhangi bir problem söz konusu olduğunda eski haline getirmek için çalışan sağlık profesyonelleridir. Fizyoterapistler, birçok farklı alanda çalıştıkları gibi palyatif bakım hizmetleri içerisinde de görev almakta ve bu alandaki rehabilitasyon ekibinin ayrılmaz üyeleri arasında bulunmaktadır. Palyatif bakım ekibi içerisinde görev alarak hastaları kendi bilgileri, becerileri ve yöntemleri doğrultusunda değerlendirir ve rehabilitasyon programları içerisine dahil ederler. Fizyoterapistler, yorgunluk, ağrı, depresyon, anksiyete, solunumsal problemler, kas kuvveti kaybı, fiziksel inaktivite ve fonksiyonel bağımlılık gibi problemlere sahip olan hastalarda, fonksiyonel mobiliteyi, öz bakımı, öz yeterliliği, kognitif düzeyi optimize etmeyi ve hastaların mümkün olduğunca bağımsızlıklarını korumalarını sağlayarak, hastalık ile ilişkili semptomlarının azaltılması, psikososyal durumlarının iyileştirilmesi, daha uzun yaşam süresinin sağlanması ve yaşam kalitesinin arttırılmasını amaçlarlar. Bu derleme kapsamında palyatif bakımın önemi, palyatif bakım hizmetleri içerisinde fizyoterapistin günümüzdeki rolü ve önemi, fizyoterapistin palyatif bakım hizmetlerindeki amaçları ve palyatif bakımda kullanılan kanıta dayalı fizyoterapi ve rehabilitasyon uygulamalarından detaylı olarak bahsedilmiştir.

Anahtar Kelimeler

• Palyatif bakım
• rehabilitasyon
• fizyoterapist
• fizyoterapi uygulamaları

The Role of The Physiotherapist In Palliative Care And Evidence-Based Practices

Öz

Anahtar Kelimeler

• Palliative care
• rehabilitation
• physiotherapist
• physiotherapy practices.
• Palliative care, rehabilitation, physiotherapist, physiotherapy practices.

Kaynakça

1. American Physical Therapy Association. (2001). Guide to Physical Therapist Practice. Second Edition. American Physical Therapy Association. Physical therapy, 81(1), 9–746.
2. American Physical Therapy Association. (2014). Vision statement for the physical therapy profession and guiding principles to achieve the vision. https://www.apta.org/apta-and-you/leadership-and-governance/policies/vision-statement-for-the-physical-therapy-profession Erişim tarihi: 28 Mayıs 2020.
3. Bancroft, M. I. (2003). Physiotherapy in cancer rehabilitation: a theoretical approach. Physiotherapy, 89(12), 729-733.
4. Bryan, A., Hutchison, K. E., Seals, D. R., & Allen, D. L. (2007). A transdisciplinary model integrating genetic, physiological, and psychological correlates of voluntary exercise. Health psychology : official journal of the Division of Health Psychology, American Psychological Association, 26(1), 30–39.
5. Buss, T., de Walden-Gałuszko, K., Modlińska, A., Osowicka, M., Lichodziejewska-Niemierko, M., & Janiszewska, J. (2010). Kinesitherapy alleviates fatigue in terminal hospice cancer patients-an experimental, controlled study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 18(6), 743–749.
6. Byock, I. R., & Merriman, M. P. (1998). Measuring quality of life for patients with terminal illness: the Missoula-VITAS quality of life index. Palliative medicine, 12(4), 231–244.
7. Cheville, A. L., Morrow, M., Smith, S. R., & Basford, J. R. (2017). Integrating Function-Directed Treatments into Palliative Care. PM & R : the journal of injury, function, and rehabilitation, 9(9S2), S335–S346.
8. Egan, K. A., & Abbott, P. (2002). Interdisciplinary team training: Preparing new employees for the specialty of hospice and palliative care. Journal of Hospice & Palliative Nursing, 4(3), 161-171.

9. Eyigor S. (2010). Physical activity and rehabilitation programs should be recommended on palliative care for patients with cancer. Journal of palliative medicine, 13(10), 1183–1184.
10. Frymark U, Hallgren L, Reisberg A. (2009). Physiotherapy in palliative care – a clinical handbook. Sweden: Stockholms Sjukhem,
11. Gulde, I., Oldervoll, L. M., & Martin, C. (2011). Palliative cancer patients' experience of physical activity. Journal of palliative care, 27(4), 296–302.
12. Hately, J., Laurence, V., Scott, A., Baker, R., & Thomas, P. (2003). Breathlessness clinics within specialist palliative care settings can improve the quality of life and functional capacity of patients with lung cancer. Palliative medicine, 17(5), 410–417.
13. Jette, A. M. (1994). Physical disablement concepts for physical therapy research and practice. Physical therapy, 74(5), 380-386.
14. Jeyaraman, S., Kathiresan, G., & Gopalsamy, K. (2010). Hospice: rehabilitation in reverse. Indian journal of palliative care, 16(3), 111–116.
15. Kumar, S. P., & Jim, A. (2010). Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian journal of palliative care, 16(3), 138–146.
16. Laakso L. (2006). The role of physiotherapy in palliative care. Australian family physician, 35(10), 781.
17. Lowe, S. S., Watanabe, S. M., Baracos, V. E., & Courneya, K. S. (2009). Associations between physical activity and quality of life in cancer patients receiving palliative care: a pilot survey. Journal of pain and symptom management, 38(5), 785-796.
18. McIlfatrick S. (2007). Assessing palliative care needs: views of patients, informal carers and healthcare professionals. Journal of advanced nursing, 57(1), 77–86.
19. McLeod, K. E., & Norman, K. E. (2020). "I've found it's very meaningful work": Perspectives of physiotherapists providing palliative care in Ontario. Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 25(1), e1802.
20. Montagnini, M., Lodhi, M., & Born, W. (2003). The utilization of physical therapy in a palliative care unit. Journal of palliative medicine, 6(1), 11–17.
21. Pate, R. R., Pratt, M., Blair, S. N., Haskell, W. L., Macera, C. A., Bouchard, C., Buchner, D., Ettinger, W., Heath, G. W., & King, A. C. (1995). Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA, 273(5), 402–407.
22. Prevost, V., & Grach, M. C. (2012). Nutritional support and quality of life in cancer patients undergoing palliative care. European journal of cancer care, 21(5), 581–590.
23. Pyszora, A., Budzyński, J., Wójcik, A., Prokop, A., & Krajnik, M. (2017). Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 25(9), 2899–2908.
24. Santiago-Palma, J., & Payne, R. (2001). Palliative care and rehabilitation. Cancer, 92(4 Suppl), 1049–1052.
25. Silver, J. K., Baima, J., & Mayer, R. S. (2013). Impairment-driven cancer rehabilitation: an essential component of quality care and survivorship. CA: a cancer journal for clinicians, 63(5), 295–317.
26. Spilsbury, K., & Rosenwax, L. (2017). Community-based specialist palliative care is associated with reduced hospital costs for people with non-cancer conditions during the last year of life. BMC palliative care, 16(1), 68.
27. Taspınar, O., Aydın, T., & Akcakaya, A. (2014). The importance of palliative care in cancer rehabilitation. Bezmiâlem Science, ss.31-37.
28. Toot J. (1984). Physical therapy and hospice. Concept and practice. Physical therapy, 64(5), 665–671.
29. Wittry, S. A., Lam, N. Y., & McNalley, T. (2018). The Value of Rehabilitation Medicine for Patients Receiving Palliative Care. The American journal of hospice & palliative care, 35(6), 889–896.
30. Woitha, K., Schneider, N., Wünsch, A., Wiese, B., Fimm, S., & Müller-Mundt, G. (2017). Integration and utilization of physiotherapy in hospice and palliative care: A survey on clinical practice in Germany. Schmerz (Berlin, Germany), 31(1), 62–68.
31. World Confederation for Physical Therapy (2019). Description of Physical Therapy what is Physical Therapy? https://world.physio/resources/what-is-physiotherapy Erişim tarihi: 20 Ekim 2020.
32. World Health Organization. International Classification of Functioning, Disability and Health (ICF) (2002). https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health Erişim tarihi: 20 Mayıs 2020.
33. World Health Organisation. Palliative care. https://www.who.int/health-topics/palliative-care Erişim tarihi: 28 Mayıs 2021
34. Worldwide Palliative Care Alliance & World Health Organization (2014). Global atlas of palliative care at the end of life. London: Worldwide Palliative Care Alliance. Global_Atlas_of_Palliative_Care.pdf (who.int) Erişim tarihi: 20 Mayıs 2020.